bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of retraction pockets of the pars tensa
Authors: Mills Robert P.
Published: November 2007

A study of 73 patients with retraction pockets of the pars tensa (93 affected ears) has been carried out. Of these 32 per cent had otalgia and 31 per cent reported episodes of aural discharge. Adequate audiometric data was available on 75 ears. Mean air-bone gaps were calculated using 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Thirty per cent of ears had air-bone gaps of less than 10 dB and in 93 per cent the air-bone gap was less than 30 dB. Air-bone gaps of more than 40 dB were found in seven per cent. Of this group, seven patients were selected for surgical treatment. In all cases the retraction pockets were elevated and everted. In six cases, the thinned tympanic membrane was reinforced with a composite graft of cartilage and perichondrium. This technique has also been used in three patients not included in this study group. An ossiculoplasty was performed in four cases. In the early months, the retraction pockets remained completely everted. However, by 12 months some degree of retraction had recurred in four of the six patients who have been followed for more than 12 months.
Laryngeal morphology in sudden unexpected death in infants
Authors: Harrison D. F. N.
Published: November 2007

One hundred and four larynges removed from infants registered as dying fromSudden Infant Death Syndrome (SIDS) and 20 control larynges from infants of matching ages, were examined histologically. Excessive amounts of subglottic submucosal glandular tissue had reduced the available airway by more than half in 35 per cent of the SIDS larynges within the age group two to four months. In 30 per cent of this group the airway reduction was more than 60 per cent. It is suggested that hyperplasia of subglottic mucous glands is one cause of fatal hypoxia in sudden unexpected infant death.
Distribution of ear drops using a non-aerosol spray delivery system
Authors: Wilson P. S. , Dingle Ann , Grocutt Mark , Reidal A. P.
Published: November 2007

The distribution of ear drops in normal ears is variable. A new product Otomize® (Stafford-Miller) containing dexamethasone and neomycin has a non-aerosol spray mist delivery system. This has been applied to normal ears and found to be superior in its distribution to generally available ear drops previously assessed.
A correlative manometric and endoscopic study of tubal function in dry central perforation of the tympanic membrane
Authors: El-Guindy Ahmed
Published: November 2007

Since good ventilation of the middle ear is a pre-requisite for successful myringoplasty, it was our policy to investigate the tubal function in dry central perforation of the eardrum and to correlate the manometric and endoscopic findings. Nasal endoscopy proved to be indispensable in diagnosing mechanical tubal obstruction and in localizing and even treating ‘hidden’ lesions in key areas, with probable normalization of the tubal function. The correction of the mechanical tubal obstruction must precede ear surgery. Whenever tubal obstruction is diagnosed as functional or idiopathic, the ventilation of the middle ear should be guaranteed during ear surgery by addition of a tympanostomy tube to the graft or drum remnant, and a guarded prognosis given.
Paediatric foreign bodies: the lessons of failure and near misses
Authors: Dawlatly E. E. , Al-Arfaj A. L. , Al-Azizi M. A.
Published: November 2007

In this series of seven uncommon and complicated cases of foreign bodies in the aerodigestive tract of children, the difficulties in the management, and complications encountered are described. Various factors affecting the outcome of these cases have been highlighted.
A narcotic foreign body in the throat
Authors: Somjee Shehnaz
Published: November 2007

The impaction of a cannabis-filled condom in the upper oesophagus of a 28-year-old prisoner is reported. The history was deceptive and smoking and drug abuse denied. The ENT surgeon being unaware of the identity of the drug faced tackling a possibly lethal foreign body, technically difficult to remove by the usual forceps method. (The Dormier basket is recommended for this task but we were unable to try it). Passage of the condom into the stomach occurred during attempted removal and its further progress was uneventful, indicating that gastroscopic removal of cannabis is unncessary unless obstructive symptoms occur.
Terminal parotid duct carcinoma
Authors: George M. K. , Mansour Paul , Pahor A. L.
Published: November 2007

Terminal duct carcinoma of salivary glands is an uncommon, histologically distinctive, low grade malignant neoplasm arising from the intercalated salivary duct. We present a case arising eight years after removal of a parotid tumour reported as a pleomorphic adenoma. We describe the clinico-pathological features of the present tumour, illustrate the difficulties that may be encountered in differentiating it from other salivary gland tumours, and discuss the possible significance of the previous tumour.
Bilateral thoracic empyema complicating adult epiglottitis
Authors: Hussan W. U. , Keaney N. P.
Published: November 2007

Haemophilus influenzae is a common cause of epiglottitis and meningitis in children and exacerbation of chronic bronchitis in adults. However, the ability of this organism to cause serious infections in adults is less well recognized. We report a case of a 34-year-old previously healthy female who presented with epiglottitis and later developed bilateral empyema; both blood and pleural fluid grew Haemophilus influenzae.
Giant cervical cyst: Presenting symptom of an occult thyroid carcinoma
Authors: Levy Isaac , Barki Yehiel , Tovi Ferit
Published: November 2007

A case of giant lateral cervical cystic metastasis from occult thyroid carcinoma mimicking branchial cleft cyst is reported.

