No abstract

Neck dissections sparing CN XI are associated with better pain scores on the HNQOL, less shoulder and neck pain, and less need for medications. When CN XI is spared, not dissecting level V of the neck is associated with better HNQOL pain scores, less shoulder or neck pain, and fewer physical problems.

A retrospective review of 135 patients surgically treated for obstructive sleep apnea syndrome (OSAS) from 1982 to 1987 was performed to identify perioperative complications and potential risk factors. The incidence of complications was 13% (18/135). Airway problems comprised 77% (14/18) of these complications, resulting in one death. There were three postoperative hemorrhages and one postoperative arrhythmia. Comparison of the complication group versus the noncomplication group showed a statistically significant difference in the minimum oxygen saturation (66% vs. 79%) and apnea index (75 vs. 57) on the pre-operative sleep study and in the amount of narcotic administered intraoperatively. Patients with intubation complications tended to be heavier, whereas patients with extubation complications received significantly more narcotic analgesia intraoperatively. Risk for a perioperative complication was not related to age, type of obstructive symptoms, medical problems, or concurrent septoplasty/tonsillectomy. A protocol for perioperative airway management is presented.

No abstract

After chemoradiotherapy, clinical parameters do not identify those patients with residual neck node disease or those at risk for regional failure, suggesting that ND be considered for all N2-N3 patients.

Symptomatic strictures occur in 21% of patients undergoing concurrent chemoradiation for HNSCC. Female sex, BID radiation fractionation, and a hypopharyngeal primary site are significant predictive factors for stricture formation.

The findings of this study suggest that advanced T-stage and positive microscopic margins are important factors in determining the necessity for postoperative radiation therapy for ACC of the head and neck and that radiation therapy may not be necessary for patients with early T-stage tumors and negative surgical margins.

Most patients with paranasal sinus malignancies presented with locally advanced disease. Advanced T stage, regional, and distant metastasis are highly predictive of poor survival. Recurrence rate is high and typically occurs within the first year after treatment.