No abstract

To determine the association between body position and obstructive events during sleep as determined by polysomnography (PSG) in very young children (age, Յ3 years) with obstructive sleep apnea syndrome. Design: Retrospective chart review. Subjects: Children aged 3 years and younger who underwent PSG to evaluate obstructive sleep apnea and subsequently underwent adenotonsillectomy between December 1, 2000, and November 30, 2003, were included in the study. The PSGs were analyzed for data on the respiratory disturbance index (RDI), time spent in each body position, number of apneic events in each position, oxygen saturation, and time spent in each stage of sleep. The results determined the statistical significance of these parameters. Results: Sixty patients satisfied the criteria for inclusion in the study. The mean supine sleep RDI was 8.5

Objectives: To describe the various presentations and management of piriform sinus tracts in children.Methods: The case records of 7 children with piriform sinus tracts who presented to the pediatric otolaryngology service were reviewed. Data on their symptoms at presentation, investigations, therapeutic interventions, and follow-up were recorded.Results: Four different modes of presentation were identified. Two presented primarily with an intrathyroidal abscess, 2 with recurrent deep neck infections requiring repeated drainage, 2 with draining fistulas to the exterior, and 1 with hoarseness. Barium swallows identified the tracts in 4 of 7 patients. Telescopic hypopharyngoscopy identified the tracts in all 7. Five were managed with complete excision of their tracts, 1 with internal cautery of the opening, and 1 with observation. All 7 are currently asymptomatic.Conclusions: Piriform sinus tracts are rare. Most present with suppurative thyroiditis. Telescopic hypopharyngoscopy is the diagnostic modality of choice. Complete excision is curative. Internal cautery may be used in compliant patients with regular follow-up. The role of observation alone remains unknown.

salivary gland during the last 25 years to determine current survival data at our institution.Methods: Forty-two patients treated for ACC of the salivary gland between 1975 and 2003 were registered at Northwestern Memorial Hospital. Kaplan-Meier analysis was used to characterize survival for this patient population. Tumor site, staging, and size of tumor were analyzed to determine their relationship to patient survival. Prognostic factors were compared to determine if each played a significant role in predicting mortality.Results: Of the 42 patients studied, 19 patients died during follow-up after receiving treatment for ACC. Twenty-three patients were alive at the date of last contact. Kaplan-Meier analysis of the 42 patients yielded a 5-year survival rate of 82.5% and a 10-year survival rate of 61%. Tumor site, stage, and size appeared to influence survival. Conclusion:Our review represents the most current assessment of survival for patients with adenoid cystic carcinoma at our institution. The data presented in our study concur with more recent literature, suggesting survival probability in patients with adenoid cystic carcinoma may be higher due to improved surgical technique and management with radiation therapy.