bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymphagioma of the tongue. A review of pathogenesis, treatment and the use of surface laser photocoagulation
Authors: Balakrishnan A. , Bailey C. M.
Published: November 2007

Lymphangiomas of the tongue are rare tumours. Several reports of this interesting condition have appeared in the literature with varying modalities of treatment being employed to control tongue sizew. We present here our experinece with seven children who have lymphagiomas of the head and neck with tongue involvement seen over the past eight years. If the tongue is large with protrusion outside the lip margins, we advocata early tongue reduction so as to promote proper speech and deglutition, reduce of orthodontic problems and achieve good cosmesis. However, the naturel history of these tumours is one of recurrent tongue enlargement secondary to infection and trauman, irrespective of surgical reduction. We describe our technique of surface CO2 laser photocoagulation which has been successfully employed in controlling tongue size and removing superficial lymphangioma in all our patients. We propose therefore that this should be the mainstay of follow-up therapy in lingual lymphangiomas.
Sphenoid sinus mucocoele: a possible late complication of radiotherapy to the head and neck
Authors: Rejab Esa , Said Hussain , Saim Lokman , Thim Loh
Published: November 2007

A case of sphenoid sinus mucocoele following radiotherapy in a patient with nasopharyngeal carcinoma is reported. Diagnosis was made by radiological investigation and confirmed at surgery performed via a sublabial transeptal approach. Its content was completely removed and continuous drainage of the sinus was maintained by an indwelling tube. It is felt that the sphenoid mucocoele developed as a result of occlusion of the sinus ostium by scarred mucosa following radiotherapy.
Relapsing polychondritis presenting with stridor from bilateral vocal cord palsy
Authors: Hussain S. S. M.
Published: November 2007

A case of bilateral vocal cord palsy caused by relapsing polychondritis is presented. The diagnosis was not suspected preoperatively and was made solely on histopathology. A case is made for histological examination of cartilage removed during routine tracheostomy.
Radiological diagnosis of rhinoscleroma—the ‘Palatal Sign’
Authors: Dawlatly E. E.
Published: November 2007

This paper reports a characteristic radiological finding observed in seven cases of rhinoscleroma with nasal involvement. The soft palate exhibits a marked thickening at its attachment to the hard palate which tapers off towards its free edge. This new sign could be of help in the early diagnosis of this condition.
The value of CT scanning in chronic suppurative otitis media
Authors: O'Reilly B. J. , Chevretton E. B. , Wylie I. , Thakkar C. , Butler P. , Sathanathan N. , Morrison G. A. , Kenyon G. S.
Published: November 2007

High definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings.

Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent.
A safer transnasal technique for the management of bilateral choanal atresia
Authors: Singh Bharath
Published: November 2007

A study was undertaken on a 3.2 kilogram fresh stillborn neonate, to determine ways and means of preventing damage to the skull base.

Gruber and Rosen aural specula were inserted separately into the right nostril, to determine the degree of exposure of the choana with each. The position of the surgeon was varied (septoplasty versus tonsillectomy position), to determine on which anatomical site of the choana the surgeon's field of vision was focused.

The Gruber aural speculum, gave a completely, uninterrupted view of the choana.

In the tonsillectomy position, the entire field of vision was focused on the choana itself, whilst in the septoplasty position, one half was focused on the choana and the other half on the roof. Since the roof is part of the skill base, damage to this area can result in serious intracranial complications, such as CSF leak and meningitis.

These complications can be avoided if the surgeon uses the Gruber aural speculum for exposure and operates from a tonsillectomy position.
Parapharyngeal abscesses
Authors: Sethi D. S. , Stanley R. E.
Published: November 2007

Fifty-five patients with deep neck infections treated consecutively over a period of six and a half years between January 1983 and July 1989 were reviewed. Nine of these patients had abscesses localized to the pharapharyngeal space and form the basis of this study. The aetiology of the parapharyngeal abscess was odontogenic in two patients and remained unknown in the other seven. Five patients had associated systemic disease; four were diabetics and one patient had non-Hodgkin's Lymphoma.

High dosage intravenous antibiotics directed towards the causative micro-organisms, airway control and early surgical intervention was the mainstay of treatment. All patients underwent open surgical drainage of the parapharyngeal abscess within 24 h of admission. Bacteriology results showedKlebsiellasp. to be the dominant micro-organism cultured in four patients. Morbidity was low; seven patients had no post-operative complications and were discharged from the hospital between 7–24d (mean 12.9 d). There were two deaths.

