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Update on allergic and nonallergic rhinitis
Monday, September 30, 1996 6:45-7:45 AM (breakfast provided at 6:30) Grand Hyatt Washington Update on Allergic and Nonallergic Rhinitis Moderator: RICHARD WAGUESPACK, MD Speaker: ROBERTM. NACLERIO, MD Supported by: BOEHRINGER INGELHEIM PHARMACEUTICALS, INC.
6:45-7:45 AM (breakfast provided at 6:30) Renaissance Washington, D.C. Hotel Medical and Surgical M a n a g e m e n t of Resistant Infections Moderator: G. RICHARD HOLT, MD Speakers: MICHAEL POOLE, MD, PhD, and RANDAL A. O1-[O, MD Supported by: GLAXO WELLCOME INC.
lesional lightening from 50% to 90% (good response), 21 (17.8%) had lesional lightening from 11% to 49% (poor response), and 2 (1.7%) lightened less than 10% (no response). Clinical response did not vary among age groups but did show statistically significant differences between anatomical locations. A return of PWS lesions was noted in patients who were 2 or more years out from completion of treatment. Conclusion: Treatment of PWS by FPDL results in a good to complete response in the majority of patients. Anatomical location and distribution of the lesion is a valuable prognostic indicator of response to treatment. The initial impressive results of FPDL treatment of PWS may be tempered by the gradual return of the vascular lesion as time elapses after completion of therapy. Our experience indicates that PWS show a definite tendency to recur at a rate approaching 50% between 3 to 4 years after completion of treatment. 8:08 AM
WITHDRAWN
8:00 to 9:30 AM Room 38 9
Facial Plastic and Reconstructive Surgery and General Otolaryngology Session BECKY McGRAW-WALL, MD, and WILLIAM SHOCKLEY, MD (moderators), Houston, Tex., and Chapel Hill, N.C.
8;00 AM
Port-Wine Stains: An Assessmentof Five Years of Treatment STEVENS. ORTEN, MD (presenter), MILTON WANER, MD, and STEPHEN FLOCK, PhD, Little Rock, Ark.
Objective: Treatment of port-wine stains (PWS) with the flashlamp pumped dye laser (FPDL) is well established; however, reports of clinical efficacy and complication rates have been extremely variable. The purpose of this study was to objectively assess the results of FPDL treatment of 102 patients with PWS at our institutions from 1989 to 1994. Methods: Evaluation was performed by comparing preand post-treatment photographs to the patient's presenting appearance at follow-up examination. Clinical response was determined by assigning a percentage of lesional lightening score by two physicians and the patient and by reflectance spectrophotometric measurements. Results: Of 102 patients with 118 PWS seen in follow-up evaluation, 18 (15.3%) had greater than 90% lesional lightening (complete/near complete response), 77 (65.3%) had
August 1996
8:16 AM lliac Crest Versus Fibula Osseomyocutaneous Free Flaps for Lower Jaw Reconstruction THIERRYVUILLEMIN,MD, DMD(presenter),and JORAM RAVEH,MD, DMD,Bern,Switzerland In this study 53 patients underwent mandibular reconstruction following tumor ablation. In 29 cases a fibula free flap was used, and in 24 cases an iliac crest free flap was used. Thirty-four patients were irradiated postoperatively with an average dose of 58 Gy. Fixation was performed using the THORP (Synthes) and the new Locking Screw System and miniplates (Leibinger)--the indications will be discussed. The purpose of this study was to compare the pros and cons of these two types of flaps. Ninety-two percent of the flaps were successful---one fibula flap and three iliac crest flaps failed in this series. Except for one hernia, no major complication resulted from the donor sites. Both flaps proved to offer very satisfactory results, and in 50% of the cases dental implants and rehabilitation with dentures were achieved. The following major aspects were obvious and will be emphasized: (1) With regard to pain and recovery of the donor site, the fibula flaps were better tolerated; (2) the harvesting time and the vessel's diameter are in favor of the fibula flap; and (3) the iliac crest flap is more bulky and should be used mainly for large through-and-through resections of the oral cavity. The aim of this study was the comparison and longterm evaluation of the results achieved using these two free flaps for mandibular reconstruction.
