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Objective: The purpose of this study is to determine whether elective parotidectomy is necessary in patients with clinically and radiographically N0 parotid disease with isolated primary auricular nonmelanoma cutaneous malignancies. Auricular malignancies are typically managed by wedge resection or wide local excision. Although small lesions are easily managed by conservative excision, large bulky tumors, those with multifocal involvement, and recalcitrant lesions, often require more extensive resection including total auriculectomy, parotidectomy, and/or neck dissection. Study Design: A 10-year retrospective case review from four tertiary university medical centers from 1992 to 2002. Methods: Information was retrospectively retrieved using a database of patients from the department of pathology. Seventy-one charts were reviewed. Patients with a clinical history of advanced nonmelanoma auricular carcinoma undergoing elective parotidectomy and/or neck dissection with clinically and radiographically N0 nodal disease were evaluated for the presence of occult parotid metastasis. All patients underwent parotidectomy in conjunction with a total auriculectomy for surgical extirpation of their primary auricular carcinoma. Parotid specimens were evaluated for histopathologic evidence of metastatic neoplastic disease. Results: Pathological examination showed no histological evidence of occult parotid metastasis in all 19 patients who underwent elective parotidectomy in the presence of clinically and radiographically N0 nodal disease of the parotid or cervical regions. Conclusions: Parotidectomy may not be necessary in the surgical management of advanced auricularcarcinoma in the absence of clinically positive parotid disease or external auditory canal involvement. [ABSTRACT FROM AUTHOR]

Objectives: The Accreditation Council for Graduate Medical Education (ACGME) has mandated an 80-hour work week that has resulted in changes to many residency programs. In otolaryngology, most programs have switched to either home call or night float systems. Our department covers all of the maxillofacial trauma and backup airway calls, which has made it difficult to employ a home call system. Instead of a night float coverage system, our program implemented a day float coverage system that allows the residents to participate in a 24-hour call period. After call and sign-out, the residents go home; however, their clinical duties are covered by the day float resident. Study Design: A brief review of the literature pertaining to call coverage systems followed by a description of our day float system. Residents who have participated in either night float, day float, or both systems were then surveyed regarding their experiences or perceptions of both systems. Methods: A nine-question survey was handed out to our otolaryngology residents and their responses were recorded. Results: The averaged responses strongly favored the day float over the night float coverage system regardless of the level of training and the systems in which the residents have participated. Conclusions: The day float coverage system is favored by residents in our program. It allows for a more attending-like 24-hour period of call, continuity of care, attendance at educational activities, and more time with family. In addition, it eliminates a prolonged period devoid of clinical activities. [ABSTRACT FROM AUTHOR]

Supraglottitis is one possible complication of smoking crack cocaine. From 1992 through 2001, our institution treated nine patients for thermal supraglottitis secondary to crack cocaine inhalation. In this article, we describe two of these cases, and we briefly review what is known about this entity and the mechanism of injury. We also provide our recommendations for management. [ABSTRACT FROM AUTHOR]

The article describes the case of a 50 year old morbidly obese African-American man presented with a 6-month history of progressive dyspnea where a flexible laryngoscopy showed a large, right supraglottic mass. Topics discussed include findings consistent with rhabdomyosarcoma after a surgical biopsy was performed and the diagnosis of adult rhabdomyosarcona at an advanced stage due to its comparatively hidden local of origin and uncharacteristic clinical symptomatology.

The article presents a patient with a history of bulimia nervosa with bilateral parotid hypertrophy. After undergoing extensive psychological therapy, diet and behavior modification, the patient has been bulimia free for six years and was given the clearance to undergo parotid surgery with facial nerve dissection. It is the authors' opinion that patients have to be free from bulimia for several years and received psychological and medical clearance to have surgery.

The article describes the case of a 79-year-old woman with thyroid carcinoma and intravascular metastasis to the internal jugular vein (IJV). It says that a large mass was discovered within the IJV and removed intraoperatively. According to the author, pathology of the intravascular mass was consistent with metastatic papillary thyroid carcinoma. The importance of early diagnosis in avoiding the further propagation of vascular metastasis is also discussed.

The article discusses the case of a 55-year-old man, referred by his dermatologist for a mass on the left neck that has enlarged over the preceding few months. A two by two-centimeter (cm) firm, nontender mass with limited mobility and that extended deep into the subcutaneous tissues, was found on examination, at the midlevel of the posterior triangle of the left neck. The mass was excised and the overlying soft tissue was dissected free, revealing a piece of wood in the center of the mass.

The article discusses the clinical case of a 28-year-old man who complained of epiphora, intermittent medial canthal swelling and pain. The patient previously underwent a subtotal maxillectomy and rectus abdominis free flap for a left maxillary sinus tumor. Physical examination on the patient revealed chemosis, dacryocystitis, keratitis and cicatricial ectropion. He underwent open dacryocystorhinostomy, lateral canthoplasty and left maxilla reconstruction.

Objective Recently, IGF-1 secreted by fibroblasts has been shown to prevent development of squamous cell carcinoma of the sun-damaged skin. The purpose of this study is to see if skin rejuvenation regiments can increase the levels of IGF-1 secreted and thus prevent the development of squamous cell skin cancers. Methods 3 subjects were selected. Silicone cast and photos of right and left pre and post auricular sites were obtained. Each site underwent either a deep chemexfoliation, medium depth chemexfoliation or one of two novel antioxidant cream regiments. Subjects were followed for 3 months. Follow up silicone casts were obtained for surface profilometry. Biopsies of the treated regions and a control site were also obtained and sent for histological evaluations for IGF-1 levels. Results 2 out of 3 subjects showed improvement of skin wrinkles using the antioxidant regiments. Also, 2 out of the 3 subjects showed increase in IGF-1 levels using a strong antioxidant regiment. The sites treated with chemexfoliation showed decrease in IGF-1 levels when compared to control. Conclusion These results suggest that antioxidant creams used could protect the skin against squamous cell carcinoma while chemexfoliated skin can potentially be at a higher risk of developing squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

This is a case report of a 55 year old male who was seen for an enlarging neck mass. He was treated surgically and the mass was noted to be a piece of wood that had been there for 40 years. [ABSTRACT FROM AUTHOR]

This is a case report of a 28 year old male with a history left maxillary tumor. The defect was treated utilizing a customized 3D implant. [ABSTRACT FROM AUTHOR]

This is a case report of a 60 year old female who had a previous rhytidectomy scar. She was treated with a process called carboxytherapy that resulted in great improvement of the scars with minimal to no discomfort or down time. [ABSTRACT FROM AUTHOR]