This Month in Laryngoscope

Predictability of Cochlear Implant Outcome in Families

There remains substantial variability of outcome among individuals following cochlear implantation. The authors studied families in which more than one individual had undergone cochlear implantation. All subjects improved when compared to preoperative speech perception. Hearing performance of the first family member to be implanted was predictive of the outcome of subsequent family members who required cochlear implantation. See page 131

Comparison of Three Common Tonsillectomy Techniques: A Prospective Randomized, Double-Blinded Clinical Study

The authors report outcomes in 153 patients scheduled for tonsillectomy who were randomly assigned to have either electrocautery, coblator, or microdebrider resection. Assessment was based upon telephone contact with parents. Use of either the microdebrider or coblator resulted in less pain and earlier return to diet and activities. Observed complications were similar in all groups. Use of the microdebrider resulted in less surgical time and cost. See page 162

The Effect of Multilevel Upper Airway Surgery on Continuous Positive Airway Pressure Therapy in Obstructive Sleep Apnea/Hypopnea Syndrome

The authors performed a retrospective study of patients intolerant of CPAP who required multilevel surgical intervention for sleep apnea. A cohort of 52 of these patients underwent both pre- and postoperative CPAP titration studies. In 3 patients, CPAP compliance could not be obtained. However, CPAP compliance significantly improved following multilevel airway surgery in the majority of patients. The mean CPAP pressure was significantly reduced following surgery. This study suggests that when a surgical cure is not attained, a return to CPAP may be possible. See page 193

On the Cover

Endoscopic laser cricopharyngeal myotomy has been used to treat dysphagia secondary to cricopharyngeal achalasia but has not been popularized partly due to fears of mediastinitis. This image illustrates the anatomy at the level of the cricopharyngeus. It depicts the buccopharyngeal fascia as a protective barrier which prevents extravasation of pharyngeal contents into the retropharyngeal space following endoscopic cricopharyngeal myotomy. Also evident is the retropharyngeal space which is not a potential space but one filled with areolar tissue. For further reading, see the article on page 45 by Pitman and Weissbrod.

Illustration 1.