Ecthyma gangrenosum is a rare invasive cutaneous infection mostly caused by Pseudomonas aeruginosa in immunosuppressed patients, especially during neutropenic states. Embolic lesions usually accompanying with septicemia of P. aeruginosa are typically painless, round, and centrally necrotic with a surrounding erythematous halo. Facial involvement occurred only in 6% of the patients, which may result to complicated defects for reconstruction. In this article, we aimed to present a case with relapse of acute lymphoblastic leukemia presented to our clinic with 50% defect of the lower lip due to ecthyma gangrenosum and its late-term reconstruction.
Cubital tunnel syndrome is the second most common peripheral nerve compression syndrome. It is the most common peripheral neuropathy of the ulnar nerve. The surgical treatment of the cubital tunnel syndrome is widely described in the literature, however the variations of the standard muscular anatomy in the medial humeral epicondyle region may create technical difficulties during surgical management. The epitrochleoanconeus muscle, which is an aberrant muscle of this region, is a rare cause of cubital tunnel syndrome. A case with ulnar nerve compression at the elbow caused by an uncommon etiological factor, hypertrophic epitrochleoanconeus muscle, and its surgical management is reported.
Frontal sinus fractures constitute 5% to 15% of maxillofacial fractures, and isolated anterior table injuries account for 33% of frontal sinus fractures. The treatment strategy of frontal sinus fractures should be individualized according to the extent of the injury. Endoscope-assisted repair without any fixation method for the treatment of mildly and moderately displaced (1-5 mm) and closed isolated anterior table frontal sinus fractures is a good alternative technique for treatment.Between April 2010 and December 2011, 5 patients with mildly and moderately displaced isolated anterior table fractures were treated. There were no lacerations in forehead skin of the patients. Preoperatively, the patients showed forehead depression at the fracture site, and computed tomography scan was taken to determine the extent of the frontal sinus fracture. Endoscope-assisted closed reduction treatment was applied to all patients.All fractures were reduced successfully. None of the patients needed to undergo conversion to traditional incision techniques. No patients required fixation materials. Cosmetic deformity was corrected in all patients perfectly.In the standard treatment modality of frontal sinus fractures, repair is best performed by a coronal approach. However, bicoronal incision has many disadvantages. Several authors have recently described some endoscopic and closed approaches to these injuries. The main disadvantages of these methods are poor visualization or fixation requirement with exogenous materials.Endoscopic reduction of mildly and moderately displaced closed isolated anterior table frontal sinus fractures without fixation is feasible. It results in a good clinical outcome in selected cases.
Lip carcinoma is one of the most common cancers of the head and neck region. Lower lips are more frequently affected. Squamous cell carcinoma accounts for more than 95% of the cases. The aim of treatment is to achieve the highest cure rates with adequate excision with clear surgical margins while leaving the smallest defect sizes behind for reconstruction. Excised tissue is known to shrink when removed, in relation with its retractile properties. In this study, the evaluation of the amount of shrinkage in excised lip cancer specimens and determination of the relation between surgical and histopathologic margins were aimed. The study included 21 consecutive excised lip specimens for the treatment of squamous cell carcinoma of the lip. The volume of the specimen, tumor length, and margin distance measurements were measured and recorded step by step from before surgical excision to histopathologic evaluation. Specimens were evaluated in a standardized fashion by the same pathologist after 48 hours of fixation. For data analysis, Number Cruncher Statistical System 2007 and Power Analysis and Sample Size 2008 Statistical Software (Kaysville, UT) were used. The surgical margins of the excised lip specimen shrink up to 41% to 47.5% from before excision to histopathologic evaluation. The most significant step was the excision step, followed by the formalin fixation step. The histopathologic process itself and the duration of formalin fixation did not result a significant change in surgical margins. The tumor tissue itself did not show a significant shrinkage.
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