bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonography in laryngeal cancers
Authors: Erkan Mustafa , Tolu Ismet , Aslan Tahsin , Güney Ercihan
Published: November 2007

Endolaryngeal spread of laryngeal malignant tumours is usually determined by conventional endoscopy; however, it can not measure the outward extension of the tumour. As an alternative method for assessing the extension of a tumour and detecting metastatic lymph nodes, we have introduced high-resolution ultrasonography (US) in 34 patients with laryngeal epidermoid carcinoma. The ultrasonographic results were compared with the clinical, operative and histological findings. The ultrasonography revealed malignant extensions in the thyroid cartilage in nine cases, in the carotid artery in four cases, and in the thyroid gland in five cases. These were confirmed by surgical and histopathological examinations. Six patients out of the 34 were subclinical cases, who had metastatic lymph nodes, which were diagnosed by US only. In this study US had a sensitivity of 94.44 per cent and a specificity of 93.75 per cent. The sensitivity and specificity of palpation of the cervical lymph nodes were 66.66 per cent and 87.55 per cent respectively.

It may be concluded that high-resolution real-time US is a sensitive, simple and inexpensive method for evaluating laryngeal cancers and subclinical cervical lymph node metastasis.
A review of patients attending a preliminary cochlear implant assessment clinic
Authors: Ramsden Richard T. , Herdman Rory C. D. , Boyd Paul , Giles Ellen , Hamilton John
Published: November 2007

The Cochlear Implant Programme at Manchester Royal Infirmary was established in 1988 and so far (January,1992) 38 patients have been implanted with the Nucleus 22 channel intracochlear device and one with the Ineraid device. All patients who are referred for consideration for an implant are initially seen at a preliminary cochlear implant assessment clinic conducted by an ENT surgeon. One hundred and seventy three patients attended the initial outpatient screening clinic between 1987 and January 1992. Of these 112 patients (67.6 percent) went on for further investigation regarding suitability for implantation. This paper details the aetiology and severity of deafness in these patients and explains how suitability for admission to the next stage of assessment was decided.
Transcranial translabyrinthine approach to vestibular schwannomas
Authors: Feghali Joseph G. , Kantrowitz Allen B.
Published: November 2007

Surgeons who utilize the suboccipital approach for the removal of large vestibular schwannomas, can perform a planned labyrinthectomy from within the intracranial cavity via the suboccipital exposure. This transcranial translabyrinthine approach provides one of the major advantages of the conventional transmastoid translabyrinthine approach, namely, unambiguous identification of the facial nerve as it exits the internal auditory canal, without the need for complete mastoidectomy and labyrinthectomy. The labyrinthectomy is best performed prior to the complete exposure of the internal auditory canal. The approach requires the surgeon to identify the endolymphatic sac intracranially, then drill the temporal bone and follow the vestibular aqueduct to the utricle. The lateral and superior semicircular canal ampullae, the superior vestibular nerve, Bill's bar, and the facial nerve at the lateral end of the internal auditory canal can then be identified. After testing on multiple cadaver temporal bones, this approach was used in patients with large tumours that extended far laterally in the internal auditory canal. The steps in the technique are described in detail.
Grommets, swimming and otorrhoea — a review
Authors: Pringle M. B.
Published: November 2007

Ever since Armstrong reintroduced the concept co grommeet insertion parents have been asking ‘may my child swim?’, yet there is still no consensus as to the correct answer. This paper reviews the work that has been done on this subject in the last 25 years. A review of teh reates of otorrhoea following grommet insertion, irrespective of swimming, shows a variation from 12 to 64 per cent. Evidence suggests that pressures of 12–23 cm H2O are needed to push water through a grommeet and that it is unlikely that water will enter the middle ear during surface swimming. Only bath water seems to cause significant inflammtory changes to middle ear mucosa. Not a single paper comparing swimming without ear protection can be safely permitted for children with grommets.
Recovery from rhinocerebral mucormycosis in a ketoacidotic diabetic patient: a case report
Authors: Kemper J. , Kuijper E. J. , Mirck P. G. B. , Balm A. J. M.
Published: November 2007

An 18-year-old woman with insulin-dependent diabetes mellitus developed an infection of the paranasal sinuses with Rhizopus oryzae resulting in facial swelling, hemiplegia and blindness of the right eye. The therapy of this rhinocerebral mucormycosis consisted of extensive surgical debridement, administration of high-dose amphotericin B, hyperbaric oxygen and control of the underlying predisposing diabetes mellitus. The patient eventually recovered with however, the loss of one eye.
Localized tracheopathia osteoplastica of the subglottis
Authors: Birzgalis A. R. , Farrington W. T. , O'Keefe L. , Shaw J.
Published: November 2007

Tracheopathia osteoplastica is a benign dysplasia of the tracheobronchial tree which rarely presents clinical problems especially when localized. We present a case which caused an unexpected difficulty in intubation and was subsequently removed endoscopically using the CO2 laser.
Type 2 neurofibromatosis: the need for supraregional care?
Authors: Evans D. Gareth R. , Ramsden Richard , Huson Susan M. , Harris Rodney , Lye Richard , King Tom T.
Published: November 2007

