Diffuse thyroidal FDG uptake may be an indicator of chronic thyroiditis. The actual prevalence of the disorder was not low in this series, and such lesions may be found incidentally at FDG PET.

Subglottic stenosis carries devastating consequences. Its pathogenesis, and therefore prevention, have thus far eluded precise definition. The following data suggest that tracheostomy results in a contaminated wound, secondarily infecting a larynx which may have been injured by prior intubation, fracture, or surgery. The interpretation of these data is based upon the tested assumption that infection prolongs healing of injured tissue and predisposes to scar and stricture formation. Therefore, the ability of control stomal contamination by the judicious use of topical or systemic antibiotics may play an important role in the prevention of complications in an organ functionally by-passed by the tracheostomy cannula.

The clinical observation of aspiration following prolonged tracheostomy prompted a neurophysiologic investigation of the glottic closure reflex in dogs longitudinally evaluated after permanent tracheostomy. The data support significant alterations in the central organization of the protective closure reflex heretofore considered phylogenetically primitive and therefore physiologically stable over wide ranges of functional demand. The data indicate that chronic upper airway bypass results in: 1. increased threshold of the evoked adductor response; 2. random shifts in its latency; 3. rapid attenuation of the primary evoked response to repetitive SLN stimulation; and 4. reduced after-discharge activity, all of which contribute to a weakened, ill-coordinated closure respons.

No abstract

In the cancer screening with FDG PET for 1,872 medical health club members, high FDG accumulation in the parotid gland was found in four males (age, 57-70 years). Warthin's tumor was confirmed by surgical pathology. The exact mechanism of high FDG accumulation in Warthin's tumor is not yet known. This tumor may be found incidentally during FDG PET studies. When high FDG accumulation is found in the parotid gland, integrated consideration of the results of the physical examination, medical history and 99mTc-pertechnetate scintigraphy makes it possible to differentiate Warthin's tumor from other lesions.

Role of chemotherapy in 5 000 patients with head and neck cancer treated by curative surgery: a subgroup analysis of the Meta-Analysis of Chemotherapy in Head and Neck Cancer

No abstract

Although the phonatory activity of cricothyroid muscle is well-known, its respiratory role often remains unrecognized. Recent data suggest this muscle plays a major role in the overall regulation of breathing by its control of expiratory resistance and flow. Cricothyroid contraction in expiration results in vocal elongation increasing glottic size. Such a mechanical effect reduces airway resistance and shortens expiratory duration. By such a mechanism, the rate of respiration may ultimately be modified using the larynx as the principal effector of this control. In this regard, cricothyroid expiratory activity is a pressure-sensitive evoked response influenced by afferent vagal stimuli. Its activity is triggered by a critical threshold of pressure-increase with respect to time, and its duration is directly dependent on the duration of positive subglottic pressure. The threshold of cricothyroid activation is reduced in hypercapnia and elevated in hypocapnic states.