Six-year retrospective study of reconstructive options for defects of the skull base after resection of tumour.

The successful management of tumours that involve the skull base depends on resection and reconstruction of the defect. The challenge is to create a protective vascularised seal between the intracranial contents and the adjacent paranasal sinuses, nasopharynx, and oral cavity. Failure to create a protective barrier for the intracranial contents can result in cerebrospinal fistulas, potentially fatal infections, and radiotherapy being delayed. Local or regional flaps may be adequate for small defects, but larger ones require microsurgical free tissue transfer. As a part of the skull base surgical team, we present our experience in the reconstruction of defects after resection of tumours. A total of 41 patients had operations over a 6-year period from January 2004 to January 2010, and 26 free tissue transfer flaps and 20 local or regional flaps (46 flaps) were used for reconstruction. Ninety-two percent of the free flaps were successful. We also report details on disease, complications, and survival at 3, 6, and 12 months. Survival depended not only on the type of disease, coexisting conditions, and adequate resection of tumour, but equally on the reconstruction of the defect.

Chronic orbital infection caused by migration of an orbital Silastic implant.

A Silastic sheet was used for the repair of a lateral orbital wall defect in a 48-year-old man. Migration of this implant through the defect has caused recurrent episodes of orbital infection. Although migration of Silastic within the orbit has been reported previously, the absence of fixation together with further remodelling of the lateral orbital wall defect contributed to this phenomenon.

Sialolithiasis in children as a diagnostic dilemma.

Sialolithiasis is an uncommon disorder in childhood. Initially asymptomatic, symptoms may appear gradually. These can vary from moderate discomfort to severe pain with large glandular swelling accompanied by trismus. The correct interpretation of symptoms and a proper investigation for localization of salivary stones are important for effective treatment. A case of submandibular sialolithiasis in a 9-year-old girl is used to exemplify the problems had in clinical diagnosis.

Unusual elimination of a salivary calculus. A case report.

Salivary calculi are frequently formed in the submandibular duct. The most common sites are where the duct turns round the distal edge of the mylohyoid, where the duct crosses the lingual nerve, and just distal to the duct orifice. Untreated calculi can cause obstruction and glandular atrophy, and then may exfoliate through the floor of the mouth. An unusual case of cutaneous exfoliation of a salivary gland stone is presented. The importance of early diagnosis and treatment of sialolithiasis are discussed.

[Minor salivary gland lithiasis simulating a mucocele. Apropos of a case]. / Lithiase d'une glande salivaire accessoire simulant une mucocèle. A propos d'un cas.

Lithiasis of minor salivary glands is often considered to be extremely rare. However, recent publications reveal that minor salivary gland calculi are not so rare. Clinical features are not always typical, so clinical misdiagnosis is possible. Clinicians have to be aware to make a correct diagnosis. A case of sialolithiasis of minor salivary gland mimicking a mucous cyst is reported.

[Osteosarcoma of the mandible]. / Ostéosarcome de la mandibule.

We describe a case of osteosarcoma of the mandible presenting as a soft tissue mass associated with an enlargement of the mandibular canal at imaging work-up. Radiographic, isotopic, CT and MR features are reported.