Early open surgical drainage remains the most appropriate method of treating parapharyngeal space infections; it avoids life threatening complications with rapid recovery.
Surgical treatment of laryngomalacia
Authors: Jani Piyush , Koltai Peter , Ochi James W. , Bailey C. Martin
Published: November 2007

Laryngomalacia is the commonest cause of congenital stridor. The majority of cases are mild and do not require surgical intervention. However in approximately 10 per cent of these infants the condition is life-threatening. The standard treatment for these patients has been to perform a tracheostomy. Recent reports have shown encouraging results following endoscopic surgery to the supraglottic structures. We report a series of twelve patients in whom a tracheostomy was avoided by performing an aryepiglottic fold trim—‘aryepiglottoplasty’. Dramatic improvements were seen in the respiratory obstruction and failure to thrive following surgery.
Nutritional support in patients with low volume chylous fistula following radical neck dissection
Authors: Al-Khayat M. , Kenyon O. S. , Fawcett H. V. , Powell-Tuck J.
Published: November 2007

One of the well known complications of radical neck dissection is a chylous fistula, which results from injury to the thoracic duct as it enters the left subclavian vein. Such fistulae may cause considerable increased morbidity to a patient who is already debilitated by malignancy and by the increased catabolic response to surgery. Further surgery may be appropriate for those with a high fistula output but conservative therapy is normally advocated for the remainder. Nutritional and electrolyte support for these patients is essential and poses potential problems in management.

We present three such patients. One was fed parenterally and two enterally and in all cases the fistulae closed spontaneously. We examine the known physiological stimuli to chyle production and conclude that the enteral feedings of these patients with fat or an isomolar enteral feed does not, contrary to current belief, increase chyle flow or delay the healing of these fistulae.
ENT manifestations of Fraser syndrome
Authors: Ford G. R. , Irving R. M. , Jones N. S. , Bailey C. M.
Published: November 2007

Fraser Syndrome is a rare autosomal recessive disorder (Gupta and Saxena, 1962; Smith, 1982). The most consistent feature is cryptophthalmos (hidden eye), but frequently abnormalities of the ears (meatal stenosis, dysplastic pinna), nose (hypoplastic notched nares, choanal stenosis or atresia), and larynx (glottic web, subglottic stenosis), as well as numerous other anomalies are encountered. We present four cases that have been treated at the Hospital for Sick Children in the last ten years, and describe the various ENT anomalies characteristic of this syndrome.
The role of endoscopic laterofixation of the vocal cord in the treatment of bilateral abductor paralysis
Authors: Moustafa Hassan , El-Guindy Ahmed , El-Sherief Sayed , Targam Alt
Published: November 2007

Different techniques were compared in management of 36 patients with bilateral abductor paralysis of the vocal cords. Ten patients were treated by microsurgical arytenoidectomy through a mid-line thyrotomy, with successful decannulation in only three. Fifteen patients were treated by endolaryngeal microsurgical arytenoidectomy, with failure to decannulate four cases.

The procedure of endoscopic laterofixation of the vocal cord was used to treat 11 patients. Ten patients had an adequate long-lasting airway with a socially acceptable voice function. One patient had a revision surgery and was successfully decannulated. The technique was found to be a reliable option in the management of bilateral abductor paralysis. It is a modifiable procedure with a feasibility to adjust the position of the vocal cord under endoscopic control. It can be combined with endolaryngeal arytenoidectomy if the gain in the airway size produced by laterofixation is found insufficient.
Metabolic stridor: bilateral vocal cord abductor paralysis secondary to hypokalaemia?
Authors: Moralee S. J. , Reilly P. G.
Published: November 2007

A previously unreported association between bilateral abductor paralysis and hypokalaemia is reported in a patient presenting with stridor. Both the stridor and the bilateral abductor paralysis gradually resolved as the serum potassium was corrected. A causal link is suggested though the mechanism is unclear.
True carcinosarcoma of the larynx
Authors: Klijanienko J. , Vielh P. , Duvillard P. , Luboinski B.
Published: November 2007

A case of carcinosarcoma of the larynx and pyriform sinus with sarcomatous and epithelial malignant components is described in a 68-year-old male. The primary site was composed of spindle-shaped malignant mesenchymal cells with osteosarcomatous and chondrosarcomatous differentiation intermingled with areas of well differentiated squamous cell carcinoma, tubular and papillary adenocarcinoma, and trabecular neuroendocrine carcinoma. The metastatic lymph node showed squamous cell carcinoma and chondrosarcoma. Immunohistochemical studies showed that keratin was present in epithelial cells and negative in sarcoma, whereas vimentin and S-100 protein were present in sarcoma, but negative in carcinoma. Neuron-specific enolase was present in the neuroendocrine part of the tumour.
Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease): a rare case of subglottic narrowing
Authors: Courteney-Harris R. G. , Goddard M. J.
Published: November 2007

A case of subglottic narrowing caused by an extranodal deposit of sinus histiocytosis in an eight-year-old child with Rosai-Dorfman disease is presented. The airway obstruction was initially managed with a tracheostomy, and then on confirmation of the diagnosis by lymph node biopsy, by excision of the extranodal deposit with a CO2 bronchoscopic laser.
Nebulized racemic ephedrine in the treatment of acute exacerbations of laryngeal relapsing polychondritis
Authors: Gaffney R. J. , Harrison M. , Blayney A. W.
Published: November 2007

A case of relapsing polychondritis of the larynx and upper trachea is presented. We report the use of nebulized racemic ephedrine, as a new treatment modality of the life threatening airway oedema which characterizes acute exacerbations of this disease.
Expression of carbonic anhydrase isoenzymes in the developing endolymphatic sac of the human fetus and the mouse embryo
Authors: Yamashita Hiroshi , Bagger-Sjöbäck Dan , Sekitani Toru
Published: November 2007

