bluuebunny/crossref_metadata_2025 huggingface dataset:
Olfactory neuroblastoma: A case report in an African child
Authors: Aghadiuno P. U. , Thomas S. M. , Ogan O. , Martinson F. D. , Adeloye Adelola
Published: November 2007

The case is described of an eight-year-old Nigerian boy who died from olfactory neuroblastoma which presented with nasal obstruction and epistaxis. Autopsy showed intracranial extension of the tumour into the frontal lobe, and histology revealed undifferentiated neuroblasts, forming rosette in some areas and producing tangled neurofibrils in others. The histogenesis of the tumour and its diagnosis are briefly discussed.
Otoscopy compared with tympanometry
Authors: Gimsing Steen , Bergholtz Lars M.
Published: November 2007

A study comparing otoscopy with tympanometry was carried out in 1702 ears in seven- and ten-year-old children. Pneumatic otoscopy in 917 ears showed an 88 per cent agreement with tympanometry. The agreement was better in ears considered normal by the otoscopist than in ears that were considered abnormal. Furthermore, the accuracy of otoscopy was better in the older children than in the younger ones.

A procedure employing simple otoscopy in 785 ears gave an 83 per cent agreement, but in about 15 per cent of these ears the examiner felt unable to base his evaluation on certainty.

It was found that a middle-ear pressure of –100 mm. H2O correlated with recognizable pathology when pneumatic otoscopy was performed.
Phonocephalography and pulsatile tinnitus in a surface cerebral angioma
Authors: Tewfik Sayed
Published: November 2007

Phonocephalography is a simple, passive non-invasive diagnostic technique in tinnitus and cerebral angiology.

Pulsatile tinnitus may occur in hypertension, haemodynamic disorders, or extracranial and intracranial vascular abnormalities. It is ignored by otologists and neurologists. Phonocephalography is the amplification and recording of sounds from the surface and cavities of the head. In this case report, the technique of phonocephalography was used to records these sounds and the tinnitus in a case of surgace cerebral angioma.
Evaluation of CT in the diagnosis of congenital choanal atresia
Authors: Hasegawa M. , Oku T. , Tanaka H. , Watanabe I. , Suzuki S.
Published: November 2007

A six-year-old female with congenital bilateral choanal atresia was examined by CT (computed tomography) and contrast radiography. CT clearly demonstrated the existence of choanal atresia, and differentiated osseous stenosis from membranous stenosis in the choanae. CT may be the first choice of radiological examination for the pre-operative diagnosis of congenital choanal atresia.
Functional voice disorders
Authors: Bridger M. W. M. , Epstein Ruth
Published: November 2007

The records of 109 patients, presenting with functional voice disorder during the years 1977–1981, have been reviewed. The mean age was 45 years and the F: M ratio is 2: 1. Excess voice use was not obviously an aetiological factor. Sixty-one of the 109 patients (56 per cent) were cured by speech therapy, in that their voices returned to their pre-morbid state, and a further 28 (26 per cent) were improved by therapy; seven patients (6 per cent) did not improve and 13 (12 per cent) were lost to follow-up. Of the patients that were ‘cured’, 54 per cent were discharged after three months' treatment and 72 per cent after six months' treatment. Eight per cent required treatment for more than a year.
Lateral sinus thrombosis in the eighties
Authors: Debruyne F.
Published: November 2007

In spite of the increasing use of more efficient medical therapy, different types of otogenic intracranial complications continue to occur.

A detailed description of two cases of lateral sinus thrombosis illustrates that its present-day clinical course can differ from the traditional clinical picture of the disease.
The larynx in pulmonary tuberculosis
Authors: Beg M. H. A. , Marfani S.
Published: November 2007

Summary Pulmonary tuberculosis is still a common disease in the developing countries of the world. One hundred patients with pulmonary tuberculosis showed laryngeal involvement in 37 patients. The posterior part of the larynx followed by the epiglottis are the commonest sites to be involved in the laryx. Ulcerative lesions and perichondritis. so common in prechemotherapeutic days, were not seen.
The levator scapulae muscle flap
Authors: Marks Nicholas J. , Cummings Charles W.
Published: November 2007

The design and use of the levator scapulae flap is reviewed. Particular attention is paid to the blood flow. A description is given of how this flap may be employed to repair smaller defects of the mouth and pharynx. It is used in association with split skin. The use of such a technique is compared to musculo-cutaneous flaps, with particular reference to the skin blood flow.
Carcinoma of the external auditory meatus and middle ear
Authors: Stell P. M. , McCormick M. S.
Published: November 2007

A staging system is suggested for carcinomas of the external and middle ear, based on a personal series of 47 patients. Statistical analysis showed that the proposed system was a valid method of identifying significant predictor factors. Other significant predictors of survival were histology, lymph node metastases, and the patients' general condition. Stage-for-stage there was no significant difference in survival between tumours of the external and middle ear.
Primary Ewing's sarcoma of the ethmoid bone
Authors: Howard David J. , Lund Valerie J.
Published: November 2007

Primary Ewing's sarcoma of the ethmoid bone has not been previously described. This case presented as a mass at the nasal bridge and posed diagnostic and therapeutic difficulties. The clinical, radiological, macroscopic and microscopic features are described. The treatment by the combined therapies of cranio-facial resection, radiotherapy and chemotherapy are discussed.
Surgery of sialorrhoea
Authors: Sellars S. L.
Published: November 2007

The drooling that accompanies motor neurone disorders adds to the burden of an individual already severely handicapped socially. Control of this problem can be achieved by a number of measures, such as the surgical repositioning of the salivary gland ducts and by use of medical or surgical means of reducing salivary production.

