Good oncologic results and vocal outcomes with no difference between controls and subepithelial and subligamental cordectomies support the use of CO2 laser endoscopic surgery as the first line of treatment for early glottic cancer.

Objectives To compare clinical variables and outcomes for children with subperiosteal abscesses of the orbit (SPAO) managed medically vs surgically to identify clinical prognosticators. Study Design Case series with chart review. Setting Tertiary children's academic institution. Subjects and Methods The study included 48 children between the age of 1 month and 14 years, with SPAO from 2003 to 2013. Variables included age, sex, physical examination findings, laboratory results, computed tomography (CT) findings, hospital length of stay, length of antibiotic therapy, and placement of a peripherally inserted central catheter (PICC). Intended methods for comparison were the Student t test for continuous variables and Fisher's exact test for categorical variables, and a forward stepwise multiple logistic regression. Results Thirty-two (67%) children were successfully treated with antibiotic therapy only, and 16 (33%) required surgery. Abscess volume, abscess width, and the presence of gaze restriction were statistically different between the 2 groups. A multivariate analysis found abscess volume as the only predictor for surgical intervention. A subgroup analysis including only patients with an abscess volume of ≥500 mm (n = 26) was performed. Eleven patients were treated medically and 15 treated surgically, with the medical group having longer hospital stays ( P = .048), duration of antibiotic therapy ( P = .035), and higher incidence of PICC placement ( P = .005). Conclusions This is the first study to report that abscess volume has clinical implications, as children with SPAO volume ≥500 mm treated medically have longer inpatient admissions, antibiotic therapy durations, and PICC placement. When children present with an abscess ≥500 mm, early surgical intervention should be strongly considered, even in the absence of other surgical criteria, to shorten duration of hospitalization and accelerate clinical improvement.

Extramedullary plasmacytomas are uncommon tumors, with a worldwide annual incidence of 3 per 100,000 population. They accountfor 1% ofall tumors ofthe head and neck and 4% ofall nonepithelial tumors ofthe nasal tract. A variety of treatment options has been suggested. These treatments VQl Y according to the site ofpresentation, the presence of locoregional spread, and the histologic picture. Radiotherapy has been widely used as a treatment modality, but little has been written about surgery as a single management modality. However, such an option assumes importance in a developing nation, where patient follow-up is errati c and treatment costs must be kept low. We discuss the feasibility of surgery in such a circumstance, and we describe our surgical treatment of a case of extramedullary plasmacytoma in an elderly woman who presented to our hosp ital in India.

The facelift approach is a cosmetically superior approach to parotid tumors as proven by objective data. Most publications in the literature pertaining to the modified facelift incision for parotidectomy have been in the past decade, lending credence to its rising popularity.