The likelihood of occult cervical lymph node metastasis for patients with salivary gland carcinoma is driven predominantly by histological subtype. Implications for elective neck irradiation are discussed.

The objective of this manuscript is to review a single institution's experience with superficial or total parotidectomy in outpatient and observation/inpatient groups. All patients who underwent superficial or total parotidectomy between 2009 and 2015 were identified. Patients were excluded if they had undergone concurrent surgery such as neck dissection, had prior radiation treatment or surgery at the operative site. Main outcomes were perioperative complications in both groups. 215 consecutive patients were included in the study, 116 (54%) patients in the inpatient group and 99 (46%) in the outpatient group. Aside from a higher observed rate of cardiac disease in the outpatient group (24.2 vs. 11.2%, p = 0.014) and larger mean body mass index (BMI) in the inpatient group (32.448 vs. 30.034, p = 0.017), there were no significant differences for age, sex or smoking status. Average operative time differed between groups with 2 h 42 min for inpatients and 2 h 18 min for outpatients (p < 0.001). There were 26 complications in the inpatient group (22.4%, including two hematomas) and 8 in the outpatient group (8.1%). The rate of seroma/sialocele formation was significantly higher in the inpatient group at 15.5% (n = 18) compared with the outpatient group at 3% (n = 3, p = 0.001). Our study shows that parotidectomy, superficial or total, was performed safely as an outpatient procedure without significant increase in complications when compared to patients observed for at least one night after surgery.

Recent studies lead to the conclusion that focused attention, through the activity of corticofugal and medial olivocochlear (MOC) efferent pathways, modulates activity at the most peripheral aspects of the auditory system within the cochlea. In two experiments, we investigated the effects of different intermodal attention manipulations on the response of outer hair cells (OHCs), and the control exerted by the MOC efferent system. The effect of the MOCs on OHC activity was characterized by measuring the amplitude and rapid adaptation time course of distortion product otoacoustic emissions (DPOAEs). In the first, DPOAE recordings were compared while participants were reading a book and counting the occurrence of the letter “a” (auditory-ignoring) and while counting either short- or long-duration eliciting tones (auditory-attending). In the second, DPOAEs were recorded while subjects watched muted movies with subtitles (auditory-ignoring/visual distraction) and were compared with DPOAEs recorded while subjects counted the same tones (auditory-attending) as in Experiment 1. In both Experiments 1 and 2, the absolute level of the averaged DPOAEs recorded during the auditory-ignoring condition was statistically higher than that recorded in the auditory-attending condition. Efferent-induced rapid adaptation was evident in all DPOAE contours, under all attention conditions, suggesting that two medial efferent processes act independently to determine rapid adaptation, which is unaffected by attention, and the overall DPOAE level, which is significantly affected by changes in the focus of attention.

Routine oral calcium and vitamin D supplementation and autotransplantation of at least 1 parathyroid gland effectively reduced symptomatic hypocalcemia and permanent hypoparathyroidism in total thyroidectomy.