The results of a U.K. study of 145 cases of type 2 neurofibromatosis has shown generally very poor operative results in terms of hearing and facial nerve preservation. Only 9 out of 118 vestibular schwannoma (acoustic neuroma) operations resulted in any clinically detectable hearing preservation and only 32 left the patient with good or normal (House grade I or II) ipsilateral facial nerve function. Although operation is still the definitive treatment of vestibular schwannoma (acoustic neuroma) and may be a lifesaving procedure, it appears that the evidence in favour of early operation is only valid when carried out in highly specialized centres. The special problems of NF2 cases who may go on to develop multiple spinal and cranial tumours making them wheelchair bound and blind as well as deaf warrants a careful experienced approach. Timing of operations may be critical for the enhancement of useful years of quality life. We therefore propose the setting up of a national NF2 register, with the management of cases at a few supraregional centres.
Glottic reconstruction by implant of homologous laryngeal cartilages
Authors: Garozzo A. , Rossi M.
Published: November 2007

This paper describes a case of reconstructive laryngectomy in a patient with epidermoid carcinoma of the glottis. Reconstruction of the skeletal laryngeal architecture was carried out by implanting homologous cartilages, whilst the glottis was reconstructed with sternohyoid muscle. Laryngeal function was restored within 30 days of the operation.
Angioleiomyoma of the nasal tip
Authors: Ophir Dov , Ruchvarger Edward , Cordoba Mario
Published: November 2007

The clinical, histological and immunohistochemical findings of a rare case of a solitary subcutaneous angioleiomyoma (vascular leiomyoma) of the nasal tip in a 74-year-old woman are described. Histogenesis and histological characterization of this lesion are discussed.
False-positive MRI in a patient with otoneurological pathology
Authors: Barbara M. , Saliola S. , Filipo R.
Published: November 2007

After a short survey on the diagnostic work-up for acoustic neuroma, the authors underline the importance of magnetic resonance (MRI), enhanced by gadolinium, for otoneurological pathology. Through the presentation of a clinical case, the pros and cons for the routine application of MRI in suspect cerebellopontine angle (CPA) tumours in particular are reviewed. The possibility of false-positive MRI findings is discussed, although in this specific case a proper therapeutic approach was eventually carried out in order to resolve the associated Vllth nerve disturbance.
Parathyroid adenomas: pre-operative localization with ultrasound combined with fine-needle biopsy
Authors: Tikkakoski Tapani , Stenfors Lars-Eric , Typpö Tapani , Lohela Pentti , Apaja-Sarkkinen Meeri
Published: November 2007

Sixteen patients with biochemically proven primary hyperparathyroidism (PHPT) underwent ultrasonography (US), fine-needle aspiration (FNA) for cytologic sampling (n = 9), or intact parathormone assay (n = 3) before operation (n = 15) in order to determine the accuracy of the methods. Pre-operative US was found sensitive (100 per cent), but two thyroid lesions were initially diagnosed as parathyroid tumours by US (i.e. false positives). Parathyroid cells were detected in six cytologic specimens, one sample was insufficient and another inconclusive, while one was diagnosed as thyroid tissue. Parathormone assay revealed a high hormone content in all three patients who underwent the procedure. We conclude that US is sufficiently sensitive to detect enlarged parathyroid tumours. Specificity can be improved by US-guided FNA for cytology or parathormone assay prior to neck exploration.
Carboplatin ototoxicity: an animal model
Authors: Wake Mark , Takeno Sachio , Ibrahim Danyl , Harrison Robert , Mount Richard
Published: November 2007

A new animal model of ototoxicity is presented using intravenous carboplatin in adult chinchillas. A range of physiological and morphological effects was produced using doses calculated from the recommended therapeutic range (200–400 mg/m2). Auditory thresholds to tone pips stimuli were monitored using brain stem evoked responses (ABR). Cochlear histopathology was studied by light microscopy (LM) and ultrstructural hair cell abnormalities investigated with scanning electronmicroscopy (SEM). Carboplatin in this animal model predominantly affected the inner hair cells. This may provide an important model for the study of selective loss of the main afferent input in the auditory system.
Audit of the incidence of persistent perforation of the tympanic membrane following T-tube removal or extrusion
Authors: Todd G. B.
Published: November 2007

Audit of the incidence of persistent perforation of the tympanic membrane following T-tube removal or extrusion was carried out on 100 patients (151 ears). The incidence was found to be 11.9 per cent. This was independent of whether the tube was surgically removed or extruded; of the grade of surgeon carrying out the operation; and whether the patient treatment was carried out privately or on the N.H.S. Changes of practice have resulted from the audit.
Alteration of airflow and mucociliary transport in normal subjects
Authors: Barr G. S. , Tewary A. K.
Published: November 2007

The effect that variation of nasal airflow has on the mucociliary clearance was studied in healthy volunteers.

The nasal saccharin particle clearance time was found to have an inverse relationship with the nasal airflow.
Pathology of the eustachian tube in otitis media: an electron microscopic study
Authors: Elwany Samy
Published: November 2007

The ultrastructure of the mucosa of the eustachian tube was studied in four temporal bones showing tympanosclerosis, cholesteatoma, otitic meningitis and a grafted tympanic membrane (tympanoplasty). The mucosa of tube was abnormal in the four cases confirming the relationship between the state of the eustachian tube and the inflammatory process in the middle ear. The observed abnormalities included: ciliary loss, abnormal ciliary morphology and motility, oedema of the microvilli, hyperplasia of the goblet cells and the seromucinous acini, desquamation of the non-ciliated cells and appearance of mast cells in the lamina propria of the tube. Ciliary changes were the most frequent abnormalities and the morphological changes, in general, were fewest in the case of healed tympanoplasty. The pathophysiology of the morphological changes was discussed and correlated with the disease in the middle ear.
Profound deafness treated by the Ineraid multichannel intracochlear implant
Authors: Gray R. F. , Baguley D. M. , ll. Harries M. , Court I. , Lynch C.
Published: November 2007

