bluuebunny/crossref_metadata_2025 huggingface dataset:
Remediastinoscopy
Authors: Balle V. H. , Bretlau P.
Published: November 2007

The experiences and results of four re-mediastinoscopies are presented. All the patients had to some degree developed mediastinal fibrosis but not to a degree seriously interfering with the procedure. It is concluded that re-mediastinoscopy should be done if it can contribute to the diagonsis.
Eosinophilic granuloma of the temporal bone
Authors: Fradis M. , Podoshin L. , Ben-David J. , Grishkan A.
Published: November 2007

Involvement of the temporal bone by eosinophilic granuloma is rare. Four cases are presented here and the pertinant literature is reviewed.

This disease must be kept in mind by the otolaryngologist because of the diagnostic and therapeutic problems that may arise.

Direct injection of methyl-prednisolone sodium succinate is suggested as a treatment of eosinophilic granuloma in the temporal bone.
Extracochlear eight-channel electrode system
Authors: Banfai P. , Hortmann G. , Kubik S. , Karczag A. , Lüers P. , Sürth W.
Published: November 2007

The Cologne-Diiren research group has developed a new extracochlear eight-channel electrode system. The first observations on six cases have shown encouraging psychoacoustic results.
Causes of glue ear
Authors: Black N.
Published: November 2007

Over the past one hundred years medical views on the cause of glue ear have frequently changed. The medical literature was reviewed to see if these changes reflected advances in the level of scientific support for different causes. This revealed that only a few of the many proposed causes command any scientific support. An explanation for the changing pattern of views on the aetiology of glue ear was therefore sought by considering secular changes in medical knowledge and belief in general. This suggested that the views held on the cause of glue ear at any given time are influenced and largely determined by the prevailing knowledge and beliefs of medicine as a whole. This phenomenon is not peculiar to glue ear—though conditions about which there is considerable uncertainty are probably more susceptible to such influences.
Naproxen in otitis media with effusion
Authors: Abramovich S. , O'Grady J. , Fuller A. , MacKinnon M. , Lavelle R.
Published: November 2007

The levels of prostaglandian E2(PGE2) were measured in aspirates of the effusion fluid from children suffering from secretory otitis media. The effects of naproxen 5 mg./kg. twice daily for eight weeks on the condition were studied in a placebocontrolled double-blind trial.

Nineteen middle-ear aspiraes from 13 children, six of whom had bilateral aspirations were examined. Detectable levels of PGE2and those without.

In a separate trial of naproxen, 11 patients received active drug and 13 received placebo. Naproxen had no significant effect on otalgia or hearing loss compared to placedo.

These findings suggest that is it unlikely that non-steroidal anti-inflammatory drug will be of therapeutic benefit in secretory otitis media.
Peristaltic closure of a safety pin—An unusual fate of a safety pin seen as a foreign body in the gastrointestinal tract
Authors: André Lars , Ingelstedt Sven , Tjernström Örjan
Published: November 2007

This report presents a case where an open safety pin passed through the Esophagus and where Nature herself finally solved the problem by closing the pin, which was afterwards carried in the faecal stream and discharged from the body without any harm to the patient.
Use of tongue flap in submucous palatal fibrosis
Authors: Tepan M. G. , Saigal G. S. , Tilak Sheela B.
Published: November 2007

Submucous palatal fibrosis invariably leads to trismus due to fibrosis in the retromolar region. Medical lines of treatment are of no use in relieving the trismus once it is established. Various surgical methods, such as excision of fibrous tissue or excision of fibrous tissue with skin grafting, have been suggested, but none of them has been proved to give a lasting cure. We have made use of tongue flaps on either side in cases of trismus due to submucous palatal fibrosis in the retromolar region. Twentyfive cases have been operated upon with this technique and the results are quited encouraging. Regular follow-up for up to three years has shown good results without any complications.
Papillary cystic oncocytoma and Warthin's tumor of the parotid gland
Authors: Wackym P. A. , Gray G. F. , Rosenfeld L. , Friedmann I.
Published: November 2007

A 69-year-old white female had a left superficial parotidectomy for a papillary cystic oncocytoma. The histologic appearance was identical to Warthin's tumor except that it lacked a lymphoid component. This case suggests that the general morphology of a Warthin's tumor does not depend on the presence of lymphoid tissue or association with an intra-parotid lymph node. We reviewed 50 patients with Warthin's tumor to investigate the histogenesis of the lesion. We found that most Warthin's tumors (86%) appeared to be within lymph nodes, as indicated by the presence of a lymph node capsule or sinuses. The anatomy of intra-parotid lymph nodes in glands containing Warthin's tumors has been compared with that found in 11 parotid glands containing mucoepidermoid carcinomas. So-called heterotopic ductal inclusions may actually represent the normal intimate relationship of parotid gland to intra-parotid lymph nodes.
S-100 protein and myoepithelial neoplasms
Authors: Batsakis J. G. , Ordonez N. G. , Ro J. , Meis J. M. , Bruner J. M.
Published: November 2007

Besides advancing our knowledge of histogenesis, immuno-cytochemical studies of salivery gland tumors have added an important objective component to the diagnosis and classification of the tumors. Cellular localization of S-100 protein now allows identification of myoepithelial cells and tumors composed of these cells. The four tumors presented in this report illustrate the diagnostic advantages afforded by S-100 protein immunocytochemistry.
Labyrinthine sequestrum
Authors: Mathews T. J.
Published: November 2007

