Optic nerve decompression is controversial in posttraumatic visual loss and as a prophylactic therapy in fibrous dysplasia involving the optic canal. It is less controversial for the treatment of optic nerve compression in fibrous dysplasia. Thirteen patients with craniomaxillofacial fibrous dysplasia who underwent 16 optic nerve decompressions at the Chang Gung Craniofacial Centre for both therapeutic (10) and prophylactic (6) indications are reported. One patient sustained a clinically useful improvement in vision in response to two therapeutic decompressions, and another demonstrated marked improvement after therapeutic decompression, with visual acuity improving from 0.4 to 1.0 in the affected eye. No patient underwent a permanent deterioration of vision as a result of either therapeutic or prophylactic decompression. One patient suffered extraocular muscle dysfunction that was corrected with strabismus surgery. A review of the literature clarifies the controversies and allows establishment of indications for optic nerve decompression.
We have described the case of a 14-year-old boy who developed an acute squamous cell carcinoma within a healed burn scar 6 weeks after thermal injury. This is a rare condition necessitating early excision and histopathologic confirmation of clearance. The authors recommend early skin grafting of deep partial- and full-thickness burns to prevent future malignant transformation and a low index of suspicion of any nodules or ulceration appearing within a healed burn.
Keratinc cyte cell culture has been studied by a large number of investigators, resulting in an extensive body of often contradictory literature. The advantages and disadvantages of the two major techniques, explain and disaggregated culture, will be examined, followed by a critical evaluation of the major technical variables. Suggested standardized methods for both explant and disaggregated culture, and the indications for the use of each, will be proposed. Finally, further directions for basic research will be suggested in order to improve this useful tcol.
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