bluuebunny/crossref_metadata_2025 huggingface dataset:
CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery
Authors: Lloyd G. A. S.
Published: November 2007

A control series of biplane CT scans of the paranasal sinuses, derived from patients examined for orbital tumours, is described. The scans were assessed for the presence of anatomical variants in the middle meatus, said to contribute to meatal stenosis, and for signs of asymptomatic infection revealed by the presence of clouding or mucosal thickening in the sinuses.

Of the anatomical variants, only concha bullosa (pneumatisation of the middle turbinate) was associated with a high incidence of infection in the sinuses (85 per cent). Evidence of asymptomatic sinus infection was as high as 39 per cent overall, the highest incidence occurring in the ethmoid cells (28 per cent). Isolated ethmoid clouding on CT was observed in 15 per cent and is likely to be found in as many as one in seven of the adult population in the UK. It is concluded that in the majority of patients clouding confined to a few ethmoid cells shown on CT is without clinical significance.

The evidence from the control series did not support the concept that most sinus infection starts in the middle meatus. The presence of a large reservoir of quiescent or chronic sinus infection in the control group suggests that in most instances sinusitis derives from a recrudescence of this pre-existing infection.
Flow cytometric analysis of DNA content in laryngeal cancer
Authors: Feinmesser Raphael , Freeman Jeremy L. , Noyek Arnold
Published: November 2007

DNA content was measured by flow-cytometric analysis in 30 paraffin embedded sections from patients with laryngeal squamous cell carcinoma. The morphological characteristics and N staging of the tumours as registered in their clinical charts were correlated with their DNA content. Eighty per cent of the tumours were found to have a predominantly aneuploid distribution of DNA values. There was no correlation between the N stage of the tumour or degree of cell differentiation and DNA content. A multiploid pattern correlates with non-metastatic laryngeal tumours and we suggest that this pattern may be a good indicator for biological activity.
A lingual thyroid cyst complicating a foreign body in the oesophagus
Authors: Harris William E.
Published: November 2007

A case report is presented of a man who had a foreign body in his oesophagus complicated by the fact that he also had a large cyst of a lingual thyroid. The problems encountered and his subsequent management are discussed. The possibility that a cyst of the tongue base may contain the only functioning thyroid tissue and the dangers of haemorrhage at its removal are emphasized.
Thyroid lobectomy for removal of a fish bone
Authors: Muhanna A. Al. , Abu Chra K. A. , Dashti H. , Behbehani A. , Al-Naqeeb N.
Published: November 2007

A 42-year-old female Jordanian patient presented with a history of sudden painful dysphagia following swallowing of a fish bone. Though soft tissue X-rays showed a foreign body in the neck, repeated oesophagoscopies failed to reveal it. Computed axial tomography was done and showed a fish bone embedded in the left thyroid lobe. Left thyroid lobectomy was carried out and the fish bone was seen within the lobe surrounded by an area of acute inflammation.
Haemangioma in a cervical lymph node
Authors: Har-El Gady , Heffner Dennis K. , Ruffy Mauro
Published: November 2007

Haemangiomas of the head and neck are mainly cutaneous or mucosal; rarely, they may be found in bone or soft tissue. Haemangiomas of lymph nodes are extremely rare; here we present such a case in a cervical lymph node. This is, to the best of our knowledge, only the second report of such an entity.
Acoustic neuroma and the contralateral ear: recovery of auditory brainstem response abnormalities after surgery
Authors: Deans J. A. J. , Birchall J. P. , Mendelow A. D.
Published: November 2007

Auditory brainstem responses are an established technique in the diagnosis of acoustic neuroma. In several reports abnormalities are shown to occur in the contralateral ear.

That these abnormalities recover has been demonstrated, but only in terms of changes in inter-peak latency. In only one case has the waveform trace showing this been published. We present a case in which a highly abnormal wave form was obtained from the ear contralateral to a large acoustic neuroma. Following excision of the lesion, the waveform reverted to a normal pattern. The literature on the subject is reviewed.
Size variation of mastoid air cell system in Indian people at different age groups: a radiographic planimetric study
Authors: Chatterjee D. , Ghosh T. B. , Ghosh B. B.
Published: November 2007

A radiographic planimetric study of mastoid air cell system was carried out on 100 normal human subjects of which 50 were males and 50 females–who were further subdivided into five age groups. They had no history of past ear disease or any other clinical ENT abnormality. The mean area of the mastoid air cell system was measured planimetrically on X-rays and the data analysed according to age and sex. It was 12.05±0.67 cm2in males and 11.45±0.70 cm2in females (which are more or less the same as that of Western people).

The size of the cranial bones has no apparent role in the size variation of the mastoid air cell system. The development of the latter was very rapid up to 10 years of age in both sexes and it continued even after 20 years of age but at a much slower rate.
Second primary tumours of the larynx following bronchial carcinoma
Authors: McGarry G. W. , Mackenzie Ed. K.
Published: November 2007

The occurrence of multiple primary malignancies in patients with laryngeal cancer is well known. The possibility that lung cancer patients may be at risk of subsequent laryngeal cancer is less well recognized. The possibility of laryngeal cancer developing later has implications for the follow-up of lung cancer patients.