Nineteen patients aged 5 to 9 years, with excessive drooling as a result of perinatal brain damage, have been treated surgically at Groote Schuur Hospital, Cape Town, by bilateral tympanic neurectomies, unilateral chorda tympani nerve section and contralateral submandibular gland excision. In all 19, salivary flow was reduced and the drooling problem significantly improved. No post-operative complications occurred.
The place of ‘salvage’ petrosectomy
Authors: Stell P. M. , Miles J. B.
Published: November 2007

Thirty-three of 58 patients with carcinoma of the external auditory meatus and middle ear were treated by radiotherapy. Nineteen patients suffered a recurrence. This proved to be unsuitable for petrosectomy in all patients with a tumour of the middle ear. A few patients with tumours of the external auditory meatus, usually of non-squamous variety, have survived for a reasonable period after ‘salvage’ petrosectomy.
The treatment of recurrent tonsillitis in adults
Authors: Stafford N. , von Haacke N. , Sene A. , Croft C.
Published: November 2007

A prospective study comparing surgical and antibiotic treatment for recurrent tonsillitis in adults suggests that, whilst tonsillectomy is very effective, adequate medical treatment provides an equally good alternative in the majority of patients.
Facial nerve paralysis following embolization for severe epistaxis
Authors: de Vries N. , Versluis R. J. J. , Valk J. , Snow G. B.
Published: November 2007

Embolization to treat intractable epistaxis is becoming increasingly popular. Twelve cases of facial nerve paralysis after embolization of branches of the external carotid artery have been reported. In this paper, a new case is reported. In epistaxis. embolization should be reserved for patients with contraindications to ligation or in emergency procedures.
Long-term results after treatment of nasal fractures
Authors: Illum Peter
Published: November 2007

One hundred and six patients with nasal fractures, treated by reduction in 65 percent, were seen three months and three years after the trauma. The results were compared with a normal group.

Sixteen patients (15 per cent) had sustained recent nasal injuries, and another four patients had undergone correction of the nose during the follow-up period. These patients were left out of the statistical analysis, which thus comprises 88 patients.

Ninety per cent were satisfied with the result, and 84 per cent reported normal passage of air. Physical examination revealed a considerable number of deformities in all groups. including the normal group. Deviation of the external nose was significantly more common in the patients than in the normals. During the follow-up period, secondary deformity—saddling or hump—developed in some cases. Most deformities were slight and of little importane to the patient. Septal deformities were present in over 50 per cent of all groups, including the normal group. There was no aggravation of septal deformities or increasing nasal stenosis during the follow-up period. There patients were interested in secondary corrective treatment.

It is concluded that closed reduction of nasal fractures affords satisfactory long-term results. The study does not support the view that a large number of cases of nasal fracture should be treated by open reduction.
Monostotic fibrous dysplasia of the ethmoid Surgical treatment using a combined endocranial and transfacial approach
Authors: Gil-Carcedo L. M. , Gonzalez M.
Published: November 2007

Two cases of monostotic fibrous dysplasia of the ethmoid are presented. This condition is of interest to the rhinologist because of the difficulty of differential diagnosis, its location, and the frequent tendency to local recurrence. The two patients presented in this paper were aged fifteen and seven respectively, with almost iddentical lesions and with very similar x-rays. A clinical picture of each patient is given, following a brief description of fibrous dysplasia. Special emphasis has been placed on the treatment which is necessarily surgical. In both cases extensive radical surgery of the lesion was performed using a combined craniofacial approach. Finally, a brief evaluation is made of these two cases.
Nasal mucus clearance
Authors: Golhar Sanjiv
Published: November 2007

Nasal mucus clearance (N.M.C.) varies with geographical conditions. Studies on the evaluation of this important function have so far been done only in the western part of the world, but now the normal values of N.M.C. in India have been established by measuring the transportation of saccharine crystals through the nose. This has been compared with the values obtained in various diseases of the nasal and lower respiratory tracts, thus establishing the prognostic and diagnostic importance of measuring the nasal mucus clearance.
Transcannular maxillary antral biopsy with Tru-Cut needle
Authors: Ijaduola Taiwo G. A.
Published: November 2007

A Transcannular Tru-Cut needle maxillary antral biopsy technique, which has been devised as an out-patient procedure to speed up histological diagnosis in antral disease, is here described. A trial carried out with this technique shows that the histological diagnosis reached from such biopsy specimens compares favourably with that reached from specimens taken through an intranasal antrostomy.
Neurilemmoma of the larynx: (A case report)
Authors: Takumida M. , Taira T. , Suzuki M. , Yajin K. , Harada Y.
Published: November 2007

The authors have treated a 61-year-old woman with neurilemmoma of the larynx. The tumour was located in the submucosal region of the arytenoid on the right side of the larynx. Surgical resection of the tumour had to be done by external neck excision instead of endoscopically.
Untreated persistent middle ear effusion
Authors: Leiberman A. , Bartal N.
Published: November 2007

