The use of the lower eyelid transconjunctival approach in the setting of orbital trauma has becoming increasingly popular in recent years. However, experience has found that access to the lateral orbital rim can be somewhat limited with this type of incision. Many authors supplement the approach with a lateral canthotomy in order to gain adequate access laterally. Although usually well tolerated, there can be side effects associated with this incision. We examine the upper lid transconjunctival approach to the lateral orbital rim. Furthermore, we compare this technique to the more traditional transcutaneous approaches used for orbital trauma. We have found this technique to be safe, effective, and to cause no more complications than the more traditional approaches.

The findings suggest positive correlation between the development of osteonecrosis and drug exposure as measured by number of infusions and total infusion hours. However, the relatively low incidence of osteonecrosis precluded definition of a direct dose-response relationship.

The quality of epithelial regeneration is potentially affected by the form of HA present in the healing milieu. In this series, the most optimal healing characteristics were seen in unpacked controls. Between the preparations of HA studied, HACMC exhibited more favorable healing patterns, which were nearly similar to controls.

Advanced sinus inflammatory disease associated with frontal lobe compression may have indolent presentation but significant morbidity. Minimally invasive techniques averted the need for craniotomy in 13/15 patients in this series.

9074 Background: Intravenous bisphosphonate therapy has been used for treatment of various benign and malignant bone diseases, including bony metastasis. Recent single case reports have described osteonecrosis (ON) of the mandible or maxilla as a previously unknown complication of this therapy. Methods: Records of 638 patients treated with intravenous pamidronate or zoledronic acid were reviewed to determine the incidence of jaw ON. Number of infusions, dosing interval, dosage administered, and duration of treatment were analyzed to determine risk factors for the development of this complication. Results: Mean age of the study group was 67 years and 61% were female. The most common primary malignancies included prostate, lung, breast, and multiple myeloma. The overall incidence of osteonecrosis was 6/638 (0.94%). Patients treated with pamidronate (n=336), zoledronic acid (n=169), and both agents (n=133) had an incidence of ON of 1.2%, 0%, and 1.5% respectively (p=NS). No significant relationship was observed between the incidence of ON and demographic parameters, primary tumor, cumulative drug dose, or dosing interval. However, patients who developed ON had a significantly greater mean number of infusions (20.7 versus 10.7, p=0.016) and significantly greater mean hours of infusion time (42.7 versus 17.7, p=0.0036) than those who did not develop the complication. Underlying dental disease appears to be associated with ON. Conclusions: This review represents the largest single series to date of patients treated with IV bisphosphonate therapy. The findings suggest positive correlation between the development of ON and drug exposure as measured by number of infusions and total infusion hours. However, this data must be interpreted with caution as the overall incidence of the complication was low (<1%), precluding rigorous statistical analysis. Dental comorbidity should be addressed prior to initiation of bisphosphonate therapy. No significant financial relationships to disclose.