Search Our Scientific Publications & Authors

J Med Case Rep 2019 Mar 10;13(1):73. Epub 2019 Mar 10.

Neonatal Intensive Care Unit, Ruth Rappaport Children's Hospital, Rambam Health Campus, Haifa, Israel.

Background: A giant congenital cervical teratoma is often highly vascularized; thus, in addition to a life-threatening airway occlusion at birth it comprises a high risk for significant and lethal blood loss during resection. In the case presented, an endovascular embolization of the carotid artery that supplied a giant congenital cervical teratoma was done as part of a three-stage treatment soon after birth and contributed to an overall good outcome. Embolization in cases of cervical teratomas was not described previously. Read More

J Vasc Surg 2019 01;69(1):181-189

Division of Vascular Surgery, Eastern Virginia Medical School, Norfolk, Va. Electronic address:

Objective: Head and neck cancer can involve the surrounding vasculature and require technically challenging vascular interventions. These interventions can be complicated by tumor invasion, history of prior surgery, and history of radiation therapy. Our aim was to examine patients with vascular interventions in association with head and neck cancer to determine outcomes and best practice. Read More

J Neurosurg Pediatr 2018 12;23(3):325-332

OBJECTIVE Carotid body tumors (CBTs), extraadrenal paragangliomas, are extremely rare neoplasms in children that often require multimodal surgical treatment, including preoperative anesthesia workup, embolization, and resection. With only a few cases reported in the pediatric literature, treatment paradigms and surgical morbidity are loosely defined, especially when carotid artery infiltration is noted. Here, the authors report two cases of pediatric CBT and provide the results of a systematic review of the literature. Read More

Ann Vasc Surg 2019 Apr 27;56:355.e11-355.e15. Epub 2018 Nov 27.

Department of Vascular Surgery, Singapore General Hospital, Singapore.

Background: Surgical management of advanced head and neck tumors involving the carotid artery remains controversial with compromised survival outcomes and heightened risks of morbidity and mortality.

Case: We describe a case of a 74-year-old lady with previous T1N0M0 left tongue squamous cell carcinoma, who developed a left nodal recurrence encasing the left external carotid artery from the carotid bifurcation. She underwent an extended left radical neck dissection with carotid artery patch plasty and remains well to date, 10 months after surgery. Read More

World Neurosurg 2019 Feb 22;122:e1491-e1504. Epub 2018 Nov 22.

Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Electronic address:

Background: Based on our experience with the endoscopic endonasal approach (EEA) and transorbital approach (TOA) for middle cranial fossa tumors, we evaluated the efficacy and limitations of visualization and the clinical outcomes associated with the approaches depending on the surgical corridors. In addition, we determined the optimal strategy for each approach.

Methods: Between September 2015 and May 2018, we retrospectively reviewed clinical outcomes in 21 patients who underwent minimally invasive endoscopic surgery for middle cranial fossa tumors involving the cavernous sinus. Read More

J Neurol Surg B Skull Base 2017 Apr 9;78(2):120-124. Epub 2016 Sep 9.

Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, United States.

 An ectopic pituitary adenoma presenting as a clival or sphenoid mass is a rare clinical occurrence that may mislead the clinician and result in unnecessary interventions or potential medicolegal consequences. Here, we present one of the largest multi-institutional case series and review the literature with an emphasis on radiological findings and critical preoperative workup.  Retrospective chart review. Read More

Dan Med J 2017 Mar;64(3)

PTA is a collection of pus located between the tonsillar capsule and the pharyngeal constrictor muscle. It is considered a complication of acute tonsillitis and is the most prevalent deep neck infection (approximately 2000 cases annually in Denmark) and cause of acute admission to Danish ENT departments. Teenagers and young adults are most commonly affected and males may predominate over females. Read More

J Neurol Surg B Skull Base 2017 Feb 20;78(1):52-58. Epub 2016 Jun 20.

Division of Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida College of Medicine, Jacksonville, Florida, United States; Division of Surgical Oncology, University of Florida College of Medicine, Jacksonville, Florida, United States.

