1. Department of Otolaryngology, Lange Land Hospital, Zoetermeer, the Netherlands (Dr van der Erden); Department of Surgery, Amphia Hospital, Breda, the Netherlands (Dr Verdam); Department of Otolaryngology, Queen Alexandra Hospital, Portsmouth, England (Dr Dennis); and Department of Otolaryngology and Facial Plastic Surgery, Gooi-Noord Hospital, Blaricum, the Netherlands (Dr Vuyk).