The April 2004 issue of Otolaryngology focuses on head and neck surgery

In this issue:

The efficacy of a new cancer-fighting virus is tested in the study, “Treatment of Solid Sarcomas in Immunocompetent Mice with Novel Oncolytic Herpes Simplex Viruses.” A team of multi-disciplinary Japanese researchers found that a weakened version of herpes simplex virus (HSV) effectively eradicated neck and flank tumors in mice.

Juvenile angiofibroma is an invasive non-cancerous growth in the back of the nose or nasopharynx usually found in adolescent boys. In the small study “Flutamide as a Preoperative Treatment in Juveile Angiofibroma (JA) with Intracranial Invasion. Report of 7 Cases,” otolaryngologist – head and neck surgeons sought to determine if Flutamide, a tumor reducing drug used to treat prostrate cancer, would be helpful in reducing juvenile angiofibroma. No advantages were found in using Flutamide, but more research should be conducted to verify these results.

Electrocochleography (ECoG) is a test, commonly used to diagnose Meniere’s disease, where an electrode is placed as close as possible to the cochlea to measure intracochlear electrical potential changes associated with hearing. “Extratympanic Electrocochleographic Changes on Noise-Induced Temporary Threshold Shift” explores the usefulness of ECoG in the early detection of noise-induced hearing loss (NIHL).

Cartilage grafts are often used in reconstructive surgeries involving the ear or nose. Grafting cartilage from one’s own tissue has distinct advantages such as: absence of immune response, lower rate of infection or extrusion, and ready availability. In an experimental study, “Radiologic and Histologic Evaluation of Otojen Sliced Cartilage Grafts at the Tip of the Chin of Rabbits,” Turkish otolaryngologist – head and neck surgeons determine the efficacy of cartilage grafts taken from the ear and inserted in the chin.

The number of cosmetic surgery procedures performed increases each year and medical investigators continue to seek the most effective and least invasive treatments for facial rejuvenation. Otolaryngologist – head and neck surgeons explore the effectiveness of ThermaCool TC™ in the study, “The Use of a Non-ablative, Radiofrequency Device to Rejuvenate the Upper One-third of the Face.” They conclude that ThermaCool TC™ is effective in rejuvenating the upper third of the face in most patients, but the majority of patients did not perceive a benefit.

Facial paralysis of unknown origin is often diagnosed as Bell’s palsy. Now, otolaryngologist – head and neck surgeons at the Mayo Clinic have determined that malignancy of the facial nerve can be another cause of unilateral facial paralysis in patients with otherwise normal clinical and imaging findings. In their study, “Facial Nerve Paralysis Secondary to Occult Malignant Neoplasms,” the researchers conclude that facial nerve exploration should be considered for patients with a history of pain or regional skin cancer, involvement of other cranial nerves, and prolonged facial paralysis.

Individuals with chronic vertigo and balance problems endure greatly reduce mobility and quality of life. A new study, “Decreased Ataxia and Improved Balance after Vestibular Rehabilitation” concludes that many such patients can improve balance during stance and gait by using a simple home program of vestibular habituation head movement exercises.

Benign positional paroxysmal positional vertigo (BPPV) is a common source of dizziness and is thought to be caused by small crystals of calcium carbonate accumulated within a part of the inner ear. “Benign Positional Vertigo: Prognostic Factors,” a retrospective chart review of 104 patients with BPPV indicates that prior trauma or labryrinthitis lowers the success rate of treatment with canalith repositioning, while endolymphatic hydrops and dizziness related to the central nervous system indicate a higher recurrence rate.

Velocardiofacial syndrome (VCSF), a chromosomal disorder, is the most common syndrome associated with cleft palate in children. An anterior glottic web refers to tissue that grows over the vocal cords, restricting the airway. Though several case reports indicate an association between the two, the study “Association of Anterior Glottic Webs with Velocardiofacial Syndrome” is the first to determine that the presence of anterior glottic webs should indicate further evaluation for velocardiofacial syndrome.

Is it a migraine or sinus headache? In the study, “Non-rhinologic Headache in a Tertiary Rhinology Practice,” researchers set out to determine the cause of headache in 100 patients that were referred for sinus evaluation but were found to have no evidence of sinusitis. Migraine was found to be the most common type of headache in patients with normal sinus evaluations.

The most common locations for cerebrospinal fluid (CSF) leaks are the nose and ear, where surgery is often employed to repair the leak. In the study, “Cerebrospinal Fluid (CSF) Pressure Monitoring after Repair of CSF Leaks,” otolaryngologists – head and neck surgeons determined that the elevation of intracranial pressure after surgery to repair a CSF leak provides important information regarding the pathophysiology of CSF leaks.

Chronic otitis media is one of the most common childhood illnesses and can contribute to hearing loss. In their study, “Hearing Loss with Semicircular Canal Fistula in Exotoxin A-Deficient Pseudomonas Otitis Media,” otolaryngologists found that treatment to neutralize the effects of exotoxin A (a strain of Pseudomonas aeruginosa) may minimize the risk of hearing loss with canal fistula (an abnormal connection between the air-filled middle ear and the fluid filled inner ear) in chronic otitis media.

Ventilator-associated pneumonia is a major cause of death in intensive care patients due to microbial biofilm formation on the endotracheal tube. The study, “Electron Microscopic Analysis of Biofilm on Endotracheal Tubes Removed from Intubated Neonates” is the first to demonstrate the presence of biofilm on the outer surface of neonatal endotracheal tubes.

These studies were published in Otolaryngology—Head and Neck Surgery, the peer-reviewed, scientific journal of the American Academy of Otolaryngology—Head Neck Surgery. The findings of these research studies do not necessarily reflect the policies or opinions of the Academy. The American Academy of Otolaryngology—Head and Neck Surgery represents more than 10,000 physician-specialists dedicated to the diagnosis and treatment of the wide range of disorders of the ear, nose, throat, and related structures of the head and neck.