Browsing by Author "Magdycz, William P."

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    Diagnosis and Treatment of a Benign Pediatric Mandible Tumor
    Joy, Matthew T.; Liao, Christopher D.; Magdycz, William P.; Parulis, Albert W.; Thompson, James D. (Ovid Technologies, 2019-10-15)
    Pediatric mandible tumors are rare and generally benign but can be locally aggressive. Diagnosis and treatment involve tumor identification, excision, and subsequent reconstruction. Successful reconstruction should address form and function of the mandible while minimizing morbidity. The authors review the diagnosis and treatment of a benign pediatric mandible tumor and the use of nonvascularized rib graft for mandible reconstruction. The subject of interest is an 8-year-old boy who presented with progressive left-sided facial swelling and examination findings concerning for a mandibular neoplasm. A large bony tumor of the left mandibular ramus and condyle was identified on computed tomography scan. Needle aspiration was performed but was nondiagnostic. The patient underwent en bloc resection and immediate reconstruction utilizing nonvascularized rib graft. Pathologic analysis demonstrated a benign fibro-osseous lesion consistent with fibrous dysplasia, ossifying fibroma, or aneurysmal bone cyst. The patient had excellent recovery of jaw function and resumption of solid diet 5 weeks after reconstruction. Mandibular defects >6 cm in length often require free vascularized bone flaps for reconstruction; however, these procedures can have greater morbidity in the skeletally immature patient. Nonvascularized rib graft is a viable alternative that also allows for reconstruction of the mandibular condyle using the costocartilagenous cap of the harvested rib. The authors present this case as an example of a rare pediatric head and neck tumor and review of the approach to diagnosis and treatment, including special considerations for complex pediatric mandibular reconstruction.
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    Nonsyndromic bilateral second branchial cleft fistulae: A case report
    Worden, Cameron P.; Michaels, Kenan C.; Magdycz, William P. (Elsevier, 2021-04-27)
    Branchial cleft anomalies are rare congenital malformations that result from the abnormal persistence of branchial clefts during embryogenesis and manifest clinically as cysts, sinuses, or fistulae. In greater than 95% of cases, branchial cleft anomalies originate from remnants of the second branchial cleft. Identification of branchial cleft anomalies, particularly branchial cleft fistulae, are clinically important as these findings may be part of a larger syndromic clinical presentation such as the branchiootorenal syndrome, which necessitates further workup. Branchial cleft anomalies are bilateral in approximately one percent of cases; however, bilateral second branchial cleft fistulae are, for unknown reasons, much rarer. To the best of our knowledge, there have been less than ten cases of nonsyndromic, bilateral second branchial cleft fistulae recorded in the literature. In this report, we present the CASE of a 50-year-old woman with recent left-sided pain, drainage, and swelling in the lower one-third of her neck. The patient reported a history of bilateral “cysts” in the lower one-third of her neck for most of her adult life, which frequently become infected. She denied a personal or family history of renal anomalies or hearing loss. Computed tomography scan with intravenous contrast of the soft tissues of the neck revealed bilateral soft tissue tracts beginning in the region of the tonsillar fossae and extending bilaterally along the anterior borders of the sternocleidomastoid muscle (SCM) down to the skin surface near the level of the thyroid gland, consistent with bilateral second branchial cleft fistulae.