Transoral robotic surgery for treatment of obstructive sleep apnea-hypopnea syndrome.

Objectives/hypothesis: To evaluate the efficacy of base of tongue (BOT) resection via transoral robotic surgery (TORS) in the treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS).

Study Design: Case series

Methods: Between June 2010 and May 2012, BOT resection via TORS was performed on 27 patients with OSAHS. Patients were excluded from this analysis if other concomitant upper airway procedures such as uvulopalatopharyngoplasty were performed, or if postoperative polysomnograms were not available.

Single-incision transaxillary robotic thyroidectomy: challenges and limitations in a North American population.

Objective: We reviewed our initial experience with robotic thy-roidectomy to identify challenges and limitations of this new surgical approach when applied to a North American population.

Study Design: Case series.

Setting: Academic institution.

Sinonasal mucosal melanoma: a 13-year experience at a single institution.

Objective: Report the experience of the Karmanos Cancer Institute with sinonasal mucosal melanoma (SNMM) in patients diagnosed between 1995 and 2007.

Results: Eighteen patients, ages 31 to 85 (mean, 67), whose most common presenting symptoms included epistaxis and facial pressure. Most common anatomic locations were the maxillary sinus and nasal cavity.

Cartilage grafts in dorsal nasal augmentation of traumatic saddle nose deformity: a long-term follow-up.

Objectives/hypothesis: To document the long-term advantages and disadvantages of cartilage grafts used to correct traumatic saddle nose deformity. Additionally, to demonstrate functional improvement and cosmetic satisfaction with the use of this graft.

Study Design: Retrospective chart review and prospective follow-up telephone survey of 20 patients after dorsal augmentation of saddle nose deformity secondary to trauma.

Conservative management of iatrogenic esophageal perforation in head and neck cancer patients with esophageal stricture.

Objective: Evaluate the efficacy of conservative management of iatrogenic esophageal perforation following dilatation of a stricture secondary to the treatment of head and neck cancer.

Study Design: Case series with chart review.

Subjects And Methods: Retrospective chart review of 24 patients with esophageal perforation treated at the Detroit Medical Center from 1999 to 2008.

Craniocervical necrotizing fasciitis with and without thoracic extension: management strategies and outcome.

Objective: First objective was to review cases of craniocervical necrotizing fasciitis (CCNF) at Wayne State University/Detroit Medical Center (Detroit, MI) for the last 18 years. Second was to analyze patients with and without thoracic extension for contributing factors.

Methods: Retrospective review of 660 patients with necrotizing fasciitis treated at WSU/DMC from January 1989 to January 2007 was conducted.

Tongue base schwannoma: report, review, and unique surgical approach.

Base of tongue schwannomas are exceedingly rare and therefore often are not immediately included in the differential diagnosis and treatment of oropharyngeal tumors. After a thorough review of the English literature, we found only 6 previously reported cases of tongue base schwannomas. We are contributing a report of a 37-year-old woman with progressive dysphagia, dysarthria, and large tongue base schwannoma.

Cell carcinoma of the paranasal sinuses and skull base.

Purpose: To evaluate patients with squamous cell carcinoma of the paranasal sinus and skull base for factors that might predict clinical outcome.

Methods: A multi-institutional 13-year retrospective review of anterior skull base malignancies.

Results: Of 73 patients with anterior skull base malignancies, squamous cell carcinoma was the most prevalent-30 patients or 41%.

Facial fracture repair in the traumatic brain injury patient.

Purpose: To review the surgical complications of patients who had facial fractures repairs in the setting of a traumatic brain injury (TBI).

Patients And Methods: A review of all individuals admitted with the diagnosis of TBI based on an evaluation by the neurotrauma service who also underwent facial fracture repair was performed. More than 600 charts were reviewed and 99 patients met study criteria.

Functional outcomes of the retromaxillary-infratemporal fossa dissection for advanced head and neck/skull base lesions.

The retromaxillary-infratemporal fossa (RM-ITF) dissection, using a preauricular incision, was initially popularized for the treatment of temporomandibular joint disorders, facial fractures, and orbital tumors. This approach has been expanded for the treatment of advanced head and neck and skull base tumors extending into the infratemporal fossa. We studied prospectively eight consecutive patients requiring a RM-ITF dissection.

Visual risks of facial fracture repair in the setting of traumatic optic neuropathy.

Objective: To identify whether facial fracture repair in patients with traumatic optic neuropathy results in visual deterioration.

Design: A retrospective analysis was performed of all patients admitted from 1992 through 1997 with the diagnosis of facial fracture and traumatic optic neuropathy. Vision was recorded before and after fracture repair using logarithm of the minimum angle of resolution measurements.

Acinic cell carcinoma of the parotid gland: a 15-year review limited to a single surgeon at a single institution.

The course of acinic cell carcinoma of the parotid gland following surgical and nonsurgical interventions is variable. The objective of this study was to report our experience in treating this disease and to evaluate the factors that might be involved in the treatment of the tumor and the prognosis of the patient. To limit the contributory variables that are usually found in most studies, we included only those patients (n = 11) who had been treated by a single surgeon at a single institution from 1988 through 2003.