An unusual case of a labyrinthine sequestrum is presented. During mastoidectomy on a patient with chronic recurrent mastoiditis, a large sequestrum in the labyrinth was found. Four years earlier he had been treated for a posterior fossa abscess, which had followed acute otitis media. An extensive ablative and drainage procedure of the pars superior and pars inferior with preservation of the facial nerve was indicated in this patient.
Cranial hyperostosis and hearing loss (A new syndrome?)
Authors: Moesker W. H. , Tange R. A.
Published: November 2007

We present two patients, mother and daughter, with a skeletal disorder of the skull, hearing loss and in one of them recurrent facial paralysis. In one patient middle ear exploration was performed. The malleus and incus were found to be fixed in the epitympanum.

The differential diagnosis is discussed. We reviewed all known hereditary conditions with hearing loss and musculoskeletal disease but we could not accept any of these diagnoses for our patients.
The use of mini-tracheostomy and high frequency jet ventilation in the management of acute airway obstruction
Authors: Squires S. J. , Frampton M. C.
Published: November 2007

A case is described in which upper airway obstruction was successfully treated using cri-cothyroidotomy in association with high frequency jet ventilation. This procedure allowed time for the patient to be transferred to the operating theatre for formal tracheostomy under optimal conditions. It is suggested that the Portex ‘Mini-trach’ kit, though primarily designed for tracheobronchial toilet, can be used to provide a satisfactory and safe airway during the resuscitation of an obstructed patient, particularly if jet ventilation is available.
Pharyngectomy for post-cricoid carcinoma with preservation of the Larynx
Authors: Stafford F. W. , Mathias D. B.
Published: November 2007

A technique for resection of post-cricoid carcinoma with preservation of a functioning larynx is described. Two case histories are presented; indications, contraindications and relevant anatomy are discussed.
Intracranial hypertension following neck dissection
Authors: de Vries W. A. E. J. , Balm A. J. M. , Tiwari R. M.
Published: November 2007

A 51-year-old man developed prolonged papilloedema as a result of increased cerebrospinal fluid pressure following staged bilateral radical neck dissection. The patient recovered completely with no further specific therapy. Although the prognosis for vision is usually good in patients with longstanding papilloedema due to raised cerebrospinal fluid pressure, permanent visual impairment remains a serious complication. In the presence of anatomical variations of the venous pathways by which the blood leaves the brain, a raised intracranial pressure may also develop following unilateral radical neck dissection. Nine cases of increased intracranial pressure following unilateral radical neck dissection reported in the literature until now are briefly reviewed.
Otitis media in Dar es Salaam, Tanzania
Authors: Manni J. J. , Lema P. N.
Published: November 2007

To assess the prevalence of otitis media in Tanzania a study was made of 3772 patients attending for the first time the ENT out-patient department of Muhimbili Medical Centre, University Hospital of Dar es Salaam. Otitis media in one form or another was present in 524 patients (14 per cent). The majority reported a long history of ear discharge.

Hearing loss was a major complaint and was often found to be between 40–60 dB. H.L. Most patients admitted previous treatment, but otoscopy had rarely been performed. The medical profession in Tanzania cannot possibly deal with the large number of cases of chronic otitis media.

With the recent introduction of otorhinolaryngology into the curriculum of the medical school of Tanzania it seems advisable to include otology in the programme for primary health workers.
Life-threatening laryngeal polyp in a child (a case report)
Authors: Juhlin-Dannfelt M. , Densert O.
Published: November 2007

A laryngeal polyp caused a life-threatening airway obstruction in a 3-year-old child. This condition required an emergency tracheotomy, which was performed without previous intubation. The histological picture indicated the diagnosis of a teleangiectatic granuloma. No other case of solitary laryngeal polyp causing upper airway obstruction in a child has been previously reported.
Carcinoid tumour of the middle ear associated with systemic symptoms
Authors: Latif M. A. , Madders D. J. , Barton R. P. E. , Shaw P. A. V.
Published: November 2007

Carcinoid tumour is one of the rarest middle-ear neoplasms. We describe here a case of carcinoid tumour of the middle-ear cleft that presented with aural as well as systemic symptoms. Diagnostic difficulty was encountered using light microscopy, but electron microscopy revealed the neurosecretory granules.
Diffuse meningeal melanosis
Authors: Sooknundun Mukhesh , Kacker S. K. , Gupta Mala , Kapila K. , Narayan P. K.
Published: November 2007

An unusual presentation of diffuse meningeal melanosis with involvement of the temporal bones, the spheno-ethmoidal complex, the pharynx and the viscera is reported.
The effect of Otosporin and Gentisone HC on the mitotic index and thickness of the tympanic membrane and meatal skin in the guinea pig.
Authors: Monkhouse W. S. , Chir B. , Curry I. P.
Published: November 2007

