Background: Management of advanced laryngeal cancer is complex and ideal strategy is yet to be defined. This study evaluates the experience of a single head and neck oncologic centre in the management of T4 laryngeal cancer. Methods: Retrospective assessment of cases primarily treated for T4a squamous cell carcinoma of the larynx, between 1980 and 2007, at a tertiary referral center. Results: A total of 384 cases were studied. Five-year disease specific survival was 56.2% and local control 87.4%. Regional and distal control estimates were 90.3% and 88.3% respectively. Prognosis was significantly superior for cases treated with primary surgery compared to cases solely managed with non-surgical modalities. Positive surgical margins and regional disease worsened prognosis. Conclusion: This study suggests that primary surgery remains a key element in the treatment of advanced laryngeal cancer. The need for well-designed, prospective, randomised studies in order to further evaluate the remaining role of primary surgery in the modern management of locally advanced laryngeal lesions is emphasized.

Objective: To investigate long-term recovery after Bell's palsy and evaluate specific parameters for predicting the long-term outcome of facial weakness. Study Design: Retrospective clinical study combined with long-term follow-up. Setting: Tertiary care university hospital (Department of Otorhinolaryngology, Head and Neck Surgery, University of Thessaloniki, Greece). Patients: Forty-four patients who were followed up 2 to 6 years (mean, 4.01 yr) after the onset of facial weakness. Main Outcome Measures: The failure rate of complete recovery was studied for age, initial nerve excitability test, electroneurography, initial severity of paralysis, and number of days from onset of facial weakness to the start of medical treatment. Results: Thirty-two (73%) of 44 patients had a satisfactory outcome, and 12 (27%) had a nonsatisfactory recovery. Initial House-Brackmann grades V/VI and electroneurographically detected degeneration of 90% or more were shown to affect the long-term outcome of facial weakness significantly (p = 0.024 and p = 0.000, respectively). Conclusion: The initial severity of facial weakness and the electroneurographically detected facial nerve degeneration were found to be important factors in predicting the long-term prognosis of Bell's palsy.

Up to Quiz Ref ID 75% of stenoses of the salivary ducts are located in the parotid duct, and these cause approximately 15% to 25% of all unclear salivary gland diseases.^1,2 Chronic parotitis is the major cause of this type of stenosis, but associations with allergic, infectious, granulomatous, and autoimmune diseases, as well as status after radiotherapy or radioiodine therapy, have also been reported.^3-5 Quiz Ref ID Ultrasonography is currently the diagnostic method of choice in our department. Ultrasonographic imaging of parotid gland stenosis shows a hypoechoic band on the masseter muscle, as evidence of dilation of the ductal system, and also hypoechoic parenchymal changes, as signs of obstruction of the gland.⁶