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Multidisciplinary management of aggressive head and neck skin cancer
Otolaryngology Head and Neck Surgery Volume 112 Number 5
COURSE 4621 - i One-period course ($20)
Instruction Courses-- Wednesday
Room NOCC-83 2:30-3:30
Multidisciplinary Management of Aggressive Head and Neck Skin Cancer RANDALS. WEBER,MD, and MICHAELMILLER,MD Houston, Texas
Educational objectives: To identify the histologic and clinical features of biologically aggressive skin cancer and to develop an understanding o f the need f o r a multidisciplinary approach to eradicate the disease and restore form and function.
Basal and squamous cell carcinomas of the skin are the most frequently encountered malignancy in the head and neck. The majority of these are early cancer that can be managed effectively with local excision, electrodesication, and curettage or cryosurgery. In contrast, patients presenting with advanced nonmelanoma skin cancer of the head and neck pose a great challenge for the head and neck surgeon. Advanced skin cancer may be defined as a large tumor usually greater than 2 cm, invading bone, muscle, or nerves. Other criteria for advanced disease include involvement of the regional lymph nodes and neoplasms, for which surgical resection would involve removal of a cosmetic structure or functional unit, such as the lip, eyelid, nose, or pinna. This course will deal with the clinical diagnosis, principles of surgical management, and contemporary methods of reconstruction and prosthetic rehabilitation. A modified Moh' s technique of surgical resection will be described along with the reconstructive ladder from skin grafts to microvascular free tissue transfer. Data from a large series of patients with advanced basal and squamous cell carcinomas of the skin of the head and neck will be presented and supplemented by case presentations that emphasize key therapeutic and reconstructive principles.
COURSE4622-1 One-period course ($20)
Room NOCC-84 2:30-3:30
Sudden Sensorineural Hearing Loss: An Otologic Emergency TERRENCEP. MURPHY,MD Atlanta, Ga.
Educational objectives: To evaluate and treat a sudden sensorineural hearing loss.
Sudden sensorineural hearing loss is an otologic emergency that requires a systematic approach to its evaluation and treatment, The purpose of this course is to outline an approach to the evaluation and management of a sudden sensorineural hearing loss. Handouts and bibliography will be provided.
P 177
A. Etiology 1. Idiopathic a. Viral b. Vascular c. Endocochlear potential breakdown 2. Autoimmune 3. Infectious 4. Traumatic 5. Acoustic neuroma 6. Demyelinating disease B. Evaluation 1. Audiologic 2. Laboratory 3. Radiologic C. Management 1. Steroids 2. Vasodilators 3. Carbogen 4. Renograffin 5. Rheologic agents 6. Surgery
COURSE 4623-1 One-period course ($20)
Room NOCC-85 2:30-3:30
Pediatric Nasal Airway Obstruction: Diagnosis and Management ORVALE. BROWN,MD, SCOI"rC. MANNING, MD, and RICHARD MABRY,MD Dallas, Texas
Educational objectives: To diagnose and differentiate common and unknown pediatric nasat problems and to become familiar with current treatment recommendations for such entities.
This course will provide an orderly approach to the diagnosis and management of nasal airway obstruction in infants and children. Differential diagnosis with the use of flexible fiberoptic examination, rigid telescopic endoscopy, and imaging modalities will be discussed. Emphasis will be placed on entities to include rhinitis of infancy, purulent rhinitis, choanal atresia, piriform aperture stenosis, meningocele and encephalocele, and other nasal airway problems in children such as deviated septum, hypertrophic turbinates, and adenoid hypertrophy. The timing and choice of surgical procedures in bilateral and unilateral choanal atresia, piriform aperture stenosis, and other structural nasal problems will be presented. The techniques of stenting and postoperative care will be presented. Other rarer causes of nasal airway obstruction such as congenital nasal lacrimal duct cysts will be presented and discussed. Nasal airway obstruction caused by allergic rhinitis in the pediatric age group will be presented, as will a practical approach to diagnosis and management of allergic rhinitis in children.
