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ABSTRACT: The crestal approach to elevating the antral membrane by a resorbable StemVie Post is a modification of the sinus lift technique. This technique can add 4 to 10 mm bone height for severely atrophic ridges in areas that are difficult to access through a lateral window. The procedure is minimally invasive, simple, predictable, and has less postoperative morbidity because of smaller flap design and minimal osteotomy. If sufficient alveolar bone is present for stabilization, an implant can be placed simultaneous with antral elevation and graft. The StemVie Post completely resorbs and is replaced by the patient's own bone.
Implant dentistry 06/2011; 20(3):e53-60. · 1.51 Impact Factor
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ABSTRACT: Cerebellopontine angle arachnoid cysts are usually asymptomatic, but are frequently found incidentally because of increased use of neuroimaging. Nevertheless, as these cysts enlarge, they may compress surrounding structures and cause neurological symptoms. Patients may present with vague, nonspecific symptoms such as headache, nausea, vomiting, and vertigo. Cranial nerve palsies, including sensorineural hearing loss and facial weakness, although rare, have also been reported in association with posterior fossa arachnoid cysts. Although surgery for these entities is controversial, arachnoid cysts can be treated surgically with open craniotomy for cyst removal, fenestration into adjacent arachnoid spaces, shunting of cyst contents, or endoscopic fenestration. Reversal of sensorineural hearing loss following open craniotomy treatment has been described in the literature in only 1 adult and 1 pediatric case. Improvement in facial weakness has also been reported after open craniotomy and arachnoid cyst fenestration. The authors report the first case of complete recovery from sensorineural hearing loss and facial weakness following endoscopic fenestration in a patient with a cerebellopontine angle arachnoid cyst.
Journal of Neurosurgery Pediatrics 02/2011; 7(2):157-60. · 1.53 Impact Factor
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ABSTRACT: To examine the causative organisms in pediatric neck infections, delineate risk factors in methicillin-resistant Staphylococcus aureus (MRSA) pediatric neck infections, and define patient populations that should be empirically treated with MRSA sensitive antibiotics.
Retrospective chart review.
Two hundred twenty-eight consecutive patients were reviewed, ages 0 to 17, presenting at a tertiary care center between 1999 and 2007 with computed tomography proven neck abscesses. Characteristics of patients with differing causative organisms were compared.
Forty-eight percent of all pediatric patients' with head and neck abscesses had S. aureus as the causative organism, 29% of which were community-acquired MRSA -- recent years showed that up to 66% of pediatric neck abscesses were MRSA culture positive. When comparing MRSA infections vs. other causative organisms multiple clinical characteristics were found which did not help to differentiate those patients at a higher risk for MRSA. Characteristics which did trend to predict an MRSA infection were few. For example, the average age of patients with MRSA was 32.5 months compared with only 16 months for the methicillin-sensitive S. aureus patients. MRSA sensitivities and resistances were also examined.
This study presents a large cohort of pediatric neck abscess patients, in which the emergence and characteristics of MRSA are shown. As community-acquired MRSA infections become more prevalent, empiric antibiotic therapy must be considered. The results of this study show that the incidence of MRSA has greatly increased and clinical risk factors are not helpful in choosing those patients which may be at higher risk for an MRSA infection.
The Laryngoscope 11/2008; 118(12):2111-4. · 1.75 Impact Factor
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ABSTRACT: The crestal approach to elevating the antral membrane by a resorbable StemVie post is a modification of the sinus lift technique. This technique can add 4-10 mm of bone height for severely atrophic ridges in areas that are difficult to access through a lateral window. The procedure is minimally invasive, simple, and predictable, and has less postoperative morbidity due to smaller flap design and minimal osteotomy. If sufficient alveolar bone is present for stabilization, an implant can be placed simultaneously with an antral elevation and graft. The StemVie post resorbs completely and is replaced by the patient's own bone. Healing is enhanced with the addition of bone marrow aspirate and/or peripheral venous blood to the StemVie post graft. The graft will absorb the blood or the marrow, allowing them to infiltrate through the porosity present in the graft. Bone marrow aspirate aids in healing with the addition of precursor osteoblastic stem cells, cytokines, and growth factors, while peripheral blood supplies mostly cytokines and growth factors.
General dentistry 60(2):e86-94.