Human papillomavirus (HPV) transcripts in malignant inverted papilloma are from integrated HPV DNA.

Objectives: The objectives of the study were to detect human papillomavirus (HPV) sequences in nasal inverted papilloma (IP) lesions and to determine whether HPV is involved in the progression of IP to sinonasal squamous cell carcinoma (SCC).

Study Design: A retrospective study was performed on 14 patients diagnosed with IP within the last 12 years. Three of these 14 patients developed SCC.

Integration of human papillomavirus type 11 in recurrent respiratory papilloma-associated cancer.

Objectives/hypothesis: The main objective was to demonstrate that human papillomavirus (HPV) type 11 is an aggressive virus that plays a significant role in the development of laryngeal cancer in patients with a history of recurrent respiratory papillomatosis (RRP). We have done so by preliminary investigation into the molecular mechanism underlying the malignant transformation of RRP to invasive squamous cell carcinoma.

Study Design: An experimental, nonrandomized, retrospective study using tissue specimens from nine patients with a history of RRP that progressed to laryngeal or bronchogenic cancer was performed.

Transoral versus extraoral reduction of mandible fractures: a comparison of complication rates and other factors.

Objective: This retrospective study evaluates results and complications of the transoral and extraoral approaches for open reduction and internal fixation of mandibular body, angle, and ramus fractures. Our aim was to describe advantages and disadvantages of the techniques and to develop criteria for choosing between surgical approaches.

Study Design And Setting: A retrospective chart review was performed on patients with mandible fractures occurring between August 1999 and October 2001 at a level I trauma center.

Hypothesis: research in otolaryngology is essential for continued improvement in health care.

The present report, in the form of a research proposal, is based on the hypothesis that research in otolaryngology is essential for continued improvement in health care. Examples of advances in otolaryngology as a result of research are noted, but for continued success, otolaryngology must maintain and find better ways to train clinically directed researchers. Traditional methods of training such as hands-on experience, courses in the basic principles of research, protected time, and mentoring are discussed and evaluated.

A comparison of parietal and iliac crest bone grafts for orbital reconstruction.

Purpose: This study evaluated the results of cranial (membranous) versus iliac crest (endochondral) bone grafts as implants to correct post-traumatic globe malposition and/or diplopia.

Patients And Methods: Twenty-two patients underwent 25 orbital reconstructions with bone for enophthalmos, hypophthalmos, and diplopia after trauma to the orbit. Inclusion criteria consisted of at least 4 months postsurgical follow-up, pre- and postsurgical quantitative orbital measurements, photographic documentation, and complete medical records regarding inpatient and outpatient data.

Craniocervical necrotizing fasciitis: an 11-year experience.

Objective: We review our experience and present our approach to treating craniocervical necrotizing fasciitis (CCNF).

Study Design: All cases of CCNF treated at Wayne State University/Detroit Receiving Hospital from January 1989 to April 2000 were reviewed. Patients were analyzed for source and extent of infection, microbiology, co-morbidities, antimicrobial therapy, hospital days, surgical interventions, complications, and outcomes.

Titanium mesh repair of the severely comminuted frontal sinus fracture.

Background: Severely comminuted frontal sinus fractures are difficult to contour and immobilize. Frequently, plates or wires are inadequate in fixating all fragments together, resulting in less than optimal outcomes. Advancements in the development of biomaterials have now made titanium mesh a new option for the repair of severely comminuted fractures.

An unusual subdural empyema: case report.

Subdural empyema in a 38-year-old patient with congenital hemangioma, suppurative parotitisis, soft tissue phlegmonia and osteomyelitis is reported. The clinical, radiological and surgical features are outlined. A review of the literature reveals the uniqueness of this case.

Nasal alar necrosis.

Objective: To describe an unrecognized clinical entity, nasal alar necrosis, and propose recommendations regarding the diagnosis, pathophysiology, and management of these cases.

Study Design: Retrospective review of four patients with this condition.

Methods: Histories, treatments, and outcomes were evaluated using office and hospital chart data.

Videostroboscopy of the pharyngoesophageal segment in laryngectomy patients treated with botulinum toxin.

Objectives: The purpose of this investigation was to use videostroboscopy to study the physiologic and biomechanical effects of botulinum toxin (Botox) injection on the pharyngoesophageal segment (PES) in total laryngectomy patients with poor-quality tracheoesophageal puncture (TEP) voice caused by PES spasm.

Methods: The following was a prospective study. Videostroboscopy of the PES and videotaped recordings of patients performing TEP voice tasks were conducted before and after Botox injection of the PES.

Nonunion of the mandible: an analysis of contributing factors.

Purpose: The aim of this study was to review our experience of nonunion of mandible fractures and to compare this information with the past and present literature. The analysis also evaluated risk factors and those conditions that lead to nonunion so that the complication may be better managed and possible avoided.

Patients And Methods: A retrospective review of mandible fractures in a major medical center was carried out on patients treated from 1994 through 1998.