The nasolabial cyst is an uncommon midfacial cyst. Twenty-six patients with nasolabial cysts were treated at the New York Eye and Ear Infirmary from 1969 to 1986. Most of these lesions manifested facial deformity, unilateral nasal obstruction, and pain when infected. The nasolabial cyst is often unrecognized or confused with other intranasal masses, or fissural and odontogenic cysts. Infection of these lesions--which occurred in 50% of the patients--may mimic facial cellulitis, periodontal abscess, acute maxillary sinusitis, or nasal furuncles. This cyst is considered to be a hamartoma because of its developmental origin from entrapped epithelium in an embryonic fusion plane. Simple aspiration invariably leads to recurrence, and complete surgical excision is the accepted treatment. The nasolabial cyst should be considered in the differential diagnosis of intranasal masses, midface infections, and swelling in the nasolabial area.

IMBI is a safe, readily available, cost-effective, and underutilized technique that facilitates rapid identification of parathyroid adenomas, helps distinguish normal glands from hyperplastic glands, and helps to locate ectopic glands. An overall reduction in operative time, especially for bilateral neck exploration, can be anticipated.

The endolaryngeal structures are subjected to insult from prolonged endotracheal intubation. Factors that may exacerbate this injury include intubation technique, duration of intubation, tube geometry and constitution, frequency of reintubation, and patient-related factors such as concomitant medical diseases. The contribution of underlying medical disease to laryngeal intubation injury was studied prospectively by sequential endoscopy from the time of tracheotomy. Diabetes mellitus, congestive heart failure, and a history of stroke or tuberculosis increased the likelihood of severe laryngeal injury. The association of these disorders with severe laryngeal injury should lead to consideration of earlier tracheotomy in such patients.

Sarcoidosis is a chronic multisystem granulomatous disease that has a predilection for pulmonary and upper respiratory tract involvement. Because the initial signs and symptoms of sarcoidosis may be identical to those of other forms of chronic sinonasal inflammatory disease, these patients will often first seek treatment from an otolaryngologist. We present a series of 28 patients whose primary symptoms was involvement of a sinonasal tract. A new staging system is proposed to categorize the severity and sites of involvement and to guide the aggressiveness of therapy. Sarcoidosis should be considered in the differential diagnosis of inflammatory sinonasal disease.

Four cases of primary squamous cell carcinoma of the thyroid gland are reported. Thorough evaluation confirmed these lesions to be of primary thyroid origin rather than from metastasis or direct invasion from contiguous structures. These cases illustrate the aggressive nature of the disease and the propensity for local and distant metastases. The clinicopathologic data presented here underscore the challenge in diagnosis and treatment of this rare entity.

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Pharyngoesophageal perforation and neck abscess formation is a rare complication of anterior cervical spine surgery. This complication usually manifests itself within the early postoperative period and is associated with soft tissue trauma at the time of surgery. We describe two cases of retropharyngeal abscesses and persistent pharyngocutaneous fistulae which occurred in a delayed fashion several months after cervical spine surgery. The etiology, diagnosis, and treatment of this problem is discussed with a review of the current literature.

As cocaine abuse has become increasingly widespread, there has been a concomitant rise in associated medical complications. Nasal inhalation ("snorting") causes profound effects on the upper respiratory tract in addition to the well known nasal septal perforation. Septal necrosis can be accompanied by bleeding, granulation tissue, ulceration, and sinusitis. There are few reports of extensive sinonasal tract osteocartilaginous necrosis from cocaine abuse. We present five patients with this complication, which must be distinguished from other destructive midface lesions such as Wegener's granulomatosis and polymorphic reticulosis.