Nasal septal perforations are anatomical defects of the nasal septum, causing dynamic alterations in nasal physiology which may lead to variable symptoms and otolaryngological referral.Repair of nasal septal perforations continues to remain a difficult surgical problem, and nowadays there is no definitive solution for their successful surgical closure.Thirty patients with small- or medium-sized anterior nasal septal perforations were treated with a simple technique of backwards extraction-reposition of the quadrangular cartilage. Prior nasal septal surgery and repeated cautery were the most common cause of perforation. After a minimum follow-up of two years the success rate for relief of symptoms and closure of the perforation was 87 per cent.This technique showed very good results in small-sized and selected cases with medium-sized perforations, but the mucosal dissection employed is not suitable for medium to large perforations.

The incidence of p53 antigen and human papillomavirus (HPV) expression in archival formalin-fixed, paraffin-embedded tissue sections from verrucous carcinoma of the larynx was determined using immunohistochemistry.The p53 oncoprotein was detected in four of 10 tissue samples (40 per cent). The same number of tumours had HPV antigen, and three cases had both p53 oncoprotein and HPV antigen. All positive cases were from heavy smokers and drinkers.After surgical treatment, no tumour recurrence was present in our series. Four patients developed a second head and neck neoplasm and death occurred in three. Three of the patients with second tumour had p53 positive immunoreactivity and two had p13 and HPV expression.Verrucous carcinoma of the larynx presented with overexpression of p53 antigen in a similar percentage to other head and neck cancers. The p53 immunohistochemical determination is well correlated with HPV detection and could have prognostic value in these tumours, but no statistical evidence was present.

Background Cytomegalovirus (CMV) infection is a common opportunistic pathogen in transplant recipients; however, cytomegaloviral laryngitis is extremely rare. Methods We present a case of disseminated CMV infection and ulcerating necrotizing laryngitis situated in the subglottis of an immunocompromised patient with a renal and cardiac transplant. The patient was initially seen with discomfort in the throat. Results Physical examination of the head and neck, fiberoptic laryngoscopy, and CT scan of the larynx were normal. Histopathology of a laryngeal ulcer in the subglottic region showed intranuclear and intracytoplasmic bodies. Immunoperoxidase stain and in situ hybridization studies were positive for CMV. Conclusions In immunosuppressed patients with persistent throat symptoms, the systematic exploration of larynx and bronchus is necessary to rule out the presence of opportunistic infections. HEAD & NECK 1996;18:455–458 © 1996 John Wiley & Sons, Inc.