Lymphoma of the nasal cavity and paranasal sinuses is extremely rare, may mimic benign processes, and may manifest either in an isolated fashion or in conjunction with systemic disease. B-cell lymphomas, a more favorable diagnosis, account for a majority of cases, whereas ENKL is associated with rapid disease progression and death. Chemotherapy and radiation are the main therapies. Histologic diagnosis is of paramount importance, and clinicians must remain cognizant of this entity to differentiate it from other sinonasal malignancies.
Increased cochlea/medulla ratio indicates increased blood-labyrinth barrier permeability in Menière disease compared with idiopathic sudden sensorineural hearing loss. Increased cochlea/medulla ratio in asymptomatic ears of patients with Menière disease also suggests an underlying systemic cause of Menière disease and may provide a pathophysiologic biomarker.
Objectives
Evaluate the effects of asymmetric superior laryngeal nerve stimulation on the vibratory phase, laryngeal posture, and acoustics.
Study Design
Basic science study using an in vivo canine model.
Methods
The superior laryngeal nerves were symmetrically and asymmetrically stimulated over eight activation levels to mimic laryngeal asymmetries representing various levels of superior laryngeal nerve paresis and paralysis conditions. Glottal posture change, vocal fold speed, and vibration of these 64 distinct laryngeal activation conditions were evaluated by high speed video and concurrent acoustic and aerodynamic recordings. Assessments were made at phonation onset.
Results
Vibratory phase was symmetric in all symmetric activation conditions but consistent phase asymmetry towards the vocal fold with higher superior laryngeal nerve activation was observed. Superior laryngeal nerve paresis and paralysis conditions had reduced vocal fold strain and fundamental frequency. Superior laryngeal nerve activation increased vocal fold closure speed, but this effect was more pronounced for the ipsilateral vocal fold. Increasing asymmetry led to aperiodic and chaotic vibration.
Conclusions
This study directly links vocal fold tension asymmetry with vibratory phase asymmetry; in particular the side with greater tension leads in the opening phase. The clinical observations of vocal fold lag, reduced vocal range, and aperiodic voice in superior laryngeal paresis and paralysis is also supported.
Objectives: 1) Summarize the epidemiology of sarcomas occurring in the head and neck. 2) Identify prognostic factors for patient survival. Methods: Cross-sectional analysis of the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program. Results: The SEER 18 database, spanning the years 1973 to 2009, was analyzed. A total of 2134 cases of sarcoma arising in the head and neck were identified, accounting for 3.9% of all sarcomas. Of head and neck sites, the bones of the skull and face were most commonly affected (n = 856), followed by the oral cavity and pharynx (n = 532), nasal cavity and paranasal sinuses (n = 365), and major salivary glands (n = 192). Overall disease-specific 2-, 5-, and 10-year survival rates for head and neck sarcoma were 69.5%, 55.9%, and 49.9%, respectively. On Cox regression analysis, histologic subtype, tumor location, gender, and patient age were found to influence mortality rate significantly ( P < 0.05), with male gender and older age portending worse outcomes. Conclusions: Sarcomas, a heterogeneous group of malignant mesenchymal tumors, are uncommonly found in the head and neck. This study represents the largest analysis of patients with head and neck sarcoma in the literature and demonstrates the impact of histology, tumor location, age, and gender on overall prognosis.
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