Otolaryngology最新文献

Sixteen patients with advanced head and neck carcinomas were treated with cis-diaminedichloro platinum chemotherapy; seven preoperatively and nine for recurrent disease. Cis-platinum was given by 24-hour infusions of 80 mg/m2 every three weeks. There was 50% regression in 38% (6) of the patients; another 38% (6) had 25% to 50% regression. Toxicity was minimal, with vomiting occurring in 75% (12) of the courses, renal toxicity in 6% (2), leukopenia in 13% (4), thrombocytopenia in 9% (3), and anemia in 31% (10). Of the seven patients who had serial audiograms, only one experienced ototoxicity. Cis-platinum, given by 24-hour infusion, was effective in reducing tumor bulk in 75% (12) of the patients, with advanced head and neck carcinomas, without undue morbidity.

We report a third case of an unusual maligant neoplasm of the paranasal sinuses in a 60-year-old woman. Similar cases have been previously reported and called malignant teratoma. In consultation with Ackerman (written communication, February 1976) we propose the term "teratocarcinoma" and believe this is to be a more descriptive term and less likely to be confused with the generic term "teratoma," which is a benign tumor.

Angiolymphoid hyperplasia with eosinophilia (Kimura's disease) is a relatively uncommon subcutaneous lesion, which can be confused with angiosarcoma. A case is presented. The differential diagnosis and therapy are discussed.

A case is presented with a child with a desmoid tumor of the pterygopalatine fossa in which approximately a third of the mandible including the condyle was removed for exposure. The trimmed mandibular segment was then returned to position with a fascia cap over the condyle and intermaxillary fixation was instituted. The graft was followed by serial roentgenogram over five years. The graft took completely, grew with the patient, and resulted in normal dental occlusion and normal mandibular excursion.

New proposed rules and regulations concerning trade practices for the hearing aid industry have been developed in response to political pressures from Congress and consumer groups. Revisions to the trade regulations proposed by the Federal Trade Commission (FTC) include (1) more stringent limitations in advertising, (2) written permission to sell a hearing aid at home or in the buyer's place of business, and (3) the right of a buyer to cancel a hearing aid sale, rental, or lease within 30 days. Testimony on hearings regarding this rule are being reviewed by the FTC presiding officer. Food and Drug Administration national standards for the labeling and sale of hearing aids became effective Aug 15, 1977. A medical evaluation by a licensed physician is required before a hearing aid may be sold. Fully informed adults may request a waiver of this requirement for religious or personal beliefs, but a medical evaluation is mandatory for persons under 18 years of age. A User Instructional Brochure, which lists several conditions for which medical advice is advised, must be reviewed with the prospective buyer. In the recognition that some physicians may be dispensers of hearing aids, the Judicial Council of the American Medical Association has recommended that a physician may dispense hearing aids if it is in the best interest of the patient, but that a physician should not be encouraged to retail hearing aids in his office if other adequate community facilities exist.

Presentation of Wegener's granulomatosis as an otologic problem is unusual and leads to incorrect diagnosis and unsuccessful therapy. In seven years, five patients with a diagnosis of otitis media failed to respond to the usual therapeutic regimens. All had surgical manipulations on the middle ear or mastoid, or both. Wegener's granulomatosis was suspected because of persistence of the otologic problem. All patients developed pulmonary lesions and had positive diagnoses by biopsy of either the lung, kidney, or upper respiratory mucosa. Withe timely treatment, all patients have survived.