Acute sinusitis mimicking antrochoanal polyp.

Three cases of antral sinusitis that presented in an unusual fashion are reported. In each case, the inflamed, swollen sinus mucosa became redundant and prolapsed into the nasal cavity through a widened sinus ostium, mimicking the findings of an antrochoanal polyp. The cases represent the first report in the radiographic literature of this unusual manifestation of maxillary sinusitis.

Low-grade adenocarcinoma of probable endolymphatic sac origin: CT and MR appearance.

The CT and MR appearance of a case of low-grade adenocarcinoma of probable endolymphatic sac origin is presented. The tumor destroyed a large part of the posterior temporal bone and showed prominent extension into the posterior cranial fossa.

Perichondrial-cartilage island graft in one stage tympano-ossiculoplasty.

A one stage reconstruction of the tympanic membrane and the ossicular chain using a composite graft of tragal perichondrium with cartilage is described (Type III tympanoplasty). The long-term results in 18 operated cases reveals closure of the air-bone gap to within 0 to 10 dB in 72% of the cases. The above procedure used autologous graft material, does not disturb the remaining middle ear structures, can be performed under local anesthesia, and in most cases is done on an outpatient basis.

Development and degeneration of hearing in the C57/b16 mouse: relation of electrophysiologic responses from the round window and cochlear nucleus to cochlear anatomy and behavioral responses.

In disorders of the auditory organ associated with hearing loss, a correlation of the anatomical, behavioral and electrophysiological studies furnishes the investigator several parameters of study to better comprehend the hearing mechanism and the various anatomical structural dysfunctions that relate to the hearing loss. Mice are interesting to study because they carry several types of genes for hereditary deafness. Until recently, it was very difficult to train mice for behavioral hearing threshold testing; however, having developed such a method, the next step was to study the normal mice in these three parameters and extend the studies to mice with hereditary hearing loss. The type of mouse studied in this research was the C57/b16 strain which carries such a gene. The results of the studies indicate that the results of the behavioral and electrophysiological studies relate well to each other, and that light microscopic studies (if taken alone) do not furnish us with the actual functional capability of the structures of the inner ear. It is recommended (and it would be most valuable) that efforts should be made to collect and study human temporal bones with all three parameters of study for a better understanding of the structures of the human inner ear. Reference is made and recommendations given as to the parameters of studies while performing human electrocochleography.

Reconstruction of the tongue.

Subtotal or total glossectomies performed for malignancies or other afflictions of the tongue are fraught with great disabling problems postoperatively. Recently the introduction of myocutaneous flaps has aroused new interest in surgical procedures to reconstruct the tongue following major resections. A new approach to functional reconstruction of the tongue is presented utilizing the sternocleidomastoid myocutaneous flap based superiorly. Neurorrhaphy between the hypoglossal nerve on the resected side of the tongue and the nerve to the sternocleidomastoid muscle is easily achieved without under tension as these nerves are in close proximity. In addition, the sternocleidomastoid myocutaneous flap is an ideal flap in tongue reconstruction as there is no fat between the skin and muscle and it resembles the bulkiness of the tongue muscle itself. A patient with a carcinoma of the tongue treated with subtotal resection and reconstruction using the above principles demonstrated full tongue movements 11 months postoperatively.

Lipoinjection for unilateral vocal cord paralysis.

Injection of Teflon paste is a commonly accepted procedure to improve the caliber of voice in unilateral vocal cord paralysis. There are several drawbacks to Teflon injection, among them respiratory obstruction (from overinjected Teflon) and unsatisfactory voice quality (Teflon causes stiffness of the vocal folds). This paper is a preliminary report on lipoinjection instead of Teflon injection into a paralyzed vocal fold. Fat appears to impart a soft bulkiness to the injected cord, while allowing it to retain its vibratory qualities. It is autologous material and can be retrieved if excessively overinjected. The fate of autologous fat injected into a paralyzed vocal cord remains unknown. Most of the literature on lipoinjection concerns repairs of depressed scars or breast augmentation. Our longest follow-up has been 12 months. Three patients have had this procedure, and the results appear to be very encouraging.