Abstarct

Twelve deaf adults and two deaf children were treated with the Ineraid (formerly Symbion) four channel intracochlear implant between September 1989 and October 1991 at Addenbrooke's Hospital in Cambridge. All were post-lingually totally deaf and had found themselves beyond the reach of hearing aids. The effect of the implant upon the patients ability to lip-read was tested with the speech tracking test, BKB sentences (comparable to CID sentences) and Boothroyd word lists (comparable to NU6 word lists). All patients showed an improvement in their ability to understand speech with the help of the implant. Discrimination of speech without lip-reading was tested with Boothroyd word lists and BKB sentences, eight patients (57 per cent) demonstrated some ‘open set’ speech discrimination. The acceptability of the carbon percutaneous pedestal is discussed from the patient's, audiologist's and surgeon's points of view.
The use of cortical bone grafts in ossiculoplasty
Authors: Mills R. P.
Published: November 2007

Abstarct

The masses of preserved ossicles and cortical bone grafts have been studied in vitro using a Stanton Unimatic CL41 balance. The cortical bone grafts prepared for use in malleus-stapes assemblies had a mean mass 28 per cent greater than that for an incus, while those prepared for use in a malleus-footplate or drum-footplate assembly had a mean mass 58 per cent greater. Analysis of the hearing results for the first 20 ossiculoplasty operations performed by the author using cortical bone grafts revealed no significant differences in outcome attributable to increased mass. However, large grafts did become fixed to surrounding structures in some cases.
Post-traumatic bilateral facial palsy
Authors: Hartley C. , Mendelow A. D.
Published: November 2007

Abstarct

Bilateral facial palsy is an uncommon condition and few clinicians have experience of more than the occasional case. Unlike its unilateral counterpart, an aetiological, factor is often demonstrable. A Wide variety of recongnized disease may give rise to the condition and thus thorough investigation is required. This paper presents an unusual example of this rare condition.
The tracheostomal washer: a simple aid for tracheooesophageal speakers with a large tracheostome
Authors: Garth R. J. N. , Fenton C. J. , Pearson C. R. , Riden K. , Thomas M. R.
Published: November 2007

A simple device is described which enables the patient with a tracheo–oesphageal valve and a large tracheostome to easily occlude the stoma, avoiding the need for stomaplasty.
Tuberculosis of the larynx in a lepromatous patient
Authors: Flanagan P. M. , McIlwain J. C.
Published: November 2007

Within the black population of South Africa tuberculosis and leprosy are endemic. There is also a significant incidence of laryngeal carcinoma. A patient who presented in acute respiratory stridor to a rural hospital with limited resources is reported. The differential diagnosis and management is discussed in the light of the available literature.
Xenograftversusautograft in tympanoplasty
Authors: Callanan Vincent P. , Curran Aongus J. , Gormley Peter K.
Published: November 2007

This retrospective study compares the tympanoplasty success rate when using a xenograft (Zenoderm) or an autograft (temporalis fascia).

Fifty-three ears were operated on over a three-year period. All the tympanoplasty operations were performed by the same surgeon. There were 43 ears in the temporalis fascia autograft group and 10 ears in the Zenoderm xenograft group. Both groups were similar with respect to patient age, type of tympanoplasty, area of tympanic membrane perforation and condition of the contralateral ear.

The tympanoplasty success rate in the temporalis fascia autograft group was 95 per cent. The tympanoplasty success rate in the Zenoderm xenograft group was only 40 per cent. All Zenoderm tympanoplasty failures were regrafted with temporalis fascia autograft. There was a 100 per cent success rate with this salvage surgery.

In conclusion, we suggest that Zenoderm is not a suitable graft material for tympanoplasty.
Osteoma of the external auditory meatus presenting as an aural polyp
Authors: Toma Abbad G. , Fisher Edward W.
Published: November 2007

Isolated osteomata of the external auditory canal are benign and often symptomless lesions, and are distinct from the much commoner exostoses. A case is reported in which an osteoma presented as a recurrent ‘aural polyp’ due to a fibroepithelial polypoid reaction in the overlying skin. The polyp and the osteoma were excised surgically. We believe this to be the first reported case to present in this manner.
Submaxillary hypoglossal neurilemmoma
Authors: Sutay Semih , Tekinsoy Bulent , Ceryan Kerim , Aksu Yavuz
Published: November 2007

Neurilemmomas of the hypoglossal nerve are uncommon neoplasms. A unique case of submaxillary hypoglossal neurilemmoma is presented with radiological and surgical results. Methods of diagnosis and differential diagnosis are discussed.
Adult T-cell leukaemia-lymphoma in waldeyer's ring: A report of three cases
Authors: Ohguro Shinji , Himi Tetsuo , Harabuchi Yasuaki , Suzuki Toshio , Asakura Kohji , Kataura Akikatsu
Published: November 2007

Adult T-cell leukaemia-lymphoma (ATLL) is a new type of T-cell malignancy which has an adult onset, a rapidly progressive terminal course and a clustering at patients' birthplaces in southeast Japan and the Caribbean. We report the clinical features of three cases of ATLL in Waldeyer's ring, which has been rarely reported in the literature. The patients complained of throat pain and lump in the neck. They received combination chemotherapy, but all died within a year of first noticing the symptoms.
Extracranial and intracranial complications of suppurative otitis media. report of 102 cases
Authors: Kangsanarak Jaran , Fooanant Supranee , Ruckphaopunt Kobkiat , Navacharoen Niramon , Teotrakul Sunanta
Published: November 2007

