The rate of total laryngectomy has dropped more than the incidence of laryngeal cancer has dropped, consistent with the trend toward nonsurgical treatment. Lower surgical volumes and/or salvage laryngectomy surgeries are hypothesized to play a role in longer length of stay, stable mortality rates despite younger patient age, and increased need for home services after discharge.

Although the data are inconclusive, there is a potential link between PDE-5 inhibitor use and SSHL. Otolaryngologists should, therefore, inquire regarding PDE-5 inhibitor use as a potential cause of SSHL. Although there is currently no direct evidence for a mechanism of this side effect, we postulate that it is related to the prolonged effects of intracellular cyclic guanosine monophosphate (cGMP) within the cochlea.

Multiple markers were used to count Langerhans' cells in the cervix. In the normal cervix, thymocyte antigen (T6) and adenosine triphosphatase ( ATPase) demonstrated the largest population of Langerhans' cells. MHC Class 11 positive cells were equivalent to 60%, and SlOO positive cells were equivalent to 35% of T6 or ATPase positive cells, Whereas Langerhans' cells demonstrated by T6, ATPase, and MHC Class I1 antigen were evenly distributed throughout the epithelium, the SlOO positive cells were seen predominantly near lymphocytic aggregates and capillaries. In human papillomavirus infection and cervical intraepithelial neoplasia the numbers of T6, ATPase, or MHC Class I1 positive Langerhans' cells were reduced by 60% but the SlOO positive cells were almost completely depleted. These findings suggested that there were different subpopulations of Langerhans' cells in the cervical epithelium. The depletion of Langerhans' cells, particularly the selective depletion of the SlOO positive subpopulation, might cause a localized immunodeficiency that impairs immune surveillance and the cell-mediated immune response to human papillomavirus infection and cervical intraepithelial neoplasia.Human papillomavirus (HPV), types 16 and 18in particular, appears to be an important aetiological factor in the development of cervical neoplasia (Gissman ef al. 1983;McCance et al. 1985; Kreider et al. 1985). Viral pathogenesis is the outcome of interaction between the virulence of the virus and the host immune

The direct health care costs of younger NSCLC patients care are substantial. These results should serve as a benchmark for future comparisons as the United States market shifts to managed care.

In this 17-year rural case series of all parotidectomy procedures done for nontrauma indications, the largest number of malignancies came from metastatic tumors. Although facial nerve paralysis is not a common complication, it occurs most often when surgery is performed for either primary or metastatic malignancy. Surgeons will benefit from this information as they counsel patients who are considering parotidectomy.