Surgical Management of the Internal Nasal Valve: A Review of Surgical Approaches.

Background: Nasal valve collapse is relatively common with a lifetime prevalence of up to 13%. Etiologies include prior rhinoplasty, other surgical procedures, facial paralysis, congenital defects, trauma, and aging. Internal nasal valve collapse leads to impairment of nasal breathing, which significantly disturbs quality of life.

Facial nerve transfer for facial reanimation with parotidoplasty approach.

Background: Facial paralysis has a profound impact on quality of life in affected individuals, primarily through loss of verbal and nonverbal communication. Common facial nerve reanimation techniques include coaptation to the masseteric or hypoglossal nerve. Most techniques require nerve grafts to achieve a tension-free neurorrhaphy.

Computational analysis of swallowing mechanics after surgery for obstructive sleep apnea.

Multilevel upper airway surgery for obstructive sleep apnea (OSA) has been shown to cause clinically significant dysphagia in some patients. We describe the cases of 2 adults with OSA who developed persistent dysphagia after multilevel upper airway surgery. Patient-specific computational analysis of swallowing mechanics (CASM) revealed absent pharyngeal shortening and aberrant tongue base retraction in both patients.

Landmarks for endoscopic approach to the parapharyngeal internal carotid artery: a radiographic and cadaveric study.

Objectives/hypothesis: To define transnasal endoscopic surgical landmarks for the parapharyngeal segment of the internal carotid artery (ppICA) using radiographic analysis and cadaveric dissection.

Study Design: Cadaveric and radiographic study.

Methods: One hundred seventy-nine computed tomography angiography studies of the head and neck were analyzed using Osirix third-party software (Pixmeo, Geneva, Switzerland).

Analysis of the petrous portion of the internal carotid artery: landmarks for an endoscopic endonasal approach.

Objectives/hypothesis: While there are many benefits to the endoscopic endonasal approach to the infratemporal fossa, involvement of the petrous portion of the internal carotid artery (ICA) poses a unique challenge. The endoscopic endonasal approach requires establishing the relationship of the petrous ICA to anatomical landmarks to guide the surgeon. This study evaluates the relationship of petrous ICA to specific anatomic landmarks, both radiographically and through cadaveric dissections.

Trans-oral robotic submandibular gland removal.

Submandibular gland excision is traditionally performed via a trans-cervical approach. While generally regarded as a relatively simple surgical procedure, several complications are possible, including injury to the marginal mandibular branch of the facial nerve, lingual nerve, hypoglossal nerve, facial artery and a visible unsightly neck scar or keloid. The trans-oral route has the ability to eliminate a cervical scar and decrease risk of injury to several structures.

Evaluating the adult patient with a neck mass.

The objective of this article is to provide the internist with general considerations when confronted with an adult patient presenting with a neck mass. A thorough gathering of historical information and a complete physical examination are crucial in developing a differential diagnosis for these patients. Specifically, the location of the mass, its time of onset, and duration are important because of the high likelihood of neoplastic processes in patients older than 40 years.

Nondestructive imaging of live human keloid and facial tissue using multiphoton microscopy.

Objectives: To use multiphoton microscopy to image collagen fibers and matrix structure in nonfixed human keloid tissue and normal human facial skin obtained following surgery and to compare the findings to existing knowledge of normal skin and keloid morphology to determine if this technology is a suitable adjunct for conventional histology.

Methods: Epidermis was removed to expose the fibroblast-rich dermal layer that was then imaged using a multiphoton confocal microscope (Zeiss-Meta 510; Carl Zeiss, Jena, Germany). An 800-nm tunable titanium/sapphire femtosecond laser (Mai-Tai; Newport Co Spectra-Physics, Mountain View, California) was used to excite the tissue; second harmonic generation between 397 and 408 nm and autofluorescent signals were collected.

Carcinoma of the oral pharynx: an analysis of subsite treatment heterogeneity.

The data indicate that SCC of the various subsites of the oropharynx can be treated successfully with acceptable locoregional control and survival rates by using either surgery or primary radiotherapy for TI or T2 primary lesions. Treatment success data for late-stage disease (T3 and T4) are less encouraging. regardless of which modality is used or which treatment center is administering treatment.

Potential biomarkers for head and neck squamous cell carcinoma.

Objective: The purpose of the study was twofold: 1) to search for potential biomarkers that were overexpressed in cell lines that could represent both a clinical premalignant (immortalized) and a malignant state, and 2) to attempt to correlate metallothionein gene expression with clinical outcome in laryngeal carcinoma.

Study Design: A series of in vitro experiments were used to unearth differentially expressed genes among normal, immortalized and tumorigenic cell lines. Secondarily, a retrospective analysis was undertaken.

Primary hyperparathyroidism secondary to simultaneous bilateral parathyroid carcinoma.

Parathyroid carcinoma is a rare malignancy, and experience with its management is limited. It is generally accepted that surgery is the treatment of choice, and the initial operative intervention might represent the only chance for long-term success. At the time of surgery, a high index of suspicion for carcinoma is vital to performing the appropriate surgical procedures, because frozen-section diagnosis of parathyroid carcinoma is notoriously unreliable.