This unique case of facial trauma with frontal sinus fracture secondary to e-cigarette explosion was managed using a combined open and endoscopic approach, allowing for the mucosa lining the frontal sinus and FSOT
to be adequately visualized and preserved.
The Diplomats in Residence and Recruitment staff prepare applicants for the FSOT
and Foreign Service Oral Assessment, holding sessions throughout the United States.
Along with a standard government job application form, the online FSOT application includes six Personal Narrative questions based on the six knowledge and skill categories in which a Foreign Service Officer is evaluated every year of his/her career: substantive knowledge, intellectual skills, communications skills, interpersonal skills, management, and leadership.
In between, the FSOT passer's file is reviewed by a Qualifications Evaluation Panel made up of trained senior Foreign Service Officers.
Another reason for revamping the Foreign Service intake process was to decrease the length of time between the FSOT and final placement on a register of eligibility for service with the State Department Foreign Service.
In earlier iterations of the test, a candidate could be on several registers, all those in which he/she received the minimum required score on the FSOT. Today, a candidate is listed only in his/her chosen career field, and, as the Department fills the classes of incoming Junior Officers, it begins at the top of the lists with invitations to join.
We retrospectively evaluated 12 patients who had received a frontal sinus stent that had been placed to keep the FSOT open (table 2).
After the osteoma was completely removed endonasally, the mucosa of the FSOT was also removed, and denuded bone was seen on all sides.
The frontal sinus opening was determined to be either (1) open so that the frontal sinus mucosa itself could be seen, (2) open but narrow so that the frontal sinus mucosa could not be assessed, (3) not visible because of the presence of polyps or scar tissue in the ethmoid, or (4) closed because of scarring in the FSOT. Additionally, all patients were asked to provide a subjective judgment of their own outcome according to four categories: (1) free of complaints or major improvement, (2) moderate improvement, (3) mild or no improvement, or (4) worse.
The goal of the stenting procedure was to prevent the closure of the FSOT by scar tissue.
However, it did prevent functional, relevant stenosis of the FSOT by scar tissue in 15 of the 21 sinuses.
Our study shows that long-term stenting of the FSOT was able to prevent restenosis by scar tissue in a large number of very difficult revision cases.