During the eight-year period, 1983–1990, 102 cases of intracranial (IC) and extracranial (EC) complications from 17 144 suppurative otitis media were reviewed. The prevalence of each complication was 0.24 and 0.45 per cent respectively. Facial paralysis, subperiosteal abscess and labynnthitis were the common complications among the EC group, while meningitis and brain abscess were common in the IC group. Twenty five per cent of the EC group and 44 per cent of the IC group had more than two complications. The reliable warning signs and symptoms for IC complications were fever, headache, earache, vestibular symptoms, meningeal signs and impairment of consciousness. Proteus spp., Pseudomonas aeuruginosa and Staphylococcus spp. were the commonest organisms isolated from both groups. Cholesteatoma and granulation/polyp in the middle earl mastoid were the major findings in both patient groups. Mortality rate in the IC group was 18.6 per cent. Morbidity rate in each group was 14.3 per cent (EC) and 27.9 per cent (IC) respectively. Epidemiological presentations, clinical features and the result of treatment are discussed.
Prevention of intracranial problems in ear and sinus surgery: a possible role for cefotaxime
Authors: Weiner Graeme M. , Williams Bernard
Published: November 2007

Cases of intracranial sepsis of otorhinogenic origin presenting to a regional neurosurgical centre from 1984 to 1992 were examined with regard to their microbiology and antibiotic sensitivities. The results lead us to believe that cefotaxime may have a role in the initial ENT management of the potentially complicated case of ear or sinus sepsis.
Fine needle aspiration cytology of salivary gland lesions reported immediately in a head and neck clinic
Authors: Roland N. J. , Caslin A. W. , Smith P. A. , Turnbull L. S. , Panarese A. , Jones A. S.
Published: November 2007

This paper describes the application of fine needle aspiration cytology (FNAC) performed on92 patients with salivary gland lesions in a Head and Neck Surgery Clinic. The aspirates were immediately reported by a cytopathologist and the reports conveyed to the surgeon during the same clinic visit. FNAC results were then compared with histology in those patients who underwent surgery and with the clinical course of the disease at subsequent clinic visits in patients where surgery was not performed. The cytological diagnosis was incorrect in five cases, one of which was a false negative result. There were no false positive results. The sensitivity was 90.9 per cent and the specificity 100 per cent. This rapid report system of fine needle aspiration cytology has been found to be safe, free of complications, and helpful in the planning of treatment.
Sensorineural hearing loss in neurobrucellosis
Authors: Thomas Ratna , Kameswaran Mohan , Murugan Vel , Okafor B. C.
Published: November 2007

A case of neurobrucellosis presenting to the otologist with sensorineural hearing loss (SNHL) as the predominant clinical feature is reported. The diagnostic features and treatment options are discussed and the need for prolonged combination treatment to prevent relapse and further deterioration of hearing stressed. SNHL in neurobrucellosis has hitherto been reported principally in neurology literature as something of an incidental finding and so escapes the attention of otologists. It is hoped that this report will alert otologists in areas where brucellosis is endemic to the need to include tests for brucellosis in the routine diagnostic screening for SNHL. Practitioners in other locations should also consider this possibility when dealing with patients who have visited or lived in endemic regions.
Pre-operative haemoglobin estimation in paediatric ENT surgery
Authors: Hoare Timothy J.
Published: November 2007

Estimation of haemoglobin is still undertaken routinely before ENT surgery in many centres despite evidence that it is unnecessary, traumatic and expensive. The haemoglobin was estimated of all 372 children about to undergo ENT surgery in a busy district general hospital over a one year period. No child was noted to be clinically anacmic, and no child had a haemoglobin of less than 9 g/dl. Of 18 children with a haemoglobin level of 10.5 or less, 10 had their operations postponed and eight did not. There were no complications in the latter group. We can find no published evidence that operating on children with mild anaemia is unsafe. Ceasing routine pre-operative haemoglobin estimation would safely save an estimated £9000 per year in our unit.
Undifferentiated carcinoma with lymphoid stroma of the parotid gland
Authors: Dündar Ahmet , Dereköy Sefa , Önder Turgut , Aktas Davut , Özünlü Adnan
Published: November 2007

A rare undifferentiated carcinoma with lymphoid stroma (UCLS) of the parotid gland is described in a white Turkish patient. The raised serum IgG to Epstein-Barr virus capsid antigen suggests a causal relationship between Epstein-Barr virus and this type of salivary gland carcinoma. Some clinical features are briefly reviewed.
The use of the rigid endoscope in trans-sphenoidal pituitary surgery
Authors: Gamea A. , Fathi M. , El-Guindy A.
Published: November 2007

The use of the rigid endoscope has been evaluated during transsphenoidal microsurgery of 10 pituitary adenomas: three were prolactin-secreting adenomas; five growth hormone (GH)-secreting adenomas; and two without evidence of known endocrine activity. The use of the endoscope allowed close inspection and differentiation between tumour tissue and glandular remains. This resulted in microdissection of the tumour with maximum preservation of pituitary function. The angled view of the telescope helped total gross removal of tumour tissue from the less accessible supra- and para-sella extensions. More cases and a longer period of follow-up are necessary to provide long-term results.
Interjugular neck dissection and post-operative irradiation for neck control in advanced glottic cancers – are we justified?
Authors: Shenoy Ashok M. , Nanjundappa A. , Kumar Pradeep , Kumar Rekha V. , Reddy B. K. M. , Kannan V. , Anantha N.
Published: November 2007

