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Objectives: A prospective non-randomised evaluation of the octyl-2-cyanoacrylate (Dermabond) for skin closure in head and neck surgery., Materials and Methods: An inception cohort of 52 patients managed by six otorhinolaryngologists head and neck surgeons at a single institution (university teaching and tertiary referral center) during the months of May-July 2004. The length of the skin incision varied from 3 to 30 cm (mean: 7 cm). Morbidity evaluation, longitudinal analysis of the evolution of the scar, and analysis of the degree of satisfaction., Results: Postoperative death was not encountered. The overall morbidity rate was 3.8% (2/52). There was no instances of wound dehiscence's. A subcutaneous abscess was noted in one patient. From an aesthetic point of view, the scar appearance was considered to be slightly retracted during the first postoperative month and to be very good 2 to 4 months from initial surgery. Only one patient developed a minimal cheloid scar. Among the 47 patients who expressed an opinion postoperatively regarding the use of the octyl-2-cyanoacrylate (Dermabond) for skin closure, the degree of satisfaction was very high due to the ability to take an early shower (40 patients) followed by the lack of skin sutures (5 patients) and the lack of any allergic skin reaction (2 patients)., Conclusion: At our department, the octyl-2-cyanoacrylate (Dermabond) for skin closure at the time of head and neck surgery is becoming more and more utilized due to the completion of a solid and aesthetic suture, the ability to take an early shower and the high degree of satisfaction expressed by the patients.

Objective: Analysis of the consequence of the preoperative information delivered orally to patients requiring surgery for benign pathology of the thyroid gland from various perspective (head and neck surgeon, physician, judge, lawyer)., Methods: Prospective study conducted in an academic tertiary care referral center. Inception cohort of 123 patients with benign pathology of the thyroid gland consecutively informed orally and by the same surgeon during the years 2003-2004. Analysis of the consequences of the preoperative information, degree of memorization regarding the surgical related risks as well as the patient's opinion regarding this information., Results: Due to the information regarding the risks related to surgery 14.6% of patients refused to undergo surgery. None of the patients remembered more than 4 out of the 6 main surgical risks. 68.8% of patients remembered only one or two surgical related risks. 12.2% of patients did not remember a single surgical related risk, 85.5% of patients remembered the risk of a unilateral laryngeal nerve paralysis, 41.1% the risk of death related to the completion of a general anesthesia and 21.1% the risk of a bilateral laryngeal nerve paralysis. Less than 11% of patients remembered the other risks (general risks related to any open field surgical approach, hypocalcemia and loss of breast feeding) Among the patients who had an opinion postoperatively, 87.6% had a positive opinion and 41.9% a negative opinion regarding the preoperative information related to the surgical related risks. Also, 28.4% of patients expressed simultaneously a positive and a negative opinion., Conclusion: Oral information of the patient regarding the surgical risks resulted in an important stress for the patient and modified the relation patient-surgeon. Due to the information, a non-neglectable group of patients elicited not to follow the advice of the surgeon. Various measures are discussed since the information on the surgical related risks is a must from a legal point of view but is also highly appreciated and requested by most of the patients.

The author describes a new technique of treatment of recurrent laryngeal nerve paralysis by intra-cordal injection of collagen after thoracic surgery. After description of the collagen used and the technique of injection, the author presents the results. It is a new method, simple, efficient, well tolerated, giving patients a voice, and treating their swallowing troubles.