Between 1944 and 1987, 112 patients with inverting papilloma of the nasal cavity were treated. The average duration of follow-up for this population was 6.2 years. The most common symptoms were nasal obstruction and history of previous surgery for nasal "polyps". Recurrence rates were lower when treatment consisted of lateral rhinotomy with medial maxillectomy (14%) vs. transnasal operation with a sinus procedure (35%) or transnasal operation alone (58%). Recurrence rates between men and women were not significantly different when treatment methods were analyzed; however, a higher-than-expected association with tobacco usage was noted. Eight (7%) of the 112 patients had associated nasal carcinoma. Current treatment is lateral rhinotomy with medial maxillectomy to prevent troublesome and potentially malignant recurrent disease.

The incidence of posttonsillectomy bleeding in this review was 1.93%, and about half (47%) of the patients with posttonsillectomy hemorrhage returned to the operating room for hemorrhage control. The highest incidence (3.61%) of posttonsillectomy hemorrhage occurred in patients 21 to 30 years of age. Patients with posttonsillectomy hemorrhage, regardless of management, had a 12% incidence of subsequent hemorrhage. We found no difference in the incidence of posttonsillectomy bleeding between outpatient and inpatient procedures.

Kikuchi-Fujimoto disease is a rare, self-limited, histiocytic, necrotizing lymphadenitis first described in Japan in 1972. Necrosis of lymph node tissue is caused by apoptosis and may be virally induced. It commonly presents with cervical lymphadenitis and fever. Despite its low incidence, Kikuchi-Fujimoto disease should be considered in patients with persistent lymphadenopathy. Originally thought to occur only in young Asian women, it is now recognized in other geographic regions. We report a 30-year-old white woman with Kikuchi-Fujimoto disease. We discuss the clinical features, differential diagnosis, radiography, pathology, and outcome.

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Otolaryngology-Head and Neck Surgery August 1999 Methods: The patient sample for this study consisted of 50 consecutive patients who presented to a private otolaryngology practice who were diagnosed with chronic rhinosinusitis using standard AAO-HNS criteria. All patients were examined with nasal endoscopy in the office at one of their first two visits and were included in the sample if they met the appropriate criteria. These patients all completed the Rhinosinusitis Disability Index (RSDI) and a symptom questionnaire at their initial visit. They all had coronal CT scans of their sinuses, which were blindly staged using the Lund-Mackay system. Allergy testing was done in all patients using serial endpoint titration (SET) as the method for testing. Endpoints were assessed on each of 18 antigens and were used for data analysis. Results: The results of the study demonstrated a mean CT stage among patients with chronic rhinosinusitis of 4.0, with a range of 0 to 18. As had been previously noted, there was no significant correlation between CT stage and quality of life as assessed by the 3 subscales of the RSDI. Of these 50 patients, all had at least one significant endpoint of 2 or higher on SET testing, demonstrating some degree of allergy among all patients presenting with symptoms of chronic sinusitis. There was no significant correlation, however, between CT stage and allergy as assessed by any of the 18 antigens or the overall SET mean. A small but significant correlation was noted between SET scores and quality of life as assessed by the RSDI. Conclusion: These findings demonstrate no association between CT stage and quality of life, confirming findings of previous researchers. In addition, there was no correlation between CT stage and severity of allergic disease. There was, however, an association between SET results and quality of life. Patients with more severe allergic disease were more impaired in their specific quality of life than those with milder disease. These findings support prior research demonstrating the association between quality-of-life impairment and allergic rhinitis. The presence of allergic disease appears to be a better indicator of impaired quality of life among patients with chronic rhinosinusitis than are CT findings. These findings support the need for careful evaluation of allergic disease among patients with chronic rhinosinusitis.