Search

Objectives: To review the management and outcome of patients with malignant neoplastic disease of the parotid lymph nodes excluding those with primary salivary gland tumors.Study Design: Retrospective review of 14 patients who had malignant parotid lymph nodes from metastatic cutaneous malignancies, direct extension from primary cutaneous malignancies, or lymphoproliferative disorders.Methods: Charts were reviewed from three institutions and tabulated for age, gender, histopathology, treatment, and outcome.Results: Fourteen patients met the criteria for study. Ten patients had neoplastic nodes from cutaneous malignancies. Seven involved squamous cell carcinoma, two were metastatic from melanoma, and one was metastatic from basal cell carcinoma. Four patients had involvement from lymphoproliferative disorders.Conclusions: Metastatic disease to the parotid nodes or direct extension to nodes from primary cutaneous malignancy demonstrates a poor prognosis in this series. Prognosis of lymphoproliferative disorder is more favorable. [ABSTRACT FROM AUTHOR]

Extensive fungal infections of the paranasal sinuses are most often associated with immunocompromised patients or poorly controlled diabetics. Seldom do young, otherwise healthy patients present with advanced disease destroying bone and compressing the dura and frontal lobe posteriorly. A case of eosinophilic fungal rhinosinusitis which grew Curvularia lunata in culture is reported. Bone destruction can be common as an expanding inflammatory mass pushes and weakens surrounding bone. The destruction of the frontal sinus with the compression of the dura into the anterior cranial fossa of a 26-year-old requires drainage, reconstruction, and medical management. Our experience with the disease and our approach is reviewed.

Tonsillectomy remains one of the most common surgical procedures performed in the world. One of the most significant complications is postoperative hemorrhage. Though most bleeding often can be controlled with local anesthesia in an office or emergency room, some patients require return to the operating room for general anesthesia to control the hemorrhage. A ten-year retrospective study was done to review patients who required return to the operating room for general anesthesia for control of hemorrhage. Variables investigated include age, gender, time of surgery, onset of hemorrhage, season of the year, and the amount of blood loss noted during initial surgery. Seven of the 756 patients (.93%) required a second general anesthesia to control hemorrhage. Seasonal and gender predilictions are noted in this study. Recent trends in tonsillectomy are reviewed. Postoperative hemorrhage creates anxiety, prolongs morbidity, and increases health care cost. Limiting this complication is clearly in the best interest of both patient and surgeon.

Background: Conchal defects secondary to surgical procedures or trauma often cannot be closed primarily., Objective: Tissue transfer for closure of defects must be tension free and not create a postauricular sulcus too shallow., Methods: A retroconchal island flap provides such a closure. A rhomboid transposition flap used to provide closure of the donor site retains the depth of the posterior sulcus., Results: The closure of the defect heals well within 4-6 weeks even in presence of scar tissue from multiple prior surgeries., Conclusion: The retronconchal island flap is a simple, reliable technique to close the defect of the concha without sacrificing the natural depth of the posterior sulcus.

Myringotomy with placement of ventilation tubes is the most common pediatric otolaryngologic procedure in the United States. Otorrhea is generally recognized as the most common complication of this procedure. The current study is a three-year prospective evaluation of post tympanostomy otorrhea to determine what variables might be associated with otorrhea. Analysis of patients from a predominantly rural population is presented.

Malignant melanoma is most commonly associated with cutaneous malignancies of sun-exposed skin, but melanoma also occurs in the mucosal surfaces of the head and neck. The symptoms of intranasal melanoma are most often associated with benign conditions that patients often ignore during the early course of the disease. Benign symptoms that persist require thorough evaluation to exclude neoplastic disease in which timely diagnosis and early treatment offers the best prognosis.

A 10-year retrospective study of maxillofacial trauma cases in Southeast Missouri reveals the causes of the trauma and profiles the age and gender of the victims. In contrast with the findings of urban institutional studies, which are more commonly reported, motor vehicle accidents accounted for the majority of these cases.

An interesting variety of cutaneous tumors of the head and neck, tumors of the eccrine differentiation, are seldom recognized. The most recent reports of these tumors appear in the dermatologic literature, probably due to the majority of them being located in the trunk and the extremities. Malignant varieties of these tumors do exist and must be treated as aggressively as more common tumors of the head and neck region. Tumors with eccrine differentiation are among a large variety of cutaneous tumors that present in the head and neck. These tumors are far less common than basal cell and squamous cell carcinomas of the head and neck. Malignant clear cell hidradenomas, a variant of the more common benign clear cell hidradenoma, is one such type of tumor of the eccrine differentiation. This is a rare tumor seldom reported in sites of the head and neck. A case of a 47-year-old white male with such a tumor of the lower half of his lip is presented. This report is particularly concerned with the histopathology of the tumor, its unique etiology, and the applicability of the lip switch flap (Stein-Abbe-Estlander) in the reconstruction of the surgical defect following total tumor excision.