Lateral cervical cystic metastases arising from occult thyroid carcinoma and their ultrasonic differentiation from true cysts are discussed.
Fronto-ethmoidal mucocoeles: a histopathological analysis
Authors: Lund Valerie J. , Milroy Christopher M.
Published: November 2007

From a series of 118 fronto-ethmoidal mucocoeles, 40 specimes have been submitted to detained histological analysis. The Frequency of each epithelial and sub-epithelial components is considered and reveals features which support a dynamic theory of bone resorption and formation rather than that of pressure erosion in the pathogenesis of mucocoeles.
Laryngectomy: the patient's view
Authors: Jay S. , Ruddy J. , Cullen R. J.
Published: November 2007

The disabilities following laryngectomy are well recognized. The incidence of these disabilities and the acceptability of the surgery to the patients were assessed by a questionnaire method. Sixty-five patients participated in the study. The incidence of disabilities are discussed. Total laryngectomy was felt to be a worthwhile operation by most of the patients in the study despite the disabilities they experienced afterwards.
The laryngeal box: an aid to laser microlaryngeal surgery
Authors: Hampal S. , Oswal V. H.
Published: November 2007

We report the use of the ‘laryngeal box’, which permits instruction of a trainee in laser microlaryngeal surgery outside the operating theatre environment.
Styloid apparatus anomaly causing dysphagia
Authors: Leighton S. E. J. , Whittet H. B. , Golding S. , Freeland A. P.
Published: November 2007

An unusual case of dysphagia due to anomalous styloid apparatus anatomy is presented. Clinical and radiological findings are documented. Variations in anatomy and clinical syndromes are discussed together with management.
Salmonella neck abscess associated with jugular vein thrombosis
Authors: Leiberman A. , Tovi F. , Barki Y. , Alkan M.
Published: November 2007

An unusual case of synergistic infection caused bySalmonella paratyphiand anaerobic streptococcus resulting in necrotizing cervical infection associated with deep neck abscess and internal jugular vein thrombosis, is presented. Salmonella acting as an oxygen consumer in the infected tissues, facilitates the growth of anaerobic cocci, hence the development of a devastating soft tissue infection. The precipitating cause was a tonsillar infection developing due to ‘post-anginal sepsis’. The aetiopathogenesis of the cervical infection is discussed.
Atypical leiomyoma of the choana
Authors: Van Ingen G. , Stel H. V. , Tiwari R. M.
Published: November 2007

Leiomyomas of the nose, nasopharynx and paranasal sinuses are rare. So far only two atypical leiomyomas at these sites have been reported in the English literature. A new case is presented and the literature on the subject is reviewed.
Metastatic seminoma of the sphenoid sinus
Authors: Andaz C. , Alsanjari N. , Garth R. J. N. , Dearnaley D. P.
Published: November 2007

Metatastic tumour of the sphenoid sinus from distant primary sites are rare. If sphenoid involvement from adjacent structures is excluded there have been 26 reported cases of metastatic sphenoid sinus tumours. Seminoma metastatizing to other paranasal sinuses has been reported but a careful literature search did not reveal this occurring previously in the sphenoid sinus.
Cervical cord compression complicating tracheo-oesophageal puncture
Authors: Diver J. P. , Murty G. E. , Bradley P. J.
Published: November 2007

Tracheo-oesophageal puncture for voice restoration is now established as a common procedure in the postlaryngectomy patient. We present what we believe to be the first recorded case of osteomyelitic cervical cord compression following this technique. This is a potentially fatal complication, but diagnosis and active surgical intervention can result in recovery of full neurological function.
Chronic bone abscess as an unusual cause of dysphagia
Authors: Connolly Art A. P. , Waldron John , Stafford Nicolas , Birch Rolfe
Published: November 2007

Chronic infections following cervical spine surgery are rare. Here we describe an unusual case presenting five years after anterior spinal fusion.
Tinnitus related to eyelid blinking
Authors: Rajah V.
Published: November 2007

Tinnitus due to muscular causes is rare. The commonest pathological muscular cause of tinnitus is palatal myoclonus.

