Permanent facial nerve paralysis after parotidectomy occurs in 0-7% of cases. Currently, a majority of otolaryngologists in the United States are employing facial nerve monitoring during parotid surgery some or all of the time, even though no studies to date have demonstrated improved outcomes with its use. Physician training background and surgery caseload were significant factors influencing usage of facial nerve monitoring in this study.

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with organ-sparing intent and to analyze the risk factors and management issues.Methods: A total of 129 patients with Stage III and IV squamous cell carcinoma of the larynx or hypopharynx were treated with concurrent radiotherapy and targeted with intraarterial infusion of cisplatin for definitive curative treatment and larynx preservation over a 9-year period. The research database pertaining to these patients and their hospital and outpatient charts was reviewed.Results: Twelve of 129 patients (9.3%) developed Chandler Grade III or IV chondroradionecrosis of the larynx in the posttreatment period; 3/12 (25%) required total laryngectomy for resolution of the necrosis and 1/12 (8.3%) underwent a surgical procedure for aspiration control. This represents an overall need for nonmalignant laryngectomy in this treatment population of 2.3%.Conclusions: The percentage of chemoradiotherapy patients with chondroradionecrosis appears increased as compared to previous patients treated with radiotherapy alone. However, the risk (2.3%) of total laryngectomy for chondroradionecrosis may be acceptable to many or most individuals with advanced head and neck cancer. It is imperative that this issue be discussed in advance to allow patients to make informed treatment decisions.

Isolated unilateral temporal muscle hypertroph y is a rarely reported clini cal entity with an unclear etiology. Considerati on of a broad differential diagnos is combined with a detailed histologic and radiologic work-up will help thephysician diagnose the underlying path ology. We report a new case ofthis uncommon entity, and we review the pertinent literature.