Seventy-nine children have been followed with persistent middle ear effusion (MEE). They were scheduled for myringotomy and insertion of ventilating tubes (VT). Several factors delayed elective surgery for two-and-a-half years in a closed population. After that period, the children were again examined otomicroscopically and hearing tests were performed. MEE persisted in 69 per cent of the ears, but was absent in 31 per cent. Atelectasis appeared in 26 per cent of the ears; in only a very few cases did severe atelectasis develop. Complications following delay of myringotomy and introduction of VT are minor.
Ear protection against water-borne infection: an objective evaluation
Authors: Laitakari Kyösti , Sorri Martti , Pirilä Tapio , Löppönen Heli , Helisten Laila
Published: November 2007

Eight different ear plug materials were tested, in 5 ears each, in artificial shallow underwater conditions for 30 minutes, in order to determine their efficacy in sealing the ear canals to avoid water-borne infections in ear canals and open middle ears. Most of the plugs tested would meet everyday requirements for protection, but the polymeric foam plugs, treated with petroleum jelly, and moldable plastic materials were most effective in protecting both the middle ear and the ear canal skin.
Carcinoid tumour of the larynx
Authors: Weighill J. S. , Tankel J. W. , Mene A.
Published: November 2007

Carcinoid tumours of the larynx are extremely rare, only 13 cases having previously been reported in the world literature. A case is reported here with the unusual complication of skin metastases. The true diagnosis is seldom made on the original biopsy, which is commonly reported as poorly differentiated carcinoma. A review of the literature is made with a discussion of the histological diagnosis and treatment modalities.
Survival after surgical treatment in maxillary neoplasms of epithelial origin
Authors: Lindeman Pontus , Eklund Ulf , Petruson Björn
Published: November 2007

During 1968–1979, 55 cases of epithelial neoplasms originating from the maxillary antrum were diagnosed and treated within the referral area of 1.5 million inhabitants.

A majority of the patients were operated upon after pre-operative irradiation therapy (40–50 Gy). No significant difference in survival rate was found between patients operated on by total maxillectomy, including orbital exenteration, and patients subjected to partial maxillectomy. Patients with tumours not completely removed during primary surgery and patients with glandular involvement had a poor prognosis despite additional surgery and radiotherapy. The prognosis for the remaining patients was considerably better, with a 5-year survival rate of 60 per cent.
Spontaneous haemorrhage from the tonsil
Authors: Mccormick M. S. , Hassett P.
Published: November 2007

The presentation and management of a two-year-old child with a severe spontaneous haemorrhage from the tonsil is reported. This was shown to be associated with an acute infection of the tonsil. It is suggested that early tonsillectomy be advised in patients with this symptom.
Posterior pharyngeal wall schwannoma
Authors: Triaridis C. , Tsalighopoulos M. G. , Kouloulas A. , Vartholomeos A.
Published: November 2007

A rare case of a schwannoma localized on the posterior pharyngeal wall is presented. It concerns a young man with an inflammatory ulcerated mass in the posterior wall of the pharynx causing severe difficulty in swallowing.

Although schwannomas of the lateral pharyngeal wall are common, only one case located on the posterior wall has been described. The origin of these tumours at this particular site is thought to be the sympathetic nervous plexus of the posterior pharyngeal wall.

In presenting our case, we comment on the origin of posterior pharyngeal wall schwannomas.
Tracheostoma valve for speech rehabilitation in laryngectomees
Authors: Singh Waryam
Published: November 2007

In the newer surgical procedures for fistula speech, finger occlusion of the tracheostoma is mandatory for speech production. This can be embarrassing as it draws attention to the patient's stoma. Finger occlusion is unhygienic and at times inconvenient. A new tracheostoma valve has been designed to eliminate the need for finger occlusion for speech. It has been evaluated clinically in nine laryngectomees, all of whom retained a good objective quality of speech similar to that obtained by finger occlusion. Vocal efficiency measurements with the valve are very encouraging. The valve is simple to use, of universal size, self-retaining, does not need any skin cleansing and obviates the need for skin adhesives to hold the valve in place.
Electrolaryngography in near-total laryngectomy with myo-mucosal valved neoglottis
Authors: Singh Waryam
Published: November 2007

Near-total laryngectomy with myo-mucosal valved neoglottis is the most recent of the various surgical procedures for speech rehabilitation. The site and mechanism of phonatory function of the neoglottis has been investigated in eight patients by means of electrolaryngography. Results demonstrate substantial similarity in the nature of function of the neoglottis when compared with the normal human glottis.
An endoscopic silastic kell for anterior glottic webs
Authors: Parker D. A. , Gupta A. R. Das
Published: November 2007

The use of a specially designed silastic keel endoscopically inserted into the larynx to prevent restenosis after division of anterior commisure webs of the larynx is described. The treatment of such webs is discussed.
Fluctuating hearing loss in presbyacusis
Authors: Martin F. W. , Ruckley R. W.
Published: November 2007