The distribution of carbonic anhydrase isoenzymes (CA) was analyzed in the developing endolymphatic sac (ES) of the mouse embryo and human fetus using immunohistochemical method. The primordial ES epithelium was labelled with CA I and CA II, but was weakly labelled with CA III and CA V. In the thirteenth and fifteenth gestational day (GD) mice, the ES epithelium was positive for CA I and CA II. After seventeenth GD, the ES epithelium was however weakly positive for CA I and CA II. In the 11 and 12 week old human fetus, the ES epithelium was strongly labelled with CA I and CA II. In the 16 week old human fetus, the ES epithelium was however weakly positive for CA I and CA II. These results suggest that the fetal ES has an activity of CA and plays a role in the otoconial formation especially in the early stage during evolution.
Histological examination of the auricular cartilage and pseudocyst of the auricle
Authors:   ENT Laboratory, the Shandong Provincial Hospital, Lixiang P. R. China Zhu , Xiuyun Wang
Published: November 2007

In our histological examination on 42 ears (auricles) which were taken from 18 fetus and three adults, the intracartilaginous fibrous tissue with blood vessels and lymphatics were found in 12 ears and interruption of the auricular cartilage in 22 ears. The intracartilaginous connective tissue with blood vessels and lymphatics were linked together with the connective tissue outside the auricular cartilage in other sections. These findings support the hypothesis of congenital embryonic dysplasia as the origin of the formation of pseudocyst of the auricle.
Complications following fast neutron therapy for head and neck cancer
Authors: Stafford N. , Waldron J. , Davies D. , Walsh-Waring G. , Smith R.
Published: November 2007

Serious complications resulting from the use of fast neutrons to treat head and neck malignancies are reported in 38 patients. The average interval between treatment and onset of complications was 5.5 years. Significant airways obstruction, requiring a tracheostomy, occurred in two patients, and a gastrostomy or pharyngostomy was performed for intractable dysphagia in six. Eight patients developed osteoradionecrosis; carotid artery rupture occurred in three patients following surgery for residual or recurrent disease.

Our experience suggests that complications following fast neutron therapy for head and neck tumours are more severe, more common and occur after a longer time interval than those seen following conventional radiotherapy. Subsequent surgery in the irradiated area is compromised by severely impaired wound healing. When radical surgery is necessary for residual or recurrent disease the entire volume of irradiated tissue must be removed if healing is to be achieved.
Laryngeal candidiasis: A cause of airway obstruction in the immunocompromised child
Authors: Fisher Edward W. , Richards Aurelia , Anderson Glenn , Albert David M.
Published: November 2007

Laryngeal involvement with Candida is usually secondary to pulmonary candidiasis and is seen in patients with impaired immunity. We report a case of isolated laryngeal candidiasis involving the vestibular folds and presenting with stridor in a one-year-old child with Down's syndrome and hypogammaglobulinaemia. Vestibular fold reduction and fluconazole achieved resolution of the disease. Candidiasis should be considered in any potentially immunodeficient child presenting with symptoms of laryngeal disease.
Measurement of nasal displacement by photography
Authors: Prinsley Peter
Published: November 2007

A simple photographic method of assessing a commonly encountered nasal deformity has been devised. The method described is of use in quantifying a subjective appearance and in assessing the result of surgery.
Vocal fold lateralization using carbon dioxide laser and fibrin glue
Authors: Linder Arne , Lindholm Carl-Eric
Published: November 2007

Lateralization of one or both vocal folds is a generally accepted surgical principle for the relief of the airway obstruction caused by bilateral vocal fold paralysis. A modified, entirely endoscopic method of lateralization has been developed, employing a carbon dioxide laser to reduce the bulk of the fold, and fibrin glue to maintain the lateral position. The results of 18 operations on 15 patients, including six who had unsatisfactory results after previous surgery, were analyzed and compared retrospectively with the results from 22 patients operated on before the introduction of the method. The patient's ability to perform everyday activities improved in 12 cases, which paralleled the results of the previous, more cumbersome methods. The incidence of re-operation was comparable, given the shorter follow-up after the more recent method.
Extranodal Rosai-Dorfman disease: an uncommon cause of persistent nodule in the ear
Authors: Tsang W. Y. W. , Chan J. K. C. , Ho W. K. , Yu H. C. , Chow L. T. C.
Published: November 2007

A 40-year-old woman presented with a nodule over the tragus of the right ear. A biopsy was initially reported as showing non-specific inflammation. In view of the persistence of the lesion, the histological material was reviewed, leading to revision of the diagnosis to Rosai-Dorfman disease, a diagnosis further confirmed by immunoreactivity of the histiocytes for s-100 protein. This case represented the extranodal form of Rosai-Dorfman disease in the absence of lymph node involvement.
Persistent stapedial artery
Authors: Pahor A. L. , Hussain S. S. M.
Published: November 2007

Persistence of the stapedial artery is rare. A case is presented in which the stapedial artery was found over the footplate during stapes surgery. The technical problems encountered are discussed.

A wire prosthesis has previously been used in the presence of a persistent stapedial artery and we describe the use of an all Teflon prosthesis.

A subsequent CT scan demonstrated the vessel in the middle ear.