A case of bilateral tinnitus, related to eyelid blinking, is presented. This is the first case reported in the literature. Previous reported cases of tinnitus related to eyelid blinking have all been unilateral and associated with recovery from a VII nerve palsy. The treatment of the condition is discussed.
Rhinocerebral mucormycosis: An unusual case presentation
Authors: Bhattacharyya Abir K. , Deshpande Anita R. , Nayak Sadhana R. , Kirtane M. V. , Ingle M. V. , Vora I. M.
Published: November 2007

Rhinocerebral mucormycosis is a rapidly fatal fungal disease which involves the nose, paranasal sinuses, orbit and central nervous system. The fungal infection is usually secondary to immunosuppression, diabetic acidosis, or antibiotic, steroid or cytotoxic therapy. It can also occur in patients suffering from burns, malignancy and haematological disorders. Current treatment consists of correction of the underlying disorder, repeated debridement of the wound in combination with intravenous amphotericin B.

This paper describes our experience with a case of rhinocerebral mucormycosis. This is an unusual case in which mucormycosis was seen in a young female where no underlying cause was found. She responded to surgical debridement in combination with intravenous amphotericin B.
Ossifying pleomorphic adenoma of the maxillary antrum
Authors: Lee K. C. , Chan J. K. C. , Chong Y. W.
Published: November 2007

An unusual case of pleomorphic adenoma with exuberant bone formation, occurring in the maxillary antrum of a 21-year-old male and showing repeated recurrence, is reported. In contrast to the endochondral ossification in the previous reported cases of pleomorphic adenoma, direct deposition of osteoid by metaplastic myoepithehal cells is suggested to explain the bone formation. The difficulties of distinguishing this tumour from osteosarcoma during intraoperative diagnosis are discussed.
Pitfalls in the follow-up of cervical and mediastinal goitres: role of CT imaging
Authors: Cohen Ohad , Herskovitz Pearl , Shindell Bella , Leiba Sara , Hadar Herzlia
Published: November 2007

Four patients with cervical and mediastinal goitres were described. Routine investigation in these patients, including chest X-rays, oesophageal and tracheal X-rays and scintigraphy of the thyroid gland, failed to show significant changes over the years, or underestimated the true extent of the goitres. Three of the goitres caused severe mediastinal compression, evident only on computed tomography (CT) imaging, and requiring urgent surgery. The pros and cons of different diagnostic modalities for imaging cervical and mediastinal gotires are discussed, stressing the importance of CT imaging as exemplified in the cases presented.
Unusually large mastoid antrum (‘mega antrum’)
Authors: Puranik K. R. , Murthy P. S. N. , Gopalakrishna Ramesh , Nayak D. R.
Published: November 2007

Patients who present with a unilateral non-tender bony swelling in the mastoid region without any clinical evidence of middle ear infection could be diagnosed as having a fibrous or bony lesion affecting the temporal bone. In such cases, if there is radiological evidence of large lucent area in the mastoid antrum without any bony dehiscence one should keep in mind in the differential diagnosis a mega antrum in addition to congenital cholesteatoma and eosinophilic granuloma. A large lytic lesion in the mastoid segment of the temporal bone with an intact tympanic membrane therefore presents a diagnostic dilemma. A case of an unusually large mastoid antrum in an young adult with no middle ear suppuration and a cosmetically unacceptable swelling behind the ear is presented.
Multimodality treatment in stage IV squamous cell carcinoma of the head and neck. A long-term follow-up
Authors: Klima A. , Bergmann I. , Szepesi S.
Published: November 2007

We treated 114 patients with advanced inoperable head and neck cancer with a combined-modality protocol that included two cycles of chemotherapy followed by radiotherapy or three cycles of chemotherapy and in 18 patients with a radiosensitizing agent. At the beginning of the treatment all but one patient presented with a stage IV cancer. With a follow-up of 42–58 months, four patients are alive (three from the radiosensitizing group and one of the chemotherapy group). Complete response after the radiosensitizing agent correlated with superior prolonged disease-free survival in comparison to complete responses after chemotherapy at the level of p<0.009.
Cavernous haemangiona of the nasal bones
Authors: McAllister R. M. R. , Rutty G. N. , Hancock K. , Sanders R.
Published: November 2007

A case report of a cavernous haemangioma arising in the nasal bones is described, together with a discussion of the relevant literature. The condition, although rare, can be reliably diagnosed pre-operatively.
Eustachian tube function in sudden hearing loss and in healthy subjects
Authors: Maier Wolfgang , Hauser Rolf , Münker Gerd
Published: November 2007

The relationship between sudden hearing loss and an ipsilateral patulous tube was tested in ourEustachian tube laboratory. Fifty patients suffering from sudden hearing loss were examined by the pressure chamber impedance method, giving objective data on Eustachian tube function. Results were compared to those obtained from 56 healthy volunteers in a preceding investigation. Ourinvestigation did not show any associations between patulous tube syndrome and sudden hearing loss, as had been claimed by several authors previously. There was even indication of a decreased patency of Eustachian tube in our patients in active and passive tubal tests. We could demonstrate a high reproducibility of values obtained by our method, indicating that results are representative in healthy persons as well as in patients.