Thirty-six patients with bilateral symmetrical presbyacusis who reported a temporary improvement in the hearing of one ear following a Valsalva's manoeuvre were further investigated. Bone conduction and air conduction thresholds, middle ear pressure and middle ear compliance were measured before and after Valsalva's manoeuvre in the ears which had a subjective improvement in hearing following auto-inflation. Bone conduction thresholds remained unaltered in 66 per cent of ears while average air conduction thresholds varied by less than 5 decibels. Middle ear pressure was unchanged in over half the ears tested and in 81 per cent of the ears there was no change in middle ear compliance. There appears to be no simple explanation for the temporary subjective fluctuation in hearing reported by patients with presbyacusis.
Laryngoplasty: results and problems after the creation of a neoglottis
Authors: Klima A. , Ilberg C. V.
Published: November 2007

Voice rehabilitation in the laryngectomy patient has been a major goal of reconstructive laryngeal surgery. 36 patients underwent laryngectomy with the creation of a phonatory neoglottis as outlined by Staffieri. In 13 patients good voice rehabilitation was achieved. In 23 patients who failed to develop voice production, altered swallowing function was the major problem.
Chondrosarcoma of the epiglottis
Authors: Kasanzew Maria , John D. G. , Newman P. , Lesser T. J. H. , Thomas P. L.
Published: November 2007

Malignant cartilaginous tumours of the larynx are very rare, and usually arise from the cricoid cartilage. We report the first documented case of a chondrosarcoma of the epiglottis. The diagnosis, histology and treatment of these tumours are discussed.
Thyroid cartilage at the suprasternal notch with low situated thyroid gland
Authors: Soliman Soliman M.
Published: November 2007

The thyroid cartilage and thyroid gland forming a lump at the suprasternal notch is a surprising congenital anomaly which I believe has not been previously reported.

A case with co-existent low hyoid bone, pharyngo-oesophageal junction and intrathoracic cricoid cartilage with no cervical trachea is presented. Its pathogenesis is suggested and its surgical importance is discussed.
Prospective management of malignant hyperthermia in the otolaryngological patient
Authors: Wackym Phillip Ashley , Abdul-Rasool Imad H.
Published: November 2007

Malignant hyperthermia (MH) is a seemingly rare genetic myopathy. Hypermetabolic crises accompanied by a rise in body temperature to as high as 44°C are its hallmark. These are usually triggered by potent inhalation anesthetics or depolarizing muscle relaxants. Because of the extraordinary risk of death in patients who are at risk, otolaryngologists may be reluctant to operate on these patients. Ten such patients undergoing tonsillectomy and adenoidectomy, myringotomy with ventilation tube insertion, and nasal polypectomy were anesthetized with nitrous oxide, barbiturates, opiates, tranquilizers and non-depolarizing muscle relaxants without complication. The patients were not treated prophylactically with dantrolene. Cardiac monitoring and rectal temperatures were followed. All ten patients had vastus lateralis muscle biopsy performed and subsequent caffeine/halothane contracture studies completed. The contracture study was positive in eight out of the patients studied. No anesthetic or surgical complications were encountered. This study demonstrates that patients at risk of developing MH crisis can have otolaryngologic procedures performed safely while undergoing appropriately selected general anesthesia.
An unusual posterior cranial fossa tumour causing hearing loss
Authors: Pace-Balzan A. , Ramsden R. T. , Lye R. H. , Jenkins J. P. R.
Published: November 2007

Clivus meningioma is an uncommon tumour arising from the region of the synchondrosis between the basal portions of the sphenoid and occipital bones. We report a case of a patient with a large meningioma of the clivus whose presenting symptom was auditory change. Alteration of hearing is a rare mode of presentation for such a tumour although it may present at a later stage in about 50 per cent of cases. The discrepancy between the size of the tumour and the paucity of physical findings, the value of a multiple test auditory screening strategy, and the surgical approach in this case are discussed.
Glomus jugulare or tympanicum?
Authors: Phelps P. D. , Stansbie J. M.
Published: November 2007

Small chemodectomas in the middle ear cavity can be recognised by otoscopy, but only radiology will show i f the jugular bulb is involved. This assessment can be difficult, but largely governs the surgical approach. Magnetic resonance is a valuable adjunct to CT, providing some tissue characterisation. The relative value of various imaging techniques is discussed.
The value of Politzerization in the treatment of atelectatic ears
Authors: Luntz M. , Sadé J.
Published: November 2007

The value of Politzerization as a method of treatment in atelectatic ears and secretory otitis media is controversial. In some places it has been used routinely for decades, in others it has been almost forgotten. A quantitative study of its therapeutic value has been difficult to find.

The present study is an attempt to evaluate the therapeutic value of such an ‘air douche’ in atelectatic ears. Thirteen middle ears with atelectasis were Politzerized daily with air or N2for up to five consecutive days. Once Politzerized, the atelectasis and retraction pockets disappeared in all the ears examined. However, continuous observation of the Politzerized ears with the surgical microscope revealed that all the ear drums returned swiftly to their retracted position. The time it took for a drum to return to its original place varied from 15 minutes up to a maximum of 335 minutes. Our observations show that even an increased number of Politzerizations did not alter the speed of reappearance of the atelectasis. It would therefore seem that the therapeutic value of Politzerization in atelectatic ears is doubtful.
Nasal mucosal blood flow in patients with diabetes mellitus
Authors: Löth S. , Löth A. , Bende M.
Published: November 2007

