Malignant melanoma of the maxillary sinus.

A 40-year-old white man presented with a mucosal malignant melanoma of the left maxillary sinus two years after removal of a Clark III melanoma of the skin, posterior to the angle of mandible. The symptoms and the successful management of the disease are described.

Division of the recurrent laryngeal nerve for idiopathic laryngeal spasm.

A rare case of idiopathic laryngeal spasm presented itself as sleep apnea in a middle-aged man. A tracheostomy followed by the division of the recurrent laryngeal nerve relieved all of the symptoms.

Ligation of the external carotid and anterior ethmoidal arteries for severe or unusual epistaxis resulting from facial fractures.

From July 1980 to December 1983, 16 patients with severe posterior epistaxis were treated by arterial ligation. The procedure was successful in all. Two cases of life-threatening and unusual epistaxis resulting from maxillary fractures are presented in detail. The authors conclude that ligation of the external carotid and anterior ethmoidal arteries is a speedy, safe and highly successful method of dealing with posterior epistaxis.

Arteriovenous malformations and vascular anatomy of the upper lip and soft palate.

Arteriovenous malformations (AVM) are a difficult clinical problem. These lesions may be extensive and diffuse and frequently prove refractory to the usual surgical methods of treatment. This paper presents three unusual AVMs of the orofacial region. Two were acquired AVMs of the upper lip, one involving columella; the third was a congential AVM of the soft palate. Complete surgical excision, following embolization, is the most successful therapy of traumatic AVM of the upper lip at this time. In addition, the blood supply of the upper lip and columella is presented, as it was found in ten cadaver dissections.

The "crossbow" incision and nasal flap--its blood supply and clinical application.

An anatomical study of the blood supply of the nose and upper lip was done on 10 specimens. This demonstrated the blood supply of an inferiorly based nasal flap, which was successfully used to gain access for an en bloc resection of adenoid cystic carcinoma of the ethmoid sinuses, frontal sinuses, and nose. The "crossbow" incision and inferiorly based nasal flap facilitate the tridimensional excision of lesions in the anterior base of the skull, the midline portion of middle base of the skull, and the paranasal sinuses.

Yellow nail syndrome and chronic sinusitis.

This paper reports the case of female patient who presented with the yellow nail syndrome and was ultimately found to have related chronic pansinusitis and bronchitis. The head and neck manifestations of this syndrome are described as well as the successful management of her sinusitis.

Adenoma of the endolymphatic sac.

A woman, who presented with symptoms of unilateral Ménière's disease, was found to have an adenoma of the endolymphatic sac, when an endolymphatic sac decompression was performed. Such a finding has not previously been reported. The possible role of the tumor in causing endolymphatic hydrops is discussed.

Cervical ankylosing hyperostosis and airway obstruction.

Forestier's disease, or ankylosing hyperostosis of the cervical spine, has been described to cause dysphagia, foreign body sensation, and aspiration. We report two patients with ankylosing hyperostosis producing ulceration of the posterior plate of the cricoid cartilage, inflammatory edema, and secondary bilateral vocal cord paralysis with airway obstruction. This disease initially produces minimal dysphagia when the primary location of the osteophyte is just above and posterior to the cricoid, then, progressive airway obstruction. The pathogenesis is infection superimposed on ulceration of the cricoid produced by laryngeal movement over a large, sharp osteophyte. Management included tracheostomy for airway management, endoscopy to rule out malignancy, intravenous antibiotic therapy, and surgical excision of the osteophyte.

[Respiratory disorders associated with cervical osteomyelitis]. / Troubles respiratoires liés a une ostéomyélite cervicale.

Two cases of cervical osteomyelitis with associated airway obstruction are presented. The pertinent diagnostic features as well as treatment are reviewed.

Benign thyroid disease and upper airway obstruction: case presentations, pathophysiology, and management.

Investigations of three cases with large goiters and marked respiratory stridor showed different mechanisms of airflow limitations. This report describes the flow volume loop and Machida fiberoptic tracheoscopy as newer methods for evaluating the larynx and trachea. Indications for tracheotomy in benign thyroid disease are discussed.