Jet ventilation for microsurgery of the larynx has been in common use at our institution since 1978. There were 942 cases performed, with ages ranging from 7 days to 90 years. A specially modified laryngoscope with multiple ports into which a 14- or 16-gauge ventilation needle can be advanced just distal to the vocal cords simplifies this form of anesthesia and ventilation. Jet ventilation has been advocated in place of conventional ventilation methods during carbon dioxide laser surgery because it eliminates the potential fire hazard of the endotracheal tube and allows superior visibility of the vocal cords. Despite these advantages, it is still not in common use. We will review the airway mechanics and special anesthesia considerations that make jet ventilation a safe and time-proven technique.

The statistic most predictive of OSA was snoring severity. Combining this with BMI yielded a highly sensitive screening test for moderate/severe OSA. This clinical assessment may be useful in risk-stratifying patients for polysomnography and therapy, facilitating deferred work-up in low-risk patients and expedited therapy in high-risk patients.

Fifty-two patients who had otitis media with effusion associated with head and neck malignancies were identified and studied retrospectively. Forty-three of the patients underwent myringotomy and tube for treatment of the effusion. Ten (23%) of the 43 patients had either multiple infections or continuous otorrhea necessitating tube removal. The patients identified as having the highest rate of serious complications following myringotomy and tube were those individuals who had nasopharyngeal carcinoma, with 6 (55%) of 11 patients in this group having suffered major infections during the study. Myringotomy and tube is a satisfactory treatment for most patients who have effusions as a result of non-malignant etiologies; however, infections were more common and more severe in the study group than those anticipated in noncancer patients. Expectant management and the use of amplification in selected cases may prove to be a viable alternative in patients with unilateral effusion and/or relatively mild symptoms.