Otosporin and Gentisone HC ear drops were inserted twice daily for 3 weeks into the external auditory meatuses of guinea pigs. An intraperitoneal injection of vincristine (1 mg/kg.) was given to each animal three hours before it was killed. Temporal bones and attached external auditory meatuses were dissected, tissues were fixed in 10 per cent buffered formalin, decalcified in EDTA, and embedded in JB4 plastic for sectioning at 4 μm. The proliferative activity in the epidermis of the bony meatus and in the lateral surface of the tympanic membrane was obtained by deriving the mitotic indices. After both types of ear drops there was a statistically significant reduction in mitotic indices, the values being about half the control values. The proliferative activity in the tympanic membrane was too low to permit statistical analysis, but no differences were apparent between the groups. The thicknesses of the epidermis and dermis of the bony canal, and of the tympanic membrane, were measured using a Kontron MOP-AM03 analyser. Although the dermis was thinner as a result of the administration of ear drops, both the epidermis of the bony meatus and that of the tympanic membrane were thicker, all these changes being statistically significant.
The sympathetic innervation of the vocal cord
Authors: Basterra J. , Dilly P. N. , Chumbley C.
Published: November 2007

Formaldehyde-induced fluorescence and electron microscopy have been used to show the sympathetic innervation of the vocal cord in the guinea pig. The topographical distribution and morphology of the sympathetic fibres and endings are commented upon.
Downbeat nystagmus during eye closure
Authors: Kitamura Ken
Published: November 2007

Two patients with dizzy spells demonstrated downbeat nystagmus during eye closure. The eye movements were examined by simultaneous horizontal and vertical electro-oculography. As the eyeballs were depressed to the midline position during eye closure, downbeat nystagmus appeared. There were no remarkable neurological findings in either patient. The pathophysiology of this nystagmus remains to be defined.
The nasopharynx and under-aeration of the middle-ear
Authors: Metcalfe Stephen
Published: November 2007

This study compared nasopharyngeal sepsis with under-aeration ear disease. Nasopharyngeal sepsis was assessed by culture taken directly from the surface of removed adenoid tissue. 156 cases were studied; 100 showed varying degrees of middle-ear under-aeration and 56 had no active ear disease or history of it. In addition, an assessment of post-nasal obstruction was made and this too was compared with middle-ear status.

The conclusions suggested that, whilst normal ears can exist in the presence of accepted nasal pathogens, diseased ears are rarely seen in the absence of nasal sepsis. The degree of post-nasal obstruction seemed irrelevant.

The commonest nasopharyngeal pathogen was Haemophilus influenzae and when found alone this had a particularly detrimental affect on middle-ear aeration, causing a significant incidence of mucoid middle-ear effusion in this group.
The supression of palatal (or intra-tympanic) myclonus by tinnitus masking devices
Authors: East C. A. , Hazell J. W. P.
Published: November 2007

Twelve cases of well established palatal myoclonus with objective clicking tinnitus were treated with tinnitus masking techniques. After a few months, three patients became completely symptom free, one for five years now. A further four patients continued to get periods of relief from their clicking sounds with continuous masking, and four patients found the distracting effects of the white noise helped them. The mechanism of palatal myoclonus is discussed with reference to the part played by masking therapy in this condition.
Granuloma gravidarum of the nasal mucous membrance
Authors: Skau N. K. , Pilgaard P. , Neilsen G.
Published: November 2007

Granuloma gravidarum of the nasal mucous membrane is a rare benign tumour. Clinically it may appear as alarming bleeding with a rapidly growing, non-tender polyp producing nasal stenosis. A case is reported in a young healthy pregnant woman, who developed a granuloma gravidarum on the right side of her nasal septum, recurring several times after delivery in spite of extirpation. Histologically foamy histocytes were present, which could represent a special feature of this type of tumour.
Ectopic thyroid malignancy in the midline of the neck
Authors: Laing Malcolm R. , Mclay Kenneth A.
Published: November 2007

A 71-year-old female presented with a midline neck mass. The clinical impression was that of a thyroglossal cyst but preoperative assessment suggested a solid lesion, possibly malignant. The mass was removed surgically using the Sistrunk technique and shown pathologically to be a mixed papillary-follicular carcinoma of the thyroid with no cystic elements. Clinically and radiologically the thyroid was normal and thyroidectomy was not performed. This management is discussed along with a brief review of the relevant literature on the pathology and treatment of similar lesions.
The styloid process in ossicular chain reconstruction
Authors: Ogale S. B. , Desouza C. , Sheode J. , Shah K. L.
Published: November 2007

Our pilot study reports twenty-six cases of resolved chronic otitis media in which the human, cadaveric styloid process was used as an ossicular graft material. A maximum follow-up of one year is presented in this paper. There was no extrusion or rejection of the styloid processes. Hearing improvement with a closure of the air-bone gap to within 10–15 dB. of the pre-operative bone conduction was found in most cases. So far the styloid process has proved to be an ideal ossicular graft though the long-term results are yet to be seen.
NED survival in head and neck cancer
Authors: Narula A. A. , Padfield C. J. , Morgan D.A.L. , MacLennan K. A. , Bradley P. J.
Published: November 2007

A common feature of reporting head and neck squamous cancer statistics in recent years has been to consider patients dying with no evident disease (NED) as successfully treated. We present two patients who died with no clinically evident squamous cancer and who could therefore have been reported as cured but for autopsy findings which showed significant distant spread. These findings are supported by several reports of distant metastases in squamous head and neck cancer and it is suggested that rates of post-mortem examinations be included in survival figures in the future.
Severe late-onset epistaxis following le Fort I osteotomy: angiographic localization and embolization
Authors: Solomons Neil B. , Blumgart Ray
Published: November 2007

Epistaxis following maxillofacial trauma or maxillofacial surgery is uncommon. It usually occurs within 24 hours of the injury and can usually be controlled by packing. Rarely internal maxillary artery ligation is necessary and embolization has been used in some cases of severe trauma.

