Biomedical subjects
Publications and source records attributed to Vanni Mondin.
Grisel's syndrome is a rare condition of uncertain etiology characterized by a non-traumatic atlanto-axial subluxation, secondary to an infection in the head and neck region. The authors discuss the history, pathogenesis, terminology, classification, clinical characteristics, diagnosis, treatment, prognosis and prevention of this syndrome.
Malignant melanomas are found in a variety of locations, ranging from sun-exposed skin to the nasal cavity and paranasal sinuses. Melanomas arising in the head and neck region comprise some 20% of all melanomas; of these, 7-15% occur in the vicinity of the external ear (most often on the helix). Auricular melanomas, like those arising elsewhere, are rare in childhood and are most often first diagnosed in men in their 50s. Melanomas of the external ear may present as flat pigmented lesions or as raised mass lesions; amelanotic (non-pigmented) variants exist as well. Auricular melanomas are frequently recognized pathologically as either superficial spreading melanomas or nodular melanomas. These tumors are aggressive, with a propensity for spreading to both regional lymph nodes and distant sites. Key pathologic prognostic features of auricular melanomas include the histological subtype, tumor thickness, level of invasion and presence of ulceration. Therapy includes both aggressive surgical attempts at excision in combination with sentinel node sampling in some instances and perhaps, adjuvant therapy as well. This is a tumor which is often overlooked until late in its course, with tragic consequences; vigilance and aggressive attempts at identifying these tumors at earlier stages are strongly advocated.
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This review discusses treatment options for nasal fracture, a common condition due mainly to road accidents, sport injuries, and physical confrontations. Being frequently associated with multiple trauma, many broken noses are not promptly diagnosed and treated, leading to secondary nasal deformities and chronic obstructions. A description of nasal anatomy is followed by considerations on the pathogenesis of nasal fracture and its clinical assessment. Each patient's history must be recorded (cause of trauma, previous facial injuries, prior nasal deformity, or obstruction) and careful physical examination guides the choice of treatment (open vs closed reduction), its timing, and the type of anesthesia required. Adequate follow-up is essential. Manipulation under local anesthesia is an effective first-line treatment for simple nasal fractures and should become a standard practice, but any associated septal injury can be responsible for postoperative nasal deformity and obstruction so other options may need to be considered.
Iatrogenic facial nerve palsy following stapedectomy is a rare but devastating complication. The authors describe a case of a 20-year-old man who presented for legal advice concerning an immediate facial nerve palsy following a left stapedectomy. The incidence, management and prognosis of such injuries are discussed.