Fifty patients with diabetes mellitus of varying duration were divided into two groups according to whether they were on treatment with insulin or not. Nasal mucosal blood flow was investigated and the results were compared with a reference material from healthy subjects, and were also related to the degree of retinopathy. Patients with diabetes mellitus had normal mucosal blood flow. There was no correlation between the duration of diabetes and nasal blood flow, nor was there any correlation between the degree of retinopathy and nasal blood flow. Diabetes mellitus does not seem to be accompanied by changes in blood flow in the nasal mucosa.
Fine needle aspiration of the larynx
Authors: Shaw H. J. , McLean N. R. , Trott P. A.
Published: November 2007

A technique for endoscopic fine needle aspiration cytology (FNAC) of the larynx is presented and its use in a preliminary study of twelve patients is discussed.
Septic cavernous and lateral sinus thrombosis
Authors: TveteråS K. , Kristensen S. , Dommerby H.
Published: November 2007

The incidence of both lateral and cavernous sinus thrombophlebitis has been significantly reduced in the antibiotic era. Since septic cavernous sinus thrombosis (CST) is mainly a complication of facial abscesses and septic lateral sinus thrombosis (LST) is almost invariably due to chronic otitis media, both conditions are of clinical relevance to the otolaryngologist.

The predominant bacterium in septic CST isStaphylococcus aureuswhereas in septic LST the bacteriology is very similar to that found in chronic otitis media. The diagnosis of septic CST can be established in most cases after thorough clinical examination, and contrast computerized tomography (CT) using the coronal projection usually confirms the clinical diagnosis. The signs and clinical course of septic LST are non-specific and the final diagnosis rests upon radiological investigations including CT-scan. The treatment of both conditions consists of broad-spectrum antibiotics, including beta-lactamase resistant penicillin in cases of septic CST. Most cases of septic LST also require surgical intervention.

Two cases oi septic intracranial sinus tiuombosis ate presented. The need for early diagnosis and treatment of this potentially lethal condition is emphasized.
Mandibular pathology presenting as a parotid tumour
Authors: Ling Jennifer , Barnard David
Published: November 2007

Swelling in the parotid region is often the presenting sign of a tumour of salivary gland origin. However, the possibility of disease involving adjacent structures must always be considered. Three cases are presented where pathology of the mandibular ramus presented as swelling in the parotid region. A clinical diagnosis of a parotid tumour was made, parotidectomy scheduled, and in two cases carried out before the correct diagnosis was reached. Difficulties of differential diagnosis are discussed, and imaging techniques reviewed. The value of plain radiographs of the adjacent hard tissues is emphasised. Careful interpretation should be based on a sound understanding of pathology of the jaws.
Fine needle aspiration cytology in the management ENT of patients
Authors: Smallman Lesley A. , Young Jennifer A. , Oates J. , Proops D. W. , Johnson A. P.
Published: November 2007

Aspirates were obtained from 142 masses in 120 patients who presented with palpable swellings in the head and neck region. 120 specimens (84.51 per cent) were adequate for diagnostic purposes and the remaining 22 (15.49 per cent) were unsatisfactory. Final diagnosis was based on resection histology in 87 cases and close clinical follow-up in 55 patients. The overall sensitivity and specificity including unsatisfactory aspirates was 81.37 per cent and 93 per cent respectively (if the technically inadequate specimens were deleted 98.81 per cent and 94.44 per cent). In comparison with the final diagnosis typing of malignant tumours was possible in 58.33 per cent. The correct diagnosis was made in 63.89 per cent of benign lesions.
BERA in the diagnosis of deafness in children: A retrospective survey of its use in a general hospital
Authors: Purmessur M. N. S. , Singh R. S.
Published: November 2007

Brainstem Evoked Responses have been used in the Audiology Unit in Crosshouse Hospital since it opened in 1984, and have now come to form a vital asset in our assessment and diagnosis of the hearing threshold in children. This particular survey is a retrospective study of the BERA used in determining the hearing threshold in children. The survey has been limited to the BERA performed on children from January, 1985 until December, 1986.
Parental smoking and middle ear effusions in children
Authors: Hinton A. E. , Buckley G.
Published: November 2007

A study was conducted on seventy children to ascertain any relationship between parental smoking and the presence of middle ear effusions in the children.

Information was collected using a questionnaire, clinical examination and audiological tests. Both groups of children (with and without effusions) has similar age, sex and social class distributions.

It was found that the presence of middle ear effusions in the children was associated with an increased incidence of parental smoking. Those children with an abnormal tympanometry result were more likely to have at least one parent who smoked than those with normal tympanometry results. There was no relationship between resolution of the effusion and parental smoking.

