Although patients with mandible fractures treated after 3 days do not have a higher risk of developing an infectious complication, this risk is elevated in patients who abuse substances regularly. The risk of technical complications increases with treatment delay, and therefore the surgical team must be even more vigilant when reducing these fractures.

When planning facial plastic surgery, the goals of the patient are of paramount importance. Although it is important to understand the ways in which people of different ethnicities and ages differ in their facial proportions as a group, facial harmony must be pursued on an individual basis.

Coccidioidomycosis involving the head and neck is uncommon. We present a case of a patient with disseminated coccidioidomycosis and massive submandibular cystic lymphadenopathy unresponsive to systemic antifungal treatment. It is our impression that significant clinical improvement resulted from concomitant needle aspiration of the cystic nodes to decrease fungal load and modification of systemic medication. Although reduction of fungal burden may provide an improved response to antifungal therapy, disseminated coccidioidomycosis is a systemic disease that requires appropriate systemic therapy.

Neck abscesses formed by direct inoculation have a relatively more benign clinical course than those resulting from spread through inflamed tissue. The latter require a longer hospital stay, more days in the ICU, and more emergent intervention.

No abstract