OBJECTIVE: To determine whether bivalve inlay cartilage-perichondrium myringoplasty (BCM) is successful in closing tympanic membrane perforations in an office setting.STUDY DESIGN: Retrospective case review.SUBJECTS AND METHODS: Adult patients with chronic perforations underwent BCM under local and topical anesthesia. Success was defined as complete closure of perforation at follow-up of at least 1 month. Predictors of success were identified by comparing the success and failure groups on pre- and postoperative pure tone average (PTA), patient demographics (age, gender), and characteristics of the perforations (size, location, duration, etiology).RESULTS: A total of 145 procedures were performed and the patients were followed for 1 to 78 months. The success rate for perforations smaller than 4 min was 75 percent. Size of the perforation, and pre- and postoperative PTAs were significantly different between the two groups. The only significant predictors of success were preoperative PTA and size of perforation.CONCLUSIONS: BCM is a viable option for closure of small and medium-sized perforations in an office setting. (C) 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.

INTRODUCTION Parathyroid cysts are uncommon lesions of the neck and superior mediastinum, rarely large enough to be of clinical significance. In 1880, Sandstrom reported the first parathyroid cyst. In 1905, Goris performed the first operative procedure to remove a parathyroid cyst. Two cases of parathyroid cysts treated at Fletcher Allen Health Care (FAHC)/ University of Vermont are reported here. In both cases, preoperative diagnosis was made by using fine needle aspiration with parathyroid hormone assay of the fluid sample.

Lymphoepithelial-like carcinomas (LELC) of the head and neck represent malignant neoplasms that are histologically similar to nasopharyngeal carcinoma (NPC), nonkeratinizing undifferentiated type but arise in locations other than the nasopharynx. The most common location for LELC in the head and neck is the salivary glands, in particular the parotid gland. However, LELC may arise in other sites including the oropharynx (tonsils, base of tongue), sinonasal tract, larynx, and middle ear/temporal bone. Unlike the nonkeratinizing undifferentiated type of NPC which is etiologically linked to Epstein-Barr virus (EBV), LELCs are not uniformly associated with EBV. The differential diagnosis for LELC varies per site and depending on the site of occurrence may include lymphoepithelial sialadenitis, sinonasal undifferentiated carcinoma (SNUC), and large cell neuroendocrine carcinoma. Treatment general includes combined (multimodality) therapy including surgical resection, neck dissection, radiation therapy and/or chemotherapy. The prognosis may vary per site overall favorable owing to a good response to therapy.