An outline of the embryology of the stapedial artery is given and the literature reviewed.
Acute leukaemic cell infiltration of the nose
Authors: Bais A. S. , Uppal K. , Logani K. B. , Narayan S.
Published: November 2007

Leukaemic cell infiltration of the nose as a first manifestation of the disease is extremely rare. We report a case of a three year-old child who had presented with a swelling at the root of the nose for one month and proptosis of the right eye for one week. CT scan revealed a mass infiltrating the nose and nasal cavity along with infiltration of the retro-orbital region. Biopsy showed it to be myeloid cell deposits. Patient was put on antileukaemic chemotherapy but died two months after the first appearance of the symptoms.
Parapharyngeal lipoma
Authors: Kakani Rajesh S. , Bahadur Sudhir , Kumar Subrindra , Tandon D. A.
Published: November 2007

Lipomatous tumours of the parapharyngeal space are rare. A case of lipoma of the parapharyngeal space is reported for its rarity, characteristic radiological findings, and effect on growth of the facial bones.
The Pope Wick as a myringoplasty ear canal dressing
Authors: McRae Duncan , Dilkes Michael , Kenyon Guy
Published: November 2007

A study of 50 consecutive patients undergoing myringoplasty using a Merocel Sponge Pope Ear wick as an ear canal dressing showed the wick to be complication free with potential advantages over the time honoured Bismuth Iodoform Paraffin Paste dressing.
What is the effect of translabyrinthine acoustic schwannoma removal upon tinnitus?
Authors: Baguley David M. , Moffat David A. , Hardy David G.
Published: November 2007

A series of 129 patients who had undergone translabyrinthine removal of a unilateral acoustic schwannoma completed a postal questionnaire about pre- and post-operative tinnitus. A simple grading system was devised from which it was possible to determine the likely outcome of translabyrinthine acoustic schwannoma surgery upon tinnitus. The results have been analyzed in detail, and as a result it is possible to advise a patient undergoing this form of surgery that if they have no tinnitus pre-operatively they are unlikely to develop it, and if they do it will not besevere enough to significantly affect their quality of life. If they have mild or moderate tinnitus it is most likely to stay the same, or become less intense. If a patient has severe tinnitus it is very likely to improve and not affect their future quality of life.
Vertical partial laryngectomy: our results after treating 81 cases of T2and T3laryngeal carcinomas
Authors: Daniilidis J. , Nikolaou A. , Fountzilas G. , Sombolos K.
Published: November 2007

From 1976 to 1989,81 patients with T2and T3laryngeal carcinomas were treated with vertical patrial laryngectomy at the University ENT Department of Thessaloniki, Greece. All patients were male with a median age of 56 years (33–71 years). Four patients had N, lymph nodes. Ten patients received post-operative radiotherapy. Seventeen patients developed local recurrences or distant metastases. Mean follow-up was more than seven years. Absolute three-year survival was 94.6 per cent for 74 patients and absolute five-year survival was 89.6 per cent for 58 patients. Actuarial five-year survival of the whole group of 81 patients was 91 per cent calculated with the Kaplan-Meier method. Recurrence rate and survival of stage II and III patients are also discussed and compared using the log-rank test. We conclude that vertical partial laryngectomy is avery successful treatment selection for T2glottic and false vocal cord carcinomas and for someselected T3glottic lesions.
Simple method of insertion of Xomed one piece septal button
Authors: Al-Khabori M. J. J.
Published: November 2007

Silicone septal buttons have been available to obturate septal perforations since the 1970s. Various methods of insertion have been suggested but the procedure is not always easy. We have devised an alternative method which has proved quick and simple to perform.
Infection of the neck spaces: a present day complication
Authors: Irani B. S. , Martin-Hirsch D. , Lannigan F.
Published: November 2007

Although advances in antibiotic therapy have made adult neck space infections an uncommon event, it is essential to bear them in mind when treating oro-dental and oro-pharyngeal sepsis, as they can often progress with life threatening sequelae.

Three cases of neck space infection as a consequence of dental infection, pharyngitis and peritonsillar abscess are presented. The management of a potentially compromised airway is of paramount importance in the immediate treatment of neck space sepsis.
Retro-pharyngeal liposarcoma
Authors: Menown I. B. A. , Liew S. H. , Napier S. S. , Primrose W. J.
Published: November 2007

We present a case of extensive recurrence of a retro-pharyngeal liposarcoma following surgical removal 18 years previously. The surgery and pathology are discussed, and management strategies of head and neck liposarcomas are reviewed.
Influence of the mode of preparation on the long-term efficacy of homologous costal cartilage implants
Authors: Adlington P. , Anscombe A. J. , Pmllips J. J.
Published: November 2007

