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Objectives/hypothesis: Detection of complications after mandibular fracture repair is generally based on the clinical examination. However, postoperative evaluation of the patient often includes imaging of the repaired mandible. At our institution, the majority of patients with mandibular fracture have had at least one panoramic mandible radiograph taken postoperatively. The purpose of this study was to assess whether these radiographic studies contributed to detection of complications and thereby had an impact on the clinical course of the patient. Study Design: Retrospective review. Methods: The available medical records over a 5-and-a-half-year period of all patients who were treated at our institution for a fractured mandible were reviewed. Patients included in the study were those who were followed for at least 2 months and two postoperative visits. Results: Our series of 289 patients included 25 patients with complications. Of these patients, 24 had postoperative panoramic radiographs. All of the complications were discovered based on history and physical examination. In six of the patients with complications, the panoramic radiograph was suspicious for a complication. There were five false-positive studies of the 240 postoperative studies performed in patients without complications. No complications were diagnosed based on radiography. Conclusions: After surgical treatment of mandibular fractures, panoramic radiographs add little to the physical examination and history toward the detection of complications. We believe that panoramic radiographs need not be used routinely, but may be reserved for patients who have complaints or physical findings suggestive of complications. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To assess clinico-demographic characteristics available before Mohs removal of nonmelanoma skin cancers of the head and neck as predictors of the need for extensive reconstruction., Study Design: Retrospective chart review., Methods: Variables examined were age, sex, race, marital status, past medical history, family history of skin cancer, use of tobacco or alcohol, history of radiation therapy, history of reconstruction, history of immunosuppression, tumor size, tumor site, histology, primary or recurrent tumor, number of tumors treated, and history and location of previous skin tumors. Univariate and multivariate analyses were performed assessing the need for extensive reconstruction after skin tumor removal as an outcome variable., Results: Age, tumor site, and a past history of reconstruction after resection of a previous skin tumor were characteristics identified as being predictive of the need for advanced reconstruction. The most common tumor locations that required postablation reconstruction were the nose (228 tumors) and the ear (148 tumors). Thirty-six of recurrent tumors and 32% of primary tumors were reconstructed. The odds of a female requiring reconstruction were 2:1. The mean ages were 64.3 years in the reconstruction group and 67.2 years in those not reconstructed. Size of tumor did not correlate with the need for reconstruction., Conclusions: Patient's age, skin tumor location, and past history of extensive reconstruction after previous resection of skin tumor are patient-specific characteristics available before tumor resection that predict the need for advanced reconstruction in patients undergoing Mohs micrographic surgery removal of skin cancers.

Objectives/hypothesis: We tested the hypothesis that recovery of dynamic oculomotor behavior (specifically the vestibuloocular reflex [VOR]) after a unilateral labyrinthectomy (UL) is independent from static deficit recovery (e.g., spontaneous nystagmus). This hypothesis predicts that VOR recovery from peripheral vestibular lesions that do not cause static symptoms, such as unilateral semicircular canal plugging (UCP), would have a similar time course and magnitude as recovery from a lesion that creates both a static and dynamic imbalance, such as UL. Furthermore, animals compensated after UCP would be expected to retain their compensated VOR response after the additional insult of ipsilateral labyrinthectomy., Study Design: An experimental study in the Mongolian gerbil animal model., Methods: The horizontal VOR was measured from both eyes using infrared video-oculography on gerbils before and after UCP, UL, or ipsilateral labyrinthectomy after a previous UCP. Eye movements were recorded during yaw rotation in the dark., Results: UL resulted in a more severe acute deficit than the UCP. Over several weeks, the UCP animals compensated their horizontal VOR, particularly on rotation toward the intact side, quicker and more completely than the UL animals. Animals that underwent ipsilateral labyrinthectomy 8 to 11 weeks after UCP demonstrated preservation of the improved gain, particularly on rotation toward the intact labyrinth. However, the difference between the UL groups with or without precedent UCP was not retained after 72 hours, and long-term compensation was poorest in the UL after UCP group., Conclusions: Plasticity in dynamic vestibular reflexes induced by UCP is preserved after a subsequent UL. However, neurologic events during the first and second day after UL appear to limit, change, or suppress the long-term dynamic compensation of the VOR, regardless of whether the animal had a previous UCP.

Objective: The purpose of this study was to develop a technique to investigate the regeneration of utricular hair cells in the adult pigeon (Columba livia) following complete hair cell loss through administration of streptomycin., Study Design: Experimental animal study., Methods: Animals were divided into four groups. Group 1 received 10 to 15 days of systemic streptomycin injections. Animals in Groups 2 and 3 received a single direct placement of a 1-, 2-, 4-, or 8-mg streptomycin dose into the perilymphatic space. Animals in Groups 1 and 2 were analyzed within 1 week from injection to investigate hair cell destruction, whereas Group 3 was investigated at later dates to study hair cell recovery. Group 4 animals received a control injection of saline into the perilymphatic space. Damage and recovery were quantified by counting hair cells in isolated utricles using scanning electron microscopy., Results: Although systemic injections failed to reliably achieve complete utricular hair cell destruction, a single direct placement of a 2-, 4-, or 8-mg streptomycin dose caused complete destruction within the first week. Incomplete hair cell loss was observed with the 1-mg dose. Over the long term, regeneration of the hair cells was seen with the 2-mg dose but not the 8-mg dose. Control injections of saline into the perilymphatic space caused no measurable hair cell loss., Conclusions: Direct placement of streptomycin into the perilymph is an effective, reliable method for complete destruction of utricular hair cells while preserving the regenerative potential of the neuroepithelium.