Aim: To describe the management of patients with elongated styloid process syndrome (Eagle's syndrome). Materials and Methods: Sixty-one patients with elongated styloid process were treated between 2000 and 2005. Computed tomography examination defines those whose symptoms suggest the diagnosis. Patients with styloid processes longer than 25 mm were treated by surgical resection. Results: Fiftyseven (93.4%) of 61 patients treated for Eagle's syndrome became asymptomatic after resection. There were no serious complications. Conclusion: Patients with clinically and radiologically established elongated styloid process can be managed successfully by surgical resection using an external approach.

Nasal irrigation with isotonic or hypertonic saline can improve mucociliary clearance time in various nasal pathologies. However, these solutions should be selectively prescribed rather than used based on anecdotal evidence. Further studies should be conducted to develop a protocol for standardised use of saline solution irrigation in various nasal pathologies.

Objectives: Evaluate preoperative and postoperative electrophysiological changes related to the accessory nerve with reference to dissection technique, modified radical neck dissection, and lateral neck dissection. Study Design: Prospective electrophysiological analysis of accessory nerve function in a total of 20 laryngeal carcinoma patients after neck dissection, 12 being lateral neck dissection (4 bilateral) and 8 being modified radical neck dissection. Methods: Distal latencies, compound muscle action potentials, and electromyography findings were investigated before surgery and, in early and late postoperative periods in 20 laryngeal carcinoma patients. Results were evaluated by Student t test and "x2 test for intragroup and intergroup differences. Results: In the lateral neck dissection group, postoperative distal latencies were longer, without statistical significance, whereas in the modified radical neck dissection group postoperative latencies were statistically longer. Postoperative compound muscle action potentials were significantly lower in both groups. Electromyographic work-up showed deterioration in early postoperative periods and improvement in late postoperative periods. When intergroup differences were compared, both postoperative compound muscle action potential and electromyographic findings were worse in the lateral neck dissection group. Conclusions: The accessory nerve function after modified radical neck dissection is better than function after lateral neck dissection because of increased stress applied to the nerve during retraction of the sternocleidomastoid muscle for achievement of a better exposed surgical field in lateral neck dissection.

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In order to evaluate lymphatic metastasis to the supraretrospinal recess (SRSR) in laryngeal squamous cell carcinoma (SCC), we separately dissected SRSR lymph nodes and submitted them to pathological examination. Fifty-three lateral neck dissections (LNDs), 2 radical neck dissections (RNDs), and 19 modified RNDs were performed in 49 previously untreated patients with laryngeal SCC. The nodal status of the patients was N0 in 29 patients, N1 in 17, and N2 in 3. The neck was pathologically positive in both RNDs (100%), in 7 of 19 modified RNDs (37%), and in 7 of 53 LNDs (13%). No SRSR lymph nodes were positive in any of the dissection materials. No metastasis was found in the SRSR lymph nodes in the N0 necks treated with LND, and none was found even in N1 and N2 necks treated with RND or modified RND. We conclude that the SRSR may be left undissected during treatment of an N0 neck with LND so that accessory nerve dysfunction can be minimized and operative time can be saved.

We studied the incidence of Frey s syndrom e and facial contour deformity in two groups of patients who had undergone supe rfic ial parotidectomy. One group was made up of 12 patients who were randomized to undergo reconstruction ofthe surgical defect with a sternocleidomastoid muscle jlap; the other 12 patients did not receive a jlap. All 24 patients were evaluated via a short questionnaire, the starch-iodine test, and a visual examination. On the questionnai re, none of the 24pati ents said they experienced abnormalfa cial sweating, flu shing, or warmth while eating, although 6 of the 12 patients in the nonjlap group had a mildly positive starch-iodine test. No patient in the flap group had a positive test. The difference between the two groups was statistically significant (p < 0.05). No statistically significant difference was seen between the two groups with respect to cosmetic results.

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Although choanal polyps frequently arise from the maxillary sinus, a choanal polyp originating from the sphenoid sinus is a rare entity. In this report, an unusual case of a large choanal polyp taking origin from the sphenoid sinus is presented. The reasons for its development and methods of management are discussed.