Otorhinolaryngology

Introduction: Pharyngocutaneous fistula is one of the most common nonfatal laryngectomy complications (7.6% to 65% of all total patients). Preoperative radiotherapy, advanced tumor stage, poor preoperative medical status, and concomitant pharyngectomy are usually accepted causative factors in fistula formation. Delay of oral feeding is a common practice used by head and neck surgeons to prevent the development of pharyngocutaneous fistula.

Cisplatin (CDDP) is one of the most potent antineoplastic drugs, but its therapeutic use is limited by side effects such as ototoxicity. This study tested the effect of aminoguanidine (AG), a specific inhibitor of inducible nitric oxide synthase, on CDDP ototoxicity. Female Wistar albino rats were randomly assigned to 4 groups: saline controls (n = 7), CDDP (n = 7), CDDP plus AG (n = 7), and AG (n = 7). Rats in the CDDP group received a single injection of cisplatin (16 mg/kg, ip). Rats in the CDDP plus AG group received aminoguanidine (20 mg/kg, ip) twice daily on the day before and on 5 consecutive days after a single injection of CDDP (16 mg/kg, ip). Rats in the AG group received aminoguanidine (20 mg/ kg, ip) twice daily for 6 days. Distortion product otoacoustic emissions (DPOAEs) were elicited from the control and experimental animals utilizing a standard commercial otoacoustic emissions apparatus. DPOAEs were measured in the rats on day 0, prior to any drug administration, an...

The nasal septum is a particularly rare site of origin of a chondrosarcoma. A 55-year-old man presented with complaints of nasal obstruction and anosmia of one year duration. A fragile mass was detected in the left nasal cavity. Computed tomography showed a large hypodense mass with scattered calcifications, eroding both ethmoid sinuses and extending to the left orbit. Following a biopsy, the tumor was resected via a lateral rhinotomy approach. No evidence for recurrent disease was detected during a three-year follow-up period. Although unusual in the nasal septum, chondrosarcoma must be considered in the differential diagnosis of calcified intranasal masses.

OBJECTIVES: To study the surgical anatomy of the vertebral artery at the craniocervical junction and its related structures defining reliable landmarks for its safe exposure. DESIGN: Ten sides of 5 fresh cadavers were dissected using the lateral approach to the craniocervical junction. RESULTS: Experience gained in studying the anatomic details of the vertebral artery at the craniocervical junction in cadavers from its exit at the transverse foramen of the second cervical vertebra to the vertebrobasilar junction provided the initial background for us to use the lateral approaches to the skull base to safely manage 4 cases with pathology reaching the close vicinity of vertebral artery at the craniocervical junction. CONCLUSION: Thorough knowledge of the anatomy of the vertebral artery is mandatory before attempting surgery at the craniocervical junction. There are reliable landmarks that, when followed, could facilitate safe exposure and identification of the artery.