The biological impact of exogenous, alternating electric fields (AEFs) and direct-current electric fields has a long history of study, ranging from effects on embryonic development to influences on wound healing. In this article, we focus on the application of electric fields for the treatment of cancers. In particular, we outline the clinical impact of tumor treating fields (TTFields), a form of AEFs, on the treatment of cancers such as glioblastoma and mesothelioma. We provide an overview of the standard mechanism of action of TTFields, namely, the capability for AEFs (e.g., TTFields) to disrupt the formation and segregation of the mitotic spindle in actively dividing cells. Though this standard mechanism explains a large part of TTFields’ action, it is by no means complete. The standard theory does not account for exogenously applied AEFs’ influence directly upon DNA nor upon their capacity to alter the functionality and permeability of cancer cell membranes. This review summarizes the current literature to provide a more comprehensive understanding of AEFs’ actions on cell membranes. It gives an overview of three mechanistic models that may explain the more recent observations into AEFs’ effects: the voltage-gated ion channel, bioelectrorheological, and electroporation models. Inconsistencies were noted in both effective frequency range and field strength between TTFields versus all three proposed models. We addressed these discrepancies through theoretical investigations into the inhomogeneities of electric fields on cellular membranes as a function of disease state, external microenvironment, and tissue or cellular organization. Lastly, future experimental strategies to validate these findings are outlined. Clinical benefits are inevitably forthcoming.

To report a novel approach for managing persistent lagophthalmos and eyelid contour abnormality after initial gold weight implantation. Paralytic lagophthalmos is defective eyelid closure due to facial nerve damage. One common, effective treatment is lid loading with eyelid weights. By implanting a weight into the upper eyelid, gravity is used to help close the eyelid, decrease corneal exposure, and prevent further disease such as exposure keratopathy. This case details a patient with paralytic lagophthalmos post resection of a vestibular schwannoma. She underwent gold weight implantation but still experienced incomplete eyelid closure and altered eyelid contour. Instead of performing common revision procedures such as repositioning or replacing the weight, a second, smaller, gold weight was added in the same eyelid. Placement of a second gold weight in the same eyelid may represent a simple alternative to revision and replacement of initial gold weight.

A 66-year-old female with a past medical history of psoriasis and chronic sinusitis presented with left orbital pain, proptosis, ptosis, and blurry vision, concerning for orbital cellulitis. Imaging revealed an enhancing soft tissue mass centered in the left anterior ethmoid cavity with extension into the nasolacrimal duct, with associated osseous erosion and orbital inflammatory changes consistent with ipsilateral orbital cellulitis. Endoscopic surgical resection was performed, and histopathology confirmed inverted papilloma without high-grade dysplasia or carcinoma. While orbital involvement has been described in prior reports, presentation with secondary infectious complications such as orbital cellulitis is rare. This case expands the limited, yet growing, body of literature on the various clinical presentations of orbital inverted papilloma.