Multiple approaches to the management of CSF rhinorrhea can be successful. An endoscopic repair results in resolution of CSF rhinorrhea in the majority of cases. Patients with spontaneous CSF rhinorrhea, elevated BMI, lateral sphenoid leaks, and extensive skull base defects are at increased risk for recurrence. Alternative management options may need to be considered in these cases.

Armstrong beveled grommet tympanostomy tubes have complication rates comparable with those reported for Armstrong or other short-acting tubes in smaller series.

GER has an important role in the cause of many otolaryngologic and pulmonary disorders. Nissen fundoplication is an effective modality to treat EER in selected cases.

Objective To determine the association of neck dissection and radiation treatment for head and neck cancer (HNC) with subsequent shoulder range of motion (ROM) and quality of life (QOL) in 5-year survivors. Design Cross-sectional convenience sample Setting Otolaryngology clinics at tertiary care hospital and Veterans Affairs medical center Patients 5-year, disease-free, HNC survivors Methods Demographic and cancer treatment information was collected, including type of neck dissection (none, spinal accessory “nerve sparing” and “nerve sacrificing”) and radiation. QOL questionnaires were administered, and shoulder ROM was measured. Main Outcome Measurements University of Washington Quality of Life (UWQOL), Functional Assessment of Cancer Therapy Head and Neck (FACT-HN), and Performance Status Scale for Head and Neck (PSS-HN). Shoulder ROM measurements included abduction, adduction, flexion, extension, internal and external rotation. Results One hundred and five survivors completed QOL surveys; 85 survivors underwent additional shoulder ROM evaluations. The nerve sacrifice group exhibited significantly poorer scores for UWQOL measures of disfigurement, level of activity, recreation/entertainment, speech, shoulder disability, and willingness to eat in public, FACT functional well-being, and FACT-HN (p<.05). Shoulder ROM for flexion and abduction was poorest in the nerve sacrifice group (p<.05). Radiation was associated with significantly worse UWQOL swallowing (p<.05), but no other differences were found for QOL or ROM measurements. Decreased QOL scores were associated with decreased shoulder flexion and abduction (p<.05). Survivors with decreased shoulder abduction had significantly (p<.05) worse scores in disfigurement, recreation/entertainment, employment, shoulder disability, and FACT emotional well-being. Conclusions Sparing the spinal accessory nerve during neck dissection is associated with significantly less long-term shoulder disability in 5-year HNC survivors. QOL measures demonstrated the highest level of function in the no dissection group, an intermediate level of functioning with nerve sparing, and poorest function when the nerve is sacrificed. Decreased shoulder flexion and abduction is associated with reduced QOL in long-term HNC survivors.

With the use of only topical anesthesia, flexible endoscopy of the lower airway in children can be performed in the office setting and can be used effectively to evaluate abnormalities of the lower airway.