From 1969 to 1990, 43 patients with tracheal stenosis were treated at the University of Mississippi Medical Center. Seventy-four percent of these patients (n = 32) had intrinsic tracheal stenosis, most frequently as a complication of prolonged endotracheal trauma. A total of 41 distinctly separate stenotic segments were identified in the 32 patients. The stenoses were considered moderate or severe in 33 (80%) of the 41 cases and the length of the stenotic segment was greater than 1 cm in 23 (56%) of the cases. An overall 70% success rate was achieved following 93 surgical procedures in this group. The concurrent presence of glottic/subglottic stenosis, multiple segments of stenosis, bilateral vocal cord paralysis, tracheoesophageal fistula, and a tendency to marked hypertrophic scar formation were found to be significant factors in the surgical management of this patient group.

Patients with carotid body tumors require accurate preoperative assessment of vessel involvement and the probable impact of interrupting blood flow through the internal carotid artery. Recent developments in imaging, methods of measuring cerebral blood flow, balloon occlusion testing, and techniques to maintain vascular flow when a graft is required have improved the surgeon's ability to completely resect these tumors with reduced complications. We discuss these methods with respect to our review of 20 carotid body tumors in 18 patients. Twenty-five percent of patients were misdiagnosed, and in four patients injury to the vessel wall required appropriate surgical intervention.

The clinical course of patients with mucormycosis of the paranasal sinuses can be unpredictable and is often determined by intrinsic host factors. The degree to and mechanism(s) by which these factors influence a patient's ability to survive the disease are poorly understood. Extensions to orbital and intracranial structures occur in some patients with paranasal sinus mucormycosis despite aggressive treatment. Controversies persist over adequate antifungal regimen, the precise role of hyperbaric oxygenation, and the appropriate extent of surgical debridement. We have developed an alloxan-induced immunocompromised murine model of mucormycosis in mice. Deferoxamine iron chelation produced rhinocerebral mucormycosis in these animals when challenged intraethmoidally with Rhizopus spores. The implications of our experimental studies in the content of our clinical experience in managing patients with intracranial extensions of paranasal sinus mucormycosis are discussed.

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