Migration of Broken Dental Needle Through the Internal Jugular Vein in the Parapharyngeal Space.

Accidental broken dental needles during dental blocks have become a rare occurrence but still occur. Although the treatment for such occurrence is controversial, an increasing body of literature demonstrates that migration of such needles is possible. In this case, we report on a 48-year-old male with migration of a broken dental needle from an inferior alveolar block.

Detection of Head and Neck Cancer Based on Longitudinal Changes in Serum Protein Abundance.

Background: Approximately 85% of the U.S. military active duty population is male and less than 50 years of age, with elevated levels of known risk factors for oropharyngeal squamous cell carcinoma (OPSCC), including smoking, excessive use of alcohol, and greater numbers of sexual partners, and elevated prevalence of human papilloma virus (HPV).

Total Auricular Rehabilitation: Combined Cosmetic and Functional Lateral Temporal Bone Reconstruction.

Objective: The aim of the study was to describe 3 cases of total auricular rehabilitation, including the novel use of iliac crest bone grafts to support bone-anchored auricular prostheses.

Study Design: This study is a retrospective case series from a single institution.

Results: Three cases with large lateral temporal bone and soft tissue defects were successfully treated with total auricular rehabilitation.

Voice outcomes after total thyroidectomy, partial thyroidectomy, or non-neck surgery using a prospective multifactorial assessment.

Background: Voice alteration remains a significant complication of thyroid surgery. We present a comparison of voice outcomes between total thyroidectomy (TT), partial thyroidectomy (PT), and non-neck (NN) surgery using a multifactorial voice-outcomes classification tool.

Study Design: Patients with normal voice (n = 112) were enrolled between July 2004 and March 2009.

Microvascular reconstructive surgery in Operations Iraqi and Enduring Freedom: the US military experience performing free flaps in a combat zone.

Background: Local nationals with complex wounds resulting from traumatic combat injuries during Operations Iraqi Freedom and Enduring Freedom usually must undergo reconstructive surgery in the combat zone. While the use of microvascular free-tissue transfer (free flaps) for traumatic reconstruction is well documented in the literature, various complicating factors exist when these intricate surgical procedures are performed in a theater of war.

Methods: The microvascular experiences of six military surgeons deployed during a 30-month period between 2006 and 2011 in Iraq and Afghanistan were retrospectively reviewed.

Primary squamous cell carcinoma of the thyroid gland: a case report and review.

Background: Primary squamous cell carcinoma (SCC) of the thyroid gland is a rare malignancy that presents with advanced disease and poor prognosis.

Methods: A 75-year-old woman with a history of Hashimoto thyroiditis presented with 6 months of dysphagia and stridor. Imaging revealed a thyroid mass invading the larynx.

The role of listener experience on Consensus Auditory-perceptual Evaluation of Voice (CAPE-V) ratings of postthyroidectomy voice.

Purpose: To determine whether experienced and inexperienced listeners rate postthyroidectomy voice samples similarly using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V).

Method: Prospective observational study of voice quality ratings of randomized and blinded voice samples was performed. Twenty-one postthyroidectomy patients' voices, representing a wide range of severities, were rated using a custom-automated version of the CAPE-V.

Functional voice outcomes after thyroidectomy: an assessment of the Dsyphonia Severity Index (DSI) after thyroidectomy.

Background: The Dysphonia Severity Index (DSI) is an objective multiparametric acoustic calculation of vocal function; however, its changes after thyroidectomy have not yet been described.

Methods: Patient-reported symptoms, as well as auditory perceptual, acoustic, and videolaryngostroboscopic (VLS) data, were collected prospectively before and after thyroidectomy. Voice outcomes (normal versus negative voice outcome [NVO]) at 6 months after thyroidectomy were based on a combination of voice symptoms and objective findings.

Prospective trial of voice outcomes after thyroidectomy: evaluation of patient-reported and clinician-determined voice assessments in identifying postthyroidectomy dysphonia.

Background: Reliable voice grading systems to identify postoperative voice dysfunction by surgeons are needed.

Purpose: To examine the utility of patient-reported and clinician-determined voice assessment in identifying postthyroidectomy voice dysfunction.

Patients And Methods: Fifty patients enrolled in a prospective observational trial evaluating voice function perioperatively by patient-reported symptoms (Voice Case History [VCHx]) and perceived voice handicap (Voice Handicap Index [VHI]), clinician-determined judgment of voice quality (Consensus Auditory-Perceptual Evaluation--Voice [CAPE-V]), and laryngeal examination via video laryngoscopy (VLS).

The functional impact on voice of sternothyroid muscle division during thyroidectomy.

Background: Post-thyroidectomy voice dysfunction may occur in the absence of laryngeal nerve injury. Strap muscle division has been hypothesized as one potential contributor to dysphonia.

Methods: Vocal-function data, prospectively recorded before and after thyroidectomy from two high-volume referral institutions, were utilized.

Revision lateral skull base surgery.

Objective: To describe functional and reconstructive results after revision lateral skull base surgery with comparison of benign and malignant lesions.

Study Design: Retrospective case review.

Setting: Tertiary referral center.

Squamous cell carcinoma of the oropharynx and hypopharynx.

Oropharyngeal and hypopharyngeal squamous cell carcinomas require an interdisciplinary approach to manage patients appropriately. Tumor stage and histology, functional outcome, and patient comorbidities are important factors to consider. Various surgical approaches as well as chemotherapy and radiation therapy alone or in combination remain the mainstay of therapy.

Tumors of the accessory lobe of the parotid gland: a 10-year experience.

Objectives/hypothesis: The differential diagnosis of midcheek masses include pathology arising from normal anatomic structures or from variations of normal accessory parotid gland tissue. Accessory parotid gland tissue has been described as salivary tissue adjacent to Stenson's duct that is separate from the main body of the parotid gland. We report our 10-year experience with the diagnosis and treatment of eight accessory parotid gland neoplasms that have been followed by the senior authors.

Glomus jugulare tumors with intracranial extension.

Glomus tumors provide unique surgical challenges for both tumor resection and defect reconstruction. Tumors with intracranial extension compound these challenges. Surgical techniques have evolved, and now, with a multidisciplinary team, single-stage surgeries are the standard.

Use of the anterolateral thigh flap for reconstruction of the head and neck.

Purpose Of Review: The anterolateral thigh free flap has achieved recent popularity in North America for the reconstruction of head and neck defects after ablative surgery. The flap is most often based on either the septocutaneous or musculocutaneous perforators of the descending branch of the lateral circumflex femoral artery. Its versatility allows for a subcutaneous, fasciocutaneous, myocutaneous, or adipofascial flap to be obtained.

Current concepts in lip reconstruction.

Purpose Of Review: Approximately 25% of all oral cavity carcinomas involve the lips, and the primary management of these lesions is complete surgical resection. The management of the resulting lip defect remains a significant reconstructive challenge, requiring meticulous preoperative planning and surgical technique to optimize the functional and cosmetic outcome. Reviewed here are the accepted techniques of lip reconstruction, as well newer techniques that have been reported.

Gaze-evoked amaurosis: a report of five cases.

Objective: To highlight the various causes of gaze-evoked amaurosis.

Design: Retrospective noncomparative interventional case series.

Participants: Five patients treated at our facility over the past 6 years.