Timothy D. Anderson

Prevalence of unsuspected acoustic neuroma found by magnetic resonance imaging.

OBJECTIVES: Acoustic neuromas (ANs) comprise 6% of intracranial tumors. Population and autopsy studies have widely divergent estimates of AN incidence. With widespread use of MRI, asymptomatic ANs will be identified, which should improve estimates of the prevalence of this tumor. METHODS: The reports of all brain MRI scans during a 5-year period were retrospectively searched for the diagnosis of AN. MRIs obtained because of a suspicion of AN were discarded, leaving only the unsuspected ANs. RESULTS: A total of 24,246 MRI studies were performed during this time period. Seventeen patients had unsuspected ANs. Eight tumors were smaller than 1 cm, 6 were between 1 and 2 cm, and 3 were 2 cm or larger. For all MRI scans, we found 7.0 unsuspected ANs per 10,000 brain MRI studies (0.07%). CONCLUSION: The true prevalence of AN is likely greater than the 10 per million per year previously reported. This implies that there may be a larger number of asymptomatic ANs than previously suspected.

Immediate percutaneous medialization for acute vocal fold immobility with aspiration.

Objectives To determine the efficacy of immediate bedside or office percutaneous, trans‐thyroidal injections of a bioabsorbable gelatin material (Gelfoam, Upjohn Co., Kalamazoo, MI) to decrease the risk of aspiration resulting from acute vocal fold immobility.

Desmoplastic neurotropic melanoma of the head and neck: The role of radiation therapy

Desmoplastic neurotropic melanoma (DNM) is an uncommon cutaneous melanoma variant with pronounced neurotropism. In contrast to ordinary melanomas, locoregional recurrences are common and distant metastasis are uncommon in patients with DNM. Local control with surgery and radiation therapy may assume a more important role in this variant of melanoma. We present a case of an unresectable skull base recurrence of DNM that was controlled using radiation therapy alone and review the literature.

Tumor Deposition of Laminin‐5 and the Relationship With Perineural Invasion

Objectives/Hypothesis Perineural invasion (PNI) is increasingly being recognized as an important indicator of aggressiveness in head and neck squamous cell carcinoma. The mechanisms of PNI are poorly understood. Laminin‐5, an important basement membrane constituent, has been shown to be essential in head and neck squamous cell carcinoma invasion and motility. We hypothesized that tumors exhibiting increased expression of laminin‐5 are more likely to be neurotropic.

Osteosarcoma of the hyoid bone

Primary lesions of the hyoid bone are exceedingly rare. Reported malignant lesions include chondrosarcoma, plasmacytoma, and metastatic squamous cell carcinoma, and benign masses include aneurysmal bone cysts, chondromas, and osteomas.1 Because all of these diagnoses present as a mass in the neck, differentiation between them is difficult. We report the first case in the English literature of a primary osteosarcoma (OS) of the hyoid bone.

Hypopharyngeal desmoid tumor (aggressive fibromatosis)

that LAUP for the treatment of snoring is time limited, requiring further treatment in some patients. Methods: LAUP was performed in the outpatient setting using the CO 2 laser and local anesthesia in all patients. A 5year follow-up sleep questionnaire was completed by two thirds of patients with a recurrence of snoring. Results: Results of our study are based on a 5-year experience from June 1993 to June 1998. A total of 409 patients were treated with LAUP for snoring and obstructive sleep apnea. A recurrence of snoring occurred in 15 (3.7%) patients. Conclusion: LAUP is a relatively new procedure for the treatment of snoring and obstructive sleep apnea with no longterm follow-up reported in the literature. Conclusions from this 5-year experience with 409 patients are that 3.7% of patients treated with LAUP had recurrence of snoring and that there are no patient characteristics that predict the recurrence of snoring.