Suction Blister Epidermal Grafting for Management of Eyelid Vitiligo: Special Considerations

BACKGROUND: Suction blister epidermal grafting is an established technique for the treatment of resistant and stable vitiligo especially over small and cosmetically important areas like the face. However, certain areas, such as lips and eyelids, require special considerations because of their anatomic peculiarities. PATIENTS AND METHODS: The current study was carried out on six patients of stable eyelid vitiligo, not responding to medical treatment. Suction blister was obtained from the thigh using the suction apparatus and the roof was grafted on to the dermabraded eyelid. Certain precautions were taken during the procedure, which will be highlighted in the current study. RESULTS: Response was excellent in all the patients in 3 to 6 months, with no complications. CONCLUSIONS: If carried out properly, suction blister technique is the procedure of choice for cosmetically important sites like eyelids.     

Osteochondral Fracture of the Fourth Metatarsal Head Treated by Open Reduction and Internal Fixation

Fracture of the metatarsal head is uncommon, and reports of isolated osteochondral fracture of the metatarsal head are rare. Because of the distal location of the fracture, it is difficult to achieve and maintain reduction, and potential complications include avascular necrosis and subchondral fatigue fracture. The authors present a case of an osteochondral fracture in a 40-year-old man, which was treated by open reduction and internal fixation with a single twist-off screw, with good results 12 months postoperatively.     

Adenoid hypertrophy presenting with systemic hypertension

A two and half year old male child was seen with systemic hypertension, left ventricular dysfunction, mitral regurgitation and congestive cardiac failure. Examination revealed adenoid hypertrophy. He was also suffering from obstructive sleep apnea. He was being treated with anti-hypertensive and anti-failure drugs. Adenoidectomy was performed following which obstructive sleep apnea symptoms disappeared and his cardiac status improved markedly. Subsequently he was weaned off anti-hypertensive and anti-failure therapy.     

Linear Nevus Sebaceus Syndrome with bilateral complex limbal choristomas and extraocular muscle involvement

A case of a child with bilateral fleshy limbal masses with a coloboma of the right upper lid is discussed. Systemic examination revealed two patches of alopecia on the right frontoparietal and right occipital areas of the scalp. Punch biopsy and histopathological examination led to the diagnosis of Linear Nevus Sebaceus Syndrome (LNSS) with bilateral complex limbal choristomas. The authors have stated that they do not have a significant financial interest or other relatioship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Treatment of pediatric femoral shaft fractures with titanium elastic nails–our experience

Management of femoral diaphyseal fractures in the age group of 6-16 years is controversial. There has been a resurgence worldwide for operative fixation in general and TENS (titanium elastic nailing system) in particular.We performed a retrospective review of pediatric femoral fractures treated by TENS. The data was collected from cases operated between July 2007 and June 2010 at Sohar Hospital, Oman.We had treated 16 children (14 boys and 2 girls) with TENS for femoral shaft fractures. The mean age was 12.5 years (range 7-16 years) and mean hospital stay was 7.6 days (range 4-15 days). All fractures were radio-graphically united at a mean of 7.5 weeks (range 5-10 weeks). The nails were removed in 14 children after a mean of 22 weeks (range 6-38 weeks) postoperatively. At follow-up, we had found leg length discrepancy of 1 cm in one child and 10° of internal rotational deformity in another. No angular deformity had occurred.Titanium elastic nailing seems to be a safe and effective method for the treatment of femoral shaft fractures in children between 7 and 16 years of age.     

Trigeminal Neuralgia in Pregnancy: A Management Challenge

Pregnancy is known to aggravate pre‐existing chronic painful conditions. Trigeminal neuralgia (TN), albeit a disease of the elderly, may afflict pregnant females, which can further complicate its management. Teratogenic effects of the commonly used drugs on the developing fetus limit pharmacological treatment. Moreover, safety of commonly performed interventional therapies is marred by their inherent fetomaternal effects and more importantly the risk for radiation effects on the fetus due to the use of fluoroscopy. This rare coexistence of TN in pregnancy has not been reported before. Here we present a case of TN in a young woman, whose pain was aggravated when she became pregnant, and she was treated successfully by conventional radiofrequency ablation of the Gasserian ganglion.     

26‐Year‐Old Man with a Cerebellar Mass

Medulloblastoma accounts for only 1% of all adult CNS tumors. Recently, we have encountered a case of medulloblastoma in a 26 year old man with divergent differentiation including myoblastic, glial, osteoblastic and chondroblastic differentiation. Here we present the results of immunohistochemical staining using several specific antibodies with a discussion and a review of literature.