Three cases of subsequent laryngeal primary cancer occurring in survivors of bronchial cancer are presented and the implications are discussed.
Epistaxis as an unusual presentation of an antrochoanal polyp
Authors: Robson A. K. , Barker C. S. , Whittet H. B.
Published: November 2007

Antrochoanal polyps rarely present with severe epistaxis. We present the case of a young male patient who presented in such a manner, thus leading to the suspicion of an angiofibroma as the underlying pathology. The radiological investigations, treatment and pathological features are discussed.
Decline in the prevalence of childhood deafness in the Jewish population of Jerusalem: ethnic and genetic aspects
Authors: Feinmesser M. , Tell L. , Levi H.
Published: November 2007

A longitudinal study was performed on 147 Jewish children with bilaterally sensorineural hearing loss of moderately severe to profound degree, born in Jerusalem during the eighteen years 1968–85.

The prevalence rate of these children declined during the years 1977–85, and at the same time the rate of consanguinity of their parents decreased; this decline was more evident in the genetic group among children with non-Ashkenazi ethnic origin. No such decline was found among the Ashkenazi children and no consanguinity among parents of these children was recorded.

Our study supports the assumption that restriction of consanguineous matings may affect the prevalence of genetic deafness in children in a well-defined population. We have tried to remain unbiased and concede certain shortcomings in our present study.
Typing ofPseudomonas aeruginosaear infections related to outcome of treatment
Authors: Englender Moshe , Harell Moshe , Guttman Ruth , Segal Shmuel
Published: November 2007

Of 142 patients withPseudomonas aeruginosa(PSA) ear infections, 88 (62 per cent) had chronic otitis media and 54 (38 per cent) external otitis. Following serotyping and pyocin typing of their bacteria, and relating the type to outcome, patients could be divided into three groups: (1) 120 patients who had no recurrence with isolation of only one PSA strain, (2) 13 patients who had recurrent infections and in whom the same PSA strain was isolated in repeated cultures, and (3) nine patients who had recurrent disease, but who had a change in their PSA strains. Most of the PSA strains isolated from patients in groups (1) and (2) were stable to pyocin, and resistent to gentamicin.

Patients in the first group were all cured initially by medical management. Of the nine patients in group (3) who had a different serotype on repeated cultures, medical treatment was successful in eight (89 per cent), but of the 13 patients in group (2) who had the samePseudomonas aeruginosaserotype cultured, medical therapy failed in six (46 per cent) and mastoid surgery was required. Serotyping ofPseudomonas aeruginosaotitis may be helpful in predicting the type of management in patients who have recurrent infections.
Multiple primary malignancies in patients with malignant tumours of the nasal cavities and paranasal sinuses
Authors: Miyaguchi Mamoru , Sakai Shun-ichi , Mori Nozomu , Kitaoku Shigeo
Published: November 2007

The incidence of multiple primary malignancies (MPM) was analysed in 1297 patients with malignant tumours of the nasal cavities and paranasal sinuses. The patients were followed for a minimum of six years or until death. The incidence of MPM was 3.4 per cent (44/1297) which is lower than in patients with malignant tumours of other regions in the upper aerodigestive tract. Five of the 44 patients had second malignancies within previously irradiated areas. There was a difference between the proportion of histologies occurring in irradiated tissues compared with the overall 1297 patients. This finding suggests that radiotherapy may induce a second cancer.
Hoarseness as the sole presenting symptom of foramen magnum meningioma
Authors: Ahmed Y. S. , Hanson D. R. , Halaka A. N.
Published: November 2007

Foramen magnum tumours are rare. They may present with bizarre symptoms and mimic many conditions. We report a presentation with the sole complaint of hoarseness, never previously described in the literature. Voice returned to normal after surgical removal of the foramen magnum meningioma.
Unusual type of foreign body in the maxillary sinus
Authors: Gupta A. C. , Murthy D. P. , Pulotu M. L.
Published: November 2007

A broken end of the spear presenting as a foreign body in the nasopharynx and right maxillary sinus in a 19-year-old Papua New Guinean is described. The types of foreign bodies and their mechanisms of introduction into this site are summarized.
Giant enterocystoma within an infant's tongue
Authors: Grime P. D.
Published: November 2007

A rare developmental cyst within the tongue and submandibular triangle ofa male infant containing heterotopic gastric and intestinal epithelium (enterocystoma) is described and its derivation discussed. This cyst was ofsuch a size as to cause feeding difficulties and partial airway obstruction during sleep. Following C.T. scanning, total obstruction necessitated an emergency tracheostomy. Successful enucleation via a median labiomandibulotomy was performed without further complication and two years later there is no sign of recurrence.
Parapharyngeal abscess and torticollis
Authors: Buchwald Chr. , Nissen F. , Thomsen J.
Published: November 2007

The combination of a parapharyngeal abscess and torticollis in an adult, due to a spastic contraction of the sterno-cleido-mastoid muscle is an extremely rare condition. We have recently been exposed to such a case, in which it was very difficult to make the diagnosis and where CT of the neck gave us the answers without any difficulty. The indication for CT at an early stage in unexplained neck infections is stressed.
Haemangiosarcoma of the maxillary antrum
Authors: Solomons N. B. , Stearns M. P.
Published: November 2007

Angiosarcomas are extremely rare in the head and neck and the histological diagnosis is often difficult. We present a case of a haemangiosarcoma of the maxillary antrum in a 33 year old male. The histological diagnosis and subsequent management are discussed.
Pharyngeal adenocarcinoma with intestinal features
Authors: Lopez Jose I. , Perez Agustin
Published: November 2007

A high grade adenocarcinoma arising primarily in the pharynx of a 67-year-old man is presented. A CT-scan revealed a tumour mass growing in the pharynx, largely affecting parapharyngeal soft tissues. Lymph node nietastases were found at clinical presentation. Both morphological and immunohistochemical studies displayed similar features to those of intestinal origin. To our knowledge, no previous examples of such neoplasm have been reported at this site. Its possible histogenetical origin is discussed.
Inner ear cholesteatoma and the preservation of cochlear function
Authors: Gamoletti Roberto , Sanna Mario , Zini Carlo , Taibah Abdel-Kader , Pasanisi Enrico , Vassalli Luca
Published: November 2007

Labyrinthine destruction by direct cholesteatoma invasion has always been considered a serious threat to the inner ear function.

