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Idiopathic epiglottic prolapse as a cause of airway obstruction
Otolaryngology Head and Neck Surgery P 190
August 1995
Scientific Posters
col was developed whereby patients with lymphoproliferative parotid lesions were treated with low-dose radiation. This therapy, although not curative, has been successful in arr e s t i n g the progression of the parotid cysts, thus avoiding the need for any invasive procedures. 101
The Use of Autosuture Devices in Pharyngoplasty Following Total Laryngectomy G. VELEGRAKIS, MD, M. VOLITAKIS, MD, HARITON PAPADAKIS, MD, and E. HEUDONIS, MD, FACS, Heraklion, Crete, Greece
Although autosuture devices have been used for several years in stomach and intestinal surgery, they are still not a routine procedure in the head and neck area. These devices were used with excellent results for the closure of the pharyngostome in four nonirradiated patients who underwent total laryngectomy. On the basis of this experience it is believed that this is a safe and time-saving procedure that is especially valuable for patients suffering from concomitant severe pathologic conditions where a reduced surgical time is required. 102
Parotid Tumors: The Charity Hospital Experience VINCENT J, PISCIOTTA, MD, PETERRIGBY, MD, and MARY FAZEKAS-MAY, MD, New Orleans, La.
The Charity Hospital experience of parotid tumors from 1948 to 1993 was evaluated in a retrospective chart review, in which 323 patients with parotid neoplasms were identified. The study revealed a predilection for blacks (122/201) and women (149/174). The prevalence of malignant disease was 45.5% (147 of 323 patients). The most common neoplasm identified was pleomorphic adenoma (177), followed by mucoepidermoid carcinoma (36), squamous cell carcinoma (31), malignant mixed tumors (20), adenocarcinoma (18), adenoidcystic carcinoma (10), and acinic cell carcinoma (10). The pathologic trends will be presented in 5-year intervals. Age, sex predilection, race, treatment, and follow-up will be reported for each tum o r type during this 45-year period. (Supported by NIH grant Nos. T32 DC00007, POIDC00379, and Kam's Fund for Hearing.) 103
Computer-Assisted Transnasal Approach to the Sella Turcica OLEH S. SLUPCHYNSKYJ,MD, AUGUSTINE MOSCATELLO, MD, SURESH RAJAMANICKAM, MD, and KENT DUFFY,MD, New York and Valhalla, N.Y.
The use of a fluoroscopic C-arm during the transnasal approach to the sella turcica allows a one-dimensional sag-
ittal view for estimation of surgical positioning from the sella. We present a computer-assisted transnasal approach to the sella using the intraoperative Viewing Wand (ISG Technologies Inc., Missassauga, Ontario, Canada). The Viewing Wand computer displays the probe position in the surgical field by a crosshair on a set of sagittal, coronal, and axial computed tomography images. This technique allows the surgeon a three-dimensional view of the operative field and a precise surgical approach to the sella, thus helping to avoid injury to the skull base, optic nerve, and carotid artery. 104
The Dynamic Nature of the Shunt of the Near-Total Laryngectomy CLARK A ROSEN, MD, JAMES I. COHEN, MD, PHD, and BRUCE W. PEARSON, MD, Memphis, Tenn., Portland, Ore., and Ponte Verde Beach, Fla.
One of the unique features of the near-total laryngectomy is the ability of the myomucosal shunt to allow lung-powered voice without allowing aspiration. The preserved innervation of the "speech fistula" of the neartotal laryngectomy is thought to be crucial to the shunt's function. The recurrent laryngeal nerve is preserved at the time of surgery and is theorized to facilitate the complex functions of the shunt. We present two cases of patients that lost shunt function, speech, and protection of aspiration because of lesions of the vagus nerve in the postoperative period. These patients demonstrate the importance of the innervation of the myomucosal shunt of the near-total laryngectomy to the complex functioning of the shunt. This report lends evidence to the belief that the myomucosal shunt of the near-total laryngectomy is a dynamic structure and requires innervation for proper functioning. 105
Idiopathic Epigloffic Prolapse as a Cause of Airway Obstruction PATRICK SLATER,MD, DENIS HOASJOE, MD, and FREDJ. STUCKER, MD, FACS, Shreveport, La.
Prolapse of the epiglottis, alone or in association with other laryngeal abnormalities, is a rare cause of upper airway obstruction in the adult. When prolapse of the epiglottis is the cause of upper airway obstruction, it is usually associated with head injury or previous surgery. One case of epiglottic prolapse causing airway obstruction will be presented. V i d e o l a r y n g o s c o p y shows the e p i g l o t t i s prolapsing and completely obstructing the upper airway. Also seen at endoscopy was marked hypertrophy of the lingual tonsils. To the best of our knowledge, this is the only reported case of idiopathic epiglottic prolapse. Management consisted of endoscopic carbon dioxide laser epiglottectomy.
