This is an RSS newsfeed from BioMed Central It is intended to be used with an RSS reader. For more information about RSS newsfeeds from BioMed Central, visit http://www.biomedcentral.com/info/about/rss/ http://www.head-face-med.com The latest articles from Head & Face Medicine (ISSN 1746-160X) published by BioMed Central A case of low-grade intraosseous fibrosarcoma of the mandible in a 9-year-old girl is described. The patient underwent pre-surgical chemotherapy which was abandoned as unsuccessful after two cycles. Radical tumour resection and mandibular reconstruction with a titanium bar were performed 3 months after diagnosis. No adjuvant therapy was given and lymph node dissection was not performed. No signs of recurrences or metastasis have been observed after a follow up time of 3 years so far. This article is presented to document the rarity of fibrosarcomas in the jaws of children and emphasizes the possible changes in the appearance of radiological imaging under tumour progression. http://www.head-face-med.com/content/4/1/21 Martin Gosau, Florian G Draenert, Wolfgang A Winter, Jörg Mueller-Hoecker and Oliver Driemel Head & Face Medicine 2008, 4:21 2008-09-16 doi:10.1186/1746-160X-4-21 Head & Face Medicine 1746-160X 4 21 2008-09-16 Ectopic internal carotid artery (ICA) is a very rare variation. The major congenital abnormalities of the ICA can be classified as agenesis, aplasia and hypoplasia, and they can be unilateral or bilateral. Anomalies of the neck artery may be vascular neoplasms or ectopic position. Carotid angiograms provide absolute confirmation of an aberrant carotid artery, while EcoColorDoppler (ECD) gives also important information about the evaluation of carotid vassels. Nevertheless Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) of the neck provide spatial information about the adjacent pharyngeal anatomy and are less invasive than angiogram. Injuries to the ICA during simple pharyngeal surgical procedures can be catastrophic due to the risk of massive bleeding. We report a case of a 56 year-old male patient suffering from dysphagia associated with aberrant ICA manifesting itself as a pulsative protruding of the left lateral wall of the oropharynx. http://www.head-face-med.com/content/4/1/20 Emmanuel P Prokopakis, Constantinos A Bourolias, Argyro J Bizaki, Spyros K Karampekios, George A Velegrakis and John G Bizakis Head & Face Medicine 2008, 4:20 2008-08-26 doi:10.1186/1746-160X-4-20 Head & Face Medicine 1746-160X 4 20 2008-08-26 Wegener's granulomatosis (WG) is a multi-system disease, characterised by the triad of necrotising granulomata affecting the upper and lower respiratory tracts, disseminated vasculitis and glomerulonephritis. Oral lesions are associated with up to 50% of cases, although are rare as a presenting feature. The most common oral lesions associated with WG are ulceration and strawberry gingivitis. We review the literature regarding oral manifestations of WG and present a case of lingual infarction, an extremely rare oral lesion associated with WG, in a severe, rapidly progressive and ultimately fatal form of the disease. http://www.head-face-med.com/content/4/1/19 Lachlan M Carter and Eitan Brizman Head & Face Medicine 2008, 4:19 2008-08-21 doi:10.1186/1746-160X-4-19 Head & Face Medicine 1746-160X 4 19 2008-08-21 Background: A cutaneous angiosarcoma is a rare malignant tumour of vascular endothelial cells with aggressive clinical behaviour and poor prognosis. Diagnosis is often delayed due to its variable and often benign clinical appearance.Case presentationThis case presents a 64-year-old man with a six-month-history of a recurrent diffuse and erythematous painless swelling below the left eye. Several resections with intraoperatively negative resection margins followed, but positive margins were repeatedly detected later on permanent sections. Histopathologic examination of the specimen diagnosed a cutaneous angiosarcoma. Neither, finally achieved negative margins on permanent sections, nor a following chemotherapy could prevent the recurrence of the disease after five months and the patient's dead 21 months after the first diagnosis. Conclusion: The case elucidates the current diagnostic and therapeutic dilemma of this entity, which shows an unfavourable clinical course in spite of multimodal therapy. http://www.head-face-med.com/content/4/1/18 Tobias Ettl, Johannes Kleinheinz, Ravi Mehrotra, Stephan Schwarz, Torsten E Reichert and Oliver Driemel Head & Face Medicine 2008, 4:18 2008-08-11 doi:10.1186/1746-160X-4-18 Head & Face Medicine 1746-160X 4 18 2008-08-11 Background: acantholytic squamous cell carcinomas (ASCC) and intraoral angiosarcoma