A number of reports in the literature have cited both patients who had preservation of hearing despite widespread erosion of the labyrinth by cholesteatoma and patients who had retained auditory function despite surgical removal of the matrix from the labyrinth. In most cases the vestibular portion of the inner ear was invaded but cases of cochlear involvement have been described as well.

Twelve cases with pre-operative auditory function preservation despite extensive labyrinthine destruction treated at our Institution are reported. Seven cases retained cochlear function post-operatively.

Possible explanations of this occurrence and implications of related with hearing preservation in the presence of widespread inner ear destruction by chronic inflammatory disease are discussed.
Lateral sinus thrombosis: a problem still with us
Authors: O'Connell Janet E.
Published: November 2007

Lateral sinus thrombosis in now a rare complication of ear disease in the developed world, since the advent of the widespread use of antibiotics. The classic picture is often modified by previous antibiotic treatment making diagnosis and management difficult. Lack of familiarity with this condition amongst present day otologists may lead to late diagnosis and treatment.

We review three cases that we have managed recently and compare their clinical courses with the classic description of the disease
A new syndrome: hearing loss and familial salivary gland insensitivity to aldosterone in two brothers
Authors: Tungland O. P. , Savage M. O. , Bellman S. C.
Published: November 2007

Two male siblings presented in infancy with hyponatremia. The levels of plasma renin activity and aldosterone were elevated. Sodium supplement was necessary to maintain normal sodium balance. The salivary sodium concentrations were markedly elevated, with sweat sodium levels being in the upper normal range. Urinary sodium concentration and renal epithelial exchange between sodium and potassium were normal. This was felt to be due to an autosomal recessive disorder.

Both siblings were later diagnosed as having a bilateral moderate to severe sensorineural hearing loss with intermittent conductive overlay due to middle ear fluid. The sensorineural loss was also felt to be autosomal recessive in origin, but the possibility of a disturbance of sodium balance in the inner ear has been questioned.
Temporal bone findings in two cases of head injury
Authors: Murakami M. , Ohtani I. , Aikawa T. , Anzai
Published: November 2007

Temporal bone findings in two cases of head injury are reported. In one patient, longitudinal fractures occurred in both temporal bones, and extended to the middle ear bilaterally. Bleeding was seen in the tympanic cavity, mastoid air cells, internal auditory meatus and facial nerve canal. Bleeding was observed in the scala tympani, cochlear aqueduct and endolymphatic sac, but there were no fractures. In the other patient, bleeding was seen in the internal auditory meatus and facial nerve canal. In the right ear, endolymphatic hydrops was observed in all turns of the cochlea.
Septic shock and death due to occult sinusitis
Authors: Hariri M. A. , Vice P. A.
Published: November 2007

We report a case of septicaemia and death due to occult sinusitis in an otherwise healthy adult. Septicaemia was diagnosed on clinical grounds and blood culture grew Streptococcus pneumoniae. Maxillary sinusitis was discovered incidentally on a CT scan four days after the onset of symptoms. A sinus wash-out revealed pus which on culture was positive for Streptococcus pneumoniae. The patient deteriorated gradually and died despite appropriate therapy. We conclude that sinusitis should be suspected in any case of septicaemia where the primary focus is not known and the patient does not respond quickly to treatment.
Burkitt's lymphoma of the tonsil
Authors: Kraus Mordechai , Fliss Dan M. , Argov Shmuel , Leiberman Alberto , Benharroch Daniel
Published: November 2007

A case of Burkitt's lymphoma involving the tonsil in a 10-year-old Bedouin boy, is presented. The biological behaviour and the clinical presentation of this unusual neoplasm are discussed and the English language literature is reviewed.

The diagnosis was made by histological examination, electron microscopy and confirmed by immunohistochemistry. The patient showed an excellent symptomatic response to surgery and chemotherapy.
Massive metastasis from squamous carcinoma of the tonsil
Authors: Prinsley Peter R. , Jarmulowicz Michael R. , Robinson Anthony C.
Published: November 2007

Squamous carcinomas of the oro-pharynx are associated with a high incidence of distant metastases at post-mortem. A case of a massive distant metastasis from a squamous cell carcinoma of the tonsil is presented. This occurred despite excellent local control. The pathology and the possible management implications are discussed.
Radiology for cochlear implants
Authors: Gray R. F. , Evans R. A. , Freer C. E. L. , Szutowicz H. E. , Maskell G. F.
Published: November 2007

One fifth of patients selected for cochlear implants have such bony irregularities in the cochlear duct that full insertion of a multichannel electrode array is impossible. Three cases of cochlear deafness are presented where pre- and post-operative radiology played an important part in the management.

