The frontal recess and frontal sinus anatomy can vary from simple to complex. The variations in the anatomy of the frontal recess and frontal sinus are considerable but almost all variations can be classified if the various cell patterns are analyzed. This consensus document was developed to improve the ability of the surgeon to understand these possible variations, plan the surgery, and communicate these complexities when teaching or reporting outcomes. Once the surgeon understands the anatomical pattern of the frontal sinus and recess cells, the extent of surgery can be planned. This document presents a classification of the extent of surgery based on the anatomical classification.

Rhinophyma is a benign dermatologic disease of the nose affecting primarily Caucasian men in their fifth to seventh decades of life. It is characterized by a slowly progressive enlargement with irregular thickening of the nasal skin and nodular deformation. It is assumed to be the end stage of chronic acne rosacea. Main reasons that urge the patients to seek help are plastic cosmetic and functional impairments such as nasal obstruction. Surgical removal of the hyperplastic tumor mass is the treatment of choice for rhinophyma. In a retrospective review, the authors describe the pros and cons of the main treatment modalities that have been described in literature and present their own clinical experience.

The use of adult mesenchymal stem cells (MSC) in cartilage tissue engineering offers new perspectives in the generation of transplants for reconstructive surgery. The extracelular matrix (ECM) plays a key role in modulating the function and phenotype of the embedded cells and contains the integrins as adhesion receptors mediating cell-cell and cell-matrix interactions. In our study, characteristic changes in integrin expression during the course of chondrogenic differentiation of MSC from bone marrow and adipose tissue were compared. MSC were isolated from bone marrow biopsies and adipose tissue. During cell culture, chondrogenic differentiation was performed. The expression of integrins and their signaling components were analysed with microarray and immunohistochemistry in freshly isolated MSC and after chondrogenic differentiation. The fibronectin receptor (integrin α5ß1) was expressed by undifferentiated MSC, and expression rose during chondrogenic differentiation in both types of MSC. The components of the vitronectin/osteopontin receptors (αvß5) were not expressed by freshly isolated MSC, and expression rose with ongoing differentiation. Receptors for the collagens (α1ß1, α2ß1, α3ß1) were weakly expressed by undifferentiated MSC and were activated during differentiation. Intracellular signaling components integrinlinked kinase (ILK) and CD47 showed increased expression with ongoing differentiation. For all integrins, no significant differences were be found in the 2 types of MSC. Integrinmediated signaling appeared to play an important role in the generation and maintenance of the chondrocytic phenotype during chondrogenic differentiation. Particularly, the receptors for fibronectin, vitronectin, osteopontin and the collagens may be involved in the generation of the ECM. Intracellularly, their signals might be transduced by ILK and CD47. To fully harness the potential of these cells, future studies should be directed to ascertain their cellular and molecular characteristics for optimal identification, isolation, and expansion.

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