Irreversible hydrocolloid: an unusual presentation of esophageal obstruction.

Upper digestive tract obstruction can occur after ingestion of various types of foreign bodies. However to the best of our knowledge, no case of a near-total obstruction caused by an irreversible hydrocolloid has heretofore been reported in the literature. We present just such a case, and we discuss our preferred method of removing foreign bodies from the cervical esophagus.

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.

Swallowing function outcomes following nonsurgical therapy for advanced-stage laryngeal carcinoma.

The purposes of this study were to (1) evaluate swallowing function using both subjective and objective measures in patients treated nonsurgically for stages III and IV laryngeal squamous cell carcinoma, (2) assess the effect of time from treatment completion on swallowing function, and (3) assess sequelae associated with modality of treatment. To achieve these objectives, a retrospective study of 14 patients was conducted. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed and evaluated by three independent judges for seven functional criteria: standing secretions, valleculae spillage, valleculae residue, postcricoid residue, laryngeal penetration, aspiration, and cough.

Cymetra injection for unilateral vocal fold paralysis.

Cymetra has shown excellent tissue biocompatibility, a low rate of resorption, and no tissue reactivity when injected for treatment of facial wrinkling. On the basis of these findings, we hypothesize that injection of Cymetra into the thyroarytenoid muscle for treatment of glottal incompetence may demonstrate similar findings and lead to long-term improvement in voice quality and glottal gap closure. Ten patients with breathy dysphonia caused by unilateral vocal fold paralysis underwent transoral injection of Cymetra into the thyroarytenoid muscle.

Voice and deglutition functions after the supracricoid and total laryngectomy procedures for advanced stage laryngeal carcinoma.

Objectives: This investigation compared speech and deglutition functions after alternative surgical treatments for advanced stage laryngeal carcinoma: the supracricoid laryngectomy (SCL) versus the total laryngectomy (TL). Study design and setting Cohort investigation at Wayne State University School of Medicine.

Methods: Quantitative studies of laryngeal biomechanics, acoustic and speech aerodynamic features, and deglutition skills of these individuals were coupled to listener and patient self-impressions of speech and voice characteristics for group comparative analyses.

Functional outcomes following nonsurgical treatment for advanced-stage laryngeal carcinoma.

Objectives: Objectives were 1) to provide comprehensive evaluations of functional outcomes using perceptual and objective measures of patients treated nonsurgically for stages III and IV laryngeal squamous cell carcinoma and 2) to propose a standard battery of tests that can be used for appraising functional outcomes in this patient population.

Study Design: Retrospective study of 14 patients.

Methods: Perceptual measures of voice were obtained using blinded expert listener impression ratings and a validated quality of life questionnaire (Voice Handicap Index).

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.

The utility of chest radiography following percutaneous dilational tracheotomy.

Objective: To determine the need for routine chest radiography following percutaneous dilational tracheotomy (PDT).

Design: Retrospective chart review.

Setting: Tertiary care academic medical center.

Laryngeal anesthetization for the treatment of acquired disfluency: a case study.

Unlabelled: The subject of this case study is an adult who became severely disfluent after a motor vehicle accident in which he did not suffer significant injuries. His disfluency persisted for 4 months notwithstanding a short trial of speech therapy. Hyperfunctional phonation subsystem disturbances were identified on follow-up evaluations.

Fiberoptic examination of the pharyngoesophageal segment in tracheoesophageal speakers.

Objective: To describe a novel use of flexible fiberoptic endoscopy to examine the pharyngoesophageal segment, upper esophagus, and distal end of the tracheoesophageal prosthesis in patients who have undergone a total laryngectomy and a tracheoesophageal puncture.

Methods: Five patients with poor-quality or no tracheoesophageal voice were evaluated by a speech pathologist and an otolaryngologist. A flexible endoscope interfaced with a video monitoring device was introduced transnasally and passed through the pharyngoesophageal segment.

Functional outcomes after supracricoid laryngectomy.

Objectives: Local control and 5-year survival rates are similar for patients undergoing total laryngectomy and supracricoid laryngectomy for the treatment of advanced-stage laryngeal carcinoma. However, comprehensive studies of functional outcomes after supracricoid laryngectomy are lacking.

Study Design: Cohort study.