Standard CT at 2 mm cuts is compared with ultra high resolution CT at 1 mm cuts. The pitfall of poor definition is that the inexperienced surgeon may find himself unexpectedly drilling out an obliterated cochlear duct. Sections 30 degrees caudal to Reid's infra orbito-meatal base line at 1 mm intervals give maximum information for minimum radiation.

Plain films show the placement of individual platinum electrode contacts in relation to the spiral ‘frequency map’ of the cochlea. This is vital information for the audiologist who has to route specific frequencies to specific sites within the ear for a good hearing result.
Tinnitus severity measured by a subjective scale, audiometry and clinical judgement
Authors: Halford Jonathan B.S. , Anderson Stewart D.
Published: November 2007

Tinnitus is discussed, with particular reference to the problem of assessing severity. The authors argue that tinnitus severity can only usefully be determined by measuring the impact of tinnitus on an individual, and therefore propose a scale to estimate severity in these terms. Data presented on 112 members of a tinnitus self-help group, demonstrated the reliability of a Subjective Tinnitus Severity Scale (S.T.S.S.), with a coefficient alpha of 0.84. This indicates a high degree of internal consistency, i.e.: statistically this scale is measuring aspects of a single dimension. The validity was established in a separate sample of 30 clinic attenders, where mean S.T.S.S. scores were found to correlate highly with two independent clinical ratings of severity (r2= 0.76, p<0.001, and r2= 0.73, p<0.001). Additionally, in these patients S.T.S.S. scores were significantly associated with several audiometric variables, although the correlations were of low magnitude.
Bilateral sudden deafness and acute acquired toxoplasmosis
Authors: Katholm Morten , Johnsen Niels Jon , Siim Christian , Willumsen Lars
Published: November 2007

An 18-year-old woman, while suffering from acute acquired toxoplasmosis, experienced sudden deafness and a total loss of vestibular function first in the right ear and three months later also in the left. Following treatment with sulphadiazine and pyrimethamine, hearing was retrieved to such a degree that the patient was enabled to communicate by means of a body-worn hearing aid and lip-reading. Taking the differential diagnostic possibilities into account, we believe that toxoplasmosis was the cause of the severe hearing loss. Since effective treatment seems to be available, we recommend that patients with acute bilateral sensorineural hearing loss of unknown origin are examined for acute toxoplasmosis with a view to instituting chemotherapy.
Otogenic Fusobacterium necrophorum meningitis
Authors: Pace-Balzan Albert , Keith Andrew O. , Curley Jane W. A. , Ramsden Richard T. , Lewis Helen
Published: November 2007

A case of meningitis secondary to acute suppurative otitis media in a previously healthy child is reported. The only organism isolated from blood after aerobic and prolonged anaerobic culture was identified as Fusobacterium necrophorum. Complete recovery followed treatment with surgery and prolonged antibiotic therapy. The role of anaerobes in the development of meningitis, the isolation and identification of Fusobacterium necrophorum, the clinical presentations of F. necrophorum infection and the choice of antibiotics in the treatment of these infections are discussed.
Massive thyroid oncocytoma
Authors: Richardson H. , Hill J. , Bennett M. , Mathias D. B.
Published: November 2007

A patient with a massive thyroid oncocytoma is presented. The symptoms of hoarseness and dysphagia were due to compression and were relieved by surgical excision of the tumour.
Scleroma of the upper respiratory passages: a CT study
Authors: Abou-Seif S. G. , Baky F. A. , El-Ebrashy F. , Gaafar H. A.
Published: November 2007

Scleroma is a chronic specific granulomatous disease endemic in Egypt. The nasal cavities were all affected in the 37 patients examined. The paranasal sinuses and nasopharynx were involved in 17 patients, while the larynx and upper trachea were affected in five patients, four of whom were females. Twenty-three patients were in the granulomatous stage; the rest of the patients were in the atrophic and fibrotic stages.

The main nasal and nasopharyngeal CT findings were soft tissue masses of variable sizes. The lesions were characteristically homogeneous, non-enhancing and had distinct edge definition; adjacent fascial planes were not invaded. The subglottic area was involved in laryngeal and tracheal scleroma. The lesions were mainly in the form of concentric irregular narrowing of the airway. In the trachea, crypt-like irregularities were diagnostic of scleroma. Intra-orbital, intra-cranial and infratemporal parapharyngeal scleromatous masses were detected inone patient.
Fracture line in post head injury optic nerve damage
Authors: Nayak Sadhana R. , Kirtane M. V. , Ingle M. V.
Published: November 2007

Diminution of vision following head injuries involving the optic canal is not uncommon. In order to find how a blunt trauma to the frontotemporal region produced damage to the optic nerve inits canalicular this study was conducted on cadaveric skulls and its results are described.
Transethmoid decompression of the optic nerve in head injuries: an update
Authors: Nayak Sadhana R. , Kirtane M. V. , Ingle M. V.
Published: November 2007

Sixty-three patients with loss of vision following head injury were subjected to decompression of the optic nerve by the transethmoid route. This paper discusses the criteria for selection of patients for surgery, the results of the operation and the prognostic factors determining the results.
Hodgkin's disease secondary to recurrent adenoid cystic carcinoma of the parotid gland
Authors: Megighian D. , Deigado H. , Blandamura S.
Published: November 2007

