ABSTRACT
Mucormycosis is a rare complication of sarcoidosis. We report only the third instance of mucormycosis occurring in a patient with sarcoidosis. Corticosteroid therapy, even short courses of less than one month duration, appears to be a major risk factor for the development of mucormycosis. Mucormycosis should be suspected upon the development of signs and symptoms of chronic sinusitis, necrotic nasal discharge, proptosis or periorbital edema. Mucormycosis is confirmed on routine hematoxylin and eosin stains by the identification of tissue invasion by the broad, aseptate mucor fungi. Prompt identification of the infection is essential to reduce morbidity and prevent mortality.
Subject(s)
Mucormycosis/etiology , Sarcoidosis/complications , Adult , Female , Humans , Methotrexate/therapeutic use , Prednisone/adverse effects , Sarcoidosis/drug therapyABSTRACT
Reconstruction of the mandible to restore continuity following resection is described in four cases using a tobramycin-impregnated methylmethacrylate implant fabricated at the time of surgery. Methylmethacrylate has excellent biocompatibility and strength and has been used in surgery for over 20 years. The technique uses readily available materials and is similar in concept to reconstruction with a metal plate. Potential advantages are: (1) the presence of a potent antibiotic within the implant that is released over a period of months to minimize postoperative infection and (2) the capability of the material to accurately fit any defect, either when used alone or in combination with a plate or rod. Three of the four patients whom we present are doing well; one implant became exposed following postoperative radiotherapy and had to be removed.
Subject(s)
Mandibular Prosthesis , Methylmethacrylates , Tobramycin , Adolescent , Adult , Aged , Female , Humans , Male , MethylmethacrylateABSTRACT
The application of laser systems for the surgical management of many congenital and acquired, as well as benign and malignant, diseases of the larynx has been established. Ideas regarding wavelength selection and the rationale for use of the laser in the larynx, including potential pitfalls and problems with wound healing, as well as new instrumentation and safety concerns are discussed. Recent contributions to the literature regarding laser treatment of benign laryngeal disease and malignant neoplasms, and the use of the laser to manage laryngeal airway obstruction and improve voice quality are presented.
