The clinical assessment of aerodynamic parameters is important in the physiology and pathophysiology of laryngeal function. Vocal efficiency is among these objective measurements and can be calculated from simultaneous recordings of subglottic pressure, airflow, and sound intensity. Modern techniques allow us to accurately determine sound intensity and airflow. However, methods to determine subglottic pressure are either invasive or laborious. We have evaluated a noninvasive, indirect method to determine subglottic pressure by using a technique based on the interruption of transglottic airflow during phonation. The correlation between the indirectly acquired subglottic pressure measured in the oral cavity by using this technique and the subglottic pressure obtained directly by translaryngeal puncture in human volunteers was highly significant in 35 trials (r = .92, p less than .01). This study describes a reliable technique for the noninvasive measurement of subglottic pressure, sound intensity, and airflow.
Hemangiopericytomas are rare tumors of vascular origin most commonly found in the extremities or retroperitoneal area. When they originatefrom the nasal cavity and paranasal sinuses, they tend to be less aggressive and generall.v do not metastasize. The term "hemangiopericytoma-like lesion" has been coined for sinonasal hemangiopericytomas that display more benign histologic and growth characteristics than do those located elsewhere. Fifteen cases of hemangiopericytoma of the nasal cavity and paranasal sinuses were reviewed over the period 1951 to 1990; included arefol/ow-up data on cases reported earlier from this institution. The clinical course, management, and outcome was evaluated and correlated with the histologic characteristics of the tumors. The recurrence rate in our series was 13.3%; the meanfol/ow-up was 11 years. No patients died of their disease or had evidence a/metastatic disease. This clinicopathologic review suggests that sinonasal hemangiopericytomas should not be classified as "hemangiopericytoma-like" lesions; rather, they should be expected to have significant local recurrence rates with low rates of distant metastasis and mortality. Long-term/ol/ow-up is essential as Rochester, Minnesota
Our results showed that experienced parathyroid surgeons will achieve comparable excellent outcomes of parathyroid surgery at both community and academic-based centers. As the field of endocrine surgery evolves and matures, producing young fellowship-trained endocrine surgeons, there will be growing need for expanding the niche of endocrine surgery into community-based hospital settings, which eventually will contribute to expanding and equalizing access to high-quality surgical care across urban and rural areas.
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