Open surgical management of early glottic carcinoma.

Three options exist for the treatment of T1 through T3 glottic carcinomas: irradiation, transoral excision (usually with a CO2 laser) and external "conservation" laryngeal procedures. Controversy re approximately mains regarding the best therapy and, in many cases, is related to the uncertainty of tumor subclassifications not being contained in the current American Joint Committee on Cancer Union International Contra Cancer system. The evaluation of patients with early glottic carcinomas and common approaches to conservation laryngeal surgery and defect reconstructions are presented. External "conservation" approaches are preferred for T1B, T2B and early T3 glottic carcinomas.

Carbon dioxide laser in otolaryngology.

Laser therapy has been an addition to our therapeutic armamentarium. Although in certain conditions (ie, webs, granulomas, and to a lesser degree papillomas) it has been serviceable, conventional methods of treatment are used in the majority of our patients.

Solitary frontal sinus fracture.

Both the anterior and/or posterior wall of the frontal sinus as well as the nasofrontal duct may be injured by blunt force, commonly secondary to automobile accidents. In this group of 13 solitary frontal sinus fractures, the anterior wall was involved in all cases, and the posterior wall in 2. Antibiotic therapy was given to prevent anticipated infection. Comminuted or depressed fractures of the anterior wall were treated by elevation and/or wiring. Surgical treatment was not employed when there was a linear fracture of the anterior wall in good alignment. Posterior wall fragments were removed and periosteal flaps used to close the defect when the dura was intact. One case required neurosurgical treatment for a dural tear and necrotic frontal lobe cortex.

Liposarcoma of the maxilla.

A clinically appearing, well-encapsulated lipoma was locally excised from the right posterior upper buccal gingival sulcus of a 24-year-old man and diagnosed histologically as pleomorphic liposarcoma. A right maxillectomy with preservation of orbital function was followed by 5,000 rads of planned postoperative radiation therapy. Four months later the tumor recurred outside of the original site, which has been controlled by further radiation and chemotherapy to these areas.

Otolaryngology in the medical school curriculum.

Whether the family practitioner will emerge as the primary physician in the area of otolaryngology, with the specialist relegated to either a secondary or tertiary role, remains as yet unsettled. Given the uncertainty of the future place of otolaryngology in general health care, more attention should be placed on teaching otolaryngology to medical students.

Horizontal tongue flap in repair of tonsillar palatal defect.

Local tissue, when available, seems superior to utilizing distant tissue for reconstruction of the tonsillar fossa region. Repair of the defect employing a horizontal posteriorly based tongue flap has been useful. It has the advantage of minimal decrease in the remaining tongue bulk and mobility, requires only 90 degrees rotation, and can be used after radiation therapy or ligation of the ipsilateral lingual artery.