At the Kidwai Memorial Institute of Oncology, advanced laryngeal cancers are subjected routinely to primary surgery and/or post-operative radiotherapy (RT). The surgery consists of wide field laryngectomy which entails total laryngectomy, ipsilateral/bilateral thyroid lobectomy, bilateral paratracheal clearance, and bilateral clearance of levels 2, 3 and 4 lymphatics. Post-operative RT is indicated in event of the following histopathological (HPE) situations to consolidate local-regional control: (1) T4primary; (2) significant subglottic extension; and (3) jugular/paratracheal metastatic deposits. This prospective study highlights the therapeutic efficacy of this protocol at our centre in 45 consecutive T4/T3glottic cancers and specifically evaluates the role of interjugular dissection and/or post-operative RT in prevention of regional recurrence. Fifty-two per cent of primary lesions needed a post-surgical upstaging as against 14 per cent of the neck lesions. Accordingly 91 per cent of the cases (41/45) qualified for post-operative RT and 82 per cent (37/41) complied with the prescribedschedule. Recurrent disease in the lateral neck was noted in 2/37 who received the prescribed schedule and 1/4 non-compliant cases; while a recurrent central neck disease was noted in 1/37 and 1/4 of these cases respectively. All cases were followed-up for a period of two years and 66 per cent of the evaluable cases for a period of five years. This study confirms conclusively that our treatment schedule yields extremely gratifying two-year local-regional control rates of 89 per cent which translates into a two and five-year actuarial survival rate of 92 and 70 per cent respectively.
Gastric tube transposition for cancer of the hypopharynx and cervical oesophagus
Authors: Marmuse J. P. , Guedon C. , Koka V. N.
Published: November 2007

A study of 20 cases of gastric tube transposition following total laryngopharyngoesophagectomy during an eight-year period is presented. The site of the tumour was: hypopharynx in 13 cases (12 pyriform sinus, 1 postcricoid); and cervical oesophagus in seven cases. There were nine (45 per cent) Stage III lesions and 11 (55 per cent) Stage IV lesions (UICC, 1987).

Post-operative morbidity rate was 15 per cent. Hospital mortality rate was 10 per cent (cause of death was myocardial infarction). Anastomotic fistula rate was five per cent. Excluding hospital mortality, the three year actuarial survival rate was 35 per cent for the whole series and 53 per cent for patients with hypopharyngeal cancer. The actuarial survival rate for patients with oesophageal cancer at one and two years was 41 and zero per cent respectively.

The transposition of a tubed stomach provided successful swallowing in two-thirds of the patients for a period of more than a year and these patients developed good neoesophageal speech.
The extraction and re-implantation of teeth for the difficult laryngoscopy
Authors: Wareing M. J. , Fisher E. W. , Manning R. H. , Gray R. F. , Lamb W. T.
Published: November 2007

We describe two cases where it was necessary to remove teeth to biopsy the larynx for malignant disease. Immediate reimplantation of the teeth proved successful.
Audiovestibular manifestations of the antiphospholipid syndrome
Authors: Vyse Tim , Luxon Linda M. , Walport Mark J.
Published: November 2007

We report on two patients who have high titres of antiphospholipid antibodies, both of whom had acute audiovestibular failure. One of the patients had systemic lupus erythematosus. The other patient had primary antiphospholipid syndrome: audiovestibular symptoms have not been reported in this condition. The occurrence of acute audiovestibular failure in the primary antiphospholipid syndrome raises the question as to whether patients presenting with acute deafness or vestibular disturbance should be screened for the presence of anticardiolipin antibodies.
Pigmented villonodular synovitis of the temporomandibular joint: report of a case
Authors: Franchi Alessandro , Frosini Paolo , Santoro Roberto
Published: November 2007

Pigmented villonodular synovitis is a benign reactive process of the synovial tissue, that usually involves the knee or other major joints. Reports of this entity in the temporomandibular joint are rare. The authors describe a case involving this joint, initially clinically diagnosed as a parotid tumour.
Clinical analysis of external laryngeal trauma
Authors: Yen P. T. , Lee H. Y. , Tsai M. H. , Chan S. T. , Huang T. S.
Published: November 2007

Thirty patients with external laryngeal trauma were analysed retrospectively. Injuries were mostly caused by motor vehicle accidents (car = 36.7 percent; motorcycle = 23.3 per cent). The main presenting symptoms and signs were hoarseness, neck tenderness, dysphagia, and neck emphysema. Sites of laryngeal injury included arytenoid swelling, vocal fold injury, soft tissue contusion or superficial mucosal laceration, cricoarytenoid dislocation, thyroid fracture, epiglottic fracture and mixed injuries. Treatment was varied depending on the severity of the injuries. Sixteen cases were managed conservatively by medical treatment; two cases received intubation; four cases were treated initially by tracheostomy; eight cases received surgical repair and/or reconstruction; 11 cases made a full recovery of the voice and 18 cases fair voice recovery due to either sustained vocal fold swelling or limitation of vocal fold movement. One case was graded as poor. Twenty-eight cases had good airway patency and two cases fair airway patency. A delay in the early detection of laryngeal trauma may precipitate into life-threatening airway problems, therefore prompt and accurate diagnosis should be followed immediately by skilful airway management.
Defects of the first branchial cleft
Authors: Hickey S. A. , Scott G. A. , Traub P.
Published: November 2007