 The objective of this study was to report the outcomes on a preliminary cohort of patients with tumor encasement of either, or both, the cervical internal carotid artery (ICA) and common carotid artery (CCA) following preoperative covered stent placement and surgical resection.  This study was set at the University of Florida College of Medicine, Jacksonville, FL.  Subjects who received preoperative stenting of the cervical ICA/CCA before surgical resection of head and neck tumors between April 1, 2015, and July 31, 2015 were participated. Read More

Otolaryngol Clin North Am 2016 Jun;49(3):777-90

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA. Electronic address:

The most common vascular tumors encountered by the otolaryngologist are rare chromaffin cell tumors termed paragangliomas. Within the head and neck region, they commonly arise from the carotid body, vagus nerve (glomus vagale), and jugular vein (glomus jugulare). Other vascular head and neck tumors include sinonasal malignancies, because of proximity to or involvement of the pterygoid plexus as well as the rich vascularity of the sinonasal mucosa; juvenile nasopharyngeal angiofibroma, a vascular tumor of male adolescents; unusual vascular tumors such as hemangiopericytoma; and metastatic renal cell cancer, which has a proclivity for an unusually rich blood supply. Read More

J Vasc Surg 2016 Jun 28;63(6):1525-30. Epub 2016 Feb 28.

Department of Surgery, Division of Vascular Surgery, University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine, Pittsburgh, Pa.

Background: The purpose of this study was to examine outcomes of a patient cohort undergoing intervention for carotid blowout syndrome associated with head and neck cancer.

Methods: Patients with head and neck cancer who presented with carotid distribution bleeding from 2000 to 2014 were identified in the medical record. Primary outcomes were short- and midterm mortality and recurrent bleeding. Read More

J Laryngol Otol 2015 Dec 8;129(12):1148-55. Epub 2015 Oct 8.

Department of Otorhinolaryngology, Head & Neck Surgery,Memorial Ankara Hospital,Turkey.

Objective: The tumour-node-metastasis staging system has a dynamic structure that is continuously being updated as scientific data develops. This review discusses some suggested revisions on tumour-node-metastasis staging of human papillomavirus negative upper aerodigestive tract cancers.

Methods: The seventh edition of The American Joint Committee on Cancer Staging Manual was reviewed and important issues that could be considered for revision were identified and discussed. Read More

J Ultrasound 2015 Jun 5;18(2):197-200. Epub 2014 Dec 5.

Department of Pediatrics, McMaster Children's Hospital, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada.

A vein of Galen arteriovenous malformation (VGAM) is a rare intracranial shunt lacking a capillary bed and resulting in subsequent aneurysmal enlargement. VGAM has been previously reported to present as cardiovascular abnormalities, including increased right-sided cardiac load and pressure, cardiac dilatation, pulmonary hypertension and retrograde flow into the aortic arch. We report the first case of VGAM presenting as a gross right-sided neck swelling in a 39-week-old immediately at birth. Read More

Neurosurg Focus 2014 ;37(4):E13

Department of Neurosurgery-Head & Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.

Object: Skull base chondrosarcomas are slow-growing, locally invasive tumors that arise from the petroclival synchondrosis. These characteristics allow them to erode the clivus and petrous bone and slowly compress the contents of the posterior fossa progressively until the patient becomes symptomatic, typically from cranial neuropathies. Given the site of their genesis, surrounded by the petrous apex and the clival recess, these tumors can project to the middle fossa, cervical area, and posteriorly, toward the cerebellopontine angle (CPA). Read More

Semin Intervent Radiol 2013 Sep;30(3):245-8

Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island.

Involvement of the carotid artery by malignant processes of the head and neck with compromise of vessel integrity and rupture-"carotid blowout syndrome" (CBS)-is one of the most devastating complications of malignancy. Most often, it is associated with squamous cell cancer and almost always in patients who have undergone prior radiation therapy. CBS is classified as threatened, impending, or acute. Read More

Stroke 2014 Jan 10;45(1):37-41. Epub 2013 Dec 10.

