Flow volume loops have been valuable in the diagnosis of upper airway obstruction in adults; however, the use of this technique in neonates has been limited because of their inability to perform a forced exhalation. We have used the tidal breathing flow volume loop (TBFV) to evaluate upper airway function in 100 neonates and infants. Eleven of the neonates and infants tested with this method were found to have laryngotracheal abnormalities such as tracheal stenosis, innominate artery compression, subglottic hemangioma, and unilateral vocal cord paralysis. Normal neonates and infants demonstrate a round or oval TBFV loop pattern, while those with upper airway obstruction show a flat inspiratory or expiratory curve. Tidal breathing flow volume loops offer a new, rapid and noninvasive method for evaluating the upper airway function in neonates and infants, and may play an important role in diagnosing upper airway dysfunction and evaluating the need for therapeutic intervention.

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The cemento-ossifying fibroma, a mesodermal type of non-odontogenic tumor, is rarely discussed in the otolaryngologic literature. It is a tumor that is seen more in blacks than in whites, appears largely in the elderly, is chiefly located in the mandibular molar or premolar area and is generally neither aggressive nor excessively destructive. The triggering mechanism for its derivation from aberrant periodontal membrane growth or development from endosteal fibrous tissue remains controversial. We report a case of cemento-ossifying fibroma in a 26-year-old Hispanic male which was located in the posterior portion of the maxilla which destroyed the maxillary bone, orbital floor, and the lateral wall of the nose. One year prior to discovery of the lesion the patient sustained severe facial trauma resulting in facial bone fractures. It may be speculated that the trauma sustained was the critical triggering factor allowing for unchecked growth and destruction associated with an otherwise non-aggressive tumor, which may have been present prior to the traumatic incident.

A 65-year-old man with a previous biopsy-proven diagnosis of amyloidosis of the palate came to the emergency department with a 24-hour history of intermittent bleeding from the mouth. He had no history of multiple myeloma, bleeding disorders, oral trauma, or smoking, and he was not taking any medications.Examination of the head and neck showed a 2 × 3 cm dark, painless, soft mass involving the soft palate, covered with a congestive, purplish mucosa (Fig. 1). The rest of the head and neck examination was normal. Laboratory findings revealed a normal complete blood cell count and normal results of liver function tests, coagulation studies, urinalysis, serum protein electrophoresis, chest x-ray analysis, and electrocardiography.Silver nitrate cautery was not effective in alleviating the bleeding. The patient required intravenous aminocaproic acid for hemostasis. He was given oral saline rinses and humidification and has since done well with no further episodes of bleeding. The patient had persistence but no progression of amyloidosis of the palate at 2-year follow-up.