It is therefore suggested that as part of the management of this condition parents should be advised of the effects of smoking on the condition and encouraged to avoid smoking in the same environment as their children.
Recurrent respiratory papillomatosis: A 10 year study
Authors: Benjamin Bruce , Parsons David S.
Published: November 2007

Sixty cases of recurrent respiratory papillomatosis in both children and adults treated over a 10 year period were reviewed. An unexpected finding was that nine of the 60 patients (15 per cent) had symptoms by two months of age; an earlier onset than previously described. The control rate was 66 per cent for paediatric onset patients and 44 per cent with adult onset; the former required more operations. No anaesthetic deaths or complications were encountered. Glottic webs were the only surgical complication. The findings confirm that there is no relationship between puberty and the rate of control of recurrence. The necessity for precise and comprehensive endoscopic examination of the upper aerodigestive tract using a range of endoscopes and rigid telescopes under general anaesthetic is emphasized.
Teratoma of the mastoid region in a newborn
Authors: Talmi Y. P. , Sadov R. , dulitzky F. , Finkelstein Y. , Zohar Y.
Published: November 2007

Teratomas are congenital tumours arising from pluripotent cells and usually consisting of tissue arising from all 3 embryonic germ layers. Teratomas are quite uncommon in head and neck sites and to date only 150 such cases have been reported. A rate case of teratoma of the mastoid region in a newborn is reported. The methods of diagnosis and treatment are discussed and the literature is reviewed.
Correlation of the sinoscopic appearance of the maxillary antrum with histological and bacteriological findings
Authors: Smith M. C. F , Cable H. R.
Published: November 2007

Assessment of the maxillary antral mucosa in chronic sinusitis prior to surgery is notoriously difficult. Sinoscopy using a Hopkin's rod system is proving increasingly popular. The accuracy diagnosis of mucosal disease by this means in 26 antra is here correlated with histological evidence of inflammation and bacteriological evidence of infection in antral mucosal biopsies. It is shown that the surgeon's assessment of the mucosal appearance correlates well with the histology and bacterial culture. Absence of mucopus or bacterial growth on culture did not indicate absence of disease.
Topical nasal steroids in non-atopic perennial rhinitis; subjective symptom scores and objective measurement of nasal resistance by active anterior rhinomanometry
Authors: Jones N. S. , Kenyon G. S.
Published: November 2007

We present a study of 22 patients with perennial non-atopic rhinitis who have been treated with a course of topical beclomethasone diproprionate (Beconase). All subjects were skin-test negative for the common inhaled allergens and had normal total and specific IgE levels. The results of treatment were assessed by symptom scoring and by active anterior rhinomanometry, and are compared to measurements of resistance made in 22 untreated controls and an equal number of normal volunteers.
Primary nasal tuberculosis masquerading as a malignant tumour
Authors: Sim David W. , Crowther John A.
Published: November 2007

Primary nasal tuberculosis is rare. We report a case of primary nasal tuberculosis in an elderly lady who presented with symptoms and signs suggestive of a nasal fossa tumour. Histological examination of the lesion revealed the diagnosis. Treatment was with standard anti-tuberculous chemotherapy. The implications of primary nasal tuberculosis are discussed.
Craniofacial resection for extensive paranasal sinus aspergilloma
Authors: Quiney R. E. , Rogers M. J. C. , Davidson R. N. , Cheesman A. D.
Published: November 2007

Craniofacial resection techniques were developed to allow complete monobloc removal of malignant tumours of the ethmoid region. Such a surgical approach may also occasionally be useful in certain non-malignant conditions. Extensive ‘destructive’ aspergillosis of the paranasal sinuses has a high mortality once the anterior cranial fossa dura is reached. Craniofacial surgery provides excellent access to excise such large infective ‘tumours’.
Sqamous carcinoma arising within a Warthin's tumour of the parotid gland
Authors: Morrison G. A. J. , Shaw H. J.
Published: November 2007

The rare case of a patient who developed a squamous carcinoma within a Warthin's tumour of the parotid gland (adenolymphoma or papillary cystadenoma lymphomatosum) is described. We have found ten previously reported cases, only four of which have shown squamous carcinomatos change.
Ototoxicity of ear drops in patients suffering from chronic otitis media
Authors: Podoshin L. , Fradis M. , David J. Ben
Published: November 2007

The sensorineural hearing loss in 150 patients with chronic otitis media who were treated in the Haifa Medical Center (Rothschild) during a ten year period was studied. There were 124 patients treated with a mixture containing neomycin, polymyxin B and dexamethasone and a control group of 26 patients with dexamethasone only.

All patients were followed up for a period of 1–2 years. Patients with hearing loss due to factors such as previous ear surgery, family history, exposure to noise etc., have been excluded.

The conclusions reached were that there is a relationship between the period of disease and the sensorineural hearing loss and that the local treatment with a mixture containing neomycin + polymyxin B appears to contribute to the worsening of the sensorineural hearing loss in patients with chronic otitis media.

Our numbers are small and further studies must be done, but the fact that currently used ear drops may produce a sensorineural hearing loss should not be ignored.
Sensorineural hearing loss in chronic otitis media
Authors: Cusimano F. , Cocita V. C. , D'Amico A.
Published: November 2007

A statistical study was done on the sensorineural component in hearing loss, using 595 patients suffering from Chronic Otitis Media (COM); of these, 195 with monolateral COM were taken into consideration. They presented criteria of valuation which excluded other possible causes of sensorineural hearing loss, such as exposure to acoustic trauma, ototoxic drugs, cardiovascular disease, past head injury and hereditary causes. The contralateral (healthy) ear served as a control. We determined the average sensorineural component in the hearing losses in relation to the age of onset and duration of the disease, examining it in relation to other eventual aural complications such as cholesteatoma.