From the Department of Neurology, Dijon University Hospital, Dijon, France (Y.B., C.A.-E., M.G.); Department of Epidemiology and Public Health, Inserm U744, Pasteur Institute, Lille, France (S.D., J.D.); Department of Neurology, EA1046, Lille University Hospital, Lille, France (S.D., D.L.); Department of Clinical and Experimental Sciences, Neurology Clinic, Brescia University Hospital, Brescia, Italy (A.P.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (T.T., T.M., A.M.); Department of Neurology, University Hospital of Basel, Basel, Switzerland (S.E., P.L.); Department of Neurology, University Hospital of Heidelberg, Heidelberg, Germany (C.G.-G., M.K.); Department of Neurology, Sainte-Anne University Hospital, Paris, France (E.T.); Department of Neurology, San Raffaele University Hospital, Milan, Italy (M.S.); Stroke Unit, Perugia University Hospital, Italy (V.C.); and Laboratory of Experimental Neurology, Université Libre de Bruxelles, Brussels, Belgium (M.P., S.A.).

Background And Purpose: Little is known about factors contributing to multiple rather than single cervical artery dissections (CeAD) and their associated prognosis.

Methods: We compared the baseline characteristics and short-term outcome of patients with multiple to single CeAD included in the multicenter Cervical Artery Dissection and Ischemic Stroke Patients (CADISP) study.

Results: Among the 983 patients with CeAD, 149 (15. Read More

AJNR Am J Neuroradiol 2014 Feb 17;35(2):360-6. Epub 2013 Oct 17.

From the Departments of Radiology and Research Institute of Radiology (L.-B.Z., H.B.S., S.P., D.-g.L., J.H.S., D.H.L., D.C.S.), University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.

Background And Purpose: Life-threatening bleeding in the head and neck requires urgent management. This study evaluated the angiographic findings related to head and neck bleeding and presents endovascular management techniques.

Material And Methods: Sixty-one consecutive patients who presented with acute bleeding in the head and neck areas and subsequently underwent endovascular therapy between January 2002 and October 2012 were included in our study. Read More

Angiol Sosud Khir 2012 ;18(4):107-12

Presented in the article is a rare clinical case report concerning successful treatment of a female patient with vaginal paraganglioma of the neck - a tumour extending from the level of the trunk of the common carotid artery in cranial direction to the base of the skull. Mentioned are difficulties of carrying out an operational intervention requiring the use of certain surgical techniques. The tumour was removed as a single block with the involvement into the process of the major vessels of the neck and nervous formations. Read More

Int J Oral Maxillofac Surg 2013 Apr 21;42(4):440-5. Epub 2012 Dec 21.

Department of Head and Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100021, China.

The surgical management of advanced cervical metastases with carotid artery involvement in patients with primary squamous cell carcinoma of the head and neck can be difficult. The authors retrospectively reviewed 73 patients over a 15-year period comparing the outcomes of carotid artery resection versus peeling the tumour off the carotid artery. Based on these findings, the authors suggest that in the absence of carotid wall involvement, nodal metastatic tumour should be peeled off the carotid artery where possible. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012 Mar;47(3):180-4

Department of Head and Neck Surgery, Hunan Province Tumor Hospital, Changsha 410013, China.

Objective: To investigate the surgical managements for residual or recurrent diseases in the neck after radiotherapy in nasopharyngeal carcinoma.

Methods: Seventy-eight cases of neck masses (39 cases for unilateral residual diseases, 9 for bilateral residual diseases and 30 for recurrent diseases) after radiotherapy in nasopharyngeal carcinoma who were treated surgically between January 1990 and December 2005 were retrospectively analyzed. There were 56 males and 22 females. Read More

J Trauma Acute Care Surg 2012 Jun;72(6):1601-10

Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan 48109, USA.

