Citations

Otolaryngologists‐head and neck surgeons and surgical pathologists should be aware of the potential for acinic cell carcinomas to dedifferentiate so that adequate histologic tumor sampling can be performed. Dedifferentiated acinic cell carcinoma is a highly malignant, newly recognized parotid malignancy. Clinical clues that may help identify this more ominous lesion must be recognized.

The purpose of this study was to examine potential toxic effects of fibrin tissue adhesive to the middle and inner ears. Using the chinchilla as our experimental model, we placed fibrin sealant on either the footplate or the round window membrane in one ear, and placed similar amounts of normal saline in the same area of the opposite ear. In addition, the fibrin adhesive was used to anchor a fascia lata graft for myringoplasty. Both fibrin adhesive and normal saline produced mild reactions in the middle and inner ears when they were placed on the round window membrane; little reaction occurred when fibrin adhesive was placed on the oval window or when it was used for myringoplasty.

Restricted exposure and inconsistencies in sinus pneumatization place the optic nerve at risk during operations on the sphenoid sinus and posterior ethmoid cells. In this study, computed tomography was used to examine these relationships. We reviewed 80 patients who underwent high‐resolution computed tomographic scanning for ophthalmologic complaints in which the scan was negative. Forty‐eight percent of posterior ethmoid cells are separated from the optic nerve by the thin bony lamina of the optic canal. Nearly 90% of sphenoid sinuses contact the ipsilateral optic nerve and 10% contact both nerves. Eight percent of posterior ethmoid cells override the ipsilateral sphenoid sinus and contact the optic nerve on that side. Paraxial reformatted displays allowed estimation of the degree of projection of the optic nerve into adjacent sinus cavities. Three percent of optic nerves have significant projection into the posterior ethmoid cell, and 23% project significantly into the sphenoid sinus. The width of the bony plate that separates the optic nerve from the sinus cavity was the same for sphenoid and ethmoid sinuses. Although sinus pneumatization varies among individuals, right and left sides are generally similar within one person.

Each of eight mongrel dogs received a 0.5 ml injection of polytef paste into the right vocal fold. These dogs were killed at 1 week, 1 month, 3 months, and 6 months after injection, and a number of organs were examined. Polarizing microscopy was used to examine the upper cervical lymph nodes, lower cervical lymph nodes, mediastinal lymph nodes, abdominal lymph nodes, cerebral cortex, brainstem, lung, liver, spleen, and kidney to determine if migration of polytef had occurred. Examination of these organs revealed that there was consistent migration of polytef particles into the cervical lymph nodes, with the highest incidence occurring in upper cervical lymph nodes on the side of injection. There was no evidence of migration of polytef particles to distant sites. The study shows that polytef particles may migrate to cervical lymph nodes after injection into the larynx; however, there is no evidence of distant migration.

Butyl 2‐cyanoacrylate was placed on the oval and round window of the ear of the chinchilla and was also used as an adhesive for myringoplasty with autogenous muscle fascia. Butyl 2‐cyanoacrylate was found to be difficult to manipulate and moderately toxic to the middle ear; there were occasional significant reactions in the inner ear.