A case of Hodgkin's disease presenting as a second primary malignancy in a patient admitted eight years previously for total parotidectomy for an adenoid cystic carcinoma is reported.
Metastatic meningioma in the neck
Authors: Leighton S. E. J. , Rees G. L. , McDonald B. , Alun-Jones T.
Published: November 2007

Although meningiomas represent 15 per cent of tumours of the central nervous system, they rarely metastasize. A case is presented in which metastasis to a cervical lymph node occurred, together with local recurrence, nine years after initial diagnosis and treatment. This case serves to illustrate that malignant meningioma is a rare cause of a neck mass.
Biocompatible implantable antimicrobial release for necrotizing external otitis
Authors: Ostfeld E. J. , Kupferberg A.
Published: November 2007

The efficacy of a biocompatible, surgically implantable, antimicrobial release system (IARS) as the exclusive antimicrobial therapy of necrotizing external otitis (NEO) was evaluated in six NEO patients. Gentamicin incorporated polymethyl-methacrylate beads were implanted, following surgical debridement and were removed two months later. Post-implantation alleviation of clinical symptoms: pain, periauricular tissue swelling, otorrhoea, eradication of pseudomonal infection (100 per cent) and substantially shortened hospitalization (4–15 days) were the salient results of this therapeutic modality. Three patients recovered. Two patients who died, one of sudden cardiac arrest and the other of paralytic ileus, 15 and 60 days postoperatively while the beads were still implanted, were symptomless. Recurrence was seen in one patient with early bead extrusion. Ipsilateral sensorineural hearing loss (one patient) and external meatal stenosis were the main complications. IARS appears to offer an effective alternative to long-term systemic antibiotic administration for the eradication of NEO-pseudomonal infection in patients who are sensitive, develop resistance, or when quinolone medical treatment has failed or is contra-indicated.
Mode of growth of acquired cholesteatoma
Authors: Wells Meher D. , Michaels L.
Published: November 2007

A histopathological study of acquired cholesteatoma in four temporal bones from two adults and one child is presented. The findings suggest that the cholesteatoma originated from the retraction pockets of the tympanic membrane and there was active growth of the squamous epithelium of the retraction pockets, which may be enhanced in the presence of otitis media.
Treatment of ‘vasomotor rhinitis” by the local application of silver nitrate
Authors: Al-Samarrae S. M.
Published: November 2007

A series of 52 patients were closely assessed prospectively to determine the effectiveness, untoward effects and patient acceptance of a new method of treatment of ‘vasomotor rhinitis’ by silver nitrate application. The patient's age ranged from 11 to 50 years except one who was 58 years old. The report describes the technique used and results obtained following the painting of the ‘trigger area’ of the nasal mucosa in patients with ‘vasomotor rhinitis’. Each patient was evaluated regularly and the evaluation was based on both subjective response and clinical examination. Only cases who had rhinorrhoea and sneezing as presenting symptoms were selected. Silver nitrate (20 per cent) was used after topical anaesthesia, and patients received four applications. Successful relief was obtained in 88.5 per cent (53.0 per cent good relief; 34.6 per cent acceptable relief), while 11.5 per cent of the cases (6 out of 52 cases) had poor relief. No complication was seen among the patients during treatment and follow-up and no silver poisoning was detected.
Polymorphous low grade adenocarcinoma of the palate in a child
Authors: Tsang Y. W. , Tung Y. , Chan J. K. C.
Published: November 2007

We report a case of polymorphous low grade adenocarcinoma involving the palate of a 12-year-old girl, the first example of this tumour occurring in the paediatric age group. The tumour displayed infiltrative growth, neural invasion, variegated histological patterns, and minimal cytological atypia. The patient remained disease-free four years after wide local excision of the tumour. The distinction of polymorphous low grade adenocarcinoma from pleomorphic adenoma and adenoid cystic carcinoma is also discussed.
Primary surgical treatment for carcinoma of the larynx: influence of the local invasion
Authors: Petrović Ž. , Krejović B. , Djukić V. , Stanković P.
Published: November 2007

In the period from 1976 to 1988, 417 patients with supraglottic carcinoma of the larynx were treated by primary surgery.

Infiltration of the pre-epiglottic space was found in 11.99 per cent (50/417) of the patients. Carcinomas of the infrahyoid epiglottis spread to this space more frequently—14.24 per cent (44/309), than those of suprahyoid localization—5.55 per cent (6/108). Tumour invasion of the pre-epiglottic space is a relative contraindication for reconstructive surgery. Partial conservation operations were performed on 32 per cent (16/50) of patients with invasion of the pre-epiglottic space. The remaining patients had a total laryngectomy.

Infiltration of the paraglottic space intra-operatively was found in 2.4 per cent (10/417) of patients and all of these tumours were from the infrahyoid localization. Spread of tumours to this site is an indication for radical surgery and laryngectomy was performed on 80 per cent (8/10) of patients.
The Relationship of nasal septal deformity and palatal symmetry in neonates
Authors: Kent S. E. , Rock W. P. , Nahl S. S. , Brain D. J.
Published: November 2007

Results are reported of a study to evaluate possible associations between nasal septal deformity and palatal symmetry in neonates.

Five hundred babies, born consecutively, were examined within three days of birth. Prenatal and delivery data were recorded for each baby and the nose was examined to determine airway patency and possible septal deformity. When a deviation of the septum was discovered an alginate impression of the palate was taken along with photographs of the nostrils. A matched control was then selected for each study group baby and similar records were obtained.

