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Acellular dermal allograft can be successfully used for the reconstruction of anterior and middle cranial fossa skull base defects. This allograft, which is easy to manipulate endoscopically, provides an effective seal and barrier in skull base reconstruction and avoids the need for a donor site.

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Since the late 1980s, the rabbit model for sinusitis has been widely used for experimental studies on sinusitis; however, the clinical relevance of these experimental data has been questioned. To elucidate the role of leukotrienes in the pathogenesis of sinusitis, leukotriene B4 (LTB4) levels were determined in acute Streptococcus pneumoniae sinusitis in this model. The rabbit model for acute maxillary sinusitis was utilized. Briefly, the right maxillary ostium of each New Zealand white rabbit was occluded with cyanoacrylate under general anesthesia. Twenty-four hours after occlusion, the occluded sinus received an inoculation of 10(8) Streptococcus pneumoniae (ATCC 10813) or a sham inoculation of saline alone. Rabbits were then sacrificed one week later, and the maxillary sinus mucosae were harvested. Leukotriene B4 levels were determined by ELISA assay. LTB4 levels in the sinuses inoculated with bacteria tended to be higher; however, statistical analysis did not reveal significant differences between the experimental and control groups. It is possible to reliably assess leukotriene B4 levels in this model of sinusitis. Although the data suggest a trend for elevated LTB4 levels, statistical analysis did not support this conclusion. The study also demonstrated significant limitations in the current rabbit model for sinusitis; that is, the standard human sinus bacterial pathogens are minimally pathogenic in rabbit sinuses and the small size of the sinus limits the material available for assay. Further modifications of the model are necessary. After such adjustments, the role of leukotrienes in sinusitis may be further explored.

Telehealth implementation has potential to reduce disparities in access to mental health care. We examined the number of mental health visits accessed and the visit format used (office, phone, or virtual) by patient demographics before and after a large health system's shift to telehealth during the COVID-19 pandemic. Patients ages 6-17 accessed relatively fewer and female patients accessed relatively more mental health visits after the telehealth transition. Demographic variables were associated with visit format used, with rural residents, older adults, females, and White and Black/African American patients using a higher proportion of phone visits. Implications are discussed for the future implementation of telehealth. Public Health Significance StatementThis study found changes in the gender and age of patients accessing mental health services before and after a large health system began providing services remotely in response to the COVID-19 pandemic. It also found that phone calls were relatively preferred by certain demographic groups. These groups may be adversely affected by limitations on reimbursement for mental health services provided by phone.