We present a case of severe late-onset epistaxis following Le Fort I osteotomy. The diagnostic approach and treatment are discussed.
Use of the fibreoptic laryngoscope in pharyngeal pouch surgery
Authors: Barton R. P. E. , Forrest A. W. , Wickham M. H.
Published: November 2007

A further new application of the fibreoptic laryngoscope as an adjunct to the excision of pharyngeal pouches is described. Its use facilitates the procedure and thus reduces the time of surgery. This is clearly advantageous, particularly as many patients with pharyngeal pouches are elderly and may be less than fully fit especially if overspill from the pouch has caused recurrent chest infections.
Pleomorphic adenoma arising in accessory salivary tissue with constriction of Stensen's duct.
Authors: Kronenberg Jona , Horowitz Ada , Creter Doras
Published: November 2007

Accessory salivary gland tissue is well recognized and is found in 21 per cent of the population. Tumours of the accessory salivary tissue are rare and comprise only 1 per cent of all parotid gland tumours.

A pleomorphic adenoma of Stensen's duct is described. A circular constriction of this duct by the tumour with retention of saliva in the parotid gland was observed.
Influence of topical phenypropanolamine on tachyphylaxis and mucociliary clearance in the human nose
Authors: Holmberg K. , Bende M.
Published: November 2007

Topical nasal phenylpropanolamine in a 2.5 per cent solution (PPA) was used in an evaluation of the possible development of tachyphylaxis and of possible effects on the mucociliary system after one week of treatment in healthy humans. The tendency of PPA to produce tachyphylaxis was evaluated by rhi-nomanometrie measurements of nasal airway resistance after repeated dose-response provocations. The mucociliary transport time was tested with the saccharine-dye test. No reduced dose-response effect or change in mucociliary transport time was found with PPA, thus indicating that one week of treatment does not contribute to such adverse effects.
Head and neck oncology service—one year's work
Authors: Procter H. M. , Wallace C. E.
Published: November 2007

A head and neck oncology service serving the Islington and Haringey District was organized in 1985. It is based at the Whittington and Royal Northern Hospitals and is conducted in conjunction with the combined clinic of the Head and Neck Oncology Group at the Royal Ear Hospital (University College Hospital). This paper presents a surgery of the first year's experience during which 29 new cases of head and neck cancer were seem.
Peripheral nerve involvement in acute Bell's palsy
Authors: Abdel-Baki F. , Moghazi H. , Eassa A. , Talaat F.
Published: November 2007

Motor nerve conduction studies were carried out on the ipsilateral and contralateral ulnar nerves (arm and forearm segments) in 20 patients presenting with unilateral acute Bell's palsy. In seven of these cases (35%), there was motor conduction delay in one or more segments of the ulnar nerve. The present study confirms the hypothesis that Bell's palsy has a viral or autoimmune aetiology resulting in a generalized polyneuropathy or mononeuritis multiplex. Paralysis is clinically more manifest in the facial nerve than other motor nerves; this is because of the peculiar anatomical course of the facial nerve inside a bony canal.
Pectoralis major flaps: Functional aspects of the repair of oral and oropharyngeal resections
Authors: Parker D.A. , Woodhead J. , Chir B. , Das Gupta A.R.
Published: November 2007

The use of pectoralis major flaps for reconstruction after oral and oropharyngeal resection in a series of seventeen patients is reported. The applications and complications are described. A post-operative assessment of speech, chewing and swallowing in ten of the patients is reported. The functional aspects of such surgery are discussed.
Weight gain in children following tonsillectomy
Authors: Barr G. S. , Osborne J.
Published: November 2007

There is much controversial evidence that children gain weight to a significant extent following tonsillectomy, usually associated with a general improvement in health. One hundred and nine consecutive children undergoing tonsillectomy in Dundee for recurrent tonsillitis had their weights recorded pre-operatively, and twelve months after surgery were re-weighed and a symptom chart completed. The results showed the patients were generally not underweight before surgery as their median weight was on the 55th. percentile. Most parents reported an improvement in their child's appetite with a reduction in the number of sore throats after surgery. Their weights following surgery had increased by an average of 20 per cent over what would normally have been expected, but this increase in weight was not confined to underweight children, but to the entire group.
Superior vena cava syndrome: presenting symptom of silent otitis media
Authors: Tovi Ferit , Hirsch Menachem , Gatot Albert
Published: November 2007

An extensive lateral sinus thrombosis secondary to silent otitis media, in a patient with a nephrotic syndrome, is presented. The thrombotic process progressed asymptomatically until the occlusion of the superior vena cava. Removal of the intractable pathology within the mastoid and administration of appropriate antibiotic therapy, prevented the further propagation of the life-threatening condition.
Obliteration of mastoid cavities using bone pâté
Authors: Solomons N. B. , Robinson J. M.
Published: November 2007

