The microvascular transfer of free osteocutaneous flaps remains the standard of care, with the fibula flap the clear favorite. Review of the evolution of this flap for segmental mandibular reconstruction provides the bulk of the literature. Improvement on this standard of practice continues to be elusive, in large part because of the effects of associated radiation. Tissue engineering holds promise but no current practical application is available.

Paranasal sinus mucoceles are epithelium-lined cystic masses usually resulting from obstruction of sinus ostia. They most frequently occur in the frontal and ethmoid sinuses. While ophthalmologic symptoms are most common, patients also report rhinological or neurological complaints. The close proximity of paranasal sinus mucoceles to the orbit and skull base predisposes the patient to significant morbidity. Computed tomography displays a non-enhancing homogenous mass with expansion of bony walls. Magnetic resonance imaging reveals variable intensity of T1-weighted images and a hyperintense mass on T2-weighted images. Histopathologically mucoceles have features of respiratory mucosa with areas of reactive bone formation, hemorrhage, fibrosis, and granulation tissue. Surgical excision is the standard treatment with trends towards endoscopic techniques.Keywords Paranasal sinus mucocele Á Magnetic resonance Á Computed tomography Á Blindness Á Ophthalmologic Á Optic neuropathy Á Cranial neuropathy Á Osteolysis Á Inflammatory infiltrate HistoryA 54-year-old female with a history of cataracts was referred by an ophthalmologist to the Otolaryngology Clinic for acute worsening of visual acuity and diplopia in the right eye. Symptoms began 5 months prior and were described as a 'white curtain' in her vision. Her ophthalmologic exam showed proptosis and chemosis of the eye and her visual acuity ipsilaterally was 20/100 (baseline 20/25). The optic disc was pink and healthy on exam. Cranial nerves III, IV, V, and VI were intact, with only minimal impairment of extraocular muscle movement. Radiographic FeaturesA non-contrast computerized tomographic (CT) scan of the head and orbits showed a 4.4 cm 9 4.2 cm 9 3.3 cm well-circumscribed expansile mass in the right ethmoid sinus. The medial orbital wall was expanded with evidence of mass effect upon the medial rectus muscle and optic nerve (Fig. 1). Nuclear magnetic resonance images (MRI) of the head with and without contrast demonstrated a hyperintense mass on T2-weighted images (WI) and a hypointensity on T1WI. The MR fluid attenuation inversion recovery (FLAIR) sequence suggested proteinaceous fluid (Fig. 2). TreatmentThe mass was emergently decompressed through an endoscopic approach in the operating room. Resistance to retropulsion of the right eye resolved immediately and the patient's visual acuity returned to baseline within 24-h of surgery.

Radiofrequency coblation seems to offer an equivalent alternative to bipolar electrocautery for the treatment of inferior turbinate hypertrophy with less discomfort during the procedure and early post-operative period.

Electronic cigarettes are increasingly popular as a supposed safer alternative to tobacco cigarettes or a smoking cessation tool. Research and debate have focused primarily on possible adverse effects caused by the inhaled aerosol produced by electronic cigarettes and on smoking cessation efficacy. Few reports in the medical literature describe injuries secondary to device malfunction. We present a case of electronic cigarette explosion, with a projectile fracturing the patient's right nasoorbital-ethmoid complex and anterior and posterior frontal sinus tables, with frontal sinus outflow tract involvement. The patient underwent combined open and endoscopic repair, including open reduction internal fixation, with reconstitution and preservation of the frontal sinus and frontal sinus outflow tract. Additionally, we review the available data on electronic cigarette malfunction-including fires, explosions, associated injuries, and possible reasons for device malfunction-and discuss new 2016 U.S. Food and Drug Administration regulations pertaining to electronic cigarettes.

Patients with an ICAD infrequently present to the otolaryngologist because of its head and neck manifestations. It is crucial to recognize atypical findings and to perform an accurate and prompt diagnostic evaluation. The foundation of treatment is aggressive anticoagulation, with surgical or radiologic intervention reserved for cases demonstrating life-threatening progression.