Background: Digital subtraction angiography (DSA) is the gold standard for radiographic diagnosis of blunt cerebrovascular injury (BCVI), but use of computed tomography angiography (CTA) and magnetic resonance angiography (MRA) has increased dramatically in BCVI screening. This study explores the utility, effectiveness, and cost of noninvasive CTA and MRA screening for BCVI.

Methods: Medical records of 2,025 consecutive adults evaluated for acute blunt neck trauma and BCVI were reviewed retrospectively. Read More

Head Neck 2013 Apr 27;35(4):527-34. Epub 2012 Apr 27.

Department of Otolaryngology-Head & Neck Surgery, International Islamic University, Malaysia, Kuantan, Malaysia.

Background: The purpose of this study was to identify the factors that may influence the management outcome in patients with jugular paragangliomas.

Methods: The surgical records of 121 cases of jugular paraganglioma (Fisch classifications C and D) were reviewed.

Results: The average follow-up was 88 months. Read More

Laryngoscope 2012 Jul 23;122(7):1615-9. Epub 2012 Mar 23.

Department of Otolaryngology-Head and Neck Surgery Medical University of South Carolina, Charleston, South Carolina, USA.

Inverted (Schneiderian) papilloma (IP) is a benign but locally aggressive tumor that is typically located in the sinonasal tract. Middle ear involvement and intracranial extension are rare. We present a patient with a history of a completely resected right nasal cavity IP that returned 7 months later with hearing loss, bilateral aural fullness, and right-sided facial weakness. Read More

Otol Neurotol 2011 Jul;32(5):882-6

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati/Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45267-0528, USA.

Objectives: Determine the prevalence of carotid artery injury (CAI) in patients with basilar skull fractures and describe significant demographic and radiographic risk factors for CAI.

Study Design: From January 2004 to December 2008, medical records of 1,279 consecutive adult patients treated for basilar skull fractures at a tertiary care academic hospital were retrospectively reviewed. Diagnostic angiography was performed in 112 patients because of concern for CAI. Read More

Cancer Control 2011 Apr;18(2):83-8

Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY 10467, USA.

Background: Central compartment lymph node dissection is a common adjunct to thyroidectomy in the treatment of papillary thyroid cancer. The indications, surgical technique, potential benefits, and operative risks of this procedure should be clearly defined in order to provide optimal care to these patients.

Methods: A systematic review of the literature and an analysis of evidence-based recommendations were performed regarding central neck node dissection for patients with papillary thyroid carcinoma. Read More

Scand J Trauma Resusc Emerg Med 2010 Nov 22;18:61. Epub 2010 Nov 22.

Anesthesia and Intensive Care Unit of Emergency Department, Careggi Teaching Hospital, Largo Brambilla 3, 50139, Florence, Italy.

Background: Incidence of Blunt Cerebrovascular Injuries (BCVI) after head injury has been reported as 0.5-1% of all admissions for blunt trauma, with a high stroke and mortality rate. The purpose of this study is to evaluate if a modification of Memphis criteria could improve the rate of BCVI diagnosis. Read More

Indian J Surg Oncol 2010 Apr 21;1(2):125-32. Epub 2010 Nov 21.

Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Mumbai, 400 012 India.

Lateral skull base tumours arise from overlying skin, parotid, temporal bone, mandible, muscle or the vasculature and they spread in midst of important neurovascular structures. This makes their diagnosis and management challenging. These tumours are primarily dealt with surgery which can be extensive, functionally disabling and cosmetically disfiguring. Read More

J Cardiovasc Surg (Torino) 2008 Dec 24;49(6):773-6. Epub 2008 Oct 24.

Department of Otorhinolaryngology and Maxillofacial Surgery, ASL 4, Turin, Italy.

Carotid involvement in head and neck tumours carries a poor prognosis and poses an additional challenge to patient management. Tumor fixity and high-definition imaging modalities can suggest, but not determine, carotid wall invasion, which can be proven only by perioperative observation. Conservative management offers no hope of cure or palliation. Read More

Head Neck 2009 Jan;31(1):136-9

Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239, USA.