Only 14 cases of septal deformity were found, an incidence of 2.8 per cent. No evidence of palatal asymmetry was found. The theory that moulding pressures during delivery may be a major cause of nasal septal deformity was not supported.
Effect of enlarged adenoids on arterial blood gases in children
Authors: Khalifa Mohammed S. , Kamel Reda H. , Zikry Mona Abu , Kandil Tarek M.
Published: November 2007

The enlarged adenoid is a common disorder in children resulting in nasopharyngeal obstruction. Many authors suggest that increased nasal resistance to respiration may cause disturbances in the pulmonary ventilation and carry the risk of obstructive sleep apnoea and/or cardiopulmonary syndrome.

This study comprised 30 children complaining of long-standing nasal obstruction due to enlarged adenoids. Adenoidectomy was performed and the arterial blood gases were measured before and one month after surgery. Twelve normal children were also included as controls. Statistical evaluation of the results showed that O2saturation and arterial O2tension (PaO2) were significantly low before the operation, and increased significantly after surgery. Arterial CO2tension (PaCO2) was insignificantly low before operation, but decreased significantly after adenoidectomy. It was concluded that enlarged adenoid may be associated with ventilatory impairment which is reversible after adenoidectomy.
Tuberous sclerosis with primary meningioma of the maxillary antrum
Authors: Irving R. M. , Ford G. R. , Jones N. S.
Published: November 2007

Primary extracranial meningiomas are uncommon; they have been documented in the ear, skin, orbit, parapharyngeal space, parotid gland, mediastinum, and rarely the paranasal sinuses. Tuberoussclerosis is an autosomal dominant neurocutaneous syndrome characterized by multiple connective tissue tumours. We report the first case of a tuberous sclerosis patient with a maxillary antral meningioma.
Chondrosarcoma of the parapharyngeal space
Authors: Okabe Y. , Shibutani K. , Nishimura T. , Furukawa M.
Published: November 2007

Chondrosarcoma is rarely found arising in the head and neck region. An unusual case arising in the parapharyngeal space in a male is reported and the differential diagnosis, pathology and treatment are discussed.
Realities in ossiculoplasty
Authors: Toner J. G. , Smyth G. D. L. , Kerr A. G.
Published: November 2007

The results of ossiculoplasty are frequently reported in terms of closure of the air-bone gap. This parameter is a reliable indicator of the degree of technical success, and is useful in comparing different materials and types of reconstructions. However, assessment of the operated ear alone does not evaluate the effect of surgery on binaural hearing ability, leading to the situation where sub-optimal advice may be given to patients pre-operatively. This article advocates a more patient orientated method of assessing the results of ossiculoplasty. Previous studies have indicated that the operated ear must reach an air conduction level of 30 dB for the speech frequencies, or be within 15 dB of the other ear, to ensure that the patient will gain significant benefit. A graphical method for the prediction of patient benefit is presented, and compared to the rule of thumb quoted above. The implications for surgeons and patients considering ossiculoplasty are obvious.

Many statements routinely made to patients prior to surgery for conductive hearing loss are unduly optimistic and unrelated to the realities of reported results. There is a need to determine what types of such hearing losses can be helped surgically, and more importantly to what extent the patients hearing disability can be relieved.
Total avulsion of an osseointegrated screw
Authors: O'Reilly B. J. , Walter C.
Published: November 2007

The close union achieved between pure grade titanium and healthy bone makes dislocation a rare event. We report the case of the total avulsion of an apparently well-integrated implant from a healthy mastoid bone.
Intracranial extension of a naso-ethmoid schwannoma
Authors: Enion David S. , Jenkins Alistair , Miles John B. , Diengdoh J. V.
Published: November 2007

A rare case of intracranial extension of a naso-ethmoid schwannoma is presented. Its subsequent removal with few sequelae confirmed the benign nature and good prognosis of the disease.
Pseudoaneurysm of the internal carotid artery: A forgotten complication of tonsillitis?
Authors: Watson M. G. , Robertson A. S. , Colquhoun I. R.
Published: November 2007

Pseudoaneurysm of the internal carotid artery is an uncommon but potentially lethal complication of tonsillar or peritonsillar sepsis, which appears to have occurred more frequently prior to the introduction of penicillin. Management of such a case is discussed, and a literature review presented.
Promontory stimulation following labyrinthectomy
Authors: Ramsden Richard T. , Timms Michael S.
Published: November 2007

Promontory stimulation testing was carried out on a series of ten patients who had undergone osseous labyrinthectomy. The thresholds, discomfort levels and dynamic ranges were found to be comparable with a series of ten patients who have subsequently been successfully implanted with the Nucleus 22 channel cochlear implant. These findings suggest that cochlear implantation might be possible in a labyrinthectomized ear.
Amelanotic Melanoma Metastatic to the Epiglottis
Authors: Ikeda Makoto , Takahashi Hirofumi , Karaho Takehiro , Kitahara Satoshi , Inouye Tetsuzo
Published: November 2007

Metastasis of melanoma in the head and neck region is often reported but the report of amelanotic melanoma metastatic to the epiglottis is an extremely rare entity.

