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INTRODUCTION: The open frontal intersinus septum takedown (FISST) technique was first described in 1976. We describe our experience with an endoscopic transnasal approach to manage a frontal sinus pyocele arising from an obstructed frontal sinus outflow tract due to anterolateral thigh flap reconstruction of a maxillectomy defect. CASE REPORT: A 40-year-old lady experienced upper eyelid swelling and purulent nasal discharge 3 weeks after undergoing a left extended medial maxillectomy with free anterolateral thigh flap reconstruction. A computed tomography (CT) scan revealed total opacification of the left frontal sinus. There was no improvement with intravenous antibiotics and she underwent a surgery, whenshe was found intraoperatively to have a frontal sinus pyocele, which was then drained. She then underwent an endoscopic transnasal FISST to ventilate the left frontal sinus via the contralateral frontal recess with good results. A CT scan performed 3 months postoperatively showed a widely patent interfrontal sinus septal window and right frontal outflow tract with no disease recurrence. DISCUSSION: The FISST is a useful technique to manage unilateral frontal sinus disease by taking advantage of the contralateral outflow tract when the ipsilateral frontal recess is obstructed.

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BACKGROUND: Optic neuritis resulting from paranasal sinusitis is an infrequently described but clinically important and treatable entity. The role of optic nerve decompression has been well established in atraumatic optic neuropathies which are compressive in origin. However, its role in optic neuritis and other infective or inflammatory processes is lacking, and the role for early surgical intervention remains controversial. CASE REPORT: In this case report, we describe a patient who presented with sudden onset of right vision loss secondary to optic neuritis from pansinusitis. He was treated with systemic antibiotics and steroids along with an urgent endoscopic sinus surgery with optic nerve decompression. Full restoration of his vision was recorded within 24 h of surgical decompression. CONCLUSION: Optic neuritis secondary to paranasal sinusitis is a clinically important entity and timely diagnosis and decompression is key to vision restoration.

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Stochastic approximation (SA) algorithms can be used in system optimization problems for which only noisy measurements of the system are available and the gradient of the loss function is not. This type of problem can be found in adaptive control, neural network training, experimental design, stochastic optimization, and many other areas. This paper studies three types of SA algorithms in a multivariate Kiefer-Wolfowitz setting, which uses only noisy measurements of the loss function (i.e., no loss function gradient measurements). The algorithms considered are: the standard finite-difference SA (FDSA) and two accelerated algorithms, the random directions SA (RDSA) and the simultaneous-perturbation SA (SPSA). RDSA and SPSA use randomized gradient approximations based on (generally) far fewer function measurements than FDSA in each Iteration. This paper describes the asymptotic error distribution for a class of RDSA algorithms, and compares the RDSA, SPSA, and FDSA algorithms theoretically (using mean-square errors computed from asymptotic distributions) and numerically. Based on the theoretical and numerical results, SPSA is the preferable algorithm to use.

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A case of a glycogen-rich adenocarcinoma arising in the minor salivary glands of the hard palate is described. The clinical, light microscopic, histochemical, and ultrastructural findings supporting this diagnosis are presented.

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This article reports on a patient with an unusual history of ankylosis of the left mandible. The case demonstrates retarded growth on the side of the ankylosis as it occurred at an early age. A gap arthroplasty performed at the angle of the mandible, lower than usual, had produced an adequate result, and a bone graft augmentation genioplasty was performed in an attempt to improve the patient's appearance. Subsequently, a mandibular bone plate implant was successfully placed through the bone graft along the anterior inferior border of the mandible.

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This article reports the case of a patient with a reasonably large maxillary hemangioma involving bone and overlying mucosa. A dramatic shrinkage of the lesion over a 4-week period was noted when sodium morrhuate was used as the sclerosing agent. Four and one half years following therapy, no recurrence of the tumor was noted. Radiographically, the area of involvement had become significantly more dense, with an increase in size and calcification of phleboliths in the area.

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