August 1995
Scientific Posters
col was developed whereby patients with lymphoproliferative parotid lesions were treated with low-dose radiation. This therapy, although not curative, has been successful in arr e s t i n g the progression of the parotid cysts, thus avoiding the need for any invasive procedures. 101
The Use of Autosuture Devices in Pharyngoplasty Following Total Laryngectomy G. VELEGRAKIS, MD, M. VOLITAKIS, MD, HARITON PAPADAKIS, MD, and E. HEUDONIS, MD, FACS, Heraklion, Crete, Greece
Although autosuture devices have been used for several years in stomach and intestinal surgery, they are still not a routine procedure in the head and neck area. These devices were used with excellent results for the closure of the pharyngostome in four nonirradiated patients who underwent total laryngectomy. On the basis of this experience it is believed that this is a safe and time-saving procedure that is especially valuable for patients suffering from concomitant severe pathologic conditions where a reduced surgical time is required. 102
Parotid Tumors: The Charity Hospital Experience VINCENT J, PISCIOTTA, MD, PETERRIGBY, MD, and MARY FAZEKAS-MAY, MD, New Orleans, La.
The Charity Hospital experience of parotid tumors from 1948 to 1993 was evaluated in a retrospective chart review, in which 323 patients with parotid neoplasms were identified. The study revealed a predilection for blacks (122/201) and women (149/174). The prevalence of malignant disease was 45.5% (147 of 323 patients). The most common neoplasm identified was pleomorphic adenoma (177), followed by mucoepidermoid carcinoma (36), squamous cell carcinoma (31), malignant mixed tumors (20), adenocarcinoma (18), adenoidcystic carcinoma (10), and acinic cell carcinoma (10). The pathologic trends will be presented in 5-year intervals. Age, sex predilection, race, treatment, and follow-up will be reported for each tum o r type during this 45-year period. (Supported by NIH grant Nos. T32 DC00007, POIDC00379, and Kam's Fund for Hearing.) 103
Computer-Assisted Transnasal Approach to the Sella Turcica OLEH S. SLUPCHYNSKYJ,MD, AUGUSTINE MOSCATELLO, MD, SURESH RAJAMANICKAM, MD, and KENT DUFFY,MD, New York and Valhalla, N.Y.
The use of a fluoroscopic C-arm during the transnasal approach to the sella turcica allows a one-dimensional sag-
ittal view for estimation of surgical positioning from the sella. We present a computer-assisted transnasal approach to the sella using the intraoperative Viewing Wand (ISG Technologies Inc., Missassauga, Ontario, Canada). The Viewing Wand computer displays the probe position in the surgical field by a crosshair on a set of sagittal, coronal, and axial computed tomography images. This technique allows the surgeon a three-dimensional view of the operative field and a precise surgical approach to the sella, thus helping to avoid injury to the skull base, optic nerve, and carotid artery. 104
The Dynamic Nature of the Shunt of the Near-Total Laryngectomy CLARK A ROSEN, MD, JAMES I. COHEN, MD, PHD, and BRUCE W. PEARSON, MD, Memphis, Tenn., Portland, Ore., and Ponte Verde Beach, Fla.
One of the unique features of the near-total laryngectomy is the ability of the myomucosal shunt to allow lung-powered voice without allowing aspiration. The preserved innervation of the "speech fistula" of the neartotal laryngectomy is thought to be crucial to the shunt's function. The recurrent laryngeal nerve is preserved at the time of surgery and is theorized to facilitate the complex functions of the shunt. We present two cases of patients that lost shunt function, speech, and protection of aspiration because of lesions of the vagus nerve in the postoperative period. These patients demonstrate the importance of the innervation of the myomucosal shunt of the near-total laryngectomy to the complex functioning of the shunt. This report lends evidence to the belief that the myomucosal shunt of the near-total laryngectomy is a dynamic structure and requires innervation for proper functioning. 105
Idiopathic Epigloffic Prolapse as a Cause of Airway Obstruction PATRICK SLATER,MD, DENIS HOASJOE, MD, and FREDJ. STUCKER, MD, FACS, Shreveport, La.
Prolapse of the epiglottis, alone or in association with other laryngeal abnormalities, is a rare cause of upper airway obstruction in the adult. When prolapse of the epiglottis is the cause of upper airway obstruction, it is usually associated with head injury or previous surgery. One case of epiglottic prolapse causing airway obstruction will be presented. V i d e o l a r y n g o s c o p y shows the e p i g l o t t i s prolapsing and completely obstructing the upper airway. Also seen at endoscopy was marked hypertrophy of the lingual tonsils. To the best of our knowledge, this is the only reported case of idiopathic epiglottic prolapse. Management consisted of endoscopic carbon dioxide laser epiglottectomy.