This paper describes a patients previously treated for cutaneous amelanotic melanoma who developed metastatic tumour involving his epiglottis. This legion was successfully excised by a intra-oral approach combined with KTP/532 laser surgery. The paper also describes the diagnostic evaluation, management, operative technique and DNA analysis of this rare case.
Lateral pharyngeal diverticulum
Authors: Pace-Balzan Albert , Habashi Sherif M. Z. , Nassar Wadi Y
Published: November 2007

We report a case of a lateral pharyngeal diverticulum arising from the right vallecula. The aetiology and clinical features of these rare lesions are discussed. Diagnosis, which is difficult clinically, was made by barium swallow examination of the pharynx. The importance of contrast radiology in the investigation of pharyngeal symptoms is emphasized by this case.
Bilateral acinic cell tumours of the parotid gland
Authors: Nuutinen J. , Kansanen M. , Syrjänen K.
Published: November 2007

A 55-year-old woman was operated because of bilateral parotid tumours which appeared with an interval of three years. Histopathologically, both of the tumours had characteristics typical of acinic cell tumour, so-called clear cell type. Both tumours were regarded to be multifocal. In the case of bilateral parotid tumours, acinic cell tumour should also be kept in mind and total parotidectomy is the treatment of choice.
A comparison of performance of Shepard and Sheehy collar button ventilation tubes
Authors: Heaton Judith M. , Bingham Brian J. G. , Osborne Jonathan
Published: November 2007

This study was designed to confirm the longer in situ life of the Sheehy collar button compared with the Shepard tube and to assess the complication rate associated with the two tubes. Cases of bilateral otitis media with effusion had a Shepard tube inserted in one ear and a Sheehy contralaterally. The insertion position was allocated randomly. The patients were then assessed at three-monthly intervals for two years. In 71 percent of those in whom at least on tube had extruded, the Sheehy remained in situ longer. The antero-inferior tube remained longer than the postero-inferior whichever type was used. There was no significant difference between complication rates, or recurrence rates of middle ear effusion after tube extrusion, for the two types. We conclude that use of a Sheehy rather than a Shepard tube carries no increased risk of complications and the patient may require further surgery less often in total.
Non-ampullary pluging of the posterior semicircular canal for being paroxysmal positional vertigo
Authors: Pace-Balzan Albert , Rutka John A.
Published: November 2007

Benign paroxysman positinal vertigo (BPPV) is a common condition which is usually self-limiting. Surgical treatment is rarely required and for many years the mainstay of such treatment has been singular neurectomy (posterior ampullary nerve section).

A new operation has recently been described for the treatment of BPPV involving occlusion of the posterior semicircular canal. We have performed this operation on five patients with intractable BPPV and report our result with follow up of between 12 and 36 months from operation.

The excellent results of posterior semicircular canal occlusion which have been previously reposted in the literature are confirmed by our experience. In our opinion the operation is a safe and effective alternative to singular neurectomy.
Mastoidectomy packs: Xeroform® or BIPP?
Authors: Chevretton Elfy B. , McRae R.D.R. , Booth J. B.
Published: November 2007

A retrospective study comparing adverse events usin bismuth iodform paraffin paste (BIPP) and Xeroform as dressings for newly fashioned mastoid cavities after mastoidectomy was undertaken. There were 20 patients in each group. Adverse events were defined as offensive packs, mastoid caivity infection and systemic signs of infection. There were no adverse using BIPP packs Whether or not prophylactic antibiotics were used. Xeroform packs were associated with a significantly higher incidence of adverse events compared to BIPP when using on antibiotic porphylaxis (P<0.005) or amoxycillin (P<0.005). Adverse events with Xeroform packs were abolished using ciprofloxacin and metronidazole prophylaxis. We conclude that BIPP is the mastoid dressing of choice.
Comparison of cocaine alone or with adrenaline on nasal mucosal blood flow
Authors: Porter M. J. , Marais J. , Tolley N.
Published: November 2007

Cocaine is commonly used in ENT practice for its vasoconstrictor and anaesthetic properties. It is sometimes combined with adrenaline. The laser Doppler Flowmeter was used to compare the effect of 5 per cent concaine alone or with adrenaline (1 in 1,000) on nasal mucosal blood flow.

The results show an average fall in blood flow of 76.7 per cent for cocaine with adrenaline, compared to 61.2 per cent with concaine alone. The difference is significant (P<0.05). The time taken for the blood flow to fall was an average of 131 s and 160 s respectively. These differences are not significant.
Cutaneous sebaceous gland carcinoma in the postauricular region
Authors: Guneri Ataman , Ufuk Gunbay M. , Deniz Ismail , Demirdoven Kaplan
Published: November 2007

Carcinomas of the sebaceous glands of the skin are uncommon. These tumours metastasize frequently. A case of cutaneous sebaceous carcinoma localized in the postauricular region is presented with its exceptional large size and very poor prognosis.
An assessment of the incidence of iron deficiency in paediatric otolaryngology inpatients
Authors: Heaton Judith M. , Blair Robin L. , Shadbolt Clemency , Christmas Helen
Published: November 2007

The aims of this study were: to determine whether there is an increased incidence of iron deficiency in paediatric otolaryngology inpatients compared with other surgical controls; and to establish whether preoperative screening of haemoglobin level is warranted in such patients.

Children aged 1–10 years admitted electively for ENT surgery or for general surgical procedures had blood taken for haemoglobin level, mean cell volume and serum ferritin. Their age, weight, socio-economic class and ethnic background were recorded.

