Accordingly, adequate precautions should be taken, patients should be counseled in this regard, and alternative medical strategies to control local seeding of thyroid tissue could be suggested.

Surgeons should be aware of the potential for benign seeding after remote-access thyroid procedures. Accordingly, adequate precautions should be taken, patients should be counseled in this regard, and alternative medical strategies to control local seeding of thyroid tissue could be suggested.

Vestibular evoked myogenic potentials (VEMPs) have an accepted role in the diagnosis of the superior semicircular canal dehiscence (SSCD) syndrome. The current impression is that ocular VEMPs (oVEMPs) are more sensitive than cervical VEMPs (cVEMPs) for detecting a SSCD and that oVEMP testing in response to air conducted sound provides an excellent screening test without risk of radiation exposure from computerized tomography (CT).

To report on patients with elevated oVEMP amplitudes but without evidence for a SSCD on multiplanar CT imaging.

Retrospective chart review of all patients referred for vestibular function testing to our department. Patients with oVEMP peak-to-peak amplitudes ≥17μν without evidence for a SSCD on imaging were evaluated.

26 patients had oVEMP peak-to-peak amplitudes ≥17μν with no evidence of a SSCD on imaging. The most common diagnosis was Meniere’s disease in those identified.

oVEMPs can provide false positive results for diagnosis of a SSCD and an elevated oVEMP amplitude in itself is insufficient for diagnosis of a SSCD.

oVEMPs can provide false positive results for diagnosis of a SSCD and an elevated oVEMP amplitude in itself is insufficient for diagnosis of a SSCD.Malignant peripheral nerve sheath tumors (MPNSTs) are a rare and aggressive subtype of sarcomas defined by their neural origin. Head and neck manifestations are particularly uncommon. Challenges exist in diagnosis, management, and recurrence. Achieving local control, particularly in the head and neck region, is difficult. We present a patient with a rapidly enlarging MPNST on the right parietal calvarium shortly after resection of a right vagus nerve MPNST. Recommendation was made for excision and reconstruction with a local advancement flap followed by radiation therapy. Local control with good aesthetic outcome was achieved by applying recommended surgical and oncologic principles.

Human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) treatment outcomes are re-defining management. Traditional margins, the role of extranodal extension (ENE) and adjuvant treatment intensity continue to be debated. This study aimed to determine the impact of margins, ENE and adjuvant therapy on survival following transoral robotic surgery (TORS).

Patients treated with TORS at an academic center were retrospectively identified (2013-2019). Survival outcomes were evaluated using Kaplan-Meier curves.

48 patients were included. 40 (83%) were male. Mean age was 61.2years. 43 (90%) were stage I. 22 (45.8%) had ENE. 31 (65%) had margins >1mm. 38 (79%) had indications for radiation therapy; 9 (24%) refused. Chemotherapy was recommended in 36 (75%) patients; 24 (67%) refused. Selleck MEK inhibitor Locoregional control was 98%, metastasis-free survival was 96%, and disease-specific survival was 100% at 5-years. Overall survival was 95%.

Given the high survival rate seen after TORS, it is likely that margins, ENE and adjuvant treatment may not significantly contribute to outcomes.

Given the high survival rate seen after TORS, it is likely that margins, ENE and adjuvant treatment may not significantly contribute to outcomes.

Tracheostomy management is a routine aspect of care in the critical care setting. While there are multiple complications that can arise in the post-operative setting after creation of a tracheostomy, dislodgement of a tracheostomy tube is associated with high mortality requiring rapid intervention. It is therefore important to prevent the occurrence with proper securement of the tracheostomy. In this study, we look at two methods commonly used to secure tracheostomy tubes suturing of the lateral flanges to the skin with the use of cloth neck ties versus cloth neck ties alone.

This is a retrospective study with data collected from 1355 consecutive tracheostomy cases at a single institution. Our institution serves the County of San Bernardino, California as a level II trauma center. Patient selection occurred between 2004 and 2018, with distribution of patients to skin-sutured with neck tie tracheostomies (ST) and non-sutured neck tied only tracheostomies (NST) groups occurring by date of tracheostomy surgehas been no study investigating dislodgement in the early post-operative period in relation to tracheostomy securement method.

Due to the emergent nature of tracheostomy dislodgement and loss of airway, prevention of this complication is critical. Our investigation found no statistically significant difference in the rate of early tracheostomy dislodgement in the skin sutured with neck tie and non-sutured neck tie only groups. This study contributes further data to the available literature regarding tracheostomy securement methods and dislodgement rate, specifically within the early post-operative period.

2b.

2b.

Currently, the first line treatment for Warthin’s tumor (WT) is parotidectomy. There is a paucity of data evaluating the safety and efficacy of non-surgical treatments for patients not amenable to surgery. Ultrasound guided ethanol sclerotherapy (UGES) has been successfully used for the management of lymphangiomans of the head and neck, thyroid nodules, and thyroid cysts. This is the first study to implement and assess the success of UGES for management of WT.

We report two patients with WT, with a total of 3 masses, who underwent UGES. All procedures were performed in the clinic. The primary outcome measured was the tumor volume reduction rate (VRR), patient satisfaction, and complications observed at follow-up.

Both patients experienced a significant reduction in tumor size upon follow up. VRR for the three treated tumors were 67.30%, 98.32%, and 55.73%. Patient were very satisfied with the results and noted significant cosmetic improvement. No complications were observed at follow-up.

Ultrasound guided ethanol sclerotherapy may be a viable option for conservative treatment of Warthin’s tumor in patients unsuitable or unwilling to undergo surgical resection.