Frontonasal malformation (FNM), also known as the median cleft face syndrome, encompasses a spectrum of phenotypes that are believed to result from a single underlying aetiology. Over the course of two decades, the Craniofacial Unit at the Radcliffe Infirmary, Oxford has been involved in the management of six same-sex twins where only a single twin is affected. With local ethical committee approval, five sets of twins were traced and consented to participation in this study. Monozygosity of all five twin pairs was confirmed, and the clinical features were reviewed. We discuss the mechanistic relationship between FNM and the twinning process and the genetic implications of this association.

Adolescent↗

PubMed2004

Treatment of nevoid hyperkeratosis of the nipple and areola by shave excision.

The case is presented of a 29-year-old female who, at the age of 13 years, developed bilateral verrucous thickening of her areolae. Despite the condition causing her significant psychosocial morbidity, a specialist referral was initially denied on the grounds that no treatment was apparently available. The condition progressively deteriorated over the subsequent 14 years. She was eventually referred for a dermatology opinion, and the diagnosis of nevoid hyperkeratosis was made. Topical therapy with keratolytics was unsuccessful, and she was referred for a plastic surgery review. Bilateral shave excision of the lesion was performed under general anesthesia, with a satisfactory outcome and no evidence of recurrence at 10 months.

Adult↗

PubMed2003

Is the internet the best resource for blushers?

Blushing can be a disabling condition that causes sufferers great distress. It causes patients to become socially isolated, frequently being labelled as "shy". Any referral to their condition is embarrassing; even a discussion with a health care professional requires a great deal of courage. Even then, the information from non-specialists is often inaccurate and inadequate and fails to inform patients of the possible treatment options available. In today's era the internet has become an important information medium. This information on almost any subject is widely available to the general public and can be accessed at any time. It is available to blushers and health care professionals alike. It offers a non-embarrassing method of seeking help for an embarrassing condition. It is a medium for specialists to inform sufferers incognito about such a condition. We report our experience from our website: a generalised hyperhidrosis, blushing and sympathectomy information web site (www.sympathectomy.co.uk) by analysing the number of hits and requests for information. We discuss the statistics of internet access to our website including the "hit rate" and enquiry rate. Paradoxically 75% of all enquiries have been from blushers with only 25% coming from patients with hyperhidrosis.A properly designed, accurate and dynamic web site tailored towards users' needs can be used to effectively educate an information hungry but shy group.

Adolescent↗

PubMed2003

The fibula free flap: advantages of the muscle sparing technique.

The amount of muscle that should be retained on the free fibula during harvest is unresolved. Muscle is used to protect the periosteum, but by harvesting a large muscle cuff, the recipient and donor site morbidity increases. A retrospective review of 47 free fibula flaps performed between January 1997 and March 2002 was undertaken. There was an average follow-up of 15 months. The dissection method used for all cases was a muscle sparing technique where the peroneal vessels were skeletonised anteromedially. Only a very thin rim of muscle (1-2 mm) was left attached to the fibula. The recipient and donor vessels were flushed with heparin saline solution intra-operatively and a Dextran 40 infusion was used for four days post-operatively in all cases. Of the 47 flaps, 39 were used for mandible reconstruction, six for maxillary reconstruction and two for long bone reconstruction following trauma. The average age was 47.7 years (range 13-82) and two-thirds (28/43) of the patients were male. There was one post-operative death. The overall failure rate was 10.9% (5/46). Two flaps were lost as a result of arterial thrombosis, one from venous thrombosis, one from sepsis and in one case the cause could not be determined. There were 2 (4.3%) recipient site haematomas. It is suggested that the low recipient site haematoma rate in this series may be related to the limited muscle bulk transferred with the flap. Harvesting less muscle also enables easier insetting and folding of skin flap, and reduces the donor site problems of haematoma and weakness of the foot. The blood supply to the fibula does not appear to be compromised.

Adolescent↗

PubMed2003

Cocaine by internal mail.

Explore the source record for details and available documents.

Child↗