The authors report on a series of 24 patients in whom open cavity mastoidectomy cavities were obliterated with bone pâté. The aim of the procedure is to provide the patients with a dry ear which then also reduces the need for frequent out-patient attendances.
Local anaesthetic with vasoconstrictor combinations in septal surgery
Authors: Mcclymont L. G. , Crowther J. A.
Published: November 2007

Local anaesthetic with vasoconstrictor combinations are often used to reduce bleeding and hence improve the operating field in septal surgery. Two commonly used combinations are lignocaine with adrenaline and prilocaine with felypressin (citanest with octapressin). Most surgeons prefer to use lignocaine with adrenaline but because of the risks of cardiac dysrhythmias when used with halothane anaesthetists prefer prilocaine with felypressin. In a trial with lignocaine 2 per cent and adrenaline 1 in 200,000 against prilocaine 3 per cent and felypressin 0.03 international units/ml in 18 patients undergoing septal surgery with local anaesthesia alone there was significantly less blood loss in the lignocaine with adrenaline group, p>0.01. The mean blood loss in the adrenaline group was 7.5 ml. and 32.7 ml. with felypressin. Both combinations were equally effective in producing adequate local anaesthesia. It is concluded that lignocaine with adrenaline is superior to prilocaine with felypressin in achieving a dry operating field in septal surgery under local anaesthesia.
Embryonal rhabdomyosarcoma of the sphenoid sinus
Authors: Durham L. , Mackenzie I. J. , For P.
Published: November 2007

Rhabdomyosarcoma is a diagnostic and therapeutic problem in the management of childhood tumours. A case of embryonal rhabdomyosarcoma affecting the sphenoid sinus and involving the cavernous sinus is presented. It has become evident that modern combined modality therapy, including surgery when required, radiation and adjuvant multi-drug chemotherapy offers the best chance of survival.
Antibody response to Pneumococcal vaccination as related to tonsillectomy
Authors: Stjernquist-Desatnik A. , Prellner K.
Published: November 2007

In each of twelve matched pairs of patients undergoing tonsillectomy one patient was vaccinated with Pneumovax®, a pneumococcal polysaccharide antigen, prior to tonsillectomy, the other patient being vaccinated after tonsillectomy. Sera were tested for antibody response to three different pneumococcal types of IgG, IgA andIgM classes. The patients with intact tonsils at vaccination did not develop higher antibody response than did those tonsillectomised prior to vaccination. On the contrary, in the case of pneumococcus type 6A, the IgM antibody response in tonsillectomised patients was significantly higher than that in patients with intact tonsils at vaccination (p = 0.021). Thus, the present study did not support the notion thattonsillectomy affects antibody response against pneumococcal vaccination. The palatine tonsils' role as an immunologically reactive organ is also discussed.
The release of histamine from nasal polyp tissue and peripheral blood when challenged with antihuman IgE, house dust mite extract and mixed grass pollen extract and compared with positive skin tests
Authors: Drake-Lee A. B. , Mcloughlan P.
Published: November 2007

Nasal polyps are a condition of uncertain aetiology but are associated with diseases of the lower respiratory tract, in particular, asthma and cystic fibrosis. Asthma may be mediated by mastcell reactions and the commonest allergen to degranulate mast cells is house dust mite. Mast cells have been shown to be degranulated in nasal polyps. This study looks at thirty-six patients who had nasal polypectomy and of whom fourteen were asthmatic to see if histamine wasreleased from polyp tissue and peripheral blood when they were challenged with antihuman IgE and extracts of house dust mite and mixed grass pollens. These results were compared with skin tests to these allergens. A release of above 15 per cent of the total histamine was considered positive. Eight patients released histamine from polyp tissue but only three patients released histamine with both anti IgE and allergen extracts. The release from blood compared well with positive skin tests (p >0.05 corrected chi square). Although allergy may cause mast cell degranulation in polyp tissue, this study suggests that it is unlikely to be a common cause of nasal polyps.
S-100 protein localization in minor salivary gland tumours: an aid to diagnosis
Authors: Campbell J. B. , Crocker J , Shenoi P. M.
Published: November 2007

The clinician is almost entirely dependent on the histopathologist to accurately diagnose minor salivary gland tumours, but in some cases the histological interpretation of the specimen is very difficult. Recently it has been demonstrated using immunohistochemical techniques that S-100 protein is present in some salivary gland tissues and its localization has been used as an aid in the differentiation of major salivary gland tumours. To assess its value in the diagnosis of minor salivary gland tumours it was localized in sections from 15 such tumours using both a standard peroxidase-antiperoxidase (PAP) and a newly developed immunogold-silver staining sequence (IGSS) technique. Strong staining for S-100 protein was seen in the nuclei and cytoplasm of the cellular areas and also in the cells in the chondroid and myxoid areas of pleomorphic adenomas. Generally the staining was more intense and widespread with the IGSS method. No staining was observed in any of the other tumour types. We conclude that S-100 protein localization is a valuable aid in the differentiation of minor salivary gland tumours. Furthermore, the IGSS method enables more sensitive ‘reading’ of the staining reaction.
Kikuchi's disease—Apparent malignancy of a neck mass
Authors: Buckley J. G. , Hinton A. , Allien C.
Published: November 2007