Background: Pseudoneurysms of the carotid artery are rarely encountered in clinical practice. When encountered they are most likely secondary to acute neck trauma, and involve the internal carotid. External carotid artery involvement is very rare. Read More

Laryngoscope 2007 Oct;117(10):1710-9

Gruppo Otologico, Piacenza-Rome, Italy.

Objective: Primary meningiomas occurring within the jugular foramen are exceedingly rare lesions presumed to originate from arachnoid-lining cells situated within the jugular foramen. The objective of this study is to analyze the management and outcome in a series of 13 primary jugular foramen meningiomas collected at a single center.

Study Design: Retrospective study. Read More

Vascular 2005 Jan-Feb;13(1):58-61

Department of Surgery, Division of Traumatology, University Medical Center, Nijmegen, The Netherlands, USA.

Surgical repair of penetrating injuries of the thoracic outlet with combined arterial and venous involvement is associated with considerable morbidity and mortality. A 37-year-old man presented to the emergency room with a left-sided penetrating zone I neck injury caused by a close-range handgun shot. This had resulted in an injury to the innominate artery and the origin of the right common carotid artery, with shunting to the brachiocephalic vein. Read More

Head Neck 2005 Aug;27(8):669-75

Vanderbilt University Medical Center, Department of Otolaryngology-Head & Neck Surgery, 5025 Hillsboro Road, 7D, Nashville, TN 37215, USA.

Background: We sought to examine surgical techniques used to remove parapharyngeal space (PPS) masses.

Methods: This retrospective search was conducted from 1980 to 2003. Age, sex, diagnosis, surgical approach, complications, and outcome were collected. Read More

Am J Otolaryngol 2004 Mar-Apr;25(2):88-93

Department of Radiology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.

Objective: The most appropriate treatment of locally advanced carcinoma of the larynx remains to be ascertained. Management of T4 laryngeal cancer patients with postoperative radiotherapy after total laryngectomy is generally advocated and not often debated. However, the effects of this combined treatment approach are poorly documented. Read More

Laryngoscope 2004 Jan;114(1):20-4

Methodist Hospital, Clarian Health Partners, Indianapolis, Indiana, USA.

Objectives: To demonstrate aggressive management of neck metastasis adherent to the internal or common carotid artery using sound oncologic principles while minimizing the significant risk of complications.

Study Design: Our 13 year experience of treating patients with recurrent or residual neck metastasis adherent to the internal or common carotid artery was retrospectively reviewed.

Methods: Angiography was used in patients who demonstrated fixation of the carotid artery on examination or imaging, followed by balloon test occlusion and single photon emission computer tomography (SPECT) scanning. Read More

Eur J Nucl Med Mol Imaging 2002 Dec 21;29(12):1571-80. Epub 2002 Sep 21.

Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln, Joseph-Stelzmann-Strasse 9, 50924 Köln, Germany.

Paragangliomas or glomus tumours of the head and neck region are rare somatostatin receptor-expressing neuroendocrine tumours. Precise preoperative diagnosis is of special importance in order to adequately weigh the potential benefit of the operation against the inherent risks of the procedure. In this study, the clinical value of somatostatin receptor imaging was assessed in 19 patients who underwent somatostatin receptor scintigraphy because of known or suspected paraganglioma of the head and neck region. Read More

Neurol Res 2002 Jun;24(4):395-8

Department of Neurology, The University of Arizona Health Sciences Center, Tucson 85724-5023, USA.

Cervicocephalic arterial dissections (CCAD) are an increasingly recognized cause of ischemic stroke in young adults. Various treatments have been suggested but no controlled trial has ever been performed. Medical treatment has included anticoagulant or platelet antiaggregant therapy. Read More

J Laryngol Otol 2002 Mar;116(3):194-9

Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012, India.

