Erkul E, Patel KG, Day T. Surgical Planning for Resection and Reconstruction of Facial Cutaneous Malignancies. Int J Head Neck Surg 2016;7(3):149-164.

Hu M. External Approach for the Treatment of the Aging Nasal Tip. Int J Head Neck Surg 2016;7(3):165-167.

To describe an approach for the diagnosis and management of patients presenting with crooked nose.

Patients with crooked nose suffer from functional ailments, most significant nasal obstruction, as well as esthetic concerns which may impact their self-image as well as others’ perception of them. As such, management of the crooked nose is an especially challenging task in that it demands careful attention to both nasal function and appearance. There are a plethora of surgical techniques which may be utilized, and the surgeon's approach must be tailored to each individual patient's presentation.

Accurate diagnosis is imperative for a successful outcome and relies on a thorough history and careful physical examination. Surgical intervention may be addressed by either an endonasal or open approach based on the location and severity of the deformity. It is helpful to break down the nose in vertical thirds when planning your surgical approach. Different techniques are used to address the upper third comprising the nasal bones, middle third composed of the upper lateral cartilages and septum, and the lower third composed of the lower lateral cartilages and caudal septum.

Management of the crooked nose is a technically challenging endeavor that highlights the need to address both form and function for a successful outcome. Effective treatment can significantly improve a patient's quality of life leading to a high level of satisfaction for both the patient and the surgeon.

Scordino JW, Stucker FJ. Management of the Crooked Nose. Int J Head Neck Surg 2016;7(3):168-172.

Our investigation attempts to identify factors associated with improved survival for early-stage laryngeal cancer based on primary therapy using the National Cancer Database (NCDB).

This is a retrospective cohort with data abstracted from the NCDB. Patients with T1 or T2N0M0 laryngeal cancer from 1998 to 2011 who received radiation only, laser surgery, or laser surgery with adjuvant radiation were included. Chi-square analysis was used to assess and investigate the association between treatment and factors. Overall survival (OS) was assessed via Kaplan–Meier method. Log-rank methods were used to determine factors significant for survival, and a multivariable Cox regression model was performed.

There were 14,276 patients from the NCDB eligible for this study. The majority (91.2%) of patients received primary radiation, 4.7% laser resection, and 4.0% laser resection with radiation. Five-year survival for laser surgery was 78.8% [95% confidence interval (CI) 75.5–82.1%] vs 67.2% (95% CI 66.4–68.1%) for radiation alone. Multivariate analysis demonstrated advanced age, increased comorbidities, public or uninsured, T2 stage, supraglottic subsite to be independently associated with worse survival. Treatment with laser only and laser with adjuvant radiation demonstrated a hazard ratio of 0.77 (p = 0.055) and 0.65 (p = 0.001) when compared with primary radiation.

Survival analysis on early-stage glottic patients in the NCDB showed multiple factors to be independently associated with survival. Outcomes based on treatment suggest an improved survival when utilizing endoscopic surgery as the primary treatment modality.

Mehta V, Thompson T, Shi R. Predictors of Survival in Early-stage Laryngeal Cancer by Treatment Modality. Int J Head Neck Surg 2016;7(3):173-181.

The purpose of this study is to review the indications, techniques, advantages, and outcomes of perichondrial cutaneous grafts (PCCG).

The PCCG is a composite graft utilized in the reconstruction of select head and neck defects. This graft, much studied and popularized by Dr Frederick Stucker, has several intrinsic benefits due to its size, thickness, contour, and unique perichondrial layer.

The PCCG is primarily utilized in the reconstruction of nasal and lower eyelid defects. This graft has been demonstrated to yield superior results to a full-thickness skin graft (FTSG) in these cosmetically sensitive locations and has the convenience of a single-stage procedure that may be performed under local anesthesia in contrast to a paramedian forehead flap (PMFF). Animal studies have shown less contraction in comparison to FTSGs. Large case series have reported low rates of graft loss and good esthetic outcomes.

The PCCG is an option to consider in the reconstruction of select head and neck defects, as it tends to offer excellent cosmetic results and minimal morbidity.

The PCCG has several advantages over a FTSG for moderate to large defects of the face, and is an excellent reconstructive option for nasal defects in which a PMFF may not be a viable option.

Bizzell JG, Boyette JR. Perichondrial Cutaneous Grafts in Facial Reconstruction. Int J Head Neck Surg 2016;7(3):182-187.

Lian TS, Thompson RW. Management of Rhinophyma. Int J Head Neck Surg 2016;7(3):188-191.