In a case report the importance of objective diagnostic methods in differential diagnostics of Eustachian tube pathology is emphasized.
Temporal bone histopathological findings in campomelic dysplasia
Authors: Takahashi H. , Sando I. , Masutani H.
Published: November 2007

Both temporal bones of a newborn (35 gestational weeks old) with campomelic syndrome were studied histopathologically. This is to our knowledge the second temporal bone report (third case) of this syndrome. The findings included: abnormal cartilagenous and osseous tissues and abnormality in the globuli interossei in the otic capsule; deformities of the vestibule and semicircular canals, probably due to compression by the abnormal cartilaginous tissue; hypoplastic cochleaand semicircular canals; aberrant course of the facial nerve; wide dehiscence of the facial canal in the tympanic portion; slight hypoplasia of the malleus and anomalies in the incus and stapes; and large epitympanic space. These findings closely resembled those of the first report, and suggest that: 1) campomelic dysplasia is a definite disease entity with consistent pathogenesis, and 2) similar otologic manifestations may be expected in the majority of patients with this syndrome.
Prognosis in mouth cancer: host factors
Authors: Stell P. M.
Published: November 2007

A personal series of 842 patients with a tumour of the oral cavity is presented. Five hundred and twelve of these patients had a histologically proven squamous cell carcinoma, and were previously untreated.

Increasing age was associated with worsening performance status. Women were older at presentation than men, and tumours of the upper part of the mouth were more common in the elderly, but there was no relation between age and histological grade or stage grouping.

Sex had no correlation with performance status or histological grade. However, men were more likely to have an advanced tumour, and tumours of the floor of the mouth and alveolus were much commoner in men.

There was no correlation between performance status and site or histological grade, but patients in poor general condition were more likely to have stage III-IV tumours.

Multivariate analysis showed that sex had no impact whatever on survival, but survival fell with increasing age and worsening performance status. The effect of age and performance status disappeared when the survival of treated patients was adjusted for deaths due to other causes.
The role of electron microscopy in the diagnosis of tumours of the Head and neck
Authors: Fisher C. , Flood L. M. , Ramsey A. D.
Published: November 2007

A four-year study was undertaken to determine the value of electron microscopy in the diagnosis of head and neck tumours. During this period 80 samples were submitted for examination, of which 69 contained assessable tumour. Electron microscopy made a major contribution to the diagnosis in 25 cases (36 per cent). Areas in which ultrastructural examination was of diagnostic significance included the precise categorization of apparently undifferentiated carcinoma and the identification of melanomas. Little diagnostic benefit was gained from electron microscopic examination of thyroid, lymphoid or salivary gland neoplasms. The value of electron microscopy in relation to immunohistochemistry is discussed.
Von Hippel-Lindau disease associated with an invasive choroid plexus tumour presenting as a middle ear mass
Authors: Blamires T. L. , Friedmann I. , Moffat D. A.
Published: November 2007

Cerebellar haemangioblastomata and angiomata of the retina are the most common vascular tumours seen in von Hippel-Lindau disease. A definite association between this condition and choroid plexus tumour has not been described previously and its presentation as a middle ear mass is unique.
Vascular cross-compression of the Vllth and VIIIth cranial nerves
Authors: Ohashi Naoki , Yasumura Satsuki , Nakagawa Hajime , Mizukoshi Kanemasa , Kuze Shougo
Published: November 2007

A 53-year-old male patient had been suffering from severe aural symptoms (pulsatile right-sided tinnitus and paroxysmal dizziness attacks with nausea) and right hemifacial spasm. Treatment had involved stellate ganglion block with lignocaine and the injection of intravenous sodium bicarbonate solution for attacks of Meniere's syndrome and facial nerve block with lidocaine for hemi-facial spasm. Despite these treatments, the dizzy attacks became more frequent, developing into the clustering state. Air CT cisternography and vertebral angiography demonstrated an enlarged and curved vertebral artery. Vascular cross-compression of the Vllth and VHIth cranial nerves was therefore suspected. Microvascular decompression was performed. After operation, the pulsatile tinnitus, dizziness and hemifacial spasm disappeared. From the present case and a review of the literature, we conclude that vascular cross-compression of the VHIth cranial nerve should be an indication for microvascular decompression only when symptoms of vascular cross-compression of the Vllth cranial nerve are also seen.
Combined internal maxillary and anterior ethmoidal arterial occlusion: the treatment of choice in intractable epistaxis
Authors: Singh Bharath , Med M.
Published: November 2007

Whilst it is generally accepted that the standard management for anterior or benign epistaxis is either cautery or anterior nasal packing, that of posterior or intractable epistaxis remains controversial. Various modalities of treatment, ranging from posterior nasal packing to arterial ligation and embolization, have been advocated but none have been unanimously accepted as the treatment of choice.

