Practice analysis: techniques of head and neck surgeons and general surgeons performing thyroidectomy for cancer.

Objective: Medical practice governance is made more challenging by the fact that many procedures may be performed by various medical or surgical specialties. Thyroid cancer surgery is performed by both physicians with general surgery (GS) and those with otolaryngology/head and neck surgery (HNS) credentials. Analyses describing differences in practice patterns between the 2 services have not been published previously.

Head and neck manifestations of disseminated coccidioidomycosis.

Objectives/hypothesis: Coccidioidomycosis is a fungal disease endemic to semiarid regions in the southwestern United States, northern Mexico, and parts of South America. Although this is primarily a pulmonary disease, approximately 0.5% to 1.

Wegener granulomatosis presenting as an infiltrative retropharyngeal mass with syncope and hypoglossal paresis.

We describe a woman who presented with syncopal episodes and unilateral hypoglossal paresis in association with a highly infiltrative retropharyngeal mass. After an extensive malignancy workup, the patient was found to have Wegener granulomatosis (WG), an autoimmune necrotizing vasculitis that presents with inflammatory lesions anywhere in the respiratory tract and variable renal involvement. The archetypal presentation in the head and neck is erosive sinonasal crusting, though otologic, pharyngeal, and laryngeal findings are common.

Follow-up of head and neck cancer patients post-radiotherapy.

Diverging opinions exist regarding follow-up studies post-radiotherapy for head and neck cancer. This report describes the efficacy of follow-up physical examinations, thyroid function tests and screening chest X-rays in post-radiotherapy patients in a practice analysis schema. This analysis suggests that physical examination and thyroid function testing remain valid parts of routine follow-up for head and neck cancer patients; chest X-rays appear less vital unless the patient's clinical situation warrants aggressive therapy of a second primary lung cancer.

Merkel cell carcinoma arising in the head and neck: optimizing therapy.

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine dermal neoplasm. Because of the limited number of cases described in the literature (approximately 600 to date), statistically significant data regarding treatment are difficult to obtain. The majority of MCC cases affect the head and neck and are thought to be caused by the actinic damage associated with sun exposure.