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Between January 1980 and December 1989, 110 patients with squamous cell carcinoma of the supraglottis were treated with supraglottic laryngectomy and neck dissection. The stage distribution was stage I 23%, II 34%, III 15%, and IV 28%. Adjuvant radiotherapy (5,000 to 6,500 cGy) was given to all pN+cases. All patients were followed until death or for a minimum of 36 months, with an average of 65 months. Decannulation was achieved in 96% of the cases, with only 1 patient undergoing total laryngectomy because of aspiration. The average hospital stay was 22 days. Arytenoid edema was a frequent cause of delayed decannulation in patients undergoing radiotherapy. The overall 3-year survival was 78%, with 10 patients dying of unrelated causes. Local control was 94.6% and regional control was 83.6%. No significant difference was found in survival according to T stage, but survival rate was significantly influenced by N stage.

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The AA. present a retrospective study regarding their experience, in the last 20 years (1973-1993), on diagnosis and management of tumors localized in the parapharyngeal space. In this interval 16 patients, carrying on 17 parapharyngeal tumors, were diagnosed. The incidence was similar in both sexes, the ages ranging widely, the clinic inspecific and the diagnosis confirmed late. They advise the CT with opaque media, nowadays associated to NMR, as suitable diagnostic routine. Fine needle biopsy is not recommended as regular procedure. The great deal of cases carried benign tumors, though individually metastatic epidermoid carcinomas were the most prevalent, followed by salivary and neurogenic growths. 15 individuals underwent surgery. In all but one the cervical approach without mandibulotomy--supposed to be the selective procedure--was done. No one was tracheotomized. Four postoperative nervous complications presented: 2 corresponding to malingnancies. Neither major complications nor perioperative mortality resulted.

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In spite of its rarity Wegener's granulomatosis is of great concern to be otolaryngologist because the malady may start in the territory of the speciality, challenging the actual diagnosis, owing to the inespecificity of the symptomatology, to its torpid evolution, as well as the potential harmfullness of process. This paper inform of the retrospective study done by the AA. in the last ten years, about 4 cases diagnosed and treated by them. All the possible diagnostic measures are contemplated: clinical and histopathological findings and the newly introduced tests for anticytoplasmatic antibodies against the neutrophiles. A review of the bibliography on the subject is adjoined. All the considered patients consulted at the beginning with the otolaryngologist. Diagnostic suspicion aroused only in patients with nasal complaints (50 percent) and were not under suspicion those with ear symptoms. Positive diagnosis were confirmed in all cases through renal biopsies. Nasal biopsies resulted negatives. When the syndrome started in low aged patients the evolutive course showed deleterious and the affected died after a short term of few months. In more aged a survival of 8-9 yeas was reached.

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We have studied the post-surgical results of 48 perforations of the nasal septum, regarding their etiology, location and size, which must be taken into account when deciding which closure technique to use.

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The main point in managing suspected impaction of esophageal foreign bodies is to decide whether the patient needs an esophageal endoscopy. Decision-making is based on clinical history, physical examination, and radiographic studies. We review 100 cases of adults having esophagoscopy for removal of esophageal foreign bodies. Fish bones were the most frequently responsible foreign body and the cervical esophagus was the most frequent level of impaction. Decision-making based on clinical history and patient-referred symptoms revealed a positive esophagoscopy in 72% of the suspected cases. Radiographic studies gave falsely positive and falsely negative information in 30% of the cases. Rigid esophagoscopy was used successfully for foreign body removal in 99% of the cases. Average hospital stay was 3.2 days. No complications associated with the use of a rigid esophagoscope were found.

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The incidence of severe complications following thyroid gland surgery is a major reason to recommend total thyroidectomy or a less radical procedure in treating thyroid gland diseases. A retrospective study on 335 thyroidectomies was performed to assess the incidence of postoperative complications. Rates for hypocalcemia were based on patients undergoing bilateral procedures (n = 185) and on nerves at risk for recurrent laryngeal nerve injury (n = 513). Permanent hypocalcemia (8%) and unilateral laryngeal nerve injury (2.3%) were the major complications, with 0.8% having fatal complications. The achievement of long-term normal serum calcium levels has been the most frequent complication. Recurrent laryngeal nerve injury had a significant relationship with secondary procedures, histologic findings, and no nerve identification during surgery. In our series, major complications can be blamed on technical pitfalls, even in the hands of experienced surgeons.

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