Cartilaginous reinforcing sutures were found to provide a higher force requirement for tracheal anastomotic rupture when compared with anastomoses without these sutures. This improved stability in tracheal anastomosis may result in a decreased risk of early tracheal rupture after anastomosis.

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Objective: Hypocalcemia is one of the principal complications of total or completion thyroidectomy. A number of different protocols for managing this potential complication have been published. Our simple postoperative regimen is described and the safety and cost-effectiveness assessed.Method: Prospective analysis of a consecutive series of patients undergoing thyroid surgery from January 2008 through June 2010 was performed. Data collected included age, gender, procedure performed, levels of ionized calcium, parathyroid hormone, vitamin D, complications, and need for readmission. Standard descriptive statistics were used to summarize this data.Results: A total of 526 patients had thyroid surgery during the 30-month study period. Of these, 307 patients underwent completion or total thyroidectomy and were prescribed a 3-week, tapering course of calcium carbonate postoperatively. Twenty-four patients (7.8%) experienced symptoms of hypocalcemia which were managed easily with additional doses of oral calcium. A single patient (0.3%) required readmission. The cost of a 3-week regimen of calcium carbonate is approximately $15. This is considerably less expensive than the cost of overnight admission or published laboratory protocols that are designed to predict the risk of hypocalcemia. Conclusion:Prophylactic calcium supplementation without routine laboratory assessment proved to be a safe and costeffective method of preventing and managing postoperative hypocalcemia following total or completion thyroidectomy. Head and Neck SurgeryCan Pathology of a Thyroid Nodule Be Determined by Positron Emission Tomography? Brendan C. Stack Jr, MD (presenter); Jacob O. Boeckmann, MD; Donald Bodenner, MD, PhD; Eric R. Siegel, MS Objective: Positron emission tomography (PET) uptake in the thyroid gland is common. It occurs incidentally in diagnosis or surveillance of many cancers. Focal uptake indicates thyroid mass lesions. The goal was to determine if standardized uptake values (SUV) on PET can predict pathology in masses of the thyroid gland.Method: A total of 23,982 PET scans were retrospectively reviewed from the University of Arkansas for Medical Sciences in Little Rock, AR. These scans were performed from 2002 to 2010. 1,290 (5.4%) of scans had uptake in the thyroid gland, 614 were considered to be diffuse and 676 were considered focal.Results: A total of 112 patients had PET scan with accompanying thyroid cytology or pathology. The mean SUV for benign (N = 78) was 3.75 ± 2.99 and for malignant (N = 35) was 8.22 ± 7.91, × 2 0.0011. Age, lesion size, and gender were not significant. Receiver operating curves (ROC) were constructed with empirical or binormal distribution assumptions. The area under the curve (AUC) was 0.693 and 0.702 respectively. A SUV of 3.6 maximized empirical sensitivity and sensitivity while minimizing (FP) and negatives (FN). A SUV threshold of 3.6 minimized binormal FP and FN whereas a SUV of 7.9 maximized sensitivity and specificity.Conclusion: Uptake on the thyroid on PET scan is a common incidental fi...

Objective: Some patients with jaw anamorphosis symptom who underwent orthognathic surgery for lower jaw. By conducting auditory tube function tests before and after orthognathic surgery for the lower jaw, studied were the pathophysiology, incidence, causes and treatment of auditory tube dysfunction occurring following orthognathic surgery for lower jaw. Method: Regarding auditory tube function tests, the impedance test, or tympanometry, was sonotubometry, and TTAG were conducted. Patients whose auditory tubes conducted dysfunction was found to be aggravated were observed with daily TM testing until the function recovered to the preoperative level. Results: 1) Postoperative auditory tube dysfunction was noted subjectively in 18.3% and determined by TM in 60.4%. Lowered auditory tube function was found by TM at a high rate following orthognathic surgery for the lower jaw. Approximately 30% of patients with TM aggravation complained of ear symptoms. Among subjective ear symptoms, the most prevalent was a feeling of ear obstruction, and the second most prevalent was dysacusis. 2) It was suggested that TTAG could be a useful test for prediction of postoperative TM aggravation. Conclusion: Postoperative auditory tube dysfunction correlated with preoperative TTAG values, indicating that TTAG was a useful test for the prediction of TM aggravation. There was no correlation between postoperative auditory tube dysfunction and sonotubometry values. Postoperative auditory tube dysfunction recovered spontaneously in an average of 3.48 days without provision of ventilation treatment.