Metastasis of tumors to level IIb lymph nodes is rare in patients with laryngeal squamous cell carcinoma (LSCC); this area can be ignored during selective neck dissection (SND) to avoid damaging the spinal accessory nerve (SAN), making this surgery more conservative and minimizing SAN morbidity, according to the March 2012 issue of Otolaryngology-Head and Neck Surgery. The authors acknowledge that the medical literature stresses the importance of preserving the SAN to prevent postoperative limitations in shoulder function and pain in patients who undergo neck dissection. They note, however, that "insufficiency in shoulder function has been observed in 31% to 60% of cases in which the SAN was preserved." Studies show nerve insufficiency is present despite the SAN preservation due to the stretching and retracting of the nerve to clean level IIb.
Researchers at King's College London and Hiroshima University, Japan, have identified a specific gene linked to throat cancer following a genetic study of a family with 10 members who have developed the condition. The study, published in American Journal of Human Genetics, uncovered a mutation in the ATR gene, demonstrating the first evidence of a link between abnormality in this gene and an inherited form of cancer. The researchers say this finding raises new ideas about genetic factors linked to throat cancer and provides a platform for exploring the role of ATR more generally in cancer biology. Scientists carried out a genome-wide linkage study in a US family with an unusual hereditary condition affecting 24 members of the family over five generations. Characteristics include developmental abnormalities of hair, teeth and nails as well as dilated skin blood vessels.
Archives of Otolaryngology - Head & Neck Surgery, released an article today, looking at the ramifications of Surgery for Obstructive Sleep Apnea, which is when a person experiences pauses in breathing while they are asleep. When a patient undergoes a surgical procedure to correct the obstruction in their airway, traditional thought categorizes them as in a dangerous and potentially life threatening post operative state. They need to be monitored with caution, because these patients are at higher risk for airway compromise. Kenny P. Pang, F.R.C.S.Ed., F.R.C.S.I.(OTO), of the Pacific Sleep Centre, Singapore, and colleagues reviewed data from nearly 500 patients with obstructive sleep apnea (OSA) who underwent surgical procedures from January 2007 to May 2010. The surgeries to correct sleep apnea included nasal, palate and tongue procedures.
Today's tree pollen count in Chicago is 1600, which is 100 more than the 1500 limit, which indicates a dangerous air quality warning. Dr. Joseph Leija, who performs the official allergy count for the Midwest states: "After only seven days of allergy count recording, we are documenting the first air quality alert in the 2012 allergy reporting season. This is the first day of spring and this air quality alert will make many Midwesterners very miserable." Today's official Gottlieb Allergy Count in Chicago is, "Trees Very High, Grass Low, Mold Low and Ragweed Low", which means that many people in Chicago will be complaining about headaches, sinus congestion, runny noses and fatigue today. Dr. Joseph Leija, allergist at Loyola's Gottlieb Memorial Hospital, is the only certified allergist by the National Allergy Bureau to perform the daily official allergy count for the Midwest.
On March 1, 2012, the American Academy of Otolaryngology-Head and Neck Surgery Foundation published a new Clinical Practice Guideline on Sudden Hearing Loss (SHL). This guideline is published as a supplement to Otolaryngology-Head and Neck Surgery. A sudden loss of hearing is a frightening symptom that most often prompts urgent medical care. Current diagnosis and treatment plans vary greatly. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of adults who present with SHL. Prompt, accurate recognition and management of sudden sensorineural hearing loss (SSNHL), a subset of SHL, may improve hearing recovery and patient quality of life. SSNHL affects 5 to 20 per 100, 000 population, with about 4, 000 new cases per year in the United States.