Background: Chronic rhinosinusitis has a major impact on the quality of life of patients with cystic fibrosis (CF)

Osteocutaneous radial forearm flaps provide comparable functional outcomes with less morbidity compared to fibula free flaps for selected segmental mandibulectomy defects. The overall dental implantation rate was low and more commonly performed in osteocutaneous radial forearm flaps compared to fibula flaps.

Frontal sinus CSF leaks were successfully closed in 97.3% of individuals. Our data supports the routine use of endoscopic repair in the treatment algorithm for frontal sinus skull-base defects.

Sinupret strongly activates transepithelial Cl(-) secretion through a mechanism known to hydrate the ASL of respiratory epithelium. This is one means by which the medication is likely to exert therapeutic benefit.

Background The cystic fibrosis transmembrane conductance regulator (CFTR) serves as a predominant Cl− transport conduit in airway epithelium and is inhibited by cigarette smoke in vitro and in vivo. Activation of secondary Cl− transport pathways through calcium-activated Cl− channels (CaCC) has been postulated as a mechanism to bypass defects in CFTR-mediated transport. Because it is not known whether CaCC’s are also inhibited by tobacco exposure, the current study was designed to investigate the effect of cigarette smoke condensate (CSC) on CaCC transport. Study Design In vitro study Methods Well-characterized primary murine nasal septal epithelial (MNSE) and human sinonasal epithelial (HSNE) cultures were exposed to CSC in Ussing chambers. We monitored CaCC short-circuit current through stimulation of P2Y purinergic receptors with UTP or ATP and selective inhibition of the CFTR dependent secretory pathway. Characterization of CaCC current was also accomplished in primary airway cells derived from transgenic CFTR−/− (knockout) murine models. Results Change in CaCC-mediated current (ΔISC - representing transepithelial Ca-mediated Cl− secretion in µA/cm2) was significantly decreased in CSC-exposed wild type MNSE when compared to controls{(32.8 +/− 4.6 vs. 47.5 +/− 2.3; respectively) p < 0.02}. A similar effect was demonstrated in CFTR−/− MNSE cultures(33.4 +/− 2.8 vs. 38.6 +/− 2.0; p<0.05}. HSNE cultures also had a significant reduction in ISC (16.1 +/− 0.6 vs. 22.7 +/− 0; p=0.008). Conclusions CSC affects multiple pathways fundamental to airway ion transport, including both cAMP and calcium activated Cl− transport. Inhibition of Cl− transport may contribute to common diseases of the airways, such as chronic rhinosinusitis and chronic obstructive pulmonary disease.

Objective-To compare outcomes following osteocutaneous radial forearm and fibula free flap reconstruction of lateral mandibular defects.Study Design-Retrospective case controlled study. Setting-Two academic tertiary care centers.Subjects and Methods-Patients who underwent free flap reconstruction of lateral mandibular defects from 1999 to 2010 were classified into four groups based on type of reconstruction: 1) radial forearm swing (n = 8), 2) radial forearm with bar (n = 5), 3) osteocutaneous radial forearm (n = 73) and 4) fibula free flap reconstruction (n = 51). Patient characteristics, length of hospital stay, recipient and donor site complications, and long term outcomes including postoperative diet were evaluated.Results-The majority of patients were male (67%) and presented with advanced T-stage (73%) squamous cell carcinoma (93%) involving the alveolus (26%) retromolar trigone (21%) or oral tongue (25%). Median length of hospital stay was 8 days (range 4-22). The recipient site complication rate approached 34% and included infection (n=11), mandibular malunion (n=9), exposed bone or mandibular plates (n=11) and flap failure (n=5). Most patients demonstrated little to no trismus following reconstruction (81%) and were able to resume a regular or edentulous diet (61%). No difference in complication rates or postoperative outcomes was seen between osteocutaneous radial forearm and fibula free flap groups (P > 0.05). One patient underwent dental implantation following osteocutaneous radial forearm free flap reconstruction. No patients from the fibula free flap group underwent dental implantation. Conclusion-The osteocutaneous radial forearm and fibula free flap provide equivalent wound healing and functional outcomes in patients undergoing lateral mandibular defect reconstruction.

Preoperative serum calcium and baseline iPTH levels may be useful in predicting parathyroid adenoma weight and volume, respectively. Adenoma weight may relate to the percentage decrease of iPTH levels at the 10-minute postparathyroidectomy interval.

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