Devitalized homologous costal cartilage is widely employed as an implant in the management of the saddle nose. The tissue response induced by the implant is a combination of enveloping fibrosis and implant resorption, which will probably, ultimately, be complete. We have studied the balance between resorption and fibrosis, following different modes of cartilage preparation, in the mouse. Homologous costal cartilage was devitalized by four common methods—irradiation, formalin, glutaraldehyde and alochol. Segments of this cartilage were inserted at separate sites in the subcutaneous plain of the tail. These implants were harvested after one year for histology. Variations in the mode of cartilage devitalization, while inducing variations in the degree of the tissue response, did not influence the balance between fibrosis and resorption. Thus the long term maintenance of tissue bulk following homologous cartilage implantation is not influenced by the mode of preparation. Evidence suggests that the ultimate cosmetic results of autologous and homologous costal cartilage implantation would be much the same, and the use of homologous cartilage must be justified on other grounds.
Bilateral acute mastoiditis complicated by lateral sinus thrombosis
Authors: Oyarzabal M. F. , Patel K. S. , Tolley N. S.
Published: November 2007

A case of bilateral mastoiditis with subperiosteal abscesses complicating acute otitis media in a two and a half year old girl is presented. Contrast enhanced computerized tomography confirmed the diagnosis of right lateral sinus thrombosis. The aetiology, diagnosis and management of these conditions are discussed.
Functional aphonia in young people
Authors: Harris Carol , Richards Coral
Published: November 2007

The study reviewed the case histories of 14 young aphonies. A questionnaire was completed by the five speech therapists involved with these cases. The patients were all initially examined by E.N.T. specialists and then treated by speech therapy. All the patients were ‘cured’ by speech therapy, that is the voice returned to its premorbid state. This study looks at common characteristics of presentation, different approaches to management, and the patterns of voice return.
Percutaneous tracheostomy in a head and neck unit
Authors: Fisher Edward W. , Howard David J.
Published: November 2007

A recent innovation in the technique of tracheostomy is now available as a commercial kit. A standard tracheostomy tube is inserted using a guidewire and dilator as in the Seldinger technique. The kit was used in nine cases in a unit with a head and neck oncology interest. Two failures were experienced but no serious or fatal complications. The technique is limited when applied to necks which are not anatomically ‘ideal’, and hence will have application in head and neck surgery only after careful patient selection
Salivary terminal duct carcinoma
Authors: Tay H. L. , Reilly P. G. , Akosa A. B.
Published: November 2007

We report two cases of terminal duct carcinoma of the minor salivary glands. The histological features, biological behaviour, treatment and the long-term management are described.
Antroscopy in rhinoscleroma
Authors: Soni N. K.
Published: November 2007

Rhinoscleroma is a chronic specific granulomatous inflammatory condition that has an affinityto the mucosa of the upper respiratory tract. Involvement of maxillary antrum is said to be very uncommon. In the present study antroscopy was performed in 20 patients with rhinoscleroma to find out the type, nature and site of the lesion in the maxillary antrum. The maxillary antrum was involved in 60 per cent of cases with rhinoscleroma. The lesions occurred in the form of atrophic changes, granuloma, and the fibrotic thick healed stage. The anterior–inferior part and medial wall of the antrum are found to be more commonly affected. It is suggested that involvement of maxillary antrum in scleroma may act as a reservoir of infection and such patients may therefore take a longer time to respond to antibiotic therapy.
Is injectable collagen truly safe?
Authors: Takayama Etsuyo , Ikeda Makoto , Tsuru Sumiaki , Ogura Masami , Kitahara Satoshi , Inouye Tetsuzo , Healy Gerald B.
Published: November 2007

Most patients have no response to injectable collagen or silicone, but some cases may have positive or ‘undersea’(= clinically negative but immunologically positive) response to collagen. From the results of the Macrophage migration inhibition test, the relative immunogenicity was augmented most when we used implants with the following combination. The firstimmunization was collagen and the second one was collagen with silicone.

The augmented antigenicity might be enough to cause an allergic reaction to the patients who had no response to each implant alone. The purpose of this article is to warn of the potential hazard of injection.
Surgery of the ‘only hearing ear’ with chronic ear disease
Authors: Sanna Mario , Shea Coyle M. , Gamoletti Roberto , Russo Alessandra
Published: November 2007

The management of chronic ear disease affecting the only hearing ear is a controversial subject. The relative scarcity of literature on the subject prompted us to prepare a questionnaire which was sent to European and American otologists and to review 19 cases operated at the ENT Clinic of the University of Parma, Italy, and 16 cases operated at The Baptist Memorial Hospital, Memphis, U.S.A. Surgery of cholesteatoma involving the only hearing ear is advised by all the interviewed otologists without exception, even in the presence of a labyrinthine fistula. The cases from the University of Parma were managed as follows: a classic modified radical mastoidectomy was performed in 10 cases, a staged intact canal wall tympanoplasty was done in four cases, an open tympanoplasty in three and a radical mastoidectomy in the remaining two cases. The cases from The Baptist Memorial Hospital were managed with an intact canal wall tympanoplasty (ICWT) in nine and with an open procedure in seven cases. All the otologists interviewed agreed that surgery of the only hearing ear requires particular attention and experience, and should be performed with extreme care by a very experienced surgeon.
Cisplatin-albumin complex for treatment of cancer of the head and neck
Authors: Vreeburg G. C. M. , Stell P. M. , Holding J. D. , Lindup W. E.
Published: November 2007