Four cases of first branchial arch defects are presented. The literature relating to such defects is reviewed and a possible embyrogenic mechanism is proposed with particular reference to the disposition of the facial nerve. The classification of these defects into Types I and II by Work (1972) is supported
An open safety pin in the larynx: a case report
Authors: Hussain S. S. M. , Raine C. H. , Caldicott L. D. , Wade M. J.
Published: November 2007

Inhalation of a foreign body is a serious event. The number of foreign bodies that become impacted in the larynx is small and requires urgent recognition. We describe the case of a six-month-old baby with an impacted open safety pin in the larynx. The sharp end of the safety pin was upwards and had penetrated the anterior end of the left vocal fold. We discuss the management and describe our method of removal of the foreign body. Tracheostomy was not required in this case and the child had an uneventful recovery

A brief review of the literature is included
CT scanning and laryngocoeles
Authors: Morgan N. J. , Emberton P.
Published: November 2007

Laryngocoele is a well known but uncommon condition in Otolaryngology. CT scanning is superior to other imaging modalities in establishing the diagnosis, delineating the anatomy and aiding in the management. A case is presented with a review of the literature
Relevant demographic factors and hearing impairment in Saudi children: epidemiological study
Authors: Bafaqeeh Sameer Ali , Zakzouk Siraj M. , Muhaimeid Hamad Al , Essa Abdulrahman
Published: November 2007

A representative sample of 6421 Saudi children were clinically examined and screened for hearing loss. Hearing impairment was detected in 494 children (7.7 per cent). In 326 of the children it was due to chronic secretory and suppurative otitis media (5.07 per cent) and in 168 of them sensorineural hearing loss (2.6 per cent).

The study revealed that parental education, low income, and employment of the mother showed a slightly higher at risk rate of hearing impairment. Children from related parents were also at a higher risk of hearing impairment and they demonstrated a marked adverse effect on the incidence of hereditary sensorineural hearing impairment. Comparison with other surveys of school children in developed and developing countries has been carried out.
Association of recurrent acute otitis media with nasopharynx dimensions in children
Authors: Niemelä Marjo , Uhari Matti , Lautala Pentti , Huggare Jan
Published: November 2007

The purpose of this study was to evaluate the hypothesis that the nasopharyngeal anatomy has influence in the risk of recurrent acute otitis media (AOM) attacks. We analysed the occurrence of acute otitis media in 238 healthy schoolchildren who were X-rayed for orthodontic purposes. Six measurements reflecting the size and shape of the bony nasopharynx were recorded from lateral cephalograms. The means for almost all the dimensions of the bony nasopharynx measured were smaller in the children with two or more attacks of AOM in their history than in those with no attack or only one attack. Logistic multivariate modelling showed the distance from the posterior nasal spine to the sella-basion line to be a significant risk factor for recurrent otitis media in girls (difference 1.0 mm; 95 per cent confidence interval 0.1–2.0 mm; p = 0.04) and the shape of the nasopharynx (roundness) in boys (difference 1.9 mm; 95 per cent confidence interval 0.1–4.0 mm; p = 0.01). Measuring the nasopharyngeal bony dimensions may help to identify those children with a risk of recurrent otitis media, at whom prophylactic therapies should be targeted.
Use of the trimmed Shah permavent tube in the management of glue ear
Authors: Abdullah V. A. , Pringle M. B. , Shah N. S.
Published: November 2007

Twenty-five children (mean age six years) with de novo bilateral ear effusions received a ‘trimmed’ high grade silicone (HGS) Shah permavent ventilation tube in one ear and a conventional polyethylene Shah grommet in the other.

The extrusion rate and the degree of tympanosclerosis formation was examined. At 29 months the conventional grommet had extruded in 90 per cent of children and a recurrent middle ear effusion was found in over 50 per cent of these ears.

The average length of stay for the conventional grommet was 12.5 months. Five permavent tubes had extruded, one was extruding but the remainder were all in place and patent. Comparing ears on each side the amount of tympanosclerosis was worse in the ear with the conventional grommet in 47 per cent of children and worse on the permanent side in 11 per cent of the children.

The ‘trimmed permavent’ appears to act as a medium to long-term grommet which self extrudes without serious complications. Its use at the primary operation in young children may save repeated insertions of conventional grommets.
Munchausen syndrome by proxy unmasked by nasal signs
Authors: Magnay A. R. , Debelle G. , Proops D. W. , Booth I. W.
Published: November 2007

The protean manifestations of child abuse continue to cause diagnostic difficulty. Recent observations of the high mortality in victims of Munchausen syndrome by proxy, and their siblings, reinforce the need for early diagnosis and appropriate intervention. We report the nasal manifestations which unmasked Munchausen syndrome by proxy in an infant who presented with intestinal and peri-orifical signs masquerading as Crohn's disease. The possibility of Munchausen syndrome by proxy should be considered in an infant with persistent nasal excoriation presenting as part of an undiagnosed illness.
Day case surgery in otolaryngology: The setting up and first year of a freestanding unit
Authors: Lesser T. H. J. , Al-Jassim A. H. H.
Published: November 2007

A freestanding day case surgery unit for ENT cases is described and the first year 's experience reviewed. Special attention is paid to the variety, and complications, of surgery as the freestanding unit is 17 miles from the main ENT centre. The difficulties of running the unit are reviewed. The problems encountered include arranging training for the staff and maintaining optimum throughput of cases. Consideration is also given to the setting up and running costs of the unit.

