The effect of treatment on survival in patients with advanced laryngeal carcinoma.

Objectives/hypothesis: Over the last 2 decades, survival from laryngeal cancer has decreased. We sought to identify factors associated with decreased survival in laryngeal cancer.

Methods: Patients diagnosed with laryngeal squamous cell carcinoma from 1985 to 2002 were retrospectively reviewed.

The effect of occult nodal metastases on survival and regional control in patients with head and neck squamous cell carcinoma.

Objectives: To determine factors associated with disease-free survival (DFS) and regional control in clinically node-negative head and neck squamous cell cancer (HNSCC) patients with occult metastasis.

Study Design: Non-randomized retrospective analysis.

Materials And Methods: Patients who underwent elective neck dissection (END) from 1985 to 2002 were analyzed.

Surgical treatment of acquired tracheocele.

Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

Acute external laryngeal trauma: experience with 112 patients.

The purpose of this report is to promote early recognition, expeditious evaluation, and judicious management of acute external laryngeal trauma. A retrospective chart review was performed of 112 cases that were managed at a Medical College of Georgia tertiary care hospital by the senior author (E.S.

Use of the harmonic scalpel in superficial and total parotidectomy for benign and malignant disease.

Objectives: Use of the harmonic scalpel in superficial parotidectomy for benign parotid disease has been shown to reduce surgical time as well as intraoperative blood loss. We sought to determine whether similar results could be achieved with the expanded use of the harmonic scalpel in parotidectomy for both benign and malignant disease.

Study Design: Retrospective review.

Harmonic Scalpel versus cold knife dissection in superficial parotidectomy.

Objectives: Use of the Harmonic Scalpel has recently been described in thyroid surgery, in which it appears to result in decreased operative time and blood loss without increasing the incidence of nerve injury when compared to conventional techniques of vessel ligation and tissue division. We sought to determine whether the use of the Harmonic Scalpel in superficial parotidectomy was associated with a difference in operative time, blood loss, or facial nerve injury compared with conventional techniques.

Study Design And Setting: The medical records of all patients who underwent superficial parotidectomy for benign parotid pathology at the Medical College of Georgia and Veterans Affairs Hospital of Augusta, Georgia, from 1999 to 2002 were retrospectively reviewed.

'Push' versus 'pull' percutaneous endoscopic gastrostomy tube placement in patients with advanced head and neck cancer.

Objectives/hypothesis: Percutaneous endoscopic gastrostomy tube (PEG) placement by means of the "pull" method has been reported to result in a significantly higher complication rate when compared with "push" PEG placement. These findings have led to a renewed interest in the push, or Russell introducer, method of PEG placement at the authors' institution when PEG is required before definitive treatment of advanced head and neck cancer. The authors sought to determine whether the push method of PEG placement is associated with a lower incidence of complications in this patient population.

The rhinology laboratory.

Objectives: This study seeks to develop a rhinology lab model and to assess its effectiveness for physicians-in-training.

Study Design: We established a rhinology lab at our institution with simple and affordable modifications to our temporal bone lab. Residents attended a seven-part lecture series and received a list of endoscopic and open procedures to perform on computed tomography (CT)-scanned, vessel-injected cadaver heads.

Flow cytometry and squamous cell carcinoma of the maxillary sinus: A possible prognostic indicator for multimodality intervention.

Malignant tumors of the paranasal sinuses constitute less than 1% of all malignancies. Unfortunately, few prognostic factors have been identified regarding the efficacy of interventional therapy. Patients with carcinoma of the maxillary sinus frequently present with an advanced stage of disease and multimodality therapy is often proposed.

Timing of percutaneous endoscopic gastrostomy tube placement in head and neck cancer patients.

Percutaneous endoscopic gastrostomy (PEG) is an effective method for providing alimentation in patients with upper aerodigestive tract carcinoma. Multiple complications of this procedure have been reported, ranging from leakage around the tube to tumor seeding of the abdominal cavity. This study was undertaken to determine whether the timing of PEG tube placement with respect to primary tumor extirpation led to a difference in the number and severity of observed complications.

Management of chronic sinusitis in the adult cystic fibrosis patient.

