Most American clinicans have been relectant to utilize aspiration biopsy due to poor interpretive skills by the pathologists in the past and a fear of tumor spread by the needle. Voluminous European series and recent American series have proved aspiration to be safe and reliable. In our series of 78 cases, both thin-needle aspiration and conventional tissue biopsies were made. The diagnoses were compared and the overall agreement rate was 90%.
A recent case of a vascular malvormation involving the mandible prompted the review of this subject. There are less than 80 cases of this rare but serious disease reported in the literature. There is no accepted standard treatment, but recent contributions have improved the safety and effectiveness of therapy.
Between March and November 1976, 30 patients with sudden hearing loss (SHL) were treated with vasodilators and diatrizoate meglumine (Hypaque). Nine (30%) of the patients had a good response, 7 (23%) had a moderate response, and 14 (47%) had no response to treatment. Most of the patients who responded were treated within the first month and had no vertigo associated on their onset of SHL. Their hearing loss was also less than 90 dB for any of the frequencies tested. Using the criteria of SHL of less than one month's duration, no vertigo associated with onset, and a loss less than 90 dB, seven patients were treated with vasodilator plus Hypaque during the period between January and August 1977. Six (86%) of the seven patients had return of serviceable hearing.
Malignant osteopetrosis is the autosomal recessive form of osteopetrosis. Besides anemia, hepatosplenomegaly, and the osteopetrotic bone seen on roentgenogram, the head and neck manifestations are important to the diagnosis and clinical course of this disease. Eye, ear, nose, face, teeth, mandible, maxilla, central nervous system structures, and cranial nerves are often involved.
One hundred ninety-nine infants (birth to 15 weeks) were administered an impedance battery to describe emerging characteristics of the acoustic reflex in this age range. Tympanometry results suggest that the middle ear system changes from a highly flaccid state at birth to a relatively normal compliance by 15 weeks. Acoustic reflexes were observed infrequently in the newborn population and gradually increased as a function of age, but never exceeding 43% of the ears tested. A conservative approach regarding the relevance of the presence of the reflex in young children is warranted.
The rationale for use of perioperative shortterm prophylactic antibiotics in prevention of postoperative infection in major head and neck surgery was reviewed. Cefazolin and placebo were compared in 50 patients and results showed that short-term perioperative cefazolin was a useful adjunct in reduction of postoperative infection. Findings suggest perioperative antibiotics may be safely and effectively used to reduce postoperative morbidity from infection after surgical procedures in volving skin and mucosa of the upper aerodigestive tract.
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