Four hundred and seventy-seven patients were treated from 46 lists. This accounted for 64 per cent of the total number of patients having ENT surgery in 1992 from our area.
CO2 laser repair of the facial nerve: an experimental study in the rat
Authors: Dort Joseph C. , Wolfensberger Markus , Felix Heidi
Published: November 2007

The facial nerve is often injured by trauma, infection or during the course of tumour resection. Many techniques of nerve anastomosis have been described with the current standard nerve repair using the microscope and monofilament suture. The purpose of this study was to evaluate the CO2 surgical laser as a tool for facial nerve anastomosis. Following preliminary electrical measurements 36 nerves were anastomosed using either laser or conventional monofilament suture. Laser anastomosis had neither beneficial nor detrimental effects on nerve regeneration. This method of anastomosis may be advantageous when surgical access is limited. In addition this study found that the use of CO2 laser as a dissecting or vapourizing tool in proximity to intact facial nerves results in degenerative changes.
Scleroma of the lower respiratory tract: a bronchoscopic study
Authors: Soni N. K.
Published: November 2007

Twenty cases suffering from rhinoscleroma were studied. Bronchoscopy was performed for detection of secondary involvement of the subglottic region, trachea and bronchus. The study revealed that the larynx was involved in 40 per cent, the trachea in 20 per cent and the bronchus in 10 per cent of cases. The intranasal lesion, endotracheal and endobroncheal lesions all occur in the form of an atrophic stage, granulomatous (proliferative) stage and finally a fibrotic or scarring stage. The role of bronchoscopy in early diagnosis, initial symptomatic treatment and in follow-up is discussed in the light of the available literature.
Advancement cheiloplasty for reconstruction of floor of mouth defects
Authors: Rubin John S.
Published: November 2007

In many cases of carcinoma of the floor of mouth, oncologic resection includes marginal mandibulectomy. Reconstruction poses a significant challenge. Requirements include coverage with thin but supple tissue to allow for dental implant or denture, and recreation of a mobile tongue and sensate floor of mouth gutter. Reconstructive efforts have ranged from skin grafts to free flaps, with variable success in fulfilling the above-mentioned requirements.

This paper describes the preferred technique of the author, in which external mandibular periosteum is saved and elevated with a submucosal flap of lower lip, raised to the level of the vermilion border. This flap is then advanced to ventral tongue. In this manner the entire anterior floor of mouth can be reconstructed.

Cases are presented demonstrating different aspects to the technique.
Bing-Neel syndrome or malignant external otitis in waldenstrom's macroglobulinaemia?
Authors: Lee W. C. , Sharp J. F.
Published: November 2007

Malignant external otitis is classically associated with insulin-dependent diabetes mellitus probably due to generalized systemic immunodeficiency (Mowet and Baum, 1971). A unique case of malignant external otitis associated with Waldenstrom's macroglobulinaemia is presented.
Alar cartilage haematoma
Authors: Meehan T. , Kaddour H. , Lannigan F. J.
Published: November 2007

We present a previously undescribed site of a subperichondrial haematoma – the alar cartilage. Two children presenting acutely, following trauma, with the clinical appearance of a ‘blueberry’ within the nasal vestibule are described. We recommend early surgical drainage of this lesion, as delay in definitive treatment may give rise to a cosmetic deformity.
Three cases of mycobacterial cervical lymphadenitis
Authors: Dabrowski M. T. , Keith A. O.
Published: November 2007

Three cases of mycobacterial cervical lymphadenitis in children are presented. The diagnosis and treatment are described in brief. None of the patients were from the risk groups traditionally associated with tuberculosis. With an increasing number of tuberculosis cases reported in the UK, the need for awareness of this re-emerging condition to ENT surgeons and paediatricians is stressed.
The use of digital subtraction angiography in penetrating neck injury–a very instructive case
Authors: Pringle M. B. , Charig M. J.
Published: November 2007

This case report illustrates the value of intravenous digital subtraction angiography (DSA) in cases of penetrating neck injury. The debate continues between a policy of mandatory exploration of all penetrating neck wounds versus one of selective exploration with observation of the remainder. The argument for the former policy is that vascular trauma can occur without clinical signs. Whichever policy is followed a DSA provides invaluable information in strengthening the decision either not to operate or if operating which operation to perform and which approach to use. DSA is a quick, simple and safe investigation that can be carried out at any time of day or night.
Plasmacytoma of the hyoid
Authors: Goel Sanjay , Moorjani Vijay , Kulkarni Pradeep , Patange Vijay , Sharma O. P.
Published: November 2007

A case of plasmacytoma arising from the hyoid bone is described, this is a distinctly unusual site, as the marrow-containing flat bones are more commonly affected. On a review of the literature this appears to be the first report of plasmacytoma occurring in the hyoid bone. The patient underwent a CT scan and plain radiographs. Histopathology was diagnostic.
The assessment of hearing results following surgery for otitis media with effusion using the Glasgow Benefit Plot
Authors: Tay H. L. , Mills R. P.
Published: November 2007