We report a case of Kikuchi's disease presenting as cervical lymphadenopathy in an adolescent. The original histololgical diagnosis in this case was a metastatic neoplasm. We wish to highlight the importance of this rare condition because of its potential for mimicking malignancy.
Pseudosarcoma of the oesophagus
Authors: John D. G. , Cross S. S. , Lewis M. S.
Published: November 2007

The presentation, histology and management of a pseudosarcoma (or polypoid carcinoma) of the oesophagus are presented. Historical and modern theories of pathogenesis are discussed. Though rare, ENT surgeons should be aware of these tumours, as patients with such tumours present early and potentially have a much better prognosis than those with the more common oesophageal malignancies.
Perforations of the tympanic membrane following the use of Goode-Type ’long term‘ tympanostomy tubes
Authors: Hawthorne Maurice R. , Parker Andrew J.
Published: November 2007

A retrospective review of 64 Goode ‘T’ tube insertions is presented. These were inserted into 61 ears of 48 patients over a period of four years. At the time of review of these 61 ears, 34 tubes were found to be in situ, 27 had extruded spontaneously and three had been removed surgically. Ten ears in which the tube had been extruded or removed had central perforations of the tympanic membrane of which eight had been present for more than six months. The number of previous myringotomies or grommet insertions did not increase the likelihood of developing a perforation. Tympanostomy tubes of this type should not be used indiscriminately.
Spontaneous passage of a submandibular salivary calculus in a child
Authors: Walsh S. S. , Robson W. J.
Published: November 2007

Inflammatory Salivary disease in childhood is an infrequent clinical entity. That associated with sialolithiasis is rare. We report a case of a child with spontaneous passage of a submandibular calculus. We believe she represents the youngest patient documented to demonstrate the phenomenon.
Intractable aspiration in a young child and its surgical management
Authors: Violaris N. S.
Published: November 2007

Intractable aspiration is a life-threatening condition. The problems encountered in a young child with severe intractable aspiration due to bilateral bulbar palsy following the surgical removal of a cerebellar astrocytoma are described. The various options of surgical treatment are discussed and Sasaki's technique of triple layer closure of the larynx using a superiorly based sternohyoid muscle flap is outlined in detail.
Hyperextension fracture of the hyoid bone
Authors: Padgham N. D.
Published: November 2007

A case of hyperextension fracture of the hyoid bone is presented. The management is discussed, with reference to the mode of injury, emphasizing that symptomatic treatment only may be necessary. The literature is briefly reviewed.
Oesophageal carcinoma: endoscopic and clinical findings in 258 patients
Authors: Puhakka H. J. , Aitsalo K.
Published: November 2007

During the 10-year period 1917–1980, oesophagoscopy was carried out on a total of 3235 patients in the Department of Otolaryngology, Turku University Central Hospital, Finland. Oesophageal carcinoma was diagnosed in 258 patients, 113 (44 per cent) men and 145 (56 per cent) women. The diagnosis was verified in 228 cases (88.4 per cent) by using an optical rigid oesophagoscope and in 30 cases (11.6 per cent) by a fibreoptic endoscope. The most common and earliest symptom was difficulty in swallowing in 50 per cent of cases. In 44 per cent of patients the symptoms persisted over six months before diagnosis. Upper and middle thoracic portions of the oesophagus were the sites of origin of the carcinoma in 57 per cent of the patients. The macroscopic picture obtained by oesophagoscopy was regarded as malignant in 83 per cent of patients and extraoesophageal spread of the tumour was estimated to be present in 48 per cent of patients by the time of diagnosis. Histological studies showed the tumour to be squamous cell carcinoma in 62 per cent of patients and in 24 per cent well differentiated. Squamous cell carcinoma was seen more often in men than in women. In patients with carcinomain situ, alcohol and tobacco were regarded as aetiological factors in 53 per cent of cases. The need for repeated oesophagoscopy in patients with symptoms related to swallowing is stressed.
Stage 1 Hodgkin's disease of the nasopharynx
Authors: Daniel F. , Mancero F. S. M. , Conrad J. G. , Tyrrell C. J.
Published: November 2007

Primary nasopharyngeal involvement with Hodgkin's Disease (HD) is a rare event. Most such cases are associated with other sites of involvement. In this paper we present a case of State 1 HD in the nasopharynx and review the literature.
Effect of respiration on nasopharyngeal radiographs when assessing adenoidal enlargement
Authors: Britton P. D.
Published: November 2007

Clinical assessment of adenoidal enlargement in children is difficult and so the lateral nasopharyngeal radiograph is frequently used to assess both adenoid size and the appearance of the adjacent airways. Various measurements of the soft tissues and airways can be made to assess normality or otherwise. Little previously has been mentioned about the physiological conditions, particularly the mode of respiration, under which these radiographs should be obtained and how changes in these conditions affect their appearance. The marked effect in the appearances of nasopharyngeal soft tissues and palatal airway on simply changing from mouth to nose breathing is presented, and an alternative method of examination, for use under certain circumstances is described.
View from beneath—Pathology in Focus Malignant melanoma of the nasal cavity
Authors: Going J. J. , Kean D. M.
Published: November 2007

