Weekly docetaxel and cisplatin is active in recurrent head and neck cancer and shows an excellent toxicity profile. Its influence on the stabilization of quality of life is less significant.

Only some aspects of QOL are maintained or improved. The QLQ-H&N35 questionnaire seems to be more appropriate to measure QOL, but needs to be improved to account for the peculiarities of modern palliative chemotherapy.

The incidence of wound botulism is increasing dramatically among intravenous drug users. Efficient intensive care and early treatment with antitoxin is essential to avoid lethal courses. The clinical picture of botulism is of descending, symmetric, flaccid paralysis. Early symptoms include cranial nerve palsies resulting in blurred vision and diplopia, difficulty in focusing, ptosis, facial weakness, dysphagia, dysphonia, and dysarthria. Because patients presenting with dysarthria and dysphagia will often be seen by an ear, nose and throat specialist initially, this rare but upcoming neurologic disease must be considered in the differential diagnoses.