Improved outcomes in patients with head and neck cancer using a standardized care protocol for postoperative alcohol withdrawal.

Objective: To show clinical benefit in the main outcome measures by the use of a standardized protocol for identification, characterization, and treatment of alcohol withdrawal syndrome (AWS) in postoperative patients with head and neck cancer.

Design: Prospective cohort study with a retrospective cohort control.

Setting: Tertiary care university.

Laryngeal trauma in sport.

The larynx and surrounding soft tissues are vulnerable to injury during athletics despite protective equipment and rule modifications. Laryngeal injuries are uncommon but potentially fatal conditions that pose risks to the voice, airway, and esophagus of athletes who sustain blunt or penetrating neck trauma. Common symptoms and signs of laryngeal trauma include hoarseness, dyspnea, hemoptysis, dysphonia, respiratory distress, anterior neck tenderness, subcutaneous emphysema, and loss of normal laryngeal architecture.

Surgery and postoperative radiotherapy for squamous cell carcinoma of the larynx and pharynx.

Objective: To determine the rates of local-regional control, survival, and complications for patients treated with postoperative radiation for squamous carcinomas of the larynx, hypopharynx, and oropharynx.

Methods: There were 295 patients with previously untreated squamous cell carcinomas of the larynx (n = 199), hypopharynx (n = 80), and oropharynx (n = 16) treated postoperatively with radiotherapy (RT).

Results: Five-year local-regional control rates according to site and pathologic American Joint Committee on Cancer (AJCC) stage were: stage III larynx, 89% versus stage IVA larynx, 85% (P = 0.

Postoperative radiotherapy for squamous cell carcinoma of the head and neck.

This review discusses the role of postoperative radiotherapy (RT) for patients with squamous cell carcinoma of the head and neck. Patients with unfavorable pathologic features have a high-risk of local-regional recurrence and a decreased likelihood of survival after surgery alone. Postoperative RT reduces the risk of local-regional failure and probably improves survival.

Definitive radiotherapy for tonsillar squamous cell carcinoma.

Purpose: The purpose of this study is to update our experience with definitive radiotherapy (RT) for carcinoma of the tonsillar area.

Patients And Methods: There were 503 patients treated between October 1964 and May 2003 (potential follow-up for at least 2 years). Of these, 198 patients underwent a planned neck dissection and 57 patients received induction (18 patients) or concomitant (39 patients) chemotherapy.

Evaluation of the thyroid nodule.

Background: Thyroid nodules are common, yet treatment modalities range from observation to surgical resection. Because thyroid nodules are frequently found incidentally during routine physical examination or imaging performed for another reason, physicians from a diverse range of specialties encounter thyroid nodules. Clinical decision making depends on proper evaluation of the thyroid nodule.

Corticosteroid response and supporting cell antibody in autoimmune hearing loss.

Objective: To determine whether antibodies to supporting cells are associated with response to corticosteroids in patients with autoimmune sensorineural hearing loss.

Design: Prospective analysis of antibody to inner-ear antigens.

Setting: Collaborating otology practices in Pennsylvania, Michigan, and Indiana.

Otolaryngology-head and neck surgery residency match: applicant survey.

Objective: To examine satisfaction with the match process and reported failures to comply with the match rules among applicants of the January 2002 Otolaryngology-Head and Neck Surgery match.

Design: A survey was mailed to all applicants completing the 2002 San Francisco Matching Program match.

Participants: Surveys were mailed to 312 applicants, and the 151 returned surveys were entered into a database, which was then subjected to statistical analysis.

Identification and characterization of choline transporter-like protein 2, an inner ear glycoprotein of 68 and 72 kDa that is the target of antibody-induced hearing loss.

The Kresge Hearing Research Institute-3 (KHRI-3) antibody binds to a guinea pig inner ear supporting cell antigen (IESCA) and causes hearing loss. To gain insight into the mechanism of antibody-induced hearing loss, we used antibody immunoaffinity purification to isolate the IESCA, which was then sequenced by mass spectroscopy, revealing 10 guinea pig peptides identical to sequences in human choline transporter-like protein 2 (CTL2). Full-length CTL2 cDNA sequenced from guinea pig inner ear has 85.

Oxaprozin-induced symptomatic hepatotoxicity.

Objective: To describe a case of symptomatic hepatotoxicity attributed to oxaprozin use.

Case Summary: A 41-year-old white woman was admitted to the hospital with malaise, anorexia, and right upper quadrant pain. The patient was found to have severe jaundice with liver enzyme elevation.

Gastric ulceration as a complication of hepatic artery infusion chemotherapy.

Based upon the cases reported in this paper and upon a literature review encompassing 1,783 patients having received HAIC, it is our opinion that upper gastrointestinal tract ulceration is a potentially significant complication of hepatic artery infusion chemotherapy. In addition, we believe that the mechanism responsible for HAIC-induced ulceration often involves direct perfusion of the gastric arterial supply with chemotherapeutic agents. The occurrence of ulcerations in patients with surgically placed catheters is disconcerting, and does not allow for any apparent easy method of alleviating HAIC-induced ulceration.

The treatment of retained stones in the common bile duct with sodium cholate infusion.

Six patients with stones retained in the common bile duct after cholecystectomy and common duct exploration were treated by intraductal infusion of a sodium cholate solution. In the five patients whose stones were between the T-tube and the duodenum the treatment was successful within a few days. A stone became transiently impacted in the ampullary region soon after beginning therapy in three patients and produced mild pancreatitis in two.