Primary mucosal melanoma of the head and neck is rare and few published cases give proof that the mucosal site is primary. We present a man with malignant melanoma of the nasal cavity which was associated with melanoma-in-situ of the adjacent mucosa, proving that the lesion was primary. He presented with symptoms due to secondary deposits of melanoma in the brain rather than the more usual nose bleeds or blocked nose. The primary site wasfound when his neurological symptoms were investigated by CT and NMR scans of the head.
Swimming in chlorinated water and its effect on Eustachian tube function
Authors: Morgan D. W. , Shenoi P. M.
Published: November 2007

Middle-ear effusion in children is considered to be the result of multiple factors. Swimming in chlorinated water has been incriminated as one such possible aetiological factor. To test the hypothesis that the chemical disinfectant in the swimming pool is probably responsible for the Eustachian tube dysfunction, 30 children between the ages of four and eight years were selected at random from the community health department computer records and were randomly allocated into two groups. Eustachian tube function was assessed by standard tympanometry both immediately prior to swimming (control) and 30 to 45 minutes following swimming in Group 1 and approximately 14 hours following swimming in Group 2. The results of the study showed no significant change (p>0.05) between pre- and post-swimming tympanometry. It is therefore concluded that swimming on the surface of chlorinated water does not compromise the Eustachian tube function in children with healthy middle ears.
Superficial malignant schwannoma on the face: A case for early radical surgery
Authors: Bleach N. R. , Keen C. E. , Dixon J. A.
Published: November 2007

A case of superficial epithelioid schwannoma is presented. The lesion arose as a skin papule in the infra-orbital region and recurring repeatedly over a five-year period, caused significant local morbidity without metastasis. Radical surgery was delayed in the hope of preserving binocular vision. The similarity of this tumour with a rare variant of malignant melanoma, the neurotropic melanoma, is discussed.
Granular cell myoblastoma of the supraglottis
Authors: Robb P. J. , Girling A.
Published: November 2007

Granular cell myoblastoma is an unusual benign tumour, which, when occuring in the larynx usually affects the vocal cords and causes hoarseness. We present a case presenting with symptoms strongly suggestive of globus pharyngis.

These tumours probably arise from neuroectodermal tissue, and the current nomenclature is a misnomer. Complete excision rather than biopsy is recommended, as biopsy material may be misinterpreted as squamous carcinoma.

In this case, endoscopic removal of the tumour was successful in producing complete symptomatic relief.
Effect of gentamicin on the carbohydrates of the vestibular end organs: An investigation by the use of FITC-lectins
Authors: Takumida M. , Urquiza R. , Bagger-Sjöbäck D. , Wersäll J.
Published: November 2007

The effect of gentamicin on the glycoconjugates in the vestibular end organs is demonstrated using FITC-lectins. Five milligrams of gentamicin dissolved in 0.1 ml. saline was injected in a single dose into the middle ear of adult guinea pigs. Seven days after the injection, the fluorescent reactivity of Wheat germ agglutinin (WGA), Abrus precatorius agglutinin (APA), Concanavaline A (Con A), and Latyrus odoratus agglutinin (LOA) was decreased in the apical epithelial cell surface as well as in the gelatinous layer of the otolithic membrane of the maculae. In the cupula of the crista ampullaris, the reactivity for WGA and Con A was reduced. The otoconia, however, showed no detectable changes. This indicates that gentamicin may induce an altered carbohydrate metabolism resulting in a decrease of N-acetyl-glucosamine, mannose, galactose and glucose in the glycocalyx lining the epithelial cells as well as in the gelatinous layer of the otolithic membrane or cupula in the vestibular end organs.
Use of a Foley catheter for short-term drainage in frontal sinus surgery
Authors: Ijaduola T. G. A.
Published: November 2007

Frontal sinus surgery for chronic disease presents a variety of problems, in particular that of drainage. No matter how successful the surgical technique is in clearing disease from the sinus, it is still important that the fronto-nasal duct is kept patent unless the procedure is an obliterative one. Usually a tube is inserted for drainage and has to be kept in place for several weeks or months. This paper presents a study of 16 patients,
suffering from frontal sinus disease, in whom a short-term drainage technique using a Foley catheter was employed between 1979 and 1988 at Lagos University Teaching Hospital, Nigeria. This type of drainage allows effective anchorage and irrigation with a decongestant. It has been found to give satisfactory results after 14 days in place and has had no unusual complications. It is therefore recommended for use in such cases.
Middle ear neoplasms showing adenomatous and neuroendocrine components
Authors: Davies J. E. , Semeraro D. , Knight L. C. , Griffiths G. J.
Published: November 2007

Middle ear adenomas are rare epithelial tumours. Reports indicate that neuroendocrine (carcinoid) tumours may also occur at this site, often in association with an adenomatous component. The clinico-pathological findings (including C.T. scan appearances) of such a ‘mixed’ neoplasm are presented together with a brief review of the few previously described cases. The importance of immuno-histochemistry and electron microscopy for accurate pathological diagnosis of these neoplasms is confirmed.
Endoscopic transnasal dacryocystorhinostomy
Authors: McDonogh M. , Meiring J. H.
Published: November 2007

