Faculty Bibliography

The vomeronasal organ is a chemoreceptive structure located at the base of the nasal septum with direct axonal connections to the accessory olfactory bulb in many terrestrial vertebrates. Pheromones presumably bind to the vomeronasal organ and exert behavioral or physiologic responses, thereby allowing chemical communication between animals of the same species. The presence and function of the vomeronasal organ in humans is debated. A phenotypic classification schema for the human vomeronasal organ is described and applied to 253 human subjects who underwent nasal examination. Of these subjects, only 6 percent possessed a vomeronasal organ with 64 percent unilateral and 36 percent bilateral in appearance. No difference existed in gender, age, or race between those subjects with or without a vomeronasal organ. There is no evidence supporting involutional senescence of this structure. Future investigations should use this phenotypic schema for the vomeronasal organ to allow accurate comparisons of study populations

We retrospectively reviewed the cases of 23 adults and six children who had been given a presumed diagnosis of acute supraglottitis between 1987 and 1997. The most common symptoms in these patients were odynophagia, dysphagia, hoarseness, and fever. Stridor and drooling were also observed, primarily in the children. Fiberoptic laryngoscopy confirmed the presence of edema and erythema of the supraglottic structures in all patients. Blood cultures were positive for Hemophilus influenzae type b in three children and for Serratia marcescens in one adult. All other blood cultures were negative. All patients were treated with intravenous broad-spectrum antibiotics and humidified oxygen, and two-thirds received intravenous corticosteroids. Patients were monitored with pulse oximetry and serial fiberoptic laryngoscopy. Two patients required intubation; one had an epiglottic abscess, and the other had laryngeal edema so severe that vocal fold mobility could not be assessed. The length of stay in the intensive care unit ranged from 1 to 7 days (mean: 1.9). All patients recovered and were discharged free of symptoms after 2 to 11 days of overall hospitalization (mean: 4.4)

This article presents optimal patterns of care for management of head and neck cancer patients. Discussion includes how the head and neck cancer multidisciplinary team makes decisions regarding treatment for head and neck cancer patients and the role of the speech pathologist as part of the team. Specifically addressed issues are how speech pathologists can become team members, provide pretreatment intervention, and implement clinical and instrumental assessment of swallowing and swallowing treatment. Types of treatments for head and neck cancer are described, including surgical and organ preservation (radiotherapy with or without chemotherapy). Types of surgeries are described, including surgical resection and surgical reconstruction with discussion of the effects of both resection and reconstruction on swallowing. Management of swallowing disorders in the partial laryngectomy, total laryngectomy, partial pharyngectomy, and oral cancer patient are reviewed, as well as use of palatal prostheses and the speech pathologist's role in collaborative construction of the prosthesis and follow-up management of swallowing. Types of radiotherapy and chemotherapy treatments and their side effects are discussed as are specific types of swallowing problems seen after these therapies and management of swallowing in this population. Optimal care patterns, including timing and duration of swallow management specific to various head and neck cancer populations, are presented

The abundant glands situated in the lamina propria of the human anterior middle nasal turbinate were complex tubules that consist of serous, seromucous, and mucous cells, either singly or in combination. Serous granules were homogeneously dense, but could have a small lighter core. Seromucous granules had a dense rim and a large compartment of appreciably lighter density. Gradation between serous and seromucous granules made precise identification of these secretory cell types difficult. Mucous cells were of conventional morphology. The secretory tubules, which possessed a complement of myoepithelial cells, gradually transformed into ducts or the changeover was relatively sudden. The ductular portions of the tubules consisted either of tall prismatic cells or of shorter columnar cells, both of which lacked secretory granules, but had many mitochondria in their supranuclear cytoplasm. In many cases the ducts, for most of their length, consisted of secretory cells. These glands clearly participate in the elaboration of the glycoconjugate coat that serves to protect the nasal mucosa and keeps it from drying out