Michael D. Maves

Relationship between psychological status and compliance in a sample of patients treated for cancer of the head and neck.

The psychological status of patients treated for advanced head and neck cancer is an area of patient care that has not received sufficient attention from caregivers and can be influential in terms of patient outcomes.

Comparison of electroglottographic and acoustic analysis of pitch perturbation.

Pitch perturbation is a measure of the cycle-to-cycle variation in vocal fold vibration. Perturbation can be assessed by means of electroglottographic or acoustic signals. The purpose of this study was to determine if these two analysis techniques are equivalent measures. The Laryngograph, an electroglottograph, and the Visi-Pitch, an acoustic analyzer, were used to measure pitch perturbation in 80 dysphonic subjects. Both instruments use Koikes formula to calculate relative average perturbation. While intrasubject variability appeared erratic, statistical analysis of intersubject data indicated that the two instruments provided an equivalent measure of pitch perturbation.

Superiorly based trapezius flap for emergency carotid artery coverage

Three to four percent of patients with carotid artery exposure following major head and neck surgery suffer a rupture of the carotid artery system.le4 Preoperative radiation, orocutaneous fistula, tumor recurrence, infection, and local flap failure are the most common contributing factors to wound breakdown and carotid artery exposure.’ Carotid vessels that are exposed to a direct salivary stream will undergo desiccation and digestion of their surface. Also, local wound infection and tumor recurrence place the arterial wall at risk for weakening and potential rupture. As stated by Shumrick, “A carotid artery rupture should never occur.‘” Therefore, the authors recommend a policy of active early intervention in all patients with an exposed carotid artery. A “wait and see” attitude with regards to carotid exposure only invites the potential catastrophic complication of a carotid “blow out.” Several methods have been historically used but have inherent limitations affecting their utility for carotid coverage.6 Dermal and fascial grafts do not have an independent blood supply and thus are unreliable in infected contaminated wounds. They also need to be placed at the time of initial surgery. The levator scapulae flap is locally available, but difficult to transpose. Additionally, the entire length of exposed carotid artery cannot be covered with the levator scapulae flap. The