The conservative treatment for a high jugular bulb is regular follow-up with serial imaging studies to detect possible progression, even in asymptomatic cases.
The pathogenesis of amyloidosis appears to be multifactorial, but the common final pathway is identical in all forms of the disease; i.e., the production of amyloid fibrils in the extracellular matrix.
An 82-year-old man was referred for evaluation of nodular lesions on the tongue and left buccal mucosa. He had an 8-year medical history of chronic renal failure and had been treated with hemodialysis. Two months prior to presentation, the first nodular lesion appeared on the tip of his tongue. Seven days later, four new nodular lesions appeared...
Conventional therapy for cicatricial pemphigoid has consisted of the administration of a steroid alone or a steroid plus an immunosuppressant.
We conducted a study to analyze the effectiveness of transnasal esophagoscopy (TNE) as an alternative to operative endoscopy (OE) for the evaluation of primary head and neck cancers and for the surveillance of synchronous esophageal cancers. Our study population was made up of 96 consecutively presenting patients-75 men and 21 women, aged 45 to 88 years (mean: 64)-who were treated at our institution for squamous cell cancer of the head and neck. Of this group, 42 patients had been evaluated with TNE and 54 with OE. More OEs were performed in patients with an unknown primary (26 vs. 3). Incidental findings on TNE included 3 cases of gastritis, 2 cases each of hiatal hernia and esophagitis, 1 case of Barrett esophagus, and 1 inlet patch. No incidental findings were reported during OE. Primary cancers were biopsied by TNE through a port on the endoscope in 4 patients; 2 of these cancers were in the tongue base, 1 in the hypopharynx, and 1 in the aryepiglottic fold. After the initial visit, patients in the TNE group waited significantly fewer days for their endoscopy than did those in the OE group (median: 6.5 vs. 16; p < 0.05). Conversely, patients in the OE group waited significantly fewer days for treatment following endoscopy (median: 12 vs. 20; p < 0.05). However, there was no significant difference between the TNE patients and the OE patients in the total number of days comprising their entire course of management, from the initial visit to definite treatment (median: 27.5 and 33 days, respectively; p = 0.7). We conclude that TNE is a reasonable alternative to OE for the initial screening for synchronous esophageal cancers in patients with squamous cancers of the head and neck. OE is preferred for the initial workup of unknown primary cancers and for large tongue base cancers. The rate of detection of clinically relevant incidental findings is higher with TNE. Biopsy is possible during TNE for all subsites within the upper aerodigestive tract.
Acantholytic squamous cell carcinoma (ASCC) of the mucosal membranes has been documented sporadically. The highly aggressive behavior of a mucosal ASCC arising in the oral cavity has been recently reported. To the best of our knowledge, only 1 autopsy case of maxillary ASCC previously has been reported in the literature. We pre-sent what we believe is only the second case of maxillary ASCC. Our goal is to emphasize the aggressive behavior of this tumor in order to add weight to the argument that the prognosis is poor.
Acantholytic squamous cell carcinoma (ASCC) is an uncommon histologic variant of squamous cell carcinoma (SCC).1-3 It generally arises in the sun-exposed skin of the head and neck, although a few sporadic cases in the mucosal membranes have been documented.2,3 In a recent case report, Kerawala suggested that mucosal ASCC is more...
Medial canal fibrosis is an uncommon condition characterized by progressive stenosis of the bony external auditory canal.
A 64-year-old woman presented with a gradual left-sided hearing loss and intermittent otorrhea that had been present for 2 to 3 years. She also complained of aural fullness and pressure. She previously had been treated with topical antibiotic/steroid drops, boric acid powder, and oral antibiotics.
Much debate currently exists as to the timing of vocal fold atrophy following denervation and as to why some patients maintain excellent muscle tone despite long-standing nerve injury.
A 56-year-old woman presented to the Lakeshore Ear Nose and Throat Center with a 6-week history of a breathy voice after an upper respiratory infection. She denied any other head and neck symptoms such as otalgia, dysphagia, and odynophagia and reported no weight loss. She had no history of surgery to the head and neck, tobacco use, or alcohol...
Extracorporeal septoplasty represents a novel and evolving technique for the surgical correction of the severely deviated septum.
While classic techniques are often successfully employed to address mild to moderate deflections of the nasal septum, the severely distorted septum represents a unique challenge for the surgeon. Patients frequently present with both aesthetic and functional concerns, often as a result of trauma, previous surgery, and/or congenital malformations (...
The optic nerve and other important structures in the anterior skull base can be involved in chronic sphenoidal sinus disease.
The optic nerve and other important structures in the anterior skull base can be involved in chronic sphenoidal sinus disease.1,2 An unusual bony anomaly of the sphenoid sinus in the case presented here led to blindness.3,4
An extranasopharyngeal angiofibroma should be differentiated from other vascular tumors, particularly a hemangioma.