Over the last decades, several therapeutic options were considered in the treatment of the osteoradionecrosis (ORN) of the mandible, including supportive measures, ultrasound therapy, corticosteroids, hyperbaric oxygen, surgical resection with reconstruction, and, more recently, drugs capable of reversing the fibroatrophic process. Once established, the ORN does not spontaneously disappear and a standard treatment has not yet been defined. The clear clinical effectiveness of hyperbaric oxygen therapy (HBOT) varies according to the literature and there are some economic/logistic issues to be considered; the triplet tocopherol/pentoxifylline/clodronate demands greater evidence from randomized clinical trials and also resilience from the patient, given the long treatment duration and its possible side effects. Controversy around the ideal treatment of the initial stage ORN of the mandible persists. More rigorous randomized prospective trials are essential. The purpose of this article was to review the relevant literature on the physiopathology of ORN of the mandible and discuss the new perspectives of its conservative treatment. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.

First-bite syndrome (FBS) is described as a complication of parapharyngeal space surgery and consists of short-term pain in the parotid or mandibular region at the start of each meal, usually on the first bite and improving with subsequently each bite. The pathogenesis is related to a selective sympathetic denervation of the parotid gland and its treatment involves dietary modifications, medical treatment or even surgery, all with poor results. FBS is often undervalued and misdiagnosed, yet it is a pathology that may interfere with the patient's quality of life. We report two patients who underwent major cervical oncologic surgeries. One patient was subject to extended radical neck dissection into the parapharyngeal space and the other patient ligation of the external carotid artery, which post-operatively developed into FBS unresponsive to the medical treatment instituted. During external adjuvant radiotherapy, both had an unexpected FBS improvement, remaining asymptomatic after 7 and 10 months of follow-up. In this study, we discuss why FBS is misdiagnosed in oncologic patients, the possible pathophysiological mechanisms of radiotherapy and its plausibility as a new modality of treatment in selected cases.

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Conclusion: END-DCR is highly successful for both types of NLDO. Preoperative absence of flow into nose on SWO was associated with slightly higher chance of complete resolution. Results: An 18 year-old morbidly obese woman presented to the oral maxillofacial surgery clinic with complaints of malocclusion. She underwent bilateral LeFort I osteotomies and was discharged on POD1. She represented 3 days later with headache and nausea. A head CT demonstrated pneumocephalus and a fracture of the dorsal aspect of the right sphenoid sinus causing a communication with the prepontine cistern. The patient subsequently underwent endoscopic repair by the otolaryngology and neurosurgery services, using a vascularized pedicled mucosal nasoseptal flap. She was discharged from the hospital on postoperative day 7 and since has had an uneventful recovery. Rhinology/Allergy Conclusion:Postoperative recognition of CSF leak is imperative in order to ensure timely repair and to prevent further complications. Identification of surgical techniques and patient-specific factors contributing an increased risk of postoperative CSF leak is vital. Given the prior intranasal and palatal surgery, various preoperative reconstruction options must be considered. Rhinology/Allergy Changes of the Histological Features in Nasal PolypsSu Jin Kim (presenter); Seung Youp Shin; Kun Hee Lee; Sung Wan Kim; Joong Saeng Cho Objective: Depending on the inflammatory cell infiltration, nasal polyps can be categorized as eosinophilic type or noneosinophilic type. There is a geographical difference in the prevalence of a certain pathological type of polyp. More than 80% of polyps in Western people are the eosinophilic type, while this type is rarely found among Eastern people. The periodical change in the prevalence of histological types of polyps was evaluated in this study. Method:Two hundred total patients, each confirmed to the polyp biopsy, were enrolled between 1993 and 2010. Specimens were fixed in formalin, then made to a paraffin block and H&E stained slide, which was reviewed by 2 authors. The number of eosinophils per high power field (HPF) and other cellular, epithelial, and stromal markers were reviewed. Results:We compared the nasal polyp eosinophil count by periods, the average eosinophil count/HPF increased from 7.22 (±1.695) in 1993 to 20.44 (±3.635) in 2010 (P = .001). Eosinophilic polyp (showing over 5 eosinophils/HPF) increased significantly from 26% in 1993 to 52% in (P = .000 -> P < .001). Among other histologic markers, lymphocytes, basement membrane thickening, and gland hypertrophy showed significant difference. Conclusion:After comparative studies between histopathologic findings of nasal polyps from 1993 and 2010 respectively, the percentage of eosinophilic nasal polyp, known to be rare among Asians, including Koreans, have increased significantly.

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Introduction:The frequently used irrigant in dental surgery, sodium hypochlorite, is occasionally the cause of minor, usually circumscribed, adverse effects. Severe, extensive complications, with lasting sequelae, however, also can occur, as

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