Many patients with cancer of the head and neck are unable to receive or continue treatment with cisplatin, which is nephrotoxic, because of poor renal function. We present here, however, the case of a patient who underwent conventional cisplatin therapy but who then had to be withdrawn from treatment because of renal toxicity despite having undergone partial remission. Treatment was then changed to cisplatin in the form of a cisplatin-albumin complex which is not nephrotoxic. The patient went on to a histologically confirmed complete response and we suggest that although the cisplatin-albumin complex may not be as effective as the conventional form of the drug it offers a possible form of treatment of patients with compromised renal function who could not otherwise be treated.
Early changes of auditory brain stem evoked response after radiotherapy for nasopharyngeal carcinoma—A prospective study
Authors: Lau S. K. , Wei W. I. , Sham J. S. T. , Choy D. T. K. , Hui Y.
Published: November 2007

A prospective study of the effect of radiotherapy for nasopharyngeal carcinoma on hearing was carried out on 49 patients who had pure tone, impedance audiometry and auditory brain stem evoked response (ABR) recordings before, immediately, three, six and 12 months after radiotherapy. Fourteen patients complained of intermittent tinnitus after radiotherapy. We found that 11 initially normal ears of nine patients developed a middle ear effusion, three to six months after radiotherapy. There was mixed sensorineural and conductive hearing impairment after radiotherapy. Persistent impairment of ABR was detected immediately after completion of radiotherapy. The waves I–III and I–V interpeak latency intervals were significantly prolonged one year after radiotherapy. The study shows that radiotherapy for nasopharyngeal carcinoma impairs hearing by acting on the middle ear, the cochlea and the brain stem auditory pathway.
Carcinoma of temporal bone presenting as malignant otitis externa
Authors: Al-Shihabi B. A.
Published: November 2007

A 69-year-old man presented with a three-month history of otalgia and tenderness of the right ear and a one-week history of a painful right parotid swelling. Examination revealed granulation tissue in the right ear canal with normal looking tympanic membranes and a parotid abscess. Repeated biopsies from the ear canal and parotid showed non-specific inflammation. Repeated cultures from both areas grew Ps. aeruginosa. The patient's condition improved following three weeks of intensive treatment for malignant otitis externa only to relapse five weeks after the end of treatment. He received a second course, only to improve temporarily. He developed a right facial nerve palsy five weeks after he was first seen, followed four months later by palsies of all cranial nerves except the olfactory, before dying, seven months after his first appointment.

The radiological, histological and post-mortem findings are discussed.
External nasal nerve division: a treatment for post-traumatic neuralgia
Authors: Drysdale A. J. , Moore-Gillon V.
Published: November 2007

We present four patients complaining of neuralgic pains across the nasal bridge following trauma, who were successfully treated by division of the external nasal nerve. We believe it is a useful treatment in selected cases.
Closure of tympanic membrane perforation after the removal of Goode-type tympanostomy tubes: the use of silastic sheeting
Authors: Courteney-Harris R. G. , Ford G. R. , Ganiwalla T. M. J. , Mangat K. S.
Published: November 2007

The reported incidence of persistent tympanic membrane perforation after the extrusion or removal of Goodetype tympanostomy tubes varies from 3 per cent to 47.5 per cent.

A prospective randomized study of 152 Goode-type T-tube removals is presented. In one group of 79 ears, the edge of the defect was just freshened, but in the other 73 ears, the edge was freshened and a small piece of 0.13 mm silastic sheeting placed over the defect. Follow-up was performed at six weeks and three, six and nine months and shows that the use of silastic sheeting increases the rate of closure of the perforation and also significantly decreases the number of persistent perforations at nine months.
Long-term results of revision stapes surgery
Authors: Vartiainen Eero , Nuutinen Juhani , Virtaniemi Jukka
Published: November 2007

Results of 45 re-operations for persistent or recurrent conductive deafness after primary stapes surgery were studied. The mean follow-up period after the revision surgery was 7.6 years. Long-term hearing results were found to be disappointing, air-bone gap to within 10 dB was achieved in only 46 per cent of the patients. Mean hearing levels improved by 11 dB or more in 73 per cent. Outcome of surgery was dependent on the surgical pathology, the best hearing results were obtained in cases with re-fixation after stapes mobilization operation. Sensorineural hearing loss as a result of surgical trauma to the inner ear occurred in revision surgery more frequently than in primary operations, cases with regrowth of otosclerotic bone to the oval window after stapedectomy having the greatest risk of labyrinthine trauma.
Acute tonsillectomy in the management of infectious mononucleosis
Authors: Stevenson D. S. , Webster G. , Stewart I. A.
Published: November 2007

Life-threatening upper airway obstruction can be caused by tonsillopharyngitis secondary to infectious mononucleosis (IM). The administration of corticosteroids, emergency tracheostomy and acute tonsillectomy have been advocated as ways of managing this problem. In a series of 25 patients admitted over a five-year period with IM, 15 were judged to have symptoms severe enough to warrant the administration of corticosteroids. Six of these 15 patients had little improvement in their condition and thus underwent acute tonsillectomy. There were no significant complications of this surgery. A further three patients who received corticosteroids required tonsillectomy for recurrent tonsillitis later in the study period. By contrast, only one of the ten patients who did not receive corticosteroids subsequently required tonsillectomy. Acute tonsillectomy is of value in selected cases of IM tonsillopharyngitis. It may decrease the morbidity of recurrent tonsillitis after IM, in addition to averting the immediate risk of respiratory obstruction.
Fistula between the external auditory canal and the temporomandibular joint: a rare complication of otitis externa
Authors: Dingle Ann F.
Published: November 2007

