Citations

The purpose of this study was to determine the effect of acute nasal obstruction on sleep and breathing in eight normal persons. The subjects were randomized into two groups. One night the subject was studied with the nose open and a second night with the nose obstructed. The electroencephalogram, electrocardiogram, inspiratory effort, nasal and oral airflow, and oxygen saturation were monitored. Sleep proved to be both subjectively and objectively disturbed. The subjects with the nose obstructed awoke more often, had a greater number of changes in sleep stage, had a prolongation of rapid‐eye‐movement (REM) latency, and spent a greater amount of time in stage I non‐REM sleep (light sleep). Acute nasal obstruction caused a statistically significant increase in the number of partial and total obstructive respiratory events (obstructive hypopnea and obstructive apnea). Sleep apnea developed in one subject during this study merely on the basis of acute nasal obstruction.

From 1950 through 1975, 54 patients with mucoepidermoid carcinoma of the oral cavity were treated at the Mayo Clinic. Metastatic disease occurred in 13 patients; nine patients died of their disease. Mucoepidermoid tumors of the hard palate should be treated by partial maxillectomy. Complete neck dissection is necessary for tumors larger than 2 cm in the base of the tongue. Other intraoral mucoepidermoid carcinomas are treated by wide surgical excision.

This report presents six cases of obstructive sleep apnea associated with discrete anatomic abnormalities of the upper airway tract. All patients were relieved of their sleep apnea by surgical correction of the airway obstruction, and therefore permanent tracheotomy was avoided. The obstructive causative factors were nasal septal deformity, adenoidal hypertrophy, nasopharyngeal stenosis, lingual cyst, lingual tonsillar hypertrophy, and laryngeal cyst. The last‐named four conditions have not previously been reported as correctable causes of sleep apnea.

Congenital choanal atresia is rare. Previous literature has dealt with the diagnosis and management of these patients, but there are no reports that accurately describe the nature of the deformity. This is a presentation of two patients with tomographic demonstration of the abnormality which confirms the surgical descriptions of previous authors. These abnormalities are (1) narrowing of the entire nasal chamber, (2) primary bony obstruction with an area of membranous obstruction, and (3) gross deformity of the vomer.

A review of 85 Mayo Clinic patients with carcinoma of the nasal septum revealed squamous cell carcinoma (58 patients) to be the predominant cell type, with adenocarcinoma (12 patients) and malignant melanoma (7 patients) being next in frequency. Twenty‐five (29%) of the 85 patients had metastatic disease. Twenty percent (17) of the patients had another malignancy at some time during their lives. The study suggests that tobacco smoking may have a role in the etiology of squamous cell carcinomas of the nasal septum. In most patients, wide surgical excision was the initial choice of treatment.

Natural killing (NK) may play an important role in immunosurveillance against virus‐infected and malignant cells. This study has demonstrated that the NK susceptibility of Epstein‐Barr virus (EBV)‐related cell lines increases with increased viral expression within the cells. This finding has implications for surveillance against, and treatment of, EBV‐related disease. Additionally, preliminary studies of the NK status of head and neck cancer patients reveal a distinct clustering of the patients into either groups of high or low NK reactivity. This clustering phenomenon may have a correlation with patient prognosis.

Hearing acuity and otologic symptoms were examined in 200 patients with adult‐onset diabetes mellitus. Data were analyzed according to sex and age and were compared with values of other documented studies; values were within normal limits except in two instances. Speech testing revealed that median speech reception thresholds and median discrimination scores were at the lower limits of normal. Hearing loss and otologic problems did not occur with any increased frequency in patients with adult‐onset diabetes mellitus.

Because antibody titers against Epstein‐Barr virus (EBV) antigens often are elevated in patients with active undifferentiated and nonkeratinizing nasopharyngeal carcinoma, anti‐EBV serologic tests have been applied as a diagnostic aid in patients who have metastatic lymphadenopathy in the neck without an obvious source. In this study of 44 patients, the serologic testing procedure proved useful in identifying six patients with nasopharyngeal carcinoma that was initially occult but was eventually confirmed by biopsy.