Rhinosinusitis associated with the S anginosus group should be considered a more serious infection relative to those caused by other pathogens. Streptococcus anginosus group bacteria are significantly more likely than other bacteria to cause more severe intracranial complications and neurologic deficits and to require neurosurgical intervention. A low threshold for intervention should be used for infection caused by this pathogen.

2b.

Patients with head and neck squamous cell carcinoma were significantly more likely to survive with completion of follow-up and tobacco cessation. Compliance with PTS was associated with smoking cessation and traveling less than 200 miles for follow-up.

Our experience is that FEES guides appropriate and safe diet recommendations in this population.

BackgroundTrans-nasal flexible fibre-optic laryngoscopy (TFFL) is an essential skill for otolaryngologists. There is evidence to suggest that simulators help residents acquire procedural skills. The objective of this study was to examine the effect of simulation on endoscopy skill acquistion.MethodsA randomized controlled trial was conducted utilizing medical students and junior residents with limited experience in TFFL. Learners all performed a baseline endoscopy and were then randomized to receive either 45 minutes of simulation training or not. Following this, a second endoscopy was performed. Time to adequate visualization of the glottis, the percentage of time adequate visualization of the airway was maintained, and the number of collisions with mucosa were analyzed. Qualitative assessments were also obtained from the learner, patient, and staff laryngologist.ResultsTime to adequate visualization of the glottis and the number of mucosal collisions were significantly less during the second endoscopy, irrespective of the use of simulation (84.8 sec vs. 68 sec, p < 0.01; 5.0 vs. 3.2, p < 0.01, respectively). Analysis using a two-way ANOVA with interaction established that none of the quantitative measures analyzed in this study improved with the addition of simulation.ConclusionImprovements in time to visualization of the glottis and number of mucosal contacts were seen between the first and second endoscopy irrespective of simulator use. No additional benefit was conferred with the use of a low-fidelity simulator.

Although there were several differences between the groups, significant improvements in quality of life up to 12 months after endoluminal therapy were observed in most patients.

Central neck dissection seems to be performed adequately; however, there is a significant variation in lymph node yield. Future initiatives should try to standardize the central neck dissections performed, with emphasis on obtaining a sufficient yield. © 2015 Wiley Periodicals, Inc. Head Neck 38: E328-E332, 2016.

eptal perforation (SP) is a common nasal disorder. A 2003 Swedish study 1 quoted a 0.9% prevalence of SP among the general population. The origin of SP is associated with the following 4 main causes: trauma, iatrogenesis, inflammation or malignancy, and inhalation. 2 Once the mucoperichondrium of the nasal septum becomes traumatized, diminished blood supply can lead to cartilaginous and mucosal necrosis. 3 Local reepithelialization of the mucosal edges then occurs, preventing closure of the defect. 4 Patients with SP may be seen with various symptoms and signs that often correspond to the size and location of the SP. An asymptomatic SP does not require any intervention. 5 Most symptomatic SPs are large and anterior, while posterior SPs tend to be less symptomatic due to humidification of the passing air by nasal mucosa and turbinates. 3 Common symptoms include nasal crusting, discharge, epistaxis, parosmia, neu-ralgia, and a whistling sound with inspiration. Some patients may manifest low-grade perichondritis, requiring long-term antibiotic therapy. Larger long-standing SPs can also cause atrophic rhinitis and saddle nose from a lack of nasal dorsal support. 2,6,7 Despite their being a common problem, SPs have been a distinctive challenge for otolaryngologists and facial plastic surgeons. Various techniques have been described to close SPs, and no single technique is recognized as being uniformly reliable in applying to all cases. 2 Furthermore, SP repair is often performed in noses that have already undergone surgery and have limited tissue and a compromised blood supply for reconstruction. Therefore, most SPs remain unclosed because available techniques are technically difficult and require extensive training and experience to master. IMPORTANCE Numerous techniques have been described to repair nasal septal perforations (SPs). However, many are technically challenging, with varying degrees of success. OBJECTIVE To evaluate the use of polyethylene (Medpor; Porex Technologies) implants in the closure of nasal SPs. DESIGN AND SETTING Prospective cohort study in an academic research setting.