The purpose of this paper was to determine the efficacy of internal maxillary arterial ligation versus combined internal maxillary arterial ligation and anterior ethmoid arterial coagulation in intractable epistaxis.

Over a six year period, from 1985 to 1990,454 patients were admitted and treated for epistaxis. Forty-seven patients were diagnosed as having intractable epistaxis on the basis that the epistaxis failed to settle on anterior nasal packing. They were moved to the next step in management, which was combined anterior and posterior nasal packing. There were 30 failures, one was found to have choriocarcinoma of the maxilla, and was treated wtih cytotoxics, and the other 29 were moved to the next step, which was arterial ligation. Fifteen patients had internal maxillary arterial ligation, and 14 combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation.

Large windows were created in both the anterior and posterior walls of the maxillary sinuses and all identifiable branches of the internal maxillary artery were dissected out carefully and two medium size ligating clips were placed over the main trunk, the sphenopalatine and the descending palatine branches. Single clips were placed on all other identifiable branches. Coagulation of the anterior ethmoidal artery was performed with a bipolar cautery. There were three (20 per cent) failures in the internal maxillary arterial ligation group and none in the combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation group. Furthermore, the three failures were successfully treated with anterior ethmoidal arterial coagulation. The conclusion is that combined internal maxillary and anterior ethmoidal arterial occlusion is the treatment of choice in intractable epistaxis.
Audiological, vestibular and radiological abnormalities in Kallman's syndrome
Authors: Hill J. , Elliott C. , Colquhoun I.
Published: November 2007

Kallman's syndrome is a multifaceted congenital disorder with predominantly endocrine abnormalities. We have characterized the associated mixed hearing loss and identified consistent radiological evidence of abnormal temporal bone anatomy. Abnormal labyrinthine morphology is accompanied by a complete absence of response to vestibular stimulation with caloric or rotational chair testing.

The endocrine abnormalities are correctable and Kallman's syndrome is a diagnosis worthy of consideration when assessing children with congenital hearing loss.
Granulomatous cutaneous T-cell lymphoma of the neck
Authors: Blanshard J. D. , Macleod T. I. , Baer S. T. , Canter R. J.
Published: November 2007

A case of cutaneous T-cell lymphoma is presented in which the diagnosis was obscured by a concomitant granulomatous infiltrate. A working diagnosis of tuberculosis delayed appropriate treatment for several months over which time rapid progression of the disease was seen. Inclusion of overlying skin in the repeat biopsies yielded the histological information to establish the correct diagnosis and there was rapid regression on completion of a course of radiotherapy.
Experimental studies on the acoustic properties of mastoid cavities
Authors: Tolley N. S. , Ison K. , Mirza A.
Published: November 2007

This study investigated the effects of open-mastoid surgery upon ear canal resonance. In particular an attempt was made to alter resonant properties by obliterating each cavity with silastic foam. The results from this study showed that open-mastoid surgery significantly decreased resonant frequency without producing an effect upon either the peak amplitude or the quality of the resonant peak as defined by the Q-factor.

Restoring the natural resonance properties of an operated ear, if indicated, is likely to be a difficult objective to achieve in surgical terms.
Treatment of tinnitus by intratympanic instillation of lignocaine (lidocaine) 2 per cent through ventilation tubes
Authors: Podoshin Ludwig , Fradis Milo , David Yacov Ben
Published: November 2007

Idiopathic subjective tinnitus (1ST) is one of the most obscure otological pathologies. This paper presents the results of treating 1ST by intratympanic instillation of lignocaine (lidocaine) 2 per cent through a grommet, for five weekly courses. Fifty-two patients suffering from intractable tinnitus entered this therapeutic trial, but only nine finished all five courses. In one patient, the tinnitus was almost completely abolished, but in all the nine patients the decompensated tinnitus changed to a compensated one. We suggest this mode of treatment for patients that were previously treated by drugs, acupuncture and biofeedback, with disappointing results.Patients should be warned about the side effects of vertigo and vomiting, which subsides gradually with every new instillation, and that the tinnitus may not disappear but will be alleviated, enabling them to cope more easily with the disease and lead a more normal life.
Immunophenotypes of the palatal tonsil lymphocytes in Cowden's disease
Authors: Kimura Yasuyuki , Miwa Takaki , Furukawa Mituru
Published: November 2007

