Malignant nerve sheath tumors comprise approximately 5% of all soft tissue sarcomas; only 8% to 15% of these tumors arise in the head and neck. Most tumors appear as a rapidly expanding nonpainful mass in the face or lateral neck. Reported association with Von Recklinghausen's disease varies from 26% to 70%. Wide surgical excision is generally the recommended primary treatment. Recently, there has been a trend to include postoperative radiation therapy as a primary modality.
Intrasosseous hemangioma is a rare vascular malformation of bone infrequently described in the otolaryngologic literature. We report a case of this unusual tumor involving the frontal bone. Bone scan, computed tomographic (CT) scan, and histologic findings are illustrated. Differential diagnosis includes meningioma, eosinophilic granuloma, metastatic carcinoma, and other bony lesions. Treatment is complete surgical excision.
The success of a procedure to reanimate paralyzed eyelids is determined by the functional and cosmetic results. When the cornea is covered during blinking and sleeping, function has been restored, while a pleasing cosmetic result has been achieved if the eyes appear symmetrical when the lids are open. Several procedures have been developed to restore closure of the paralyzed upper eyelid (implantation of gold weights or open wire springs) or to correct lower lid lagophthalmos and ectropion (lower lid tightening with a Bick procedure or insertion of a closed eyelid spring). In some cases, even a combination of the Bick procedure and insertion of a spring may be insufficient to correct lower lid droop; therefore, we developed a technique to place cartilage into the lower eyelid to correct lid droop. The procedure, suggested by one of us (D.B.S.), has been performed on 51 patients to date. This article reviews our experience with these 51 consecutive patients.
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