Median thyrotomy has proven to be safe and successful in the treatment of supraglottic schwannoma.

\s=b\Invasive frontoethmoidal sinus mucoceles extending into the anterior cranial fossa or orbits are difficult to manage and can lead to lethal complications. In the past four years, nine cases of frontoethmoidal mucoceles were treated at the University of Texas Medical Branch, Galveston. Five cases were complicated by anterior cranial fossa invasion, orbital invasion, or both. The choice of surgical procedures used to manage these cases depended on mucocele extent and location, which were best determined by computed tomography. Two cases required craniotomy, one of which required an inferior-based pericranial flap for reconstruction of the floor of the anterior cranial fossa. Two cases were managed by osteoplastic flap and fat obliteration procedures. Intranasal drainage was the procedure used in one case that had extensive orbital involvement. Surgical complications included an intracranial abscess in one patient and a cerebrospinal fluid leak in a second patient.

Nasal airway resistances were measured bilaterally on subjects at 30-minute intervals over 6 hours using anterior rhinomanometry. The first 10 subjects found to exhibit alternating congestion and decongestion of the nasal mucosa (i.e., the nasal cycle) were included in the study. Using the saccharin method, nasal mucociliary clearance was determined for each subject in both the congested and decongested phases of the cycle. The results were statistically significant at the P less than .09 level, highly suggestive of a difference in nasal mucociliary clearance between the two phases of the cycle, with the congested phase having the more rapid clearance. However, when compared to the mucociliary clearance times in disease states, the difference in transport times between the two phases is probably not clinically significant.

Measurement of nasal airway resistance is becoming a common clinical technique. Accurate definition of the normal range of airflow is critical for maximal usefulness of this technique. Since typical nasal size and shape vary greatly with ethnic background, different norms for different ethnic groups may be appropriate. Nasal airway flow and resistance and external nasal size and shape were measured in 130 asymptomatic subjects (52 black, 56 white, and 22 Hispanic). Nasal length, width, columellar length, and nasolabial angle were similar for whites and Hispanics, but both groups differed significantly from blacks--even when changes attributable to biologic aging were factored out. In spite of these differences, there was no significant difference in any nasal airflow or resistance parameter among groups, suggesting that currently used airflow and resistance standards are valid for these three different ethnic groups.

The KTP-532 laser has decreased the technical difficulty involved in teaching and performing a stapedectomy in our residency program. Use of this laser has resulted in improved hearing and a decreased number of major and minor complications compared to an equal number of large fenestra stapedectomies performed with hand-held instruments. The major disadvantages of the KTP-532 laser are its cost and limited availability, and the inconvenience of a micromanipulator. The laser should not be relied upon entirely in performing a stapedotomy on a thick footplate. The University of Texas Medical Branch experience in training residents in both large and small fenestra stapedectomy is reported.