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We conducted a retrospective study of 6,966 patients who had undergone tonsillectomy or adenotonsillectomy to evaluate the incidence and clinical features of previously unidentified coagulation disorders in patients who experienced postoperative hemorrhage (n = 201). We found that post-tonsillectomy hemorrhage secondary to unidentified coagulation disorders is extremely rare. However, normal coagulation values and an insignificant history do not rule out coagulation disorders. If diffuse, persistent, and bilateral bleeding is not related to arterial hypertension, dissection technique, or local infection, a rapid and detailed analysis of coagulation factors should be considered.

ObjectivesAssessment of perilymphatic fistulas remains a diagnostic problem. Because of a lack of reliable clinical tests, exploratory tympanotomy is necessary to detect membrane leaks in the middle ear. To improve objectivity in the intraoperative visualization of perilymphatic fistulas, we used intrathecal fluorescein for perilymph staining to increase the sensitivity and specificity of diagnosis of perilymphatic fistulas.

This study was performed to determine the effectiveness of single photon emission tomography (SPET) in contributing to the initial staging of patients with cancers of the head and neck because information about osseous infiltration of head and neck cancer is of major importance for staging and planning of treatment. A retrospective analysis of 89 cases with probable tumor infiltration of the mandible by oral/pharyngeal cancer was undertaken by comparing the preoperative SPET as well as CT-scans, if available, with clinical and postoperative histological examinations. For SPET examinations, a sensitivity of 95% and a specificity of 48% were calculated. The positive predictive value was 65%, and the negative predictive value was 93%. CT scans showed a sensitivity of 75% and a specificity of 78%. The positive predictive value was 65%, and the negative predictive value was 93%. SPET is a powerful method to detect infiltration of carcinomas into the head and neck skeleton. Its sensitivity is high and superior to CT scans, although the specificity is small due to a high number of false positive results. © 2001 John Wiley & Sons, Inc. Head Neck 23: 979–984, 2001.

An 25 unfixierten Leichen wurde die Topographie der A. und V. circumflexa ilium superficialis und profunda sowie der A. epigastrica inferior superficialis als axiale Gefäßbündel für Transplantate der Leistenregion untersucht. Durch Farbstoffinjektionen mit Methylenblau wurde das Kapillargebiet der genannten Arterien im Knochen (Beckenschaufel), in der Muskulatur(M. obliquus internus abdominis) und in der Haut (Leistenbeuge und Oberschenkel) dargestellt.

An 15 frischen Leichen wurde beidseits die Topographie der A. und V. thyroidea superior und der Ansa cervicalis profunda als axiales Gefäß-Nervenbündel für einen infrahyoidalen Muskelfaszienlappen untersucht. Durch Farbstoffinjektionen mit Methylenblau in die A. thyroidea superior wurde das Versorgungsgebiet der Arterie in der Muskulatur dargestellt.

Description of a new neurovascular island flap derived from the infrahyoid muscles to reconstruct a total tongue or large defects of the tongue base. The surgical technique, anatomic findings, and the postoperative function tests with the patients' outcome are described.