Presentations of thyroglossal duct cysts in adults.

The thyroglossal duct cyst is the most common congenital neck mass, resulting from persistence and dilatation of remnants of an epithelial tract formed during migration of the thyroid during embryogenesis. Approximately 7% of the population has thyroglossal duct remnants. Although thyroglossal duct cysts generally present clinically in children, it is important to understand that the lesion can present in adults as well, sometimes much later in life.

Lymphadenopathy in the HIV-seropositive patient.

The problem of lymphadenopathy in HIV-seropositive patients is reviewed, and indications for further study are presented. Implications for patients who later develop AIDS are discussed.

Penetrating injuries involving the anterior cranial fossa.

Penetrating injuries of the anterior cranial fossa may result in permanent neurologic changes or even death if injuries are unrecognized and remain untreated. The diverse etiologies of such injuries are reviewed, as well as their diagnosis, treatment and prognosis.

Adenitis, adenopathy, and abscesses of the head and neck.

The emergency clinician will continue to be called on to evaluate inflammatory processes of the head and neck on a regular basis. We have attempted to describe the broad range of these problems, as well as our current considerations for diagnosis and management. Our goal has been to promote accurate diagnosis to allow early detection of situations calling for prompt medical or surgical intervention.

A traditional approach to surgery of the tonsils and adenoids.

Current indications and contraindications for tonsil and adenoid surgery are discussed and the surgical techniques used are reviewed. A philosophy for managing patients is presented.

Reconstruction of a mandible after shotgun trauma: report of case.

A case of massive facial trauma secondary to a shotgun injury has been presented. The method for managing soft tissue and bony defects incurred is discussed, and a method for reconstruction of the mandible with both an alloplastic implant and autogenous bone graft is detailed.

Management of the airway in patients with angioedema.

Angiodema can be frequently encountered in clinical practice, and usually represents transient areas of tissue edema and erythema. In general, lesions involve the deep dermis as well as subcutaneous or submucosal sites and can affect multiple organ systems, including the respiratory and gastrointestinal tracts. Although the underlying cause for the angioedema is frequently not known, it can result from atopy, specific antigen sensitivities, physical stimuli, as well as disorders that affect the complement cascade.

Ear disease in patients with Wegener's granulomatosis.

From a group of 60 patients with histologically-proven Wegener's granulomatosis managed at the National Institute of Allergy and Infectious Disease, approximately 45% were found to have disease that involved the ears. The majority of these patients had either recurrent or persistent serous otitis, resulting from eustachian tube dysfunction as a consequence of nasopharyngeal inflammations. Other pathologies included suppurative otitis, cholesteatoma, facial nerve paralyses, temporal bone granulomata, and sensory hearing losses.

Recurrent cementifying fibroma of the jaws.

The cementifying fibroma is a benign fibro-osseous tumor of the jaws, and is generally believed to originate from the periodontal ligament. The tumor commonly presents as an asymptomatic mass lesion, and is usually well-circumscribed clinically so that conservative excisions have been the treatment of choice. From 1970-1980, 94 cases of cementifying fibromas involving either the maxilla or the mandible were accessioned by the Tumor Registry of the Armed Forces Institute of Pathology.

Squamous carcinoma of the uvula.

From a study of the clinical courses of nine patients with squamous carcinoma of the uvula and a review of the clinical literature involving such lesions, we have concluded that these tumors have a very poor prognosis when metastases occur, despite seemingly adequate initial therapy to the primary tumor. Consequently, we believe that more aggressive treatment (which may include irradiation of even subclinically involved neck nodes) should be considered.

Wegener's granulomatosis.

Wegener's granulomatosis is characterized by a necrotizing granulomatous vasculitis which can be found in both the upper and lower respiratory tracts and with either focal or proliferative glomerulonephritis. However, any organ system can be affected by the disease. Over the past 17 years, 47 patients with histologically proven Wegener's granulomatosis have been treated at the National Institute of Allergy and Infectious Disease.