Faculty Bibliography

Glomus intravagale (paraganglioma of the nodose ganglion and/or vagus nerve) is an unusual tumor. There are approximately 45 cases reported in the literature; the authors report four more cases. This tumor may ba associated with other paragangliomas of the head and neck, such as carotid body tumors, and may metastasize to regional lymph nodes, although the histology always appears benign.

Posterior subglottic extension of glottic carcinoma has been a contraindication for partial laryngectomy because of the proximity of the cricoid cartilage. Resection of the upper portion of the posterior aspect of the cricoid is necessary for adequate tumor resection but is complicated by persistent aspiration. This paper presents a method of reconstruction following partial posterior cricoid resection.

This report presents a case of squamous cell carcinoma of the temporal bone induced by high dose radiation therapy. Several important surgical techniques are stressed which serve to make this procedure far safer in the avoidance of catastrophic hemorrhage.

The lamina propria of the tympanic membrane is composed of a unique system of radial and nonradial fibers which contribute importantly to its function. Over 1000 patients have undergone operations for the transplantation of the homograft tympanic membrane. Animal experiments have been presented to determine whether or not the fiber system of the lamina propria of the tympanic membrane is preserved in the homograft tympanic membrane. In conjunction with this, a small series of experiments was conducted to determine the appearance of the fiber system in perforations that heal spontaneously. Current knowledge concerning the function of the fiber network is discussed. The results of the present study indicate that the lamina propria fiber network is at least partially preserved in the homograft tympanic membrane and that the fiber network of the lamina propria is not reconstituted in spontaneously healed tympanic membranes

To gain a better understanding of tympanometric results that have been difficult to interpret, such as asymmetrical and W-shaped tympanograms, acoustic susceptance and conductance tympanograms were measured from subjects with normal hearing and from subjects with well-defined middle ear pathology. Acoustic reactance, resistance, and impedance were computed and predicted from the measured data. Asymmetrical tympanograms derive in large part from the marked asymmetry in acoustic resistance as a function of ear canal pressure. W-shaped tympanograms result from interactions between reactance and resistance that occur when the two quantities assume similar absolute values or when reactance is mass controlled. A criterion for distinguishing between W-shaped tympanograms that are normal from those that are abnormal is discussed.

Angiographic experience with chemodectomas in 21 patients is reviewed. Arterial supply was identified from the vertebral artery, the internal carotid artery, and branches of the external carotid artery. A striated cephalad extension from a cervical chemodectoma (five patients) is believed to represent arterial supply to tumor in vein. In two patients, internal and external carotid arteriograms did not opacify important arteries originating near the carotid bifurcation. Retrograde filling of sigmoid sinus (four patients), tumor mass in jugular vein (two patients), and arteriovenous shunting (nine patients) were observed during the venous phase. Thorough angiogra phy is essential for evaluation of chemodectomas of the head and neck.