Otolaryngology- Head and Neck Surgery P55
6:45-7:45 AM (breakfast provided at 6:30) Renaissance Washington, D.C. Hotel Medical and Surgical M a n a g e m e n t of Resistant Infections Moderator: G. RICHARD HOLT, MD Speakers: MICHAEL POOLE, MD, PhD, and RANDAL A. O1-[O, MD Supported by: GLAXO WELLCOME INC.
lesional lightening from 50% to 90% (good response), 21 (17.8%) had lesional lightening from 11% to 49% (poor response), and 2 (1.7%) lightened less than 10% (no response). Clinical response did not vary among age groups but did show statistically significant differences between anatomical locations. A return of PWS lesions was noted in patients who were 2 or more years out from completion of treatment. Conclusion: Treatment of PWS by FPDL results in a good to complete response in the majority of patients. Anatomical location and distribution of the lesion is a valuable prognostic indicator of response to treatment. The initial impressive results of FPDL treatment of PWS may be tempered by the gradual return of the vascular lesion as time elapses after completion of therapy. Our experience indicates that PWS show a definite tendency to recur at a rate approaching 50% between 3 to 4 years after completion of treatment. 8:08 AM
WITHDRAWN
8:00 to 9:30 AM Room 38 9
Facial Plastic and Reconstructive Surgery and General Otolaryngology Session BECKY McGRAW-WALL, MD, and WILLIAM SHOCKLEY, MD (moderators), Houston, Tex., and Chapel Hill, N.C.
8;00 AM
Port-Wine Stains: An Assessmentof Five Years of Treatment STEVENS. ORTEN, MD (presenter), MILTON WANER, MD, and STEPHEN FLOCK, PhD, Little Rock, Ark.
Objective: Treatment of port-wine stains (PWS) with the flashlamp pumped dye laser (FPDL) is well established; however, reports of clinical efficacy and complication rates have been extremely variable. The purpose of this study was to objectively assess the results of FPDL treatment of 102 patients with PWS at our institutions from 1989 to 1994. Methods: Evaluation was performed by comparing preand post-treatment photographs to the patient's presenting appearance at follow-up examination. Clinical response was determined by assigning a percentage of lesional lightening score by two physicians and the patient and by reflectance spectrophotometric measurements. Results: Of 102 patients with 118 PWS seen in follow-up evaluation, 18 (15.3%) had greater than 90% lesional lightening (complete/near complete response), 77 (65.3%) had
August 1996
8:16 AM lliac Crest Versus Fibula Osseomyocutaneous Free Flaps for Lower Jaw Reconstruction THIERRYVUILLEMIN,MD, DMD(presenter),and JORAM RAVEH,MD, DMD,Bern,Switzerland In this study 53 patients underwent mandibular reconstruction following tumor ablation. In 29 cases a fibula free flap was used, and in 24 cases an iliac crest free flap was used. Thirty-four patients were irradiated postoperatively with an average dose of 58 Gy. Fixation was performed using the THORP (Synthes) and the new Locking Screw System and miniplates (Leibinger)--the indications will be discussed. The purpose of this study was to compare the pros and cons of these two types of flaps. Ninety-two percent of the flaps were successful---one fibula flap and three iliac crest flaps failed in this series. Except for one hernia, no major complication resulted from the donor sites. Both flaps proved to offer very satisfactory results, and in 50% of the cases dental implants and rehabilitation with dentures were achieved. The following major aspects were obvious and will be emphasized: (1) With regard to pain and recovery of the donor site, the fibula flaps were better tolerated; (2) the harvesting time and the vessel's diameter are in favor of the fibula flap; and (3) the iliac crest flap is more bulky and should be used mainly for large through-and-through resections of the oral cavity. The aim of this study was the comparison and longterm evaluation of the results achieved using these two free flaps for mandibular reconstruction.
Otolaryngology- Head and Neck Surgery P55