A total of 100 patients entered the study, in a six-month period. The mean ages and weights for the two groups were statistically different, so allowance was made for this in calculations. Social class was not significantly different. No relationship could be established between haemoglobin level and ferritin level for individual patients. Multiple regression analysis for haemoglobin level, mean cell volume and for ferritin level showed that allowing for the age and weight differences these variables were not significantly different for the two groups.

This study has therefore shown no increased incidence of iron deficiency in paediatric ENT inpatients. Each Department should formulate its own policy on pre-operative haemoglobin screening, based on local considerations.
Neuroendocrine carcinomas of the larynx
Authors: Logue J. P. , Banerjee S. S. , Slevin N. J. , Vasanthan S.
Published: November 2007

The clinical and histopathological characteristics of seven cases of Moderately Differentiated Neuroendocrine Carcinomas (MDNEC) and two cases of Poorly Differentiated Neuroendocrine Carcinomas (PDNEC) have been reviewed. The tumours arose in the supraglottis of predominantly elderly men. Two cases had raised levels of urinary 5-hydroxy-indole-acetic acid at presentation but no case developed the carcinoid syndrome. PDNEC were histologically identical to the oat cell type carcinoma of the bronchus and were associated with an extremely aggressive clinical course with both patients dying of widespread metastases within one month of registration. MDNEC also metastasized frequently with four of seven cases dying with widespread disease. The tumours have previously been reported as not being radiosensitive; however three cases remain free of disease following biopsy and radiotherapy alone. The place of radiotherapy in the management of these tumours is discussed.
Hamartomatous tonsillar polyp
Authors: Abu Shara K. A. , Al-muhana A. A. , AL-Shennawyi M.
Published: November 2007

A 41-year-old male Egyptian patient presented with difficulty in swallowing, snoring, and the sensation of a lump in his throat over a long period of time. On examination, a left tonsillar polyp was seen ( 4 × 2 × 1 cm) which was pedunculated, bilobulate, with an intact surface. The polyp was excised under local anaesthesia and histopathological examination revealed an haemangiomatous hamartomatous polyp.
Ear surgery camps in Nepal and the work of the Britain Nepal Otology Service (BRINOS)
Authors: Weir Neil
Published: November 2007

The Britain Nepal Otology Service (BRINOS), founded as a registered charity in 1988, has so far held four ear surgery camps in Nepal, sponsored and organised a nationwide survey of the prevalence and causes of ear disease and deafness and is sponsoring a pilot scheme of primary care for ear disease. Seven thousand outpatients have been seen, 270 major and 170 minor ear operations have been performed in the four ear surgery camps.
Malignant external otitis: management policy
Authors: El-Silimy Osama , Sharnuby M.
Published: November 2007

Malignant external otitis is a progressive pseudomonal infection of the external auditory canal and adjacent structures. In the literature there is no unified policy regarding the management of malignant external otitis. The development of an effective nuclear scanning method and antibiotics active againstPseudomonas aeruginosahave helped in formulating our management policy. A review of four years personal experience with this condition is presented. All of our cases were cured from the disease with no fatality. Gallium67citrate scans showed that antipseudomonal treatment should continue for up to three months.
Middle ear effusion: An orthodontic perspective
Authors: Mew John R. C. , Meredith George W.
Published: November 2007

Deviations in facial form are discussed. On the basis of previously published hypotheses, it is suggested that oropharyngeal development may be influenced by the posture, and function of the tongue, lips, and jaws. Attention is drawn to the relationship between a firm tongue to palate swallow, and the pump action of the palatine aponeurosis, which it is suggested is necessary for the aeration of the Eustachian tube. The pump action appears to be reduced in long faced adenoidal children, but clinical evidence suggests that it can be regenerated by early Orthotropics (growth guidance) aimed at directing facial growth forward, instead of downward. Any reduction in the height of the face, facilitates an improved lip seal, without which the downward pattern of facial growth is likely to continue. On occasions when these objectives are achieved it would seem that sufficient room is created to align all 32 teeth, with excellent facial form, and little otolaryngological pathology.
Myringoplasty for the anterior perforation: experience with the Kerr flap
Authors: Sharp J. F. , Terzis T. F. , Robinson J.
Published: November 2007

Surgical closure of the anteriorly located tympanic membrane perforation can present a problem. The lack of anterior support for the graft frequently leads to graft failure if an underlay method is used whereas anterior blunting is a complication of onlay techniques in this situation. The experience with the Kerr flap, an underlay graft fashioned to include a tab of fascia which is placed laterally under the annulus and the anterior meatal skin, is presented. This method gave a 97.5 per cent closure rate with no cases of anterior marginal blunting and a mean auditory threshold gain of 8.5 dB (95 per cent confidence limits 5 to 11.9 dB, P<O.O1) was achieved at the frequencies tested. The use of the Kerr flap is recommended when repairing the anteriorly placed tympanic membrane perforation
The histology of ‘stored’ autologous ossicles
Authors: Wake M. , Robinson J. M. , Sheehan A. L. , Bazerbachi S. , Codling B. W.
Published: November 2007

Controversy still exists concerning the ultimate fate of transposted or transplanted ossicles in tympanoplasty. Histological studies on autologous and homologous ossicles removed at revision operations, or from animal studies, vary in their conclusions. The viability, of such materials used in the long-term is still uncertain. Whether this has any functional significance is also uncertain.

This report contains a histological review of 10 ossicle remnants stored in the ‘closed’ mastoid cavity for 12 months, following closed cavity mastoidectomy (combined approach tympanoplasty)