The hearing data from a sample of 73 children undergoing surgical treatment for chronic otitis media with effusion (OME) were analysed using a modification of the Glasgow Benefit Plot. All the patients had bilateral middle ear effusions confirmed at surgery. Using 20 dB average hearing level as the ‘cutoff’ point between normal and abnormal hearing, 65 (89 per cent) patients had binaural normal hearing, five (7 per cent) had monaural normal hearing and three (4 per cent) had bilateral hearing loss after surgery. However, 70 patients (96 per cent) were found to benefit from surgery. The cases with persistent hearing loss were re-examined to determine the cause of failure.
A severe form of sjogren's syndrome
Authors: Puterman M. , Fliss D. M. , Ziskind E. , Laufer L.
Published: November 2007

Sjogren's syndrome is an autoimmune disease characterized by exocrine gland destruction and manifested by parotid, submandibular and lacrimal gland infection. We report a case with recurrent severe parotid gland infections. The sialographic and CT findings are presented.
The carcinogenic risk of exposure to sulphuric acid fumes from lead acid batteries
Authors: Houghton D. J. , White P. S.
Published: November 2007

Prolonged exposure to sulphuric acid fumes is associated with an increased risk of developing laryngeal carinoma. Lead acid batteries are a potential source of these fumes. We present a case of an electric fork lift truck driver who developed laryngeal carcinoma as a result of such exposure.
Necrobacillosis – an unusual case of pharyngotonsillitis
Authors: Carrie Sean , Fenton Patricia A.
Published: November 2007

Necrobacillosis is a potentially life-threatening septicaemic illness occurring in the previously fit and healthy. The authors illustrate a case presenting as an atypical pharyngotonsillitis with renal complications, initially misdiagnosed as poststreptococcal glomerulonephritis. Necrobacillosis should be considered in cases of unusual pharyngotonsillitis.
The localization and specificity of guinea pig inner ear antigenic epitopes
Authors: Cao Ming-Yu , Gersdorff Michel , Deggouj Naïma , Tomasi Jean-Paul
Published: November 2007

In this study, we investigated the relative localization of some antigenic epitopes in the inner ear. The inner ear protein antigens were extracted from various parts of the guinea pig inner ear. Brain, kidney, lung, heart and liver extracts were also obtained. We found by SDS-polyacrylamide gel electrophoresis that total inner ear extracts separated into three high concentration polypeptide bands with molecular weights of approximately 30, 42, 58 kd and three low density bands of 20,25 and 35 kd. The 30 kd band was found mainly in the extract of the spiral ganglion and the acoustic nerve in the modiolus. The 42 and 58 kd bands were detected in the extract of the spiral ligament and the stria vascularis. The Organ of Corti and the basilar membrane extract gave rise to three bands of 30,42 and 58 kd. Twenty-eight of the 75 sera from patients with inner ear disease reacted with the 30 and 58 kd bands of the inner ear protein extracts by immunoblotting. Sixteen of these 28 positive sera were then used to probe immunoblots of the brain, kidney, lung, heart and liver extracts. The 58 kd band was also found in protein extracts of the brain, the lung and the liver. This study suggests that the 30 kd antigenic epitope may be mainly related to the acoustic nerve and that the 58 kd antigenic epitope is not cochlear specific.
Efficacy of fine needle aspiration cytology in the diagnosis of tuberculosis of the thyroid gland: a study of 18 cases
Authors: Mondal Asitava , Patra D. K.
Published: November 2007

Tuberculosis of the thyroid gland is an extremely rare condition. Amongst 1565 cases of thyroid lesions subjected to fine needle aspiration cytology (FNAC) over a period of nine years, 18 cases (1.15 per cent) were found to have cytological features consistent with tuberculosis thyroiditis. Acid-fast bacilli were isolated in all cases. The ages of the patients ranged from 36 to 52 years with a median age of 46 years: there were 12 females and 6 males. All the patients presented with painless solitary nodules of the thyroid. Three patients had concomitant cervical lympadenopathy and four patients were known to have tuberculosis of the lungs which was being treated. Solitary nodules of the thyroid were confirmed by a thyroid scan with radioactive iodine. Fine needle aspirates from thyroid swellings showed epithelioid granulomas with necrosis in all cases. There were no false reports or complications.

It is evident from this study that FNAC is an efficient way with which to detect tuberculosis of the thyroid gland.
Delayed extrusion of a cochlear implant: a case report of an implant extruding 21 months after the original operation
Authors: El-Nagger Mohamed , Hawthorne Maurice
Published: November 2007

We present a case report of a lady who received a Nucleus 22 Channel cochlear implant in July, 1992. She presented again in April, 1994 when the cochlear implant had extruded spontaneously. The possible aetiology of this extrusion, as well as the technique of surgical management, is discussed.
The Jepson whistle: a simple device for laryngectomees
Authors: Jepson R. H. , Alderson D. J. , Clegg R. T. , Parker A. J.
Published: November 2007

A simply manufactured whistle for the use of laryngectomees is described. It is useful for attracting attention in an emergency.
An unusual case of laryngeal pseudotumour
Authors: Anstey S. T. , Marais J. , Wallace W.
Published: November 2007

A pseudotumour represents a lesion that masquerades as a malignant neoplasm. We present an unusual case where the appearance of a tumour was the result of chronic inflammation stimulated by the presence of food matter. This inflammatory reaction resulted in upper airway obstruction associated with a mass lesion and vocal fold palsy.
Penetrating laryngeal injury: two case reports from Bosnia
Authors: Banfield G. K. , Chowdhury C. R. , Brookstein R.
Published: November 2007

Penetrating injury to the larynx is uncommon. We present two cases resulting from the recent Bosnian conflict. It is possible to achieve good laryngeal function by appropriate conservative management once the airway is secured. Progress should be monitored by repeated endoscopic examination and imaging techniques.