Otitis externa is a relatively common complication of ear syringing. Temporomandibular joint complications of otitis externa are rare. A case of otitis externa with communication between the external auditory canal and the temporomandibular joint is described.
Acute peritonsillar abscess caused by Arcanobacterium haemolyticum
Authors: Barnham M. , Bradwell R. A.
Published: November 2007

A patient is reported with a peritonsillar abscess yielding Arcanobacterium haemolyticum. This appears to be only the fifth such case described in the medical literature and the first from Europe. The organism has been reported as an occasional cause of tonsillopharyngitis with rash, resembling infection with Streptococcus pyogenes but often unresponsive to penicillin therapy. A. haemolyticum easily passes unrecognized in bacteriological cultures as a result of its slow growth, coryneform appearance in the Gram's stain and weak haemolytic activity on conventional laboratory media.
Spontaneous healing of traumatic tympanic membrane perforations in man: A century of experience
Authors: Kristensen Søren
Published: November 2007

Widespread controversy exists concerning the treatment of traumatic tympanic membrane perforations. To elucidate the issue, a reference value for the rate of spontaneous tympanic membrane closure in man, to which the healing rates following different techniques of early surgical repair should be compared, was established on the basis of a review of more than 500 texts covering a century's literature on the traumatically perforated tympanic membrane. The spontaneous healing rate appeared to be close to 80 (78.7 per cent) in 760 evaluable cases of traumatic tympanic membrane perforations of all sorts diagnosed within 14 days post injury. A relative, causal-related variation of spontaneous healing could be demonstrated, and a pathogenetic classification of direct traumatic tympanic membrane perforations into ruptures induced by air-pressure changes, heat or corrosives, solids, and water pressures, is of proved clinical value and may have medico-legal validity. There is an obvious need for clinically controlled studies on the spontaneous healing of all kinds of traumatic perforations of the tympanic membrane in humans, and important elements in the design of future studies are advocated.
Clinical and bacteriological profile of the ear in otogenic tetanus: A case control study
Authors: deSouza Chris E. , Karnad Dilip R. , Tilve G. H.
Published: November 2007

Twenty two patients presented with otogenic tetanus. Seventeen patients had acute histories with only a single episode of otitis media with otorrhoea. Fifteen patients had unilateral central perforations, five had bilateral central perforations and two had no perforations but had acutely congested tympanic membranes which were bulging suggesting the presence of purulent fluid behind them. All patients with perforations had a purulent pulsatile discharge. A coexisting aerobic infection was seen in 85 per cent of the cultures and 59 per cent of these were due tostaphylococcus aureus(versus 25 per cent in the controls). Only one patient had received partial immunization. Tetanus resulting from otitis media is not an indication for surgery.
The otological status of patients with nasopharyngeal carcinoma after megavoltage radiotherapy
Authors: Tang Nelson L. S. , Choy Alexander T. K. , John D. Gareth , van Hasselt C. A.
Published: November 2007

A middle ear effusion is a common complication of nasopharyngeal carcinoma both before and after radiotherapy. An effusion was found in 38 per cent of patients before radiotherapy and 9 per cent developed an effusion after the start of radiotherapy. Surgical treatment by myringotomy with or without grommet insertion was associated with a high incidence of otorrhoea (26 per cent) which was often refractory to treatment. In view of the frequency of this complication and the fact that a middle ear effusion may not be of concern to an adult patient with nasopharyngeal carcinoma, a ‘wait and see’ policy may be appropriate in the management of a middle ear effusion in these patients.
The midfacial degloving approach to sinonasal disease
Authors: Howard David J. , Lund Valerie J.
Published: November 2007

The midfacial degloving approach was first described by Cassonet al.in 1974 but despite a number of papers in the American literature advocating its use, it has not gained popularity in Europe. The advantages and application of the technique are presented in 36 patients, ranging from 7–78 years of age. The approach is ideally suited for extensive benign lesions in the nasal cavity, ethmoid and sphenoid sinuses and enables access to the nasopharynx and infratemporal fossa whilst avoiding an external incision. These lesions have included angiofibroma (13 cases), inverted papilloma (five cases), a variety of cysts (three cases) and six miscellaneous cases of benign pathology. Malignant lesions which have not breached the anterior cranial fossa may also be removed, up to and including bilateral maxillectomy (nine cases) and this can be combined with orbital clearance. The approach may be repeated if necessary and is associated with few significant complications though vestibular stenosis, oro-antral fistula, nasolacrimal damage and upward rotation of the nasal tip may occur. Strategies to avoid these problems can be undertaken and long-term cosmetic results are excellent.
A comparative study of calcium sodium alginate (Kaltostat®) and bismuth tribromophenate (xeroform®) packing in the management of epistaxis
Authors: McGlashan J. A. , Walsh R. , Dauod A. , Vowles A. , Gleeson M. J.
Published: November 2007

A prospective study was undertaken to compare the efficacy of calcium sodium alginate fibre (Kaltostat®) to petrolatum gauze impregnated with bismuth tribromophenate (Xeroform®) for the control of epistaxes that require hospital admission.