Cowden's disease is characterized by multiple hamartomas and neoplasias of ectodermal, mesodermal and endodermal origin. A case of a 22-year-old man suffering from nocturnal dyspnoea is reported. The patient had a large number of hyperkeratotic, lichenoid papules, scattered over the right side of the trunk, back and palm. In his oral cavity, papules were present on the gingiva and hard palate. The patient was operated on for tonsillar hypertrophy and for excluding the possibility of malignant lymphoma. An examination of immunophenotypes of the palatal tonsil lymphocytes revealed B-cell proliferation and poly-clonal immunoglobulin.
Long-term results of total ossicular chain reconstruction using autografts
Authors: Kapur T. R. , Jayaramchandran S.
Published: November 2007

The long-term results of 63 total ossicular chain reconstructions using autografts is presented. The follow-up period ranged from 18 months to 18 years with an average of 8.5 years. The primary aims of the study were firstly to assess the long-term success rate and to find out if there were any hitherto unknown causes of bone graft failure. In the event, it was found that the recently described anatomical variation of the oval windowviz., the deep oval window, was the prime cause of failure in 32 per cent of unsuccessful cases. Some measures to help to mitigate this problem, are suggested. The result were assessed on the basis of:

1. A minimum gain of 20 dB HL in air conduction (Technical success). The success rate was 55.5 per cent.

2. Patients benefited using Smyth and Patterson's criteria in conjunction with the Glasgow Benefit Plot; 54 percent of the patients benefited significantly.
Ossiculoplasty with the use of autografts and synthetic prosthetic materials: A comparison ofresults in 165 cases
Authors: Nikolaou Angelos , Bourikas Zeses , Maltas Vasilios , Aidonis Athanasios
Published: November 2007

One hundred and sixty-five cases of different kind of ossiculoplasty in patients suffering from chronic middle ear disease were performed at the ENT department of Papanikolaou Hospital in Thessaloniki, Greece, during the years 1988–1990. There were 40 cases of incus transposition, 47 cases in which polyethylene TORPs and PORPs were used and 77 cases of hydroxylapatite prostheses (41 TORPs and 37 double notch PORPs). Hearing success was defined as a post-operative air-bone gap of <20dB. According to this criterion 74 percent of the incus transposition cases were successful, 61 percent of the polyethylene TORPs, 65 percent of the hydroxylapatite TORPs, 40 percent of the polyethylene TORPs, and 89 percent of the double notch hydroxylpatite PORPs. It is obvious that ceramic PORPs produced the best results, while there was no statistical difference, regarding the hearing improvement, among the different kinds of TORPs which were used. Extrusion rate and other kinds of complications are also discussed, as well as a case of severely damaged ceramic TORP, within two years due to middle ear infection.
Radiological and endoscopic study of the maxillary sinus in primary atrophic rhinitis
Authors: Hagrass M. A. E. , Gamea A. M. , El-Sherief S. G. , El-Guindy A. S. , El-Tatawi Faika A. Y.
Published: November 2007

The maxillary sinuses of 40 patients suffering from primary atrophic rhinitis (ozaena) were studied radiologically, antroscopically and histopathologically. Sixty percent of the patients showed thick bony walls and a small cavity of the maxillary sinus on X-ray and on antroscopy. On the other hand, 25 percent of the cases revealed signs of infection including mucopurulent secretion on antroscopy associated with corresponding histopathological changes. It is concluded that poor pneumatization of the antrum plays a more important role in the pathogenesis of ozaena than infection.
Maxillary sinus fusariosis in immunocompetent hosts
Authors: Kurien Mary , Anandi V. , Raman R. , Brahmadathan K. N.
Published: November 2007

We report the first known cases of Fusariosis of maxillary sinus with granuloma and oro-antral fistula in two immunocompetent hosts. Fusarium solani was demonstrated in the direct microscopic examination and isolated in heavy growth from the biopsy materials. Both these patients were successfully treated with oral ketoconazole (200 mg daily) for three weeks followed by a Caldwell-Luc operation. Ketoconazole was continued for two months post-operatively.
Management of an unusual presentation of foreign body aspiration
Authors: Ramadan Hassan H. , Bu-Saba Nicolas , Baraka Anis , Mroueh Salman
Published: November 2007

Foreign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.
An amalgam tattoo of the soft palate: a case report with energy dispersive X-ray analysis
Authors: Mayall F. G. , Hickman Joy , Knight L. C. , Singharo Sim
Published: November 2007

A pigmented lesion of the soft palate was excised to exclude melanoma. The histology suggested an amalgam tattoo which was confirmed on energy dispersive X-ray analysis by the detection of silver and copper. This represents a very rare mimic of melanoma of the soft palate.
Perforating injury of the neck and vertebral artery trauma
Authors: Farrell M. L. , Gray R. F.
Published: November 2007

A 10-year-old schoolboy presented with a penetrating wound to the neck after a children's slide accident. A CT scan and endoscopy showed a traumatic oesophageal-cutaneous fistula. Neurologically the child deteriorated over a period of 34 hours and finally succumbed to a respiratory arrest.

