We seek to review the medical literature and explore the cultural practices and lore of self-ear-cleaning to arrive at appropriate medical advice for our patients.

The medical consensus recommends against the practice of self-ear-cleaning as it may lead to complications or injury. There is a wide gap between the recommendations of the medical community and the general public's perception about ear-cleaning habits. Despite ample advice, the practice of ear cleaning with swabs is pervasive.

A review of the available medical literature reveals a few articles that associate self-ear-clearing with injury. Even fewer articles provide data as to the prevalence of self-ear-cleaning making the relative risk of such a practice difficult to ascertain. Despite this scarcity of data, most authors continue to advocate for avoiding the practice of self-ear-cleaning.

In light of the ubiquitous use of cotton tip swabs, the practice of self-ear-cleaning deserves additional medical evaluation to identify safe and acceptable procedures regarding contemporary hygiene of the ear. It appears likely that medical advice for self-ear-cleaning has been disproportionately influenced by the unusual adverse outcomes that are possible rather than evidence-based guidelines.

Sperling NM, Portnoy WM. To Swab or Not to Swab: Appropriate Medical Advice Regarding Self-Ear-Cleaning. Int J Head Neck Surg 2016;7(1):1-4.

Review and describe the essential components of modern frontal sinus surgery.

Frontal sinus surgery has evolved considerably over the last century, and advances in imaging, optics, and instrumentation have contributed to contemporary treatment paradigms. Outcomes assessment has had an important role in identifying indications for surgery and future areas of research.

Numerous advancements are part of modern frontal sinus surgery and the treatment of frontal sinusitis. Anatomic studies have revealed variations that are associated with disease and pose challenges for surgery. Open approaches remain relevant in situations of difficult disease or as part of combined approaches. Endoscopic surgery, however, is central to contemporary surgical management of frontal sinus disease. Evolving instrumentation and the development of new implantable devices are increasingly relevant in the endoscopic era. Outcomes research has refined indications for surgery and identifies areas for ongoing research.

State-of-the-art frontal sinus surgery is the product of significant evolution and advancement. Modern surgery is reflective of improved optics and new instrumentation, and the central role of endoscopic approaches in treating frontal sinus disease. Outcomes research has been essential for developing an evidenced-based approach to frontal sinus surgery.

A review of the essential components of state-of-the-art frontal sinus surgery for the practicing otolaryngologist.

Marino MJ, McCoul ED. Frontal Sinus Surgery: The State of the Art. Int J Head Neck Surg 2016;7(1): 5-12.

Alessi A, Boruk M. Core Competency Education in Communication and Systems-based Practice: Are We Failing Our Residents? Int J Head Neck Surg 2016;7(1):13-16.

Ho S, Kay DJ. Tympanostomy Tube Selection: A Review of the Evidence. Int J Head Neck Surg 2016;7(1):17-22.

Har-El G. Management of Early Laryngeal Cancer: The Role of Individualized Medicine. Int J Head Neck Surg 2016;7(1):23-28.

Nathan J, Asadourian L, Erlich MA. A Brief History of Local Anesthesia. Int J Head Neck Surg 2016; 7(1):29-32.

Kaplowitz LJ, Joseph EM. A Practical Approach for Learning Rhinoplasty Surgery. Int J Head Neck Surg 2016;7(1):33-46.

We noted unusual cases of vocal fold polyps originating from the center of vocal sulci and propose a possible etiology for the development of these lesions.

Three patients presented to our office with acute onset dysphonia. Intraoperative examination revealed vocal polyps originating from the center of vocal sulci. Lesions were treated with microflap excisions and were sent for histopathologic analysis.

Pathology of the excised lesions showed a parakeratotic squamous epithelium with mild inflammation and with dilated vascularity suggesting an acute or subacute process. Patients had voice improvement without recurrence of the vocal-polyp or sulcus following surgical excision.

We speculate that the observed lesions result from phonotrauma to congenital sulci and propose that partial prolapse of the epithelium is responsible for the formation of the observed vocal polyps.

Mor N, Hernandez-Prera JC, Tang C, Blitzer A. Polyp within the Center of a Vocal Fold Sulcus: A Proposed Pathophysiologic Construct. Int J Head Neck Surg 2016;7(1):47-50.

Ferzli G, Bentsianov B. Dermatologic Manifestation of Streptococcal Infection: Tonsillectomy as a Treatment for Guttate Psoriasis. Int J Head Neck Surg 2016;7(1):51-52.

Our goal is to present an unusual case of posttransplant lymphoproliferative disorder (PTLD) involving the larynx. We aim to expand the literature regarding head and neck manifestations involving PTLD and for otolaryngologists to include PTLD in their differential diagnosis of laryngeal lesions in patients who have a history of solid organ transplantation.

Posttransplant lymphoproliferative disorder occurs in immunocompromised patients following solid organ transplantation. Head and neck manifestations most commonly involve Waldeyer's ring with the larynx and trachea being relatively uncommon sites of disease. However, lesions of the larynx can cause acute airway obstruction and rare fatalities have been reported in the literature.

We present the case of a 51-year-old female with a history of renal transplantation, who presented to the office after an incidental supraglottic lesion was discovered during intubation for cochlear implant placement. A mucosalized lesion arising from the right aryepiglottic fold with dynamic obstruction of the airway was noted on office endoscopic examination. Imaging revealed extension of the mass into the right posterolateral hypopharynx. The patient was taken to the operating room for microdirect laryngoscopy and CO₂ laser excision of the mass. The lesion was excised with negative gross margins. Final pathology revealed plasmacytoma-like PTLD and the patient was referred back to her transplant team for modulation of her immunosuppressive therapy.

We present the case of an incidental supraglottic lesion in a posttransplant patient. Special emphasis should be given to the tissues of Waldeyer's ring and larynx.

Posttransplant lymphoproliferative disorder, while rare, should be kept in the differential diagnosis of pharyngeal and airway lesions in patients with a history of solid organ transplantation. Expansile lesions can cause acute airway obstruction. Urgent evaluation and treatment of theses lesions is necessary in these circumstances.

Kohli N, Wasserman JM. Posttransplant Lymphoproliferative Disorder involving the Larynx. Int J Head Neck Surg 2016;7(1):53-56.