COURSE 4621 - i One-period course ($20)
Instruction Courses-- Wednesday
Room NOCC-83 2:30-3:30
Multidisciplinary Management of Aggressive Head and Neck Skin Cancer RANDALS. WEBER,MD, and MICHAELMILLER,MD Houston, Texas
Educational objectives: To identify the histologic and clinical features of biologically aggressive skin cancer and to develop an understanding o f the need f o r a multidisciplinary approach to eradicate the disease and restore form and function.
Basal and squamous cell carcinomas of the skin are the most frequently encountered malignancy in the head and neck. The majority of these are early cancer that can be managed effectively with local excision, electrodesication, and curettage or cryosurgery. In contrast, patients presenting with advanced nonmelanoma skin cancer of the head and neck pose a great challenge for the head and neck surgeon. Advanced skin cancer may be defined as a large tumor usually greater than 2 cm, invading bone, muscle, or nerves. Other criteria for advanced disease include involvement of the regional lymph nodes and neoplasms, for which surgical resection would involve removal of a cosmetic structure or functional unit, such as the lip, eyelid, nose, or pinna. This course will deal with the clinical diagnosis, principles of surgical management, and contemporary methods of reconstruction and prosthetic rehabilitation. A modified Moh' s technique of surgical resection will be described along with the reconstructive ladder from skin grafts to microvascular free tissue transfer. Data from a large series of patients with advanced basal and squamous cell carcinomas of the skin of the head and neck will be presented and supplemented by case presentations that emphasize key therapeutic and reconstructive principles.
COURSE4622-1 One-period course ($20)
Room NOCC-84 2:30-3:30
Sudden Sensorineural Hearing Loss: An Otologic Emergency TERRENCEP. MURPHY,MD Atlanta, Ga.
Educational objectives: To evaluate and treat a sudden sensorineural hearing loss.
Sudden sensorineural hearing loss is an otologic emergency that requires a systematic approach to its evaluation and treatment, The purpose of this course is to outline an approach to the evaluation and management of a sudden sensorineural hearing loss. Handouts and bibliography will be provided.
P 177
A. Etiology 1. Idiopathic a. Viral b. Vascular c. Endocochlear potential breakdown 2. Autoimmune 3. Infectious 4. Traumatic 5. Acoustic neuroma 6. Demyelinating disease B. Evaluation 1. Audiologic 2. Laboratory 3. Radiologic C. Management 1. Steroids 2. Vasodilators 3. Carbogen 4. Renograffin 5. Rheologic agents 6. Surgery
COURSE 4623-1 One-period course ($20)
Room NOCC-85 2:30-3:30
Pediatric Nasal Airway Obstruction: Diagnosis and Management ORVALE. BROWN,MD, SCOI"rC. MANNING, MD, and RICHARD MABRY,MD Dallas, Texas
Educational objectives: To diagnose and differentiate common and unknown pediatric nasat problems and to become familiar with current treatment recommendations for such entities.
This course will provide an orderly approach to the diagnosis and management of nasal airway obstruction in infants and children. Differential diagnosis with the use of flexible fiberoptic examination, rigid telescopic endoscopy, and imaging modalities will be discussed. Emphasis will be placed on entities to include rhinitis of infancy, purulent rhinitis, choanal atresia, piriform aperture stenosis, meningocele and encephalocele, and other nasal airway problems in children such as deviated septum, hypertrophic turbinates, and adenoid hypertrophy. The timing and choice of surgical procedures in bilateral and unilateral choanal atresia, piriform aperture stenosis, and other structural nasal problems will be presented. The techniques of stenting and postoperative care will be presented. Other rarer causes of nasal airway obstruction such as congenital nasal lacrimal duct cysts will be presented and discussed. Nasal airway obstruction caused by allergic rhinitis in the pediatric age group will be presented, as will a practical approach to diagnosis and management of allergic rhinitis in children.