Post-mortem findings showed a hypoplastic right vertebral artery. In the left suboccipital triangle a venous clot had blocked the dominant artery thus leading to cerebellar and brainstem infarction.

This extraluminal compression leading to obstruction of an otherwise non traumatized vertebral artery is unique in the literature.
Tuberculosis of the parotid gland: clinically indistinguishable from a neoplasm
Authors: Singh Bharath , Maharaj Tejprakash Jugpershad
Published: November 2007

Tuberculosis of the parotid gland may be clinically indistinguishable from a neoplasm. This poses a problem with regard to management, because the treatment of tuberculosis is medical, whilst that of the majority of tumours is surgical. If radical surgery with resection of a branch or branches of the facial nerve is embarked upon in a patient with tuberculosis, without prior histological diagnosis, unnecessary permanent disability will result.

Two cases of tuberculosis of the parotid gland are reported, demonstrating the clinical similarity of tuberculosis to a parotid neoplasm and the absolute need for histological diagnosis before embarking on surgery that will require resection of the branches of the facial nerve.

The conclusion is that although tuberculosis of the parotid gland is rare, it still exists and must be thought of as one of the differential diagnoses of a parotid tumour. This must be kept in mind, especially when the decision to sacrifice branches of the facial nerve is indicated, in order to get a tumour-free margin on an excisional biopsy. If the suspicion of tuberculosis is high, a therapeutic trial of antituberculous chemotherapy, for one week, can be diagnostic.
A long-standing cystic lymph node metastasis from occult thyroid carcinoma—report of a case
Authors: Hwang Chung-Feng , Wu Che-Min , Su Chih-Ying , Cheng Liang
Published: November 2007

The authors describe a patient with a cervical cystic mass present for 14 years which proved to be a cystic metastasis from apapillary carcinoma of the thyroid gland. This is probably the first case report of a long-term lateral cervical cyst caused by an occult thyroid carcinoma.
The management of quinsy—a prospective study
Authors: Chowdhury C. R. , Bricknell M. C. M.
Published: November 2007

A prospective study for the treatment of quinsy was undertaken between January 1989 and September 1991. This was to determine whether abscess tonsillectomy reduces inpatient stay without increasing operative risk compared to incision and drainage combined with interval tonsillectomy. Fifty-three patients were entered into the study. Twenty-one had abscess tonsillectomy and 32 had incision and drainage. This study showed that there is a 95 per cent probability that abscess tonsillectomy reduces hospital stay by between 2.04 and 4.84 (Student's t test t = 5.01; df = 31, p<0.001) days compared to incision and drainage followed by interval tonsillectomy. This is a significant saving in time and resources. Abscess tonsillectomy reduces patients lost to follow-up, avoids the social inconvenience of a second admission, effectively relieves symptoms, treats a contralateral abscess and is the only method of treating children with a quinsy. We recommend abscess tonsillectomy should be performed for quinsy where expertise and facilities are available.
An unusual pharyngeal pouch
Authors: Meehan T. , Henein R. R.
Published: November 2007

The third case of a double pharyngeal pouch is reported. It was excised and the patient made an uneventful recovery.
Branchial cyst—to endoscope or not?
Authors: Bath A. P. , Murty G. E. , Bradley P. J.
Published: November 2007

Cervical cystic metastases are uncommon, originating predominantly from an oropharyngeal primary. Pre-operative differentiation from a branchial cyst can prove difficult. Three cases which presented clinically as branchial cysts but were subsequently found to be cystic metastases are described, and the literature is reviewed. Endoscopy, ipsilateral tonsillectomy and blind biopsies of Waldeyer's ring, combined with excision of the cervical lesion are recommended in patients over 40 years old.
Benign nasal schwannoma
Authors: Donnelly Martin J. , Al-Sader Mohammed Hussain , Blayney Alexander W.
Published: November 2007

Nerve sheath tumours of the head and neck region mainly involve the eighth cranial nerve with only 4 per cent occurring in the paranasal sinuses. Only 32 cases of benign schwannomas occurring in the paranasal sinuses have been reported. We present a further case, review the current literature, and discuss the clinical details and specific histological features.
Nasopharyngeal tuberculosis
Authors: Bath A. P. , O'Flynn P. , Gibbin K. P.
Published: November 2007