The detection of cervical lymph nodal metastasis and carotid artery invasion by metastatic lymph nodes is an important issue in the management of head and neck malignancies. This study compared the evaluation of metastasis by palpation, ultrasonography (USG) and computed tomography (CT) in patients with known head and neck malignancies. Twenty-five consecutive patients with head and neck malignancy were prospectively evaluated for the presence of cervical lymphadenopathy and carotid artery invasion. Read More

Clin Otolaryngol Allied Sci 2001 Oct;26(5):357-66

Otolaryngology/Head and Neck Surgery Department, Hôpital Beaujon, Clichy, France.

In order to evaluate the decisional elements in the surgical strategy of deep-seated and/or extensive intratemporal lesions, a retrospective review of cases followed up between 1985 and 1996 in our department was undertaken. Eighty-one adult patients presenting temporal bone lesions located or extending beyond the middle ear limits excluding vestibular schwannomas and surgically treated were included. The population comprised 38 men and 43 women (mean age: 43 years, range: 17-81). Read More

Am J Otolaryngol 2001 Sep-Oct;22(5):336-42

Division of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Purpose: To determine appropriate management of benign lesions with significant involvement of the carotid artery at the skull base and present an algorithm for safe treatment of these patients.

Materials And Methods: From 1982 to 1999, 115 patients with significant parapharyngeal space masses were treated at our institution. Of these patients, 43 had lesions involving the carotid artery at the skull base and served as the basis for this study. Read More

Neurosurgery 2001 May;48(5):1152-6

Department of Neurosurgery, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

Objective And Importance: Mycotic aneurysms of the extracranial carotid artery are rare and difficult to diagnose. A search of the world literature published since 1966 reveals at least six cases of mycotic carotid aneurysms due to a Salmonella septicemia. We present an exceptional case of mycotic pseudoaneurysm of the bifurcation of the carotid artery due to Salmonella septicemia and discuss the pathogenesis as well as various aspects of the diagnosis and surgical management. Read More

Laryngoscope 2000 Oct;110(10 Pt 1):1660-6

Department of Otolaryngology--Head and Neck Surgery, The Neuroscience Institute, University of Cincinnati Medical Center, Ohio, USA.

Objectives/hypothesis: Cholesteatoma that is present in the anterior epitympanic space may extend medially along the supralabyrinthine route to the geniculate ganglion, labyrinth, and cochlea and medially toward Kawase's triangle and the anterior petrous apex. Superiorly it may erode into the middle fossa. Contemporary microsurgical techniques allow for optimal management of these lesions with minimal morbidity, provided that the irregular and complex osteology of the petrous base is understood. Read More

Head Neck 1999 Dec;21(8):734-42

Department of Neurosurgery, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8560, Japan.

Background: Cavernous sinus involvement represents the most difficult problem in en bloc resection of malignant skull base tumors. We developed three types of surgical procedures for manipulating the cavernous sinus to achieve en bloc resection of these tumors.

Methods: In a type 1 procedure, the cavernous sinus was dissected epidurally and retracted posteriorly. Read More

Otolaryngol Clin North Am 1998 Aug;31(4):671-86

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

This article discusses the following aspects of the management of the N+ neck: evolution of neck dissection; specificity of staging of the clinically N+ neck; limitations of neck dissection in patients with adverse histologic features; management of bilateral nodal metastases, fixed nodes, and nodes with involvement of skin, nerves or the carotid artery; retropharyngeal nodes; and salvage treatment of the N+ neck following prior irradiation. A summary of the author's own approach is then presented. Read More

Head Neck 1998 Jul;20(4):350-3

Division of Head and Neck Surgery, University of California, Los Angeles School of Medicine, 90095, USA.

Background: Retropharyngeal hematoma is a rare entity which may progress rapidly to airway obstruction. Previously documented causes have included coagulopathic states, trauma, infection, parathyroid adenoma rupture, and foreign-object ingestion. Four cases of spontaneous retropharyngeal hematomas without any known predisposing risk factors have been previously reported. Read More

J Thorac Cardiovasc Surg 1998 Feb;115(2):286-94; discussion 294-5

Thoracic Service, The Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

Objectives: Our goal was to describe the "hemi-clamshell" approach for the resection of primary and metastatic tumors of the cervicothoracic junction, evaluate its morbidity and mortality, and present survival data on a series of 42 patients who underwent resection with the use of this technique.

