Location of the vibratory segment in tracheoesophageal speakers.

The Singer-Blom tracheoesophageal puncture procedure for surgical-prosthetic voice restoration has proved to be a viable option for alaryngeal speech rehabilitation. Following tracheoesophageal puncture, occlusion of the tracheostoma shunts pulmonary air through the Blom-Singer prosthesis into the cervical esophagus. The pulmonary air passing through the cervical esophagus and into the hypopharynx causes a portion of the upper alimentary tract to vibrate in a manner similar to that of the pharyngoesophageal segment during the production of esophageal speech.

Cisplatin potentiation of radiotherapy. Long-term follow-up.

Thirty-three patients with inoperable squamous cell carcinoma of the head and neck were treated with cisplatin, 15 mg/sq m, administered synchronously with high-dose radiation therapy. Twenty-nine patients (88%) responded to the regimen; of these, 20 had complete regression of all disease. Eight of the 20 had a relapse in less than one year of their treatment.

Long-term results of the Blom-Singer speech rehabilitation procedure.

We report a 64% long-term success rate in our series of 66 patients who have undergone the tracheoesophageal puncture (TEP) procedure with follow-up ranging from one to 3 1/2 years. Poor motivation and compliance were the most common factors noted in patients who failed to obtain or maintain tracheoesophageal speech. Other problems causing failure were technical problems relating to the TEP and medical problems.

Odontogenic keratocyst: diagnosis and treatment.

The odontogenic keratocyst is a keratinizing squamous epithelium-lined cyst that occurs in the mandible and maxilla. In 5% to 10% of patients the keratocysts may be a manifestation of the basal cell nevus syndrome. The recurrence rate after surgical therapy for odontogenic keratocysts varies from 10% to 63%.

Surgical management of advanced scalp cancer.

A series of 53 advanced scalp cancer patients treated with surgery is presented. A review of these patients concludes: 1) local tumor growth--not distant metastasis--is the primary problem; 2) management is based on the tendency of a tumor to spread laterally early in its development with a deep invasion occurring later on; 3) when deep invasion occurs, radical excision and reconstruction is indicated to control the disease; 4) recurrence following adequate local therapy requires a change in treatment modality.

The Singer-Blom voice restoration procedure.

The Singer-Blom tracheoesophageal puncture (TEP) technique is an effective and safe surgical method for speech rehabilitation of the alaryngeal patient. The silicone prosthesis, which is fitted in the TEP tract, allows pulmonary air to be used for voice production but prevents aspiration. In a series of 63 patients, 56 (89%) were able to develop fluent speech, but only 45 patients (71%) currently use tracheoesophageal speech as their prime mode of communication.

The Singer-Blom speech rehabilitation procedure.

Singer and Blom have recently reported a new surgical method for speech rehabilitation of the alaryngeal patient. The method consists of a tracheoesophageal, puncture (TEP) followed 2 to 3 days later by insertion of a silicone "duckbill" prosthesis which acts as a one-way valve allowing pulmonary air to enter and vibrate the esophagus but preventing aspiration. Along with more rapid acquisition of speech, the advantage of tracheoesophageal speech over esophageal speech is the greater volume of air flow through the vibrating segment of the esophagus, which allows smoother and more prolonged speech.

Blastomycosis of the larynx.

Blastomycosis is an uncommon fungal disease which may mimic carcinoma of the larynx. Physical examination may show a granular appearance early in the disease with progression to laryngeal fibrosis. Histologic examination usually shows pseudoepitheliomatous hyperplasia, microabscesses, and giant cells.

Tongue base minor salivary gland tumor: report of a case with mucoepidermoid and acinous cell components.

A case of a large (5.5 cm), multilobulated, mucosa-covered, minor salivary gland tumor of the base of the tongue that displayed morphologic features of both a mucoepidermoid carcinoma and an acinous cell tumor is described. Generally, each of these salivary gland tumors occurs only rarely at this site.

Surgical prosthetic splints as an adjunct in treating facial fractures.

Surgical splints are a valuable adjunct in managing certain mandible and maxillary fractures. Of the various splint materials, acrylic is the easiest, fastest, and least expensive. Acrylic splints are rigid, strong, easily adjusted and repaired, translucent, lightweight, and tolerated well by the oral mucosa.

Bullous myringitis with sensorineural hearing loss.

Bullous myringitis is manifested by moderately severe otalgia associated with vesicles on the tympanic membrane and medial external auditory canal wall. This disease occurs mainly in young adults, most commonly in winter, and is usually preceded or accompanied by an upper respiratory infection. A reversible sensorineural loss developed in three of 22 patients.

Idiopathic midface lesions.

The term lethal midline granuloma has been used to describe a number of lesions which may present in the midface. A list of possible causes is presented and three entities, midline malignant reticulosis, Wegener's granulomatosis, and malignant lymphoma, are discussed in detail. The pathological descriptions, the clinical features, and the recommended forms of therapy are outlined.