Our experience with anomalies of the first branchial cleft is reviewed. This includes 38 cases, the largest series collected to date. A new classification is proposed based on the anatomic findings--whether cyst, sinus, or fistula is present. The embryology and pathology of first cleft anomalies are discussed and an approach to the diagnosis and management of these lesions is given. In addition, a patient with a branchial cleft defect involving the middle ear space is reported.

The majority of patients demonstrated significantly worse swallow function on all three methods of analysis at 19 weeks after completion of treatment. Continued detailed monitoring of patients' swallow function is critical in determining long-term effects of intra-arterial chemoradiation therapy and neck dissection.

Maragos, MD0-Vectives: Airway compromise arising from thyroplasty procedures including Isshiki type I through · IV thyroplasties, arytenoid adduction, and arytenoid fixation is uncommon yet potentially life threatening. Identification of incidence of obstruction and probable causes is important for preoperative planning, consultation, and postoperative care. Study Design: Retrospective review of all thyroplasty operations, including arytenoid adduction and arytenoid fixation. Methods: Three hundred thirty-two patients underwent a total of 630 thyroplasty procedures. Detailed information was gathered on patients manifesting symptoms of airway obstruction. Results: Seven patients required an unplanned tracheostomy for airway compromise. Five of 143 patients who underwent arytenoid adduction required a tracheostomy, for an incidence of3.5%. The median interval to developing significant stridor requiring tracheostomy was 9 hours, with five of these seven patients requiring airway surgery within the first 18 postoperative hours. No patient receiving a type I thyroplasty alone developed significant airway compromise. Tracheostomy was required in two patients with underlying n euromuscular disease-one who underwent a bilateral type I thyroplasty and one who underwent an arytenoid fixation procedure. Conclusion:The percentage of airway complications after thyroplasty is low. However, arytenoid adduction and fixation operations have a significant risk of postoperative temporary tracheostomy and warrant preoperative discussion regarding tracheostomy and postoperative overnight hospital admission.