Left Subclavian Pseudoaneurysm: A Case of Palsies in the Recurrent Laryngeal Nerve, Phrenic Nerve, and Brachial Plexus.

A patient developed a subclavian pseudoaneurysm following placement of an intravascular catheter for cancer treatment. The patient presented with palsies in the phrenic nerve, brachial plexus, and recurrent laryngeal nerve. This is a rare presentation, similar to Ortner's syndrome, which has not been previously presented in the literature.

Mandated wrapping of airway cart instruments: Limited access without the intended safety benefits.

Objectives/hypothesis: Isolated case studies have shown improper sterilization or contamination of equipment from anesthesia carts can lead to transmission of disease and even death. Citing this literature, national accrediting agencies mandated all instruments in the otolaryngology airway carts at San Antonio Military Medical Center be packaged to prevent contamination. This study sought to determine the infection and safety implications of packaged airway cart instruments.

Laryngocardiac Reflex: A Case Report and Review of the Literature.

Introduction: The vagus nerve has sensory and motor function in the larynx, as well as parasympathetic function in the thorax and abdomen. Stimulation of the superior laryngeal nerve can cause reflexive bradycardia.

Case: We describe a case of a 45-year-old man with pre-syncopal symptoms while exercising, and bradycardia found during cardiology workup.

Hemodynamic changes during otolaryngological office-based flexible endoscopic procedures.

Objectives: A preponderance of literature supports the safety of office-based flexible endoscopic procedures of the upper aerodigestive tract; however, until recently there were no data regarding hemodynamic stability during these procedures. A recent study showed intraprocedure changes in patients' hemodynamic parameters, raising the concern that perhaps patients should be monitored during these procedures. The aim of our study was to determine whether physiologically significant alterations in vital signs occur during office-based flexible endoscopic procedures.

Diagnosing aerodynamic supraglottic collapse with rest and exercise flexible laryngoscopy.

Objective: Laryngomalacia is best known as a self-resolving infantile disorder characterized by inspiratory stridor with occlusion of the larynx by collapse of arytenoid tissues due to Bernoulli forces. Adult laryngomalacia has been sporadically described in the literature. We identified a series of patients with aerodynamic supraglottic collapse mimicking laryngomalacia in our Otolaryngology clinic.

Vibratory asymmetry in mobile vocal folds: is it predictive of vocal fold paresis?

Objectives: The purpose of this study was to determine whether the videostroboscopic finding of vibratory asymmetry in mobile vocal folds is a reliable predictor of vocal fold paresis. In addition, the ability of experienced reviewers to predict the distribution (left/right/bilateral) of the paresis was investigated.

Methods: This is a retrospective chart review of all patients who presented to our clinic during a 3-year period with symptoms suggestive of glottal insufficiency (vocal fatigue or reduced vocal projection) accompanied by the videostroboscopic findings of bilateral normal vocal fold mobility and vibratory asymmetry.

Traumatic airway management in Operation Iraqi Freedom.

Objectives: To examine the role of head and neck surgeons in traumatic airway management in Operation Iraqi Freedom and to understand the lessons learned in traumatic airway management to include a simple airway triage classification that will guide surgical management.

Study Design: Case series with chart review.

Setting: Air Force Theater Hospital at Balad Air Base, Iraq.

Mass casualty response of a modern deployed head and neck surgical team.

Background: The battlefields of the Global War on Terror have created unique demands on deployed surgical teams. Modern high-energy fragmentation devices often inflict complex head and neck injuries. This series analyzes the role of the head and neck surgical team during 3 separate single explosive events that led to civilian multiple casualty incidents (MCIs) treated at a military theater hospital in Iraq from February to April 2007.

The innervation of the posterior cricoarytenoid muscle: exploring clinical possibilities.

Manipulation of the nerve supply to the posterior cricoarytenoid (PCA) muscle has potential for ameliorating the symptoms of some neurologic conditions such as abductor spasmodic dysphonia. The anatomy of the nerve supply to the PCA is better understood than in previous eras, but the anatomical understanding has not translated to clinical application yet. Microscopic dissection allowed the identification and measurement of the branches from the recurrent laryngeal nerves (RLNs) to the PCA in 43 human cadaver larynges.

Expandable tracheal stenting for benign disease: worth the complications?

Objectives: To characterize the limitations of self-expandable stents in the management of benign tracheal stenosis, we performed a retrospective review at a tertiary care medical center.

Methods: Patients who underwent tracheal stenting were assessed for the cause and severity of tracheal stenosis, comorbidities, stent-related complications, and follow-up airway procedures.

Results: Sixteen adults (12 women, 4 men; mean age, 47 years) had a total of 26 stents placed for benign disease.