Laser resurfacing of the neck: a review of 48 cases.

With the advent of the new sophisticated carbondioxide (CO2) laser, effective treatment of facial rhytides and pigmented lesions of the photodamaged skin has been gaining popularity. Partial and full facial skin resurfacings have been reported. However, resurfacing of the neck has been ignored or discouraged. The objective of this study is to assess the feasibility, benefits, and risks of laser resurfacing of the neck, combined with the additional resurfacing of the whole face. A total of 48 patients underwent the procedure with a high-power and short-exposure time CO2 laser (ultrapulse). Patients were evaluated and classified preoperatively. The great majority of patients had local anesthesia (topical and infiltrative) with minimal sedation. A computer pattern generator was used in all cases but one. In this paper, preoperative preparation, postoperative care, laser resurfacing techniques, and depth guidelines are discussed. Incorporating the neck with the facial resurfacing has given very satisfactory results, with minimal drawbacks.

Neonatal/infant rigid bronchoscopy.

OBJECTIVE: The neonatal intensive care unit (NICU) of the Montreal Children's Hospital (MCH) has averaged 358 admissions/ year over the past 10 years. Over the same period, 1.8% of these admissions have required rigid bronchoscopy in either the neonatal or infant time period: 175 rigid bronchoscopies were performed on 76 patients since 1977. METHOD: We retrospectively reviewed the findings at first bronchoscopy. Our cases were analyzed regarding indication for bronchoscopy, primary airway pathology, concomitant secondary airway pathology, management, outcome, and overall prognosis. RESULTS: Normal bronchoscopic findings were seen in 25% of cases. The remaining 75% revealed pathology in sites ranging from the oropharynx to the bronchus. The majority were subglottic (15), esophageal atresia/tracheoesophageal fistula (14), and glottic (11). There was concurrent airway pathology in 41% of the cases, ranging from 0% in the bronchial group to 75% in the oral/pharyngeal group. Thirty three percent of patients with a secondary airway pathology identified required further airway intervention, either therapeutic bronchoscopy at the same time or later airway surgery. There were no major complications from rigid bronchoscopy in our series. The mortality due to airway pathology was highest in the supraglottic/ glottic group (36%). CONCLUSION: Rigid bronchoscopy performed in the neonatal/infant period is safe. The primary and concomitant secondary diagnosis are high (75% and 41%, respectively), while both may require further airway intervention. Finally, it directs early management of these cases for better prognosis.