The Journal of craniofacial surgery
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Clinical Trial
Adenotonsillectomy for sleep-disordered breathing in children with syndromic craniosynostosis.
Syndromic craniosynostosis (SCS) is known to be associated with sleep-disordered breathing (SDB) in childhood. Problems can occur at various levels, but midface hypoplasia is a major factor in affected infants. Adenotonsillectomy (AT) has been proven to be efficacious as a first-line treatment of SDB in healthy children. ⋯ In children with SCS, in whom the cause of obstruction might be at multiple levels, AT should still to be considered as first-line treatment in the management of OSA/SDB. We acknowledge that some children may still go on to require further airway intervention. Further multicenter trials would be useful to examine more closely the significance of the effects of AT in children with craniofacial disorders experiencing SDB.
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Biography Historical Article
Treatise on skull fractures by Berengario da Carpi (1460-1530).
Jacopo Berengario was born in Carpi, a medieval city close to Modena (northern Italy), circa 1460. He studied medicine at Bologna University and, in 1489, graduated in philosophy and medicine. He was appointed lecturer in anatomy and surgery at the same university, a position that he maintained for 24 years. ⋯ Berengario wanted to demonstrate to other physicians his knowledge of anatomy and his expertise on the brain and head traumas. The book includes the illustration of an entire surgical kit or a corpus instrumentorum for performing cranial operations, which appeared for the first time in a printed book. However, Berengario's highly commendable aim was to indicate to the reader the step-by-step procedure of craniotomy for management of skull fractures along with the sequential use of the previously presented instruments.
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: Either excision of the submandibular gland during neck dissection or having the submandibular gland in radiation field can result in xerostomia, leading to reduced quality of life. The purpose of this study was to evaluate the prevalence of metastasis to the submandibular gland and to identify potential risk factors leading to the presence of metastases into the gland. ⋯ : One needs to be aware of the possibility of occult metastases in level I in oral cavity carcinomas, whereas oropharynx carcinoma constitutes a lower risk for involvement of lymph node metastases at level I. The excision of the submandibular gland should be performed in cases with positive lymph nodes at level I and in tumor sites with a high risk of occult metastasis at level I.