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Despite the availability of noninvasive neuroradiographic techniques for the evaluation of head and neck neoplasms, paragangliomas of the carotid body often achieve substantial size before definitive diagnosis. Surgical "exploration" for the attempted resection of these lesions often results in significant blood loss, inadvertent cranial nerve injury, and procedure abandonment with partial tumor removal. Sixteen carotid body tumors were surgically resected at our institution between July 1988 and January 1995. Four of these patients had undergone cytologic examination by fine-needle aspiration (FNA) and another 6 patients underwent failed attempted resection of their lesions as the result of intraoperative hemorrhage. Of the remaining 6 patients referred for the first time evaluation of a "neck mass," the diagnosis was made by patient history, physical examination, magnetic resonance imaging, or magnetic resonance angiography. Complete tumor removal was accomplished in all 16 patients using a variety of lateral transcervical and skull base approaches. This article focuses on the clinicoradiographic diagnosis of carotid body tumors that do not need preoperative histologic confirmation. Specific intraoperative techniques for tumor removal, carotid artery management, and cranial nerve preservation are demonstrated through case presentations. Perioperative morbidity and overall results are detailed for this series of patients.

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We report on our experience with nonsurgical office closure of tympanic membrane pars tensa pelf orations with the little-used but well-established Derlacki method, a procedure that had been in general use bef ore the introduction of tympanoplasty more than a half century ago. We describe our results-including a success rate of 84.2%-in treating 81 pelf orations during the 6-year span fro m 1996 through 2001.

The Southeast Asia Treaty Organization (SEATO) was a military alliance created to defend Southeast Asia against communist aggression and subversion during the Cold War. SEATO was the organization formed in 1955 to implement the Southeast Asia Collective Defence Treaty, also known as the Manila Pact, signed in Manila in September 1954. Signatory members included Australia, France, New Zealand, Pakistan, the Philippines, Thailand, the United Kingdom (UK), and the United States of America (US). The roots of SEATO can be found in one of the main events of the Cold War: communist victory in the civil war in China, leading to the establishment of the People's Republic of China (PRC) in October 1949. SEATO's declared purpose was to organize collective security to deter, or if necessary defeat, Chinese communist aggression in the region. The treaty and the organization it produced were the direct response to the military victory won by the communistled Vietminh in their war to expel French power from Vietnam. The struggle to contain communism in Vietnam defined SEATO from start to finish; massive American military intervention sidelined SEATO in 1965. This led many scholars to dismiss SEATO as an abject failure. This is hasty, but it does stem from something central: the relationship between the nature of the alliance and the problems it confronted.

Vo Nguyen Giap is a Vietnamese communist who became world famous for his role in the wars in Vietnam from 1946 to 1975. Giap has been credited for conceiving and executing the doctrine of “people's revolutionary warfare,” winning the decisive battle at Dien Bien Phu in 1954 that drove the French out of Vietnam, and being the principal strategist in the war that unified Vietnam under communist rule, despite prolonged US military intervention on a massive scale. As is often the case, the reputation strays beyond the evidence.

Despite the availability of noninvasive neuroradiographic techniques for the evaluation of head and neck neoplasms, paragangliomas of the carotid body often achieve substantial size before definitive diagnosis. Surgical “exploration” for the attempted resection of these lesions often results in significant blood loss, inadvertent cranial nerve injury, and procedure abandonment with partial tumor removal. Sixteen carotid body tumors were surgically resected at our institution between July 1988 and January 1995. Four of these patients had undergone cytologic examination by fine-needle aspiration (FNA) and another 6 patients underwent failed attempted resection of their lesions as the result of intraoperative hemorrhage. Of the remaining 6 patients referred for the first time evaluation of a “neck mass,” the diagnosis was made by patient history, physical examination, magnetic resonance imaging, or magnetic resonance angiography. Complete tumor removal was accomplished in all 16 patients using a variety of lateral transcervical and skull base approaches. This article focuses on the clinicoradiographic diagnosis of carotid body tumors that do not need preoperative histologic confirmation. Specific intraoperative techniques for tumor removal, carotid artery management, and cranial nerve preservation are demonstrated through case presentations. Perioperative morbidity and overall results are detailed for this series of patients.

No abstract