Faculty Bibliography

Myofacial pain dysfunction (MPD), a commonly occurring illness, presents with a variety of clinical appearances and patient symptoms which mimic many other illnesses. The family physician and medical specialist are often first consulted by patients suffering from the pain and/or limited functions associated with MPD. Although the definitive diagnosis and therapy is usually provided by a dental specialist, the attending physician is often required to make the initial clinical diagnosis of MPD and then select proper referrals and consultations. Physicians with an understanding of the cause and clinical picture of MPD can, by obtaining a comprehensive history and performing a concise clinical examination, make a diagnosis of MPD. A description of the nature of the illness and a clinical examination procedure are presented

Intraoral flaps are an excellent source of tissue for reconstruction after resection of small malignant tumors of the oral cavity, pharynx, and hypopharynx. The principal donor sites used are the tongue, buccal mucosa, and palate. Intraoral flaps enable rapid rehabilitation of deglutition and speech with minimal morbidity. They provide easily transferred, well-vascularized tissue from sites adjacent to the operative defects. These flaps permit closure without tension and obviate the need for more distant tissue transfers. Their use does not compromise the oncologic resection

Osteoradionecrosis of the maxilla and base of skull are rare phenomena, usually seen after combined therapy for malignancies of the maxillary sinus. While the mandible is most commonly affected by osteoradionecrosis, the maxilla and skull base may also be affected when preoperative or postoperative radiotherapy is combined with surgery. Contributing factors may be: high radiation dosage delivered to the treatment volume (greater than 6000 rads), loss of tissue protective effects due to surgery, decreased vascularity caused by surgery and radiation, and proximity of a contaminated field. Onset of symptoms may vary. One patient presented 25 years after postoperative radiotherapy. Major symptoms were pain, trismus, and purulent discharge. The best diagnostic modality remains the history and physical exam, as the area is readily accessible. CT scans may be helpful in diagnosis and treatment planning. Therapy should follow time honored principles of local wound care. Home irrigations and hyperbaric therapy have been helpful in encouraging early sequestration and rapid healing

Thromboses in Trousseau's syndrome are typically confined to the vascular system of the extremities and viscera. The authors report a case of sequential bilateral internal and external jugular-vein thromboses secondary to this paraneoplastic hypercoagulable state. The etiologies of commonly encountered head and neck venous thromboses are infection, trauma, and obstruction. This article purports that head and neck venous thromboses without a proximal inflammatory or mechanical cause may be the initial manifestation of an occult malignancy. Upon establishing the presence of a hypercoagulable state, further evaluation may lead to the early diagnosis of such an occult malignancy

A rare case of mixed ependymoma and astrocytoma of the cerebellopontine angle is reported. Its clinical presentation, characteristics on evaluation, and prognosis are compared with those of the acoustic neuroma and glioma. The central form of von Recklinghausen's disease and familial multiple lipomatosis as it applies to the patient is also discussed