Medial rectus muscle injury as a complication of FESS can vary markedly. Proper characterization and treatment are important, particularly with reference to the degree of direct MR injury (muscle tissue loss) and entrapment. Patients with severe MR disruption can benefit from intervention but continue to show persistent limitation of ocular motility and functional impairment. Prevention and early recognition and treatment of these injuries are emphasized.

Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States. Modeling estimates suggest that more than 80% of sexually active women will have acquired genital HPV by age 50 years. Although most infections are transient and asymptomatic, persistent infection with high-risk types of HPV can lead to precancerous lesions and progress to cancer. In June 2006, the US Food and Drug Administration licensed the first vaccine to prevent cervical cancers and other diseases in women. This quadrivalent vaccine protects against HPV-6, HPV-11, HPV-16, and HPV-18, which are responsible for 70% of cervical cancers and 90% of genital warts. Several studies have been published examining the vaccine's efficacy, duration, immunogenicity, and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses, and cost-effectiveness. Mayo Clin Proc. 2008;83(6):701-707 CI = confidence interval; CIN = cervical intraepithelial neoplasia; HPV = human papillomavirus; Pap = Papanicolaou; QALY = quality-adjusted life-year; RRP = recurrent respiratory papillomatosis; VLP = viruslike particle On completion of this article, you should be able to (1) review pathophysiology and transmission of human papillomavirus, (2) cite efficacy and safety profile of the new human papillomavirus vaccine, and (3) summarize current guidelines for use of the vaccine.

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