share similar histopathological features. Aim of this study was to find marker for a clear distinction. Methods: Four oral acantholytic squamous cell carcinomas and one intraoral angiosarcoma are used to compare the eruptive intraoral growth-pattern, age-peak, unfavourable prognosis and slit-like intratumorous spaces in common histological staining as identical clinical and histopathological features. Immunohistochemical staining for pancytokeratin, cytokeratin, collagen type IV, γ2-chain of laminin-5, endothelial differentiation marker CD31 and CD34, F VIII-associated antigen, Ki 67-antigen, β-catenin, E-cadherin, α-smooth-muscle-actin and Fli-1 were done. Results: Cytokeratin-immunoreactive cells can be identified in both lesions. The large vascularization of ASCC complicates the interpretation of vascular differential markers being characteristic for angiosarcoma. Loss of cell-cell-adhesion, monitored by loss of E-cadherin and β-catenin membrane-staining, are indetified as reasons for massive expression of invasion-factor ln-5 in ASCC and considered responsible for unfavourable prognosis of ASCC. Expression of Fli-1 in angiosarcoma and cellular immunoreaction for ln-5 in ASCC are worked out as distinguishing features of both entities. Conclusion: Fli-1 in angiosarcoma and ln-5 in ASCC are distinguishing features. http://www.head-face-med.com/content/4/1/17 Oliver Driemel, Urs DA Müller-Richter, Samer G Hakim, Richard Bauer, Alexander Berndt, Johannes Kleinheinz, Torsten E Reichert and Hartwig Kosmehl Head & Face Medicine 2008, 4:17 2008-07-31 doi:10.1186/1746-160X-4-17 Head & Face Medicine 1746-160X 4 17 2008-07-31 Background: With the 2005 WHO classification of salivary gland tumours and its increasingly recognized diagnostic entities, the frequency of adenocarcinoma (NOS) has decreased significantly.Case presentationThis paper describes a fast growing adenocarcinoma (NOS), originating from the minor salivary glands of the left buccal mucosa with a rapid onset of multiple local and distant metastases, especially in the lung. A lung primary was unlikely as the tumour was characterized by positivity for cytokeratin 20 and negativity for the thyroid transcription factor-1 protein (TTF-1) in immunohistochemistry. Conclusion: A rare case of an adenocarcinoma (NOS) of the minor salivary glands with a rapid development and an unfavourable clinical course is reported. It shows that additional immunohistochemical analysis can decisively contribute to determine the site of the primary tumour in cases with unknown primary. http://www.head-face-med.com/content/4/1/16 Tobias Ettl, Johannes Kleinheinz, Ravi Mehrotra, Stephan Schwarz, Torsten Eugen Reichert and Oliver Driemel Head & Face Medicine 2008, 4:16 2008-07-30 doi:10.1186/1746-160X-4-16 Head & Face Medicine 1746-160X 4 16 2008-07-30 Laryngomalacia (LRM), is the most common laryngeal abnormality of the newborn, caused by a long curled epiglottis, which prolapses posteriorly. Epiglottis prolapse during inspiration (acquired laryngomalacia) is an unusual cause of airway obstruction and a rare cause of obstructive sleep apnea syndrome (OSAS).We present a minimally invasive technique where epiglottis on cadaveric larynx specimens was treated with CO2 laser. The cartilage reshaping effect induced by laser irradiation was capable of exposing the glottis opening widely. This technique could be used in selected cases of LRM and OSAS due to epiglottis prolapse as an alternative, less morbid approach. http://www.head-face-med.com/content/4/1/15 Constantinos Bourolias, Jiannis Hajiioannou, Emil Sobol, George Velegrakis and Emmanuel Helidonis Head & Face Medicine 2008, 4:15 2008-07-25 doi:10.1186/1746-160X-4-15 Head & Face Medicine 1746-160X 4 15 2008-07-25 Background: Endothelial cells play an important role in the delivery of cells to the inflammation site, chemotaxis, cell adhesion and extravasation. Implantation of a foreign material into the human body determines inflammatory and repair reactions, involving different cell types with a plethora of released chemical mediators. The evaluation of the interaction of endothelial cells and implanted materials must take into account other parameters in addition to the analysis of maintenance of cell viability. Methods: In the present investigation, we examined the behavior of human umbilical vein endothelial cells (HUVECs) harvested on titanium (Ti), using histological and immunohistochemical methods. The cells, after two passages, were seeded in a standard density on commercially plate-shaped titanium pieces, and maintained for 1, 7 or 14 days. Results: After 14 days, we could observe a confluent monolayer