Cystic fibrosis (CF) is an autosomal recessive disorder affecting exocrine gland function. Although CF was formerly a deadly disease of infants and children, recent improvements in antibiotics, nutritional therapy, and supportive care have extended the median survival to adulthood. Patients with CF often present with sinusitis and nasal polyposis in addition to recurrent pulmonary infections.

Obstructive sleep apnea in women.

Obstructive sleep apnea is a complex disorder characterized by periodic cessation of breathing during sleep. Classically, men exclusively have been evaluated for mode of presentation or associated morbidity that accompanies obstructive sleep apnea; minimal investigation has been undertaken with regard to the female population. Recent literature indicates that obstructive sleep apnea is much more prevalent in women than previously recognized and is increasingly underdiagnosed.

The evaluation of ciliary function: electron versus light microscopy.

Diagnosing Primary Ciliary Dyskinesia can often be difficult. Physical findings suggest the disease, but definitive diagnosis should be made with a ciliary biopsy. Twenty biopsies were obtained from 16 patients and all underwent both light and electron microscopic examination.

Acute laryngeal trauma in the pediatric patient.

We reviewed the evaluation and management of pediatric laryngeal trauma, focusing on the unique characteristics of the immature airway as they affect functional results. The study was based on 91 cases of acute laryngeal trauma managed by the senior author (E.S.

Sickle cell disease and tonsillectomy. Preoperative management and postoperative complications.

Background: Patients with sickle cell disease are recognized as having a relatively higher risk for postoperative complications, including fever, atelectasis, pneumonia, or sickle cell vas-occlusion.

Objective: To present a protocol for preoperative management of patients with sickle cell disease undergoing tonsillectomy, including the use of transfusions and intravenous hydration.

Design: Retrospective chart review.

Detection of cervical metastasis. A meta-analysis comparing computed tomography with physical examination.

Background: Despite extensive coverage in recent literature, controversy continues with regard to the relative sensitivities of computed tomography (CT) and physical examination (PE).

Objective: To identify a statistically significant consensus.

Data Sources: Initially, data were reviewed on 47 consecutive patients with head and neck cancer on whom a total of 53 neck dissections were performed.

Management of subglottic foreign bodies.

Foreign body aspiration is not an infrequent encounter in the practice of otolaryngology and requires immediate attention. The vast majority of foreign body aspirations occur in children less than 3 years of age, and the actual event of aspiration is frequently not witnessed. Although inhaled foreign bodies most often lodge in the bronchi, laryngotracheal foreign bodies also occur and are potentially more dangerous.

Branchial cleft cyst posterior to the carotid vessels.

Branchial cleft anomalies may appear as a sinus fistula or cyst. An understanding of the developmental embryology and anatomy can predict branchial cleft anomalies by the relationship of the corresponding branchial arches that form at the time of development. The second branchial cleft anomalies are the most common and may be found along a tract from the anterior border of the sternocleidomastoid muscle anterior to the carotid vessels and IX and XII.

Temporomandibular joint dehiscence after mastoid surgery: a case report.

This article reminds the otolaryngologist of a rare but real complication of mastoid surgery. Additionally, we have offered a straightforward method to repair the resulting defect.

Pilomatrical carcinosarcoma of the cheek with subsequent pulmonary metastases. A case report.

We report a case of malignant pilomatrixoma with a pronounced biphenotypic morphology. The lesion, which was excised from the cheek of a 36-year-old man, was composed of a large pilomatrixoma lying within a spindled, sarcomatoid stroma. Fourteen months later, the tumor metastasized to the right upper lobe of the lung.

The management of blunt fractures of the thyroid cartilage.

Our experience with 20 cases of blunt fractures of the thyroid cartilage encountered over the last 15 years were reviewed. These injuries were classified into one of three categories: nondisplaced with minimal associated laryngeal injuries (four cases), moderately displaced with intralaryngeal defects (12 cases), and severe fractures with intralaryngeal avulsion injuries (four cases). Treatment consisted of either surgical reduction of fracture (and associated intralaryngeal injuries) or conservative, nonsurgical management.