Methods: We conducted a retrospective review of the records of all patients of a single surgeon undergoing resection of tumors of the cervicothoracic junction. Data collected includes tumor type and involvement, type of resection, complications, and survival. Read More

Arch Otolaryngol Head Neck Surg 1997 Dec;123(12):1267-70

Department of Otolaryngology, Children's National Medical Center, Washington, DC, USA.

Objective: To determine the indications for admission, requisite imaging studies, and urgent medical or surgical intervention.

Design: We retrospectively reviewed the charts of 26 children (age range, 5 months to 14 years) who were seen by the otolaryngology service in the emergency department at the Children's National Medical Center, Washington, DC, from 1985 to 1993 and who were diagnosed as having oropharyngeal trauma. We specifically looked for common findings in the history and physical examination on initial presentation to predict the necessary steps in evaluation and management. Read More

J Vasc Surg 1996 May;23(5):775-80; discussion 781-2

Department of Surgery, Ohio State University College of Medicine, Columbus, USA.

Purpose: Many patients who have advanced cancer of the neck will have involvement of the internal carotid artery. The management of this condition remains controversial, and a wide range of therapeutic options have been suggested including ligation, "shaving" the tumor off the carotid, or en bloc resection and replacement of the internal carotid artery by polytetrafluoroethylene, vein, or superficial femoral artery. We reviewed our experience with en bloc resections of the internal carotid artery in a consecutive series of patients who had malignancies involving the internal carotid artery at a single institution from 1989 to 1995. Read More

Int J Pediatr Otorhinolaryngol 1995 Aug;33(1):67-74

Department of Otolaryngology, University of Toronto Faculty of Medicine, Canada.

Although vascular involvement by deep neck space infections occurs very rarely today with the widespread use of antibiotics, they often pose a significant challenge to the modern otolaryngologist, who most likely will have had no previous experience with either the diagnosis or treatment of these potentially life-threatening infections. We describe the case of a young female presenting with fevers, dysphagia, and blood-tinged sputum, who was diagnosed by contrast-enhanced computerized tomography, to possess a mycotic pseudoaneurysm of her right extracranial internal carotid artery, for which ligation of her common carotid artery was required. We also discuss both the clinical findings which should lead one to suspect that a neck infection may be involving the extracranial carotid arteries, and the English literature, on the morbidity and mortality of ligating a common carotid artery. Read More

Otolaryngol Clin North Am 1994 Feb;27(1):91-123

Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas.

The best management of advanced head and neck tumors invading the carotid artery utilizes a collaborative, anticipatory approach. Preoperative characterization of the anatomy and extent of tumor involvement, coupled with the physiologic assessment of the cerebrovascular circulation through the variety of adjunctive studies, facilitates operative planning. Careful preoperative evaluation allows the surgeon to make the most informed decision regarding extracranial carotid artery reconstruction, should carotid artery resection be required for adequate tumor removal. Read More

J Neurol Neurosurg Psychiatry 1993 Mar;56(3):234-40

Harvard Medical School, Department of Neurology, Massachusetts General Hospital, Boston 02114.

This review of acute visual failure covers the clinical manifestations and management of ocular strokes CRA occlusion, BRA occlusion and AION. The diagnostic process for each patient requires meticulous attention to: 1. Blood pressure, heart rate and rhythm, palpation of the temporal arteries, and auscultation of the heart, neck, eyes and head. Read More

J Surg Oncol 1990 Dec;45(4):229-33

Department of Surgery, SUNY-Health Science Center, Brooklyn, NY 11203.

From the time Crile described radical neck dissection in 1906, this surgical procedure became popular in the management of metastatic cancer in the neck. Over the past two decades, the modified neck dissection has been effectively utilized for conservation of function and cosmesis while achieving the same oncologic goals. However, there are several instances where the above standard procedures are not adequate for resection of malignant tumors. Read More