Marc F. Colman

Simultaneous occurrence of hodgkin's disease and kaposi's sarcoma in a patient with the acquired immune deficiency syndrome

Kaposis sarcoma and Hodgkins disease have each been associated with abnormalities in T lymphocyte function and occur with increased frequency in the immunosuppressed host. Although the association of Kaposis sarcoma with lymphoreticular disorders has long been recognized, only sporadic cases of Hodgkins disease have been described in patients with the acquired immune deficiency syndrome (AIDS) in contrast to the frequent occurrence of non-Hodgkins lymphoma in these patients. The simultaneous occurrence of Kaposis sarcoma and Hodgkins disease in the same lymph node is described in a patient with AIDS. This case suggests an association of AIDS with both Kaposis sarcoma and malignant lymphomas and raises the question of a common pathogenetic mechanism.

Malignant external otitis with optic neuritis.

Malignant external otitis(MEO) is a progressive necrotizing infection which spreads to the skull base. The causative organism is usually Pseudomonas aeruginosa and 90% of the patients are diabetic. The infection gains access to the skull base at the temporal bone. Cranial nerve involvement is common. We present a case of malignant external otitis causing blindness due to optic neuritis. Progressive vascular involvement along the skull base is the pathogenic mechanism that best explains spread from the temporal bone to the orbital apex.

Invasive aspergillus of the head and neck

Invasive fungal infections of the head and neck are uncommon. The most common organism is Mucor which is classically seen in diabetic individuals in or immediately after a bout of ketoacidosis. This report outlines our experience of four cases of invasive fungal disease caused by the Aspergillus species. All four patients in this series were profoundly granulocytopenic. Three of the four patients remained profoundly immunocompromised and succumbed to infections. One patient recovered immune competence and became a long term survivor after antifungal chemotherapy and debridement of necrotic tissue. The literature on invasive Aspergillus of the head and neck is reviewed. Some recent insights in the medicine literature concerning the epidemiology of the more common pulmonary form of this invasive disease are also discussed.

The Effect of Vocal Cord Paralysis on the Cricoarytenoid Joint

Vocal cord reinnervation using neuromuscular pedicle techniques have met with variable success. One of the limiting factors in this type of surgery is the status of the cricoarytenoid joint. In this pilot study we studied the effect of immobilization secondary to deinnervation in the rat. There were no significant joint changes in the animals operated on after periods of up to 11 months. This agrees well with reported successes of reinnervation procedure 20 years after laryngeal paralysis.