Walter P. Work

LXI Mixed Tumors of the Parotid Gland with Extension to the Lateral Pharyngeal Space

Although much has been written about benign mixed tumors of the parotid gland in general, little has been written concerning deep mixed tumors which extend to the intra-oral and pharyngeal structures. Since the founding of the American Laryngological Association in 1879, a few cases with benign mixed tumors arising in minor salivary glands of the pharynx have been presented before the members of this Society. However, we have been unable to locate a paper in this Associations Transactions dealing exclusively with tumors arising in the parotid gland and presenting in the pharynx or the palate. Such patients often present interesting and complex problems in diagnosis and treatment. It is not entirely clear in all cases where these tumors originate in relation to the deep portion of the parotid gland. Further, the exact anatomical route of medial extension may be difficult to ascertain in some. During the past few years we have had the opportunity to treat six of these patients and wish to report our experiences. In addition, we wish to report six additional cases that were treated at the University of Michigan Hospital by other members of the Department of Otorhinolaryngology.

XLII Non-Neoplastic Lesions of the Parotid Gland

2. Physical examination. Inspection and palpation are important. This examination may include duct probing, massaging the gland to determine character and amount of secretion, and determination of tenderness and other signs of sepsis. Facial nerve function and the site of the lesion in one or both parotid glands is important and should be noted. The local lesion may be a manifestation of constitutional disease.

Fifth Daniel C. Baker Jr. Memorial Lecture. Resident education: past, present and to where.

The specialties in medicine and surgery developed slowly during the later 19th century and the early decades of this century. The American boards were the focal points for sponsoring specialty societies through which these developments occurred. The resident review committees have also played an important role. Otolaryngology resident education has developed into a progressively structured educational experience so that presently otolaryngology resident education is a broad experience in head and neck oncology, plastic and reconstructive surgery, otology, laryngology, rhinology, allergy and immunology, bronchoesophagology, teaching and research. Resident education is not static. The year of 1978 can be noted as the year of change, for the Resident Review Committee in Otolaryngology recommended that resident education be of five years in duration, one year being in surgery, three years in otolaryngology and one year being elective as to content. Such programming can be highly structured to meet a candidates present and future needs in manpower, superspecialization and general otolaryngology. In this system superspecialization can and will be recognized and awarded through channels already established in otolaryngology. Manpower and general otolaryngology will also profit.

Hemangiomas of the head and neck.

Hemangiomas are an interesting group of lesions which affect many anatomical structures of the human body. Interest today is confined to head and neck lesions which can occur in the infant, child or adult. Benign lesions affect the great majority of patients as contrasted to malignant ones. Diagnosis of the superficial lesions is usually made by inspection and palpation while additional diagnostic procedures (radiological studies and surgical exploration) may be indicated in patients with deep lesions.

Adjustable dissection and surgical table as an aid to teaching

An adjustable dissection and surgical table for teaching residents, fellows, staff, and other medical and allied health personnel about anatomy and simulated techniques of surgery in the laboratory setting is described. The table can be attached to a standard House‐Urban temporal bone dissection bench. The temporal bone laboratory can thus serve a dual purpose in teaching ear and soft tissue anatomy and surgical techniques of the head and neck. In this setting such a dual purpose laboratory can often include basic and clinical research activities as a third function.

A radiologic advance in the diagnosis of disorders of the larynx.

The cervical spine greatly reduces the usefulness of anteroposterior soft tissue radiologic examination of the larynx. Fractures of the laryngeal and cricoid cartilages are difficult to diagnose by soft tissue technique, and time‐consuming laminagraphy is often required.