Forty patients presenting with severe epistaxis requiring hospital admission were treated with either Kaltostat®r Xeroform® nasal packs. Allocation to either treatment group was made randomly. The composition of each group in terms of age, sex distribution, aetiology of epistaxis and severity of bleed was not significantly different.

There was no significant difference in the efficacy or patient acceptability of either therapeutic agent. It is concluded that calcium sodium alginate fibre should be considered as an acceptable alternative to traditional gauze packing.
A rare congenital intranasal polyp: mesenchymal chondrosarcoma of the nasal region
Authors: Roland N. J. , Mon Khine Myat , Clarke R. , Van Velzen D.
Published: November 2007

A mesenchymal chondrosarcoma of the nasal region in a neonate is described. Problems of histological interpretation and management are discussed.
Early marked arytenoid calcification in a case of suspected foreign body
Authors: Barr G. D. , Barr J.
Published: November 2007

A case of early marked calcification of the arytenoid cartilages is presented in a patient with a suspected pharyngeal foreign body. The calcification on X-ray had the appearance of the expected foreign body. Calcification of the arytenoid cartilages is discussed.
The value of head dressings for middle ear surgery
Authors: Rowe-Jones Julian M. , Leighton Susanna E. J.
Published: November 2007

A prospective trial was performed to ascertain the value of head dressings in the post-operative management of patients undergoing middle ear and mastoid surgery. One hundred consecutive patients were randomly allocated to a head dressing or no head dressing group after wound closure.

Nine patients in the head dressing group developed a wound complication as opposed to four patients in the no head dressing group.

The application of a pressure dressing following middle ear and mastoid surgery is unnecessary and may contribute to increased wound morbidity.
Fatal massive upper respiratory tract haemorrhage: an unusual complication of localized amyloidosis of the larynx
Authors: Chow Louis Tsun-Cheung , Chow Wing-Hing , Shum Bobby Shui-fung
Published: November 2007

Localized amyloidosis of the larynx is usually described as a non-bleeding lesion. We report a patient with localized laryngeal amyloidosis who developed a massive upper respiratory tract haemorrhage and died. This potentially fatal complication of localized amyloidosis of the larynx merits recognition as the disease could be controlled in most instances by surgical excision of the amyloid deposit.
Ossifying fibromyxoid tumour (of soft parts) of the head and neck: a clinicopathological and immunohistochemical study of nine cases
Authors: Williams Stephen B. , Ellis Gary L. , Meis Jeanne M. , Heffner Dennis K.
Published: November 2007

Ossifying fibromyxoid tumour (OFT) is a recently described, mesenchymal neoplasm originally defined as a borderline or low-grade malignant lesion. Prior reports of OFT characterize it as a slow growing lesion with a propensity to occur in both the upper and lower extremities. Most OFTs have occurred within the deep subcutis or skeletal muscle. We report nine cases which arose in the head and neck region. Six of the nine tumours were classified as ossifying variants of OFT while two were non-ossifying variants that lacked a discernable shell of lamellar bone. One tumour was classified as a malignant OFT. Seven lesions occurred in a subcutaneous site while two lesions occurred intraorally beneath the gingival and palatal mucosa. The OFTs occurred in six men and three women (age range of 29–75 years). The tumours had histological features compatible with previously described OFTs and consisted of lobulated nests of small, cytologically bland round cells (with the exception of one malignant OFT), with a myxoid to hyalinized stroma and were surrounded in part by dense fibrous connective tissue. Six cases had an incomplete rim of lamellar bone with occasional perpendicularly orientated spicules of bone. Five lesions were immunostained. S-100 protein, neuron specific enolase, and Leu-7 were found in three out of five tumours. Glial fibrillary acidic protein, smooth muscle actin (SMA), and muscle specific actin (MSA) were detected in two out of five lesions, although staining for SMA and MSA was weak in reactivity. Staining for vimentin was strongly positive in all five cases tested. The tumours were not reactive with antibodies directed against cytokeratin, epithelial membrance antigen or neurofilament protein. Follow-up information, available in eight cases, revealed multiple local recurrences in the one tumour believed to be a malignant OFT. The histogenesis of these tumours is uncertain, although the preponderance of evidence suggests a Schwann cell origin.
Head and neck manifestations during HIV infection
Authors: Barzan L. , Tavio M. , Tirelli U. , Comoretto R.
Published: November 2007

The ENT manifestations of HIV infection are well known and the findings in AIDS patients have been described, nevertheless there are no reports of the frequency of head and neck involvement during the various stages of the disease. From 1987 to 1991, 210 HIV positive patients had ENT evaluation without symptomsrelated selection. The majority of them were men and intravenous drug users. The frequency of enlarged neck nodes, neck mass, nasopharyngeal lymphatic tissue hypertrophy, extranodal localization of non-Hodgkin's lymphomas, Kaposi's sarcoma, oral hairy leukoplakia, candidiasis and other less common findings is reported, in relation to the stage of the disease. Overall 84 percent of the observed patients had head and neck manifestations.An ENT evaluation in every HIV infected patient is suggested.