On the basis of the data obtained, we believe that the sensorineural component in hearing loss does not change with respect to the age of onset of COM, but the duration of COM does exert a significant influence.
Hearing threshold in patients with diabetes mellitus
Authors: Kurien M. , Thomas K. , Bhanu T. S.
Published: November 2007

Hearing threshold of 30 diabetic patients and 30 healthy controls attending the medical outpatient department were determined using pure tone audiometry (Arphi Digital 900). All subjects were less than 50 years old. Subjects with otological and other metabolic diseases were excluded from the study. The patients were categorized into groups according to age, duration of disease, complications and control of diabetes. These observations were compared with those from the control subjects using appropriate statistical methods.

It was found that diabetics had a poorer hearing threshold than the non-diabetics; all age groups with diabetes showed a significant high frequency hearing loss, as compared to the control population; poorly controlled and complicated diabetics have significant, high frequency hearing loss as compared to those who were well controlled and uncomplicated; there was no relationship between duration of the diabetes and the level of hearing loss.
CT air meatography: review of side effects in 60 patients
Authors: Smith I. M. , Turnbull L. W. , Sellar R. J. , Murray J. A. M.
Published: November 2007

Sixty patients investigated for a suspected acoustic neuroma were questioned on the side effects of CT air meatography, a minimum of three months following the procedure. Twelve per cent of patients found the procedure itself so painful that a repeat examination would only be contemplated under general anaesthesia. Only 20 per cent of patients were asymptomatic after the procedure while 28 per cent of patients required bed rest for 24 hours or more (average 4.4±2.8 days). Sixty-two per cent of patients took three days or longer to return to normal health.

The duration and frequency of side effects is greater than previously reported, and emphasizes the need for full investigation of these patients prior to CT air meatography.
Culture of Rhinosporidium seeberi: Preliminary report
Authors: Krishnamoorthy S. , Sreedharan V. P. , Koshy P. , Kumar S. , Anilakumari C. K.
Published: November 2007

Every year 400 to 450 cases of Rhinosporidium are reported from Trivandrum Medical College. Twenty five swabs were collected from patients suffering from Rhinosporidiosis and cultured in standard media. Positive results were obtained in 23 cases. The conidia produced from the colony were compared with the structures obtained from the patient material. Light microscopy using histopathological techniques were used. The consistant appearance of the organism in patient material, the repeatability of growth in subcultures and the negative growth in controls indicated that the organism grown in cultures is the causative agent of the disease. The effect of parameters like pH, temperatures, etc, were also studied.
Cricothyroid muscle paralysis: its recognition and diagnosis
Authors: Bevan K. , Griffiths M. V. , Morgan M. H.
Published: November 2007

Cricothyroid muscle paralysis is often missed as the symptoms are not dramatic and the laryngeal observations, on conventional indirect mirror examination, are inconclusive. The anatomy and physiology of the superior laryngeal nerve (SLN) and cricothyroid muscle are described. Three case reports are presented to illustrate our diagnostic techniques. Videofibrolaryngoscopy and electromyography are found to be invaluable tools for the diagnosis of this condition. The importance in diagnosing this entity is discussed.
Serum enzymes in head and neck cancer. IV: 5-nucleotidase
Authors: Lal H. , Kumar L. , Kohli G. S. , Sharma A. , Goel H.
Published: November 2007

Serum 5-nucleotidase levels have been estimated in a group of 50 patients with head and neck cancer. The mean value was significantly higher in patients compared to the controls. In patients with non-malignant growths, the activity was comparable with the controls. The increase was higher in patients with proliferative lesions than those with ulcerative growths. Enzyme activity was found to be increased with the advancement in the stage of cancer. The rise was comparatively higher in patients with cervical metastasis. After radiotherapy, a gradual and significant reduction of serum 5-nucleotidase activity was observed.
Simple method to control laryngeal overspill in tracheostomized patients
Authors: Eisen S. M.
Published: November 2007

An inflatable balloon was inserted through a pre-existing tracheostomy to occlude the upper trachea. This technique controlled previously intractable laryngeal overspill for a period of three months in a patient with inoperable carcinoma of the larynx.
Asthma therapy and a tracheostomy
Authors: O'Callaghan C. , Dryden S. , Cert D. N. , Gibbin K.
Published: November 2007

A spacer device was modified to deliver aerosols of beclomethasone diproprionate, ipratropium and bromide sal-butamol, to an asthmatic child with a tracheostomy, where symptoms were poorly controlled with nebulized therapy. This resulted in a marked improvement in symptoms and a dramatic reduction in the time spent administering drugs.
Role of irradiation in the suppression of parotid secretions
Authors: Robinson A. C. R. , Khoury G. G. , Robinson P. M.
Published: November 2007

Suppression of salivary flow is of value in the management of salivary fistulae and sialectasia. It may also be beneficial in mentally defective patients and those with neurological palsies lacking control of their salivation. Nine patients were treated by irradiation to the parotid gland to control salivary flow; eight had complete resolution of symptoms and one had partial relief. Irradiation was effective as primary treatment and after failed surgery and/or drug treatment. Low doses were effective and there were no significant acute or long-term side effects. Its use avoids long-term medication and their potential side effects and may reduce the need for surgery.
Adenoid cystic carcinoma of the salivary glands: Clinicopathological survey of 51 patients
Authors: Koka V. N. , Tiwari R. M. , van der Waal I. , Snow G. B. , Nauta J. , Karim A. B. M. F. , Tierie A. H.
Published: November 2007