Isolated nasopharyngeal tuberculosis is a rare disease with very few cases having been reported in recent years. We report a case presenting in the United Kingdom with unilateral otalgia and otorrhoea.
Diffuse tuberculous parotitis
Authors: Rowe-Jones J. M. , Vowles R. , Leighton S. E. J. , Freedman A. R.
Published: November 2007

Parenchymatous parotid tuberculosis diffusely affecting the entire gland is very rare. We present a case, associated with a primary pulmonary focus, that was confirmed after positive identification of alcohol and acid-fast bacilli in gastric washings. Both sites of infection resolved with quadruple anti-tuberculous chemotherapy.
Posterior epistaxis and the undeflatable Foley's urinary catheter balloon
Authors: Choy A. T. K. , John D. G. , van Hasselt C. A. , Med M.
Published: November 2007

A rare complication relating to the use of a Foley catheter in the control of posterior epistaxis is described. The balloon failed to deflate after the catheter had been in place for 32 hours and per-oral removal was required.
Munchausen syndrome by proxy: otolaryngologists beware!
Authors: Bath A. P. , Murty G. E. , Gibbin K. P.
Published: November 2007

Munchausen syndrome by proxy (MSBP) is a rare condition in which a parent or guardian fabricates an illness in a child either by inducing physical signs or prevaricating. A case presenting as recurrent episodes of infant apnoea is reported. A high index of suspicion is required for the diagnosis and, therefore, the otolaryngologist must be familiar with the condition if the life of the infant is to be protected and potentially harmful unnecessary investigations are to beavoided.
Ectopic cervical hamartomatous thymoma showing extensive myoid differentiation
Authors: Armour A. , Williamson J. M. S.
Published: November 2007

Ectopic ‘hamartomatous’ thymoma is a rare benign neoplasm. These tumours are found in the neck and are thought to be part of a spectrum of ectopic cervical thymic neoplasia. The clinical and histological features are discussed and the literature is reviewed. An attempt is made to explain in embryological terms why such lesions appear to occur more commonly on the left side.
Subtle diagnostic markers of orbital floor blow-out fracture on coronal CT scan
Authors: Rowe-Jones Julian M. , Adam E. Jane , Moore-Gillon Victoria
Published: November 2007

The sagittal plane, computerized tomography (CT) scan has been proposed as the most important radiological view in the diagnosis of orbital floor blow-out fractures. This view however is impractical and unnecessary. Direct, coronal plane CT scan with careful attention paid to the shape of the inferior rectus muscle and antral roof will successfully diagnose this traumatic condition, as in our reported case in which no other radiological abnormalities were present.
Combined therapy for carcinoma of the nasopharynx: a report of 49 cases
Authors: Hongzheng Sheng , Haixia Jia
Published: November 2007

From April, 1986 to June 1989 49 Patients (29 male, 20 female) aged 20 to 70 years old whod developed carcinomea of naospharynx (included 15 with relapses) were trated with neoadjuvant regional chemothrapy, followed by radiotherapy, or crysurgery and radiotherapy.

Thirty-three of the patients had squamous cell carcinoma with poor differentiated, four with well differentiated squamous cell carcinoma were included. Tumours were treated with three moalities: (I) Induction regional chemotherapy with temporal aftery catheterization as well as superselective intra-arterial chemotherapy of the femoral artery (chemotherapeutic agents: pingyangmycinum (P), Cisplatin (D), Vomcromstine (V), Methotrexate (M) and P.D.M. programmes); (2)Liquid cryosurgery in 25 cases; (3) Radiotherapy was carried out for two weeks after crysosurgery after chemotherapy.

The date showed CR (complete response—all tumour gone) and PR (partial response—more than 50 percent reduction) in 40 cases (81.6 per cent) and NR (no response—less than 50 per cent or no response) in nine cases (18.3 per cent) following regional chemotherapy. All of the patients were followed up for more than one year, and 48 of them survived (97.9 per cent). Thirty-five cases were followed up over two years and 28 of them survived (80 per cent). Twenty cases were followed up over three years, and 12 of them survived (60 per cent).

The effect of regional chemotherapy and crysurgery in combined treatment for carcinoma of the nasopharynx is discussed in this paper.
Radiotherapeutic effect on oropharyngeal flora in patients with head and neck cancer
Authors: Abu Shara K. A. , Ghareeb M. A. , Zaher S. , Mobacher A. , Khalifa M. Ch. , Saleh S. Z.
Published: November 2007

The affect of radiotherapy on oropharyngeal bacterial flora was studied in the hope that this might help in controlling post-operative infections in previously irradiated patients. Eighty patients were included from whom swabs were taken before and at the end of irradiation, Swabs were also taken two weeks after treatