We found EPT to be safe and efficacious in patients with head and neck cancer, even with internal carotid artery involvement. Patients with early stage recurrences have the potential for prolonged survival beyond 2 years without the morbidity of surgery and radiation or toxicity of systemic chemotherapy. Because of its superb access qualities even for bulky tumors, EPT is a potential method of delivery for other tumoricidal agents such as in genetic-altering schemes.

A prospective, clinical study was undertaken to assess the relationship between aortocoronary bypass surgery (ACBS) and sensorineural hearing loss (SNHL). Between August 1, 1988 and July 31, 1989, 1458 patients underwent ACBS and 181 volunteers were entered into the study based on availability and capability to complete preoperative and postoperative questionnaires and audiometric testing. One hundred forty-five patients completed the study. Intraoperative audiant brainstem response (ABR) testing was performed on 7 patients with essentially normal hearing. Although 4 patients (2.8%) reported a subjective change in hearing on postoperative questionnaires, objective testing did not confirm a significant hearing change in pure-tone, speech discrimination, or speech reception threshold testing. Acute or sudden SNHL within 2 weeks following ACBS was not identified in any patient completing the study. This study did not provide evidence to support a causal relationship between SNHL and ACBS. However, if SNHL does occur following ACBS, the well-established etiology of ototoxic therapy and subsequent SNHL demands exclusion in the absence of conflicting histopathologic information.

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