Faculty Bibliography

BACKGROUND: Inverting papillomas usually originate from the lateral wall of the nose and sporadically from the ethmoid, maxillary, sphenoid, or frontal sinuses. Intracranial extension and dural penetration is rare and often associated with recurrent disease that has degenerated into squamous cell carcinoma. A case of inverting papilloma with dural penetration in the absence of malignant degeneration has prompted an investigation into the incidence and treatment of dural invasion by benign inverting papilloma. METHODS: A literature search revealed 1468 cases of inverting papilloma. A detailed analysis was performed to obtain data on the incidence of intracranial invasion. RESULTS: Of the 1468 cases, 5 were noted to be associated with intracranial extension without histologic evidence of malignancy (0.34%). Treatment consisted of surgery alone in 3, radiotherapy in 1, and combined therapy in the last patient. Dural invasion was documented histopathologically in one case. CONCLUSION: Intracranial extension and dural penetration of benign inverting papilloma is extremely rare, and a uniform treatment plan has not been established. Further investigation is necessary in the pathophysiology and management of intracranial inverting papilloma

Rejuvenation of the aging upper face can transform tired and angry features into youthful-appearing ones. This article presents the principles for analyzing and treating the aging forehead and brow. The esthetic dimensions and proportions of the brow and forehead are discussed, in context with the corresponding surgical anatomy. The goals of facial rejuvenation surgery as it relates to the upper third of the face are addressed. Various approaches, including their advantages and disadvantages, are presented. The appropriate approach is selected to eliminate unsightly features that are in need of correction while minimizing hairline shifts and forehead scarring and anesthesia. Following the principles and techniques illustrated in this article, the facial plastic surgeon may confidently treat the signs and complaints of the aging upper face

Otologic disease often extends into the hypotympanum, posterior mesotympanum, and infralabyrinthine compartments. Surgical access to these areas can be difficult because of the proximity of the facial nerve. In patients with a normal bone anatomy, these regions can be accessed by a retrofacial approach, which spares the posterior canal wall and avoids transposition of the facial nerve. The anatomy of the hypotympanum, posterior mesotympanum, and infralabyrinthine compartments will be reviewed emphasizing gross anatomic documentation. We will detail the surgical approach to these areas along the retrofacial air cell tract, and will present an appropriate case history