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.

Use of topical lidocaine in the treatment of muscle tension dysphonia.

This investigation explored the potential usefulness of topical lidocaine in the treatment of muscle tension dysphonia. Three patients with this disorder, who were previously unresponsive to standard voice therapy, were treated with lidocaine. In each case, the outcome was prompt, clinically significant, and sustained.

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.

Botulinum toxin injection of the cricopharyngeus muscle for the treatment of dysphagia.

Objective: This study was conducted to evaluate, subjectively and objectively, the diagnostic and therapeutic effects of botulinum toxin (Botox) in patients with dysphagia caused by cricopharyngeus (CP) muscle spasm and/or hypertonicity.

Methods: A retrospective chart review was done of 5 patients with normally functioning larynges treated with CP Botox injection for dysphagia caused by perceived spasm. Subjective measures of swallowing function after injection were obtained with a patient questionnaire.

Anti-CD3/anti-CD28 bead stimulation overcomes CD3 unresponsiveness in patients with head and neck squamous cell carcinoma.

Objectives: To test whether T-cell CD3 responses are altered in patients with advanced-stage head and neck squamous cell carcinoma (HNSCC) and whether anti-CD3/anti-CD28 (alphaCD3/alphaCD28) bead stimulation could reverse CD3 unresponsiveness.

Design: Anti-CD3 (alphaCD3) monoclonal antibody immobilized on tissue culture plastic was used to stimulate lymph node mononuclear cells (LNMCs) and peripheral blood mononuclear cells (PBMCs) from patients with advanced-stage HNSCC. Proliferation, T-cell phenotype, and cytokines were measured during 8-day in vitro stimulation.

Magnetic resonance imaging of the facial nerve in children with idiopathic facial paralysis.

The role of gadolinium-enhanced MRI (Gd-MRI) in the diagnosis of idiopathic facial paralysis (IFP) in children is not well defined. Fourteen children with IFP were evaluated to assess the use of Gd-MRI for the presence and pattern of enhancement and its usefulness in predicting the recovery of facial function. Six of 14 children had enhancement of the facial nerve on Gd-MRI, whereas 8 had none.

Anti-CD3/anti-CD28 monoclonal antibody-coated suture enhances the immune response of patients with head and neck squamous cell carcinoma.

Objective: To test whether anti-CD3/anti-CD28 (alphaCD3/alphaCD28) monoclonal antibodies could be coated on surgical suture and used to enhance T-cell immune function in patients with advanced-stage head and neck squamous cell carcinoma (HNSCC).

Design: AlphaCD3/alphaCD28 monoclonal antibodies at varying concentrations and ratios were coated on surgical sutures and tested on peripheral blood mononuclear cells from normal donors to identify the optimal stimulating condition. Immune-enhancing properties of alphaCD3/alphaCD28 monoclonal antibody suture were tested on peripheral blood mononuclear cells and regional lymph node mononuclear cells isolated from patients with advanced HNSCC and on normal donor peripheral blood mononuclear cells.

Nasal alar reconstruction: a critical analysis using melolabial island and paramedian forehead flaps.

Objectives: To qualitatively and quantitatively describe aesthetic and functional outcomes following Mohs ablative surgery involving the alar subunit, using a paramedian or subcutaneous melolabial island flap.

Study Design: Retrospective review.

Methods: A single surgeon's results in 38 consecutive patients were analyzed.

Botulinum toxin injection to improve tracheoesophageal speech after total laryngectomy.

Total laryngectomy patients, after undergoing a tracheoesophageal puncture (TEP), may have poor TEP speech because of hypertonicity or spasm of the pharyngoesophageal segment (PES). Conventional treatment options include speech therapy, PES dilation, pharyngeal neurectomy, and myotomy. Botulinum toxin injection into the PES has recently been reported to be effective for this disorder.

Videostroboscopy of the pharyngoesophageal segment in total laryngectomees.

Objectives: The reconstructed pharyngoesophageal segment (PES) serves as the neoglottis following total laryngectomy, as it provides the source of vibration for production of tracheoesophageal puncture (TEP) voice. To date, little information exists regarding the vibratory characteristics of the PES. The purpose of this investigation was to study the anatomy and physiology of the PES using videostroboscopy.