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Auricular composite grafts are a useful reconstructive option, particularly for nasal reconstruction. This study evaluates the effect of hyperbaric oxygen (HBO) therapy on auricular composite graft survival in rabbits. Circular chondrocutaneous composite grafts of 0.5, 1, or 2 cm in diameter were resected from the ears of rabbits. The grafts were sutured back into position. Half the rabbits in each group received HBO postoperatively, consisting of 90 minutes at 2.4 atm. Rabbits received 7 treatments in 5 days. Control rabbits did not receive HBO. On day 21 the percentage area of graft survival was calculated from gross and histologic examination. Two-centimeter grafts treated with HBO (n = 8) had a mean graft survival rate of 85.8 +/- 15.7% compared with a survival rate of 51.31 +/- 38.5% for the control group (n = 8; P = 0.0478). There was no such benefit in smaller grafts. HBO could prove clinically useful for larger composite grafts.

This study investigates whether human acellular dermis (Alloderm; LifeCell, Branchburg, NJ) revascularizes when used to reconstruct abdominal wall defects in rabbits. This could prove useful in infected situations in which prosthetic mesh is suboptimal. Twenty-five rabbits were randomly assigned to one of three groups: primary closure (n = 5), expanded polytetrafluoroethylene (GoreTex; W.L. Gore, Flagstaff, AZ) repair (n = 10), or AlloDerm (LifeCell) repair (n = 10). The rabbits in the primary closure group received a 7 cm x 0.5 cm full-thickness abdominal wall defect that was closed primarily. A 7 cm x 3 cm full-thickness abdominal wall defect was created in the other two groups. The defects were repaired with a GoreTex Mycromesh (W.L. Gore), or AlloDerm (LifeCell) patch. At 30 days, the following endpoints were evaluated: (1) incidence of herniation; (2) presence of intra-abdominal adhesions; (3) the breaking strength of the patch-fascial interface; and (4) evaluation of graft vascularization by fluorescein dye infusion and histological analysis. There was no incidence of herniation in any of the rabbits. Visceral adhesions to the patch were found in all animals in the Gore-Tex (W.L. Gore) group but in none in the AlloDerm (LifeCell) group. The size of the patch was unchanged in all the rabbits except for two rabbits in the AlloDerm (LifeCell) group that stretched 1 cm in the transverse dimension. The change in size was not statistically significant (p = 0.17) when compared with the change in size in the Gore-Tex (W.L. Gore) group. The mean breaking strength of the primary closure group was significantly higher (521.2 N/mm2 +/- 223.0) than that of the two patch-repair groups (p < 0.05). But there was no significant difference between the mean breaking strength of the AlloDerm (LifeCell) fascial interface (288.6 N/mm2 +/- 97.1 SD) and that of the Gore-Tex (W.L. Gore) fascial interface (337.0 N/mm2 +/- 141.2). Fluorescein dye infusion and histological analysis confirmed vascularization of the AlloDerm (LifeCell) graft. This study demonstrates that AlloDerm (LifeCell) does become vascularized when used as a fascial interposition graft for abdominal wall reconstruction. AlloDerm (LifeCell) also performs mechanically as effectively as Gore-Tex (W.L. Gore) in ventral hernia repair at 1 month after operation in the rabbit model.

Surgical resection of aggressive solid or multicystic ameloblastoma is a well-documented and accepted treatment modality. Controversies exist, however, with regard to the extent of operative intervention. Unresectable lesions have been treated with radiation or combined radiation and chemotherapy. The authors present a case report of a patient with recurrent ameloblastoma who underwent simultaneous hard- and soft-tissue reconstruction.

BACKGROUND:The purpose of this study was to describe the computed tomography (CT) findings in pancreatic tuberculosis (PT). METHODS:We retrospectively reviewed the CT features in six patients with PT, three of whom had AIDS. RESULTS:Pancreatic lesion masses were found in four patients, small (< 1 cm) low-attenuation pancreatic nodules in one, and diffuse enlargement of the pancreas in one. The pancreatic lesion masses were found in all the non-AIDS patients and in one patient with AIDS and were located in the head of the pancreas in two cases and involved the body, neck, and head of the gland in the other two. The masses showed low attenuation in two cases, soft-tissue attenuation in one, and appeared as an infiltrating inhomogeneous lesion with retropancreatic spread, encasing the celiac trunk and superior mesenteric artery in one. Low-attenuation peripancreatic and/or periportal adenopathies with peripheral rim enhancement were found in three cases, and slight bile duct dilatation was evident in four. Four patients had disseminated tuberculosis, whereas pancreatic and peripancreatic tuberculosis were the sole manifestation of tuberculosis in the other two. CONCLUSION/CONCLUSIONS:The present data suggest that PT usually appears as a nonspecific focal lesion mass in HIV-seronegative patients, whereas there is a variable spectrum of CT findings including focal lesion mass, multiple small low-attenuation pancreatic nodules, or diffuse enlargement of the gland in AIDS patients. Low-attenuation peripancreatic and periportal adenopathies with peripheral rim enhancement and other data of disseminated tuberculosis are ancillary findings that should support a diagnosis of PT.

Surgical access to fractures of the ascending ramus of the mandible is limited when standard techniques are employed. A new method using a facial rhytidectomy technique is described, and seven cases treated by this method are presented. The advantage of this technique includes excellent exposure, predictable and safe dissection, inconspicuous facial scar and minimal postoperative complications.

Visualization of subcondylar fractures is limited, and rigid fixation technically difficult, employing standard open surgical techniques--especially when the condyle is displaced out of the glenoid fossa. The majority of condylar neck fractures are treated by closed reduction with maxillomandibular fixation, to obviate the potential for permanent injury to the facial nerve. The technique described employs an anterior parotid, two-layer, sub-SMAS (superficial musculo-aponeurotic system) approach via a rhytidectomy incision that reliably identifies and preserves the neural elements and provides direct access to the pericondylar region. The thirteen patients presented here exhibited satisfactory functional and aesthetic results. Complications included temporary nerve palsies, plate fractures, and a hematoma.

We analyzed 3 cases of malignant ovarian germ cell tumors (MOGCTs), comprising 1 dysgerminoma and 2 immature teratomas, by banded chromosome analysis and by in situ hybridization (ISH) using a chromosome 12p painting probe. We found evidence of 12p abnormalities in two of them. A possible common genetic pathway of origin of a subset of MOGCTs with testicular germ cell tumors (TGCTs) is discussed.

We have studied six cases of choriocarcinomas in the female by conventional cytogenetic analysis and by in situ hybridization using a 12p painting probe, and found evidence for chromosome 12 abnormalities in two of them. Abnormalities of chromosome 12 are a common occurrence in genitourinary tumors of the female, but their significance is not known. We discuss the present findings in relation to those in malignant ovarian germ cell tumors (MOGCTs).