Primary osteoma of the sphenoid sinus.

Osteomas of the nose and paranasal sinuses are rather common benign tumors arising in the head and neck area. The sphenoid sinus is involved in various inflammatory and neoplastic conditions; however, an osteoma arising from the sphenoid sinus proper has not been reported in the available literature. This paper reviews, in detail, osteomas of the paranasal sinuses and their incidence, and a case of a sphenoid sinus osteoma is presented with radiological and pathological findings.

Chronic candidiasis of the oral cavity and esophagus.

Chronic candidiasis of the oral cavity and esophagus may present with a varying clinical picture. Three cases of this entity are presented. Infection occurs when the ecologic balance of normal flora and local factors are upset. Predisposing factors are listed. The different presentations, methods of evaluation, diagnosis, treatment alternatives, and immunologic applications are discussed. The problems of the chronic form of the disease, with it becoming deeply ingrained and recurrent, are stressed.

Parapharyngeal schwannomas.

Schwannomas of the parapharyngeal space are rare benign tumors arising from nerves located in the parapharyngeal space. Most of them occur as a mass behind the ascending ramus of the mandible, and bimanual palpation is important in ascertaining their exact location. The anatomy of the parapharyngeal space is described in detail. Treatment of these tumors is surgical through an external neck approach. A combined neurosurgical approach is indicated for tumors extending intracranially. Four cases of parapharyngeal schwannomas are added to the world literature (114 reported), with one extending intracranially through the jugular foramen.

Epithelial-myoepithelial carcinoma of the subglottic region: a case presentation and review of the literature.

Epithelial-myoepithelial carcinomas are a rare form of salivary gland carcinoma. They are found predominantly in the parotid glands and rarely occur in the upper airway and in minor salivary glands. These neoplasms are found predominantly in women in the seventh and eighth decades of life and account for less than 1% of all salivary gland ductal carcinomas. These tumors may demonstrate infiltrative and destructive patterns, with a tendency to metastasize. It is recommended that they be approached and treated along the same avenues as any other malignant lesions of the head and neck.

Primary T-cell lymphoma of oral cavity.

Immunopathologic studies classify lymphoma under the T-cell or B-cell groups. Such a classification gives a better indication for prognosis and treatment of lymphomas, with the T-cell group having the worse prognosis. A patient with a T-cell lymphoma of the oral cavity is presented. The diagnostic features and management are discussed.

Duplication of the esophagus.

Two patients with tubular esophageal duplications and the embryologic development of the esophagus are presented. The several theories in the formation of the esophageal duplications have been reviewed. As of yet, no definite explanation can be advanced for this developmental anomaly.

Congenital bronchoesophageal fistula in the adult.

Congenital bronchoesophageal fistulas usually present in infants and may occur with or without esophageal atresia. Twenty cases of congenital bronchoesophageal fistula in adults have been reported in the English literature. Another case of this rare developmental anomaly is presented here. The radiographic, endoscopic, surgical, and pathologic findings are discussed with a review of the literature.

Granular cell tumor of the trachea.

Granular cell tumors are rare neoplasms that arise in different regions of the body. Their cell of origin is still debated among many pathologists, but recent authors consider them to be neurogenic. These tumors are believed to be benign; however, local recurrences after excision and multifocality arouse suspicions for malignancy. In the head and neck, granular cell tumors occur most frequently in the tongue. In the laryngotracheobronchial tree, most tumors reported have been in the larynx and the next most in the bronchi. Only six cases of true tracheal occurrences have been reported previously; two additional cases are reported in this paper. The literature of the cell of origin of these tumors is reviewed, the different theories are presented, and diagnosis, treatment, and follow-up are discussed.