of endothelial cells (ECs) on the titanium surface. Upon one-day Ti/cell contact the expression of fibronectin was predominantly cytoplasmatic and stronger than on the control surface. It was observed strong and uniform cell expression along the time of α5β1 integrin on the cells in contact with titanium. Conclusion: The attachment of ECs on titanium was found to be related to cellular-derived fibronectin and the binding to its specific receptor, the α5β1 integrin. It was observed that titanium effectively serves as a suitable substrate for endothelial cell attachment, growth and proliferation. However, upon a 7-day contact with Ti, the Weibel-Palade bodies appeared to be not fully processed and exhibited an anomalous morphology, with corresponding alterations of PECAM-1 localization. http://www.head-face-med.com/content/4/1/14 Ana Cristina Breithaupt-Faloppa, Wothan Tavares de Lima, Ricardo Martins Oliveira-Filho and Johannes Kleinheinz Head & Face Medicine 2008, 4:14 2008-07-23 doi:10.1186/1746-160X-4-14 Head & Face Medicine 1746-160X 4 14 2008-07-23 Background: Apoptosis is involved in fundamental processes of life, like embryonic development, tissue homeostasis, or immune defense. Defects in apoptosis cause or contribute to developmental malformation, cancer, and degenerative disorders. Methods: The developing adenohypophysis area of rat fetuses was studied at the embryonic stage 13.5 (gestational day) for apoptotic and proliferative cell activities using histological serial sections. Results: A high cell proliferation rate was observed throughout the adenohypophysis. In contrast, apoptotic cells visualized by evidence of active caspase-3, were detected only in the basal epithelial cones as an introducing event for fusion and closure of the pharyngeal roof. Conclusion: We can clearly show an increasing number of apoptotic events only at the basic fusion sides of the adenohypophysis as well as in the opening region of this organ. Apoptotic destruction of epithelial cells at the basal cones of the adenohypophysis begins even before differentiation of the adenohypophyseal cells and their contact with the neurohypophysis. In early stages of development, thus, apoptotic activity of the adenohypophysis is restricted to the basal areas mentioned. In our test animals, the adenohypophysis develops after closure of the anterior neuroporus. http://www.head-face-med.com/content/4/1/13 Jens Weingärtner, Kristina Lotz, Andreas Faltermeier, Oliver Driemel, Johannes Kleinheinz, Tomas Gedrange and Peter Proff Head & Face Medicine 2008, 4:13 2008-07-23 doi:10.1186/1746-160X-4-13 Head & Face Medicine 1746-160X 4 13 2008-07-23 IntroductionVarious surgical procedures are available to correct paralytic ectropion, which are applied in irreversible facial paresis. Problems occur when facial paresis has an unclear prognosis, since surgery of the lower eyelid is usually irreversible. We propose a simple method to correct temporary ectropion in facial palsy by applying an adhesive strip.Patients and methodsTen patients with peripheral facial paresis and paralytic ectropion were treated with an adhesive strip to correct paralytic ectropion. We used "Steri-Strips" (45 × 6.0 mm), which were taped on the carefully cleaned skin of the lower eyelid and of the adjacent zygomatic region until the prognosis of the paresis was clarified. In addition to the examiner's evaluation of the lower lacrimal point in the lacrimal lake, subjective improvement of the symptoms was assessed using a visual analogue scale (VAS, 1–10). Results: 9 patients reported a clear improvement of the symptoms after adhesive taping. There was a clear regression of tearing (VAS (median) = 8; 1 = no improvement, 10 = very good improvement), the cosmetic impairment of the adhesive tape was low (VAS (median) = 2.5; 1 = no impairment, 10 = severe impairment) and most of the patients found the use of the adhesive strip helpful. There was slight reddening of the skin in one case and well tolerated by the facial skin in the other cases. Conclusion: The cause and location of facial nerve damage are decisive for the type of surgical therapy. In potentially reversible facial paresis, procedures should be used that are easily performed and above all reversible without complications. Until a reliable prognosis of the paresis can be made, adhesive taping is suited for the temporary treatment of paralytic ectropion. Adhesive taping is simple and can be performed by the patient. http://www.head-face-med.com/content/4/1/12 Thomas Schrom and Anke Habermann Head & Face Medicine 2008, 4:12 2008-07-21 doi:10.1186/1746-160X-4-12 Head & Face Medicine 1746-160X 4 12 2008-07-21