A clinicopathological study of 51 cases of adenoid cystic carcinoma in the head and neck region seen over a period of 20 years is presented. The correlation between various histological features and their impact on the results is attempted. Longterm results with respect to loco-regional recurrences, distant metastases and survival with various modalities of therapy are presented. Although this is a small series, radical surgery in keeping with the aim of avoiding undue mutilation, thus preserving the quality of life, followed by a full course of radiotherapy has been the mainstay of treatment and the results here presented justify this approach.
Carcinoma of the pharyngeal pouch
Authors: Stevens D. J.
Published: November 2007

The condition of carcinoma arising in a pharyngeal pouch is rare. It has been described in relation to long standing pouches and in pouches previously treated by the Dohlman's operation. Three additional cases of carcinoma of the pharyngeal pouch are described.
Spontaneous external carotid artery occlusion
Authors: Dixon J. A.
Published: November 2007

The case of a 64-year-old man who presented with severe left sided facial pain and cyanosis of the left ear, preauricular region and tongue is described. Digital subtraction angiography confirmed complete occlusion of the left external carotid artery. The patient was anticoagulated and his symptoms resolved over the following month, presumably due to improvement of collateral blood supply to the ischaemic areas. The literature on the clinical manifestations of external carotid ischaemia is reviewed and the relationship between facial pain, internal and external carotid atherosclerosis is emphasised.
Thrombosis of the internal carotid artery due to soft palate injury
Authors: Mains Brian , Nagle Michael
Published: November 2007

Thrombosis of the internal carotid artery is a rare complication of soft palate injury, only 16 cases having been previously documented. We present the case of a 51/2 year-old-boy who sustained an apparently trival laceration to the right aspect of the soft palate. However, 48 hours after injury, a right cerebral infarct occurred with subsequent left hemiparesis. On supportive and rehabilitative management he made a good recovery over a period of one year.
Temporal bone laboratory training for stapedectomy
Authors: Murrant N. J. , Gatland D. J.
Published: November 2007

Practice in the Temporal Bone laboratory is a fundamental part of Otological training. Performing a stapedectomy on a normal temporal bone is handicapped by the mobility of the footplate. We describe a simple method of producing stapes footplate fixation in a normal temporal bone so that the operative conditions found in otosclerosis are more closely simulated.
Hearing aids—a case for review
Authors: Harries M. L. L. , Baguley D. M. , Moffat D. A.
Published: November 2007

An analysis of a series of 100 patients aged 60 years or over, referred by their General Practitioner to the Department of Otolaryngology, Addenbrooke's Hospital, specifically for the provision of a hearing aid, is presented.

Forty-six per cent of patients failed to satisfy the criteria suggested by the Technicians, Therapists and Scientists in Audiology as a screening for treatable pathology.

This study has shown that the existing referral pattern of general practitioner to consultant otolaryngologist for the provision of a hearing aid reflects the highest quality of care for the patient.

Direct referral or open access of patients for hearing aid fitting may risk failure to diagnose early and treatable conditions.
Antroscopy in maxillary sinus disease associated with nasal polyposis
Authors: Gilbert J. G.
Published: November 2007

Although the association of maxillary sinusitis with nasal polyps is widely recognized little has been written on its precise incidence and degree. Antroscopy of 70 antra with ipsilateral polyps showed a high incidence of mucosal abnormalities, retained secretions and ostial narrowing. Comparison of these findings with pre-operative X-rays showed the latter were unreliable in detecting retained antral fluid. It is concluded that in nasal polyposis the antra warrant careful assessment and that antroscopy is a highly satisfactory method for this purpose.
Angiosarcoma of the nasal cavity and maxillary antrum
Authors: Kurien M. , Nair S. , Thomas S.
Published: November 2007

Angiosarcoma (malignant haemangioendothelioma) of the nasal cavity and paranasal sinuses is extremely rare. Only a few cases have been reported in literature. A case of angiosarcoma of the nasal cavity and maxillary antrum in a 38-year-old male patient is reported. He was treated with pre-operative external radiotherapy followed by wide excision of the tumour. He currently remains free of the disease 10 months after diagnosis (and seven months after completing therapy).
Laryngotracheal resection for post scleromatous laryngeal stenosis
Authors: Rifai Mohamed
Published: November 2007

Scleroma is an endemic disease in Egypt, which frequently results in subglottic laryngeal stenosis. Six patients suffering from laryngoscleroma are represented. They all underwent laryngotracheal resection of the stenosed segment, followed by direct anastomosis. The results were satisfactory in four of the patients. Surgery was abandoned in one patient who was believed to suffer from perichondritis following previous surgery. Restenosis occurred in a 14-year-old girl two weeks after surgery. This was attributed to recurrence, possibly due to residual activity of the disease which was missed before surgery.
Parapharyngeal mass presenting with sleep apnoea
Authors: Veitch D. , Rogers M. , Blanshard J.
Published: November 2007

A 60-year-old man presented with a history of progressive sleep disturbance due to an intraoral parapharyngeal salivary gland tumour.

The sleep study performed post-operatively showed rapid resolution of nocturnal hypoxic episodes. This appears to be the first recorded case of a parapharyngeal mass causing sleep apnoea and we review the current literature on obstructive sleep apnoea.