Chronic cough in infants and children: an update.

Cough is a symptom frequently encountered by the otolaryngologist--head and neck surgeon. Although most coughs are self limited, chronic cough often proves to be a frustrating problem. Seventy-two infants and children under age 16 with a normal chest radiogram have now been evaluated for chronic cough persisting for longer than 4 weeks. Cough-variant asthma was the most common cause of cough, followed by sinusitis, gastroesophageal reflux, aberrant innominate artery, psychogenic cough, and subglottic stenosis. Chronic cough is best managed by first following an individualized diagnostic protocol designed to determine the etiology of the cough. This is followed by specific therapy to treat the underlying disorder. Children with persistent cough and normal chest radiograph are best served when referred promptly for evaluation by an otolaryngologist when the primary physician's initial efforts at diagnosis and treatment are not effective. Endoscopy is underutilized in practice and its importance understated in the literature. It is particularly helpful in establishing a precise diagnosis in infants under 18 months of age.

Reconstructive and rehabilitative aspects of head and neck cancer in the elderly.

Age should not be considered a contraindication to adequate head and neck oncologic surgery. Reconstructive efforts should be by the most direct means to attain restoration of form and function in one stage. The next significant breakthroughs in the battle against cancer may well come on the cellular or molecular level. We endorse the plea of Endicott for increased education and research directed at the problem of head and neck cancer and rehabilitation as they relate to the geriatric patient.

Chondrosarcoma of the sphenoethmoid complex.

Chondrosarcoma of the nose and paranasal sinuses is extremely rare. We report a case of a child with a massive chondrosarcoma of the sphenoethmoid complex who presented with a change of visual acuity. Clinical and histologic characteristics of this lesion are discussed, along with treatment options and factors affecting prognosis.

The complementary uses of nuclear medicine and ultrasound in the kidney.

Together, sonography and renal isotope techniques can provide greater information than either technique alone. These studies can replace excretory urography in the diagnosis of hydronephrosis and renal infarction. Arteriography is no longer necessary for the diagnosis of a pseudotumor, which has a specific isotope and a helpful sonographic appearance. The diagnosis of a renal abscess opposed to pyelonephritis can be made in a more definite fashion than is possible with other imaging techniques. We believe that the sonogram and isotope studies are particularly helpful in trauma because there is a more realistic assessment of the absence of renal function with isotopes than with the excretory urogram. One may detect hematoma within and around the kidney by ultrasonography.