POSTOPERATIVE PAIN FOLLOWING FUNCTIONAL ENDOSCOPIC SINUS SURGERY.

We conducted a retrospective review of medical records using our institution electronic database with the purpose to identify factors that could influence postoperative pain after functional endoscopic sinus surgery. The studied factors were gender, age, American Society of Anesthesiologists (ASA) status, duration of surgery, extent of surgery, primary versus revision surgery, and extent of nasal packing. One hundred and twenty-four patients were enrolled in this study, 60.5% of them male, mean age 48 years. The mean postoperative pain reported on the visual analog scale was 1.20 on the day of surgery and 1.05 on postoperative day 1. On the day of surgery, patients who had unilateral type of surgery experienced less pain than patients with bilateral surgery (p<0.01). We did not find any statistically significant association of the reported postoperative pain with age, gender, ASA status, duration of surgery, antibiotic therapy, and type and extensiveness of nasal packing.

Training cerebrospinal fluid leak repair with nasoseptal flap on the lamb's head.

BACKGROUND: One of the major challenges of cranial base surgery is reconstruction of dural defects and cerebrospinal fluid leak closure. Various grafting methods have been used for smaller skull base defects with great success. The indications for endoscopic reconstruction have recently evolved to encompass much larger breeches in the skull base following tumor removal, thus emphasizing the need for vascularized tissue flaps for reconstruction. METHODS: Some authors proposed a pedicled flap of the nasal septum mucoperiosteum and mucoperichondrium, which is very vascularized and has quite a large surface. It is also long enough to easily cover even larger defects of the skull base. The elevation of a nasoseptal flap is based on a particularly advanced surgical technique and thus requires proper training before being performed in a real patient. RESULTS: Anatomical differences between human and lamb heads were observed and explained although they do not affect the procedure of the elevation of the nasoseptal flap. CONCLUSIONS: The lamb's head has been shown to be an ideal model for the adequate training of the surgical skills required for this demanding procedure.

Oral Mucormycosis and Aspergillosis in the Patient with Acute Leukemia.

A 54-year-old male patient with acute lymphoblastic leukemia was referred to the Department of Oral Medicine. He had a primary refractory disease and was treated according to HOVON71 and HAM protocol. Sixteen days after the start of the HAM protocol the patient developed palatal dark red/brownish lesion and maxillary vestibular exophytic lesion. Biopsy specimens from oral lesions were taken and microbiologic evaluation confirmed the presence of Aspergillus fumigatus and Rhizopus genus. The treatment of the patient consisted of the inferior maxillectomy and intravenous posaconazole and amphotericine B for the following 28 days. Since the coinfection with Aspergillus and Rhizopus is extremely rarely seen in the oral cavity, a diagnostic and therapeutic dilemma easily presents itself.