The rigid Hopkins endoscope has been applied to simplify the operation of dacryocystorhinostomy, preventing unnecessary trauma to the medial orbital tissues. The success of the surgical technique is absolutely dependent on a thorough knowledge of the relevant surgical anatomy.
Guillotine and dissection tonsillectomy compared
Authors: Wake M. , Glossop P.
Published: November 2007

One hundred children and twenty adults were randomly allocated to guillotine or dissection tonsillectomy operations. The study was prospective and double-blind. In the children, the guillotine technique had demonstrable advantages over the dissection technique in terms of duration of operation, blood loss and post-operative pain. There was no significant morbidity in either group. In the adults, the random allocation of patients into these groups was found to be technically unsatisfactory and this arm of the study was abandoned after twenty patients.
Sublabial rhinotomy with septal transfixion as an approach to the nasal fossa, paranasal sinuses and nasopharynx
Authors: Bingham B. J. G. , Griffiths M. V.
Published: November 2007

A sublabial incision with septal transfixion and mid-face degloving is described as an approach to the nasal cavity, paranasal sinuses and nasopharynx. A brief history of the development of the technique is given. The results of nine cases are presented. These cases have had good tumour clearance, excellent cosmetic results and the minimum of complications. The sublabial approach is most useful in children and women, particularly those with intermediate grade tumours. The advantages of the approach compared to the lateral rhinotomy incision include: superior access to the floor of the nose, inferior turbinate and anterior nasal septum; access to both sides of the nasal septum and the absence of a facial scar. The limitations of the sublabial technique are the poor access to frontal sinus and the cribriform plate.
A modified incision for the trans-septal trans-sphenoidal approach to the pituitary
Authors: Baraka Mohamed El-Fatih
Published: November 2007

The role of the otorhinolaryngologist in trans-septal trans-sphenoidal approach to hypophysectomy when undertaken conjointly with the neurosurgeon is to provide excellent and rapid exposure for the necessary neurosurgical manipulation.

For the past two years at the King Fahd Hospital of the University in Al-Khobar, Saudi Arabia, a modified incision for the trans-septal trans-sphenoidal approach to the skull base around the area of the sella turcica has been undertaken in eight cases. This incision may offer a good alternative to the standard hemi-transfixation incision.
Two-stage temporalis flap reconstruction for facial paralysis
Authors: Buchholtz Ben D. , Mickel Robert A. , Bredenkamp James K. , Hutcherson Robert W.
Published: November 2007

Treatment of the paralyzed face remains a challenging surgical problem. When facial nerve damage is irreparable or facial nerve grafting has failed, static and dynamic techniques must be considered. A two-staged modification of the dynamic muscle transfer using ipsilateral temporalis muscle is described. Initially, a free temporalis fascia graft, harvested from the contralateral scalp, is placed around the oral commissure of the paralyzed side of the face through an incision in the nasolabial crease. Several weeks later, an ipsilateral temporalis muscle and fascia transfer is made to the anterior face and attached to the previously placed fascia graft. Oral commissure grafting, as a first step, provides for a secure anchoring point for the temporalis flap, and achieves a more satisfactory correction of the oral commissure.
Cough as the sole manifestation of airway hyperreactivity
Authors: Frans A , Van Den Eeckhaut J
Published: November 2007

Abstract The authors report 18 patients who presented to the ENT department with isolated cough, which had begun one month to 14 years previously. As the ENT examination was negative, the patients were referred to the Department of General Medicine where a bronchial reactivity test with acetylcholine was found to be positive, leading to a diagnosis of airway hyperreactivity. The group was predominantly female (15/18) and atopy was rare; indeed, only one patient, who had a history of allergic rhinitis, was found to be atopic. Bronchodilators and inhaled steroids cured or helped the cough in 16/18 patients. When a patient presents with chronic cough without other respiratory symptoms it is important to consider a diagnosis of airway hyperreactivity and to confirm this with a challenge test of bronchoconstriction
Antroscopy: current practice—a survey of UK otolaryngologists
Authors: Fisher E. W. , Croft C. B.
Published: November 2007

The use of antroscopy by otolaryngologists in the UK was assessed by means of a postal questionnaire. A response of 70 per cent was obtained. Thirty-three per cent of otolaryngologists currently perform antroscopy; the principal reason for not using the technique being lack of suitable equipment. Twenty-four per cent of non-users believed that antroscopy would not alter their management of patients, and 19 per cent of all responders thought that antroscopy had no proven clinical role. Few surgeons recognized a role for antroscopy in the treatment of antral disease.

Antroscopists preferred to operate on in-patients (73 per cent), under a general anaesthetic (60 per cent) and via the inferior meatus (66 per cent); 76 per cent consider that morbidity is insignificant.

There is clearly a need for studies clarifying the role of antroscopy in clinical practice and to establish the cost-effectiveness of the technique.
The contralateral ear after translabyrinthine removal of acoustic neuromas: Is there a drill-noise generated hearing loss?
Authors: Tos M. , Trojaborg N. , Thomsen J.
Published: November 2007

To determine whether translabyrinthine acoustic surgery may result in a drill-generated, bone-conducted sensorineural hearing impairment in the contralateral ear, the audiograms from 50 consecutive patients with acoustic neuromas undergoing the translabyrinthine approach were compared before and three months after surgery. No case of sensorineural hearing impairment could be demonstrated post-operatively.