Faculty Bibliography

The purpose of this study was to review a large series of patients with adenoid cystic carcinoma of the parotid gland in order to develop clinical criteria for sacrifice versus selective sparing of the seventh nerve. We studied 43 patients followed over 36 years. Study patients were grouped according to the preoperative status and intraoperative management of the facial nerve. Criteria for choosing various management strategies are discussed.

The ability to identify surgical sinus disease using diagnostic nasal endoscopy and coronal CT scanning of the paranasal sinuses is studied prospectively. Fifty consecutive patients with symptoms of chronic sinusitis lacking surgical indications by traditional work-up comprise the patient population. Sixty percent had endoscopic or CT indications for surgery. There was a 90% correlation between endoscopy and CT examination with the combined work-up being more accurate than either modality alone. Functional endoscopic sinus surgery was performed in 18 cases. There were no major complications. Approximately 89% of the postoperative group report significant improvement, with 55.6% reporting total relief of symptoms. A complete endoscopic sinus work-up can often identify surgically correctable sinusitis despite normal routine rhinoscopic and plain-film examination. It is therefore, warranted in those patients with a suggestive history

The hearing sensitivity of 9427 railroad train crew members, determined during the first year of a company-wide hearing conservation program, was compared with hearing sensitivity in a control population not exposed to occupational noise. The hearing sensitivity of the trainmen did not differ significantly from that of the control population. Multiple regression analysis, which considered separately the effects of age and years of service, showed significant differences in hearing levels due to age, but no differences in hearing levels due to years of service. Evaluation of the data by risk categories developed by the National Institute for Occupational Safety and Health indicate that this group of trainmen had no risk of occupational noise-induced hearing loss. These analyses, combined with studies of locomotive cab noise, show clearly that trainmen are not typically exposed to hazardous occupational noise.

An autogenous split-thickness calvarial bone graft that was used to correct a marked depression in the frontal region of the forehead resulted in excellent cosmesis. Cancellous bone from the iliac crest, which was applied between the posterior wall of the frontal sinus and the anterior calvarial bone graft, eliminated the dead space and made infection less likely in an area prone to such infections

High quality slides of radiographs may be made with a simple, fast, and inexpensive technique using Kodak Rapid Process Copy film. Lecture presentations may include a slide of a pertinent plain radiograph, computed tomography (CT) scan, or magnetic resonance imaging (MRI). Although these slides may be made with a 35 mm SLR camera and flash or with a 35 mm SLR camera and a lighted viewbox, an alternative method is available that is easy to perform, inexpensive, and can produce quality slides in as little as 30 minutes

Aural cholesteatomas consist of accumulations of desquamating keratinized epithelium within the middle ear or other pneumatized portion of the temporal bone. Cholesteatomas may be classified according to presumed etiology as congenital or acquired. The theoretical mechanisms of the pathogenesis of the two types are discussed

Few reports describing manual strangulation injury to the neck are found in the otolaryngologic literature. Since most victims sustain immediate fatal asphyxiation, brain anoxia, or cardiac arrest, they are usually examined by a forensic pathologist. When strangulation attempts are nonfatal, neck injuries can lead to delayed airway obstruction. If not managed in a timely fashion, these injuries can be fatal or cause permanent laryngotracheal sequelae. We describe a patient who 36 hours following manual strangulation developed acute upper airway obstruction and neck abscess necessitating tracheotomy, neck exploration, and drainage. Patients suffering this unique type of compression injury may present initially with deceptively benign symptoms and signs. We discuss the overall management of these patients, stressing the need for early imaging studies, endoscopic assessment, and continued airway monitoring in an intensive care unit.

Cholesteatoma is a difficult disease to treat as demonstrated by the relatively high recidivism rate attained by the best of surgeons. The concept of recidivism encompasses all reoccurrence of the disease, regardless of the theorized origins. This is a term that should be accepted so that some uniformity may be introduced into the evaluation of this disease. A standard reporting format that includes the extent of the disease, the eustachian tube function, the integrity of the ossicles, and a uniform description of the surgical procedure would enhance future evaluations of this disease. The future of otology still lies in finding new ways to eradicate this disease and to avoid recidivism

A retrospective review of 64 total thyroidectomies performed at Memorial Sloan-Kettering Cancer Center was conducted. Only one patient had permanent hypocalcemia (1.6%) requiring calcium supplementation. Eight patients had a total of 11 complications, for a complication rate of 12.5%. These results are in sharp contrast to those published in 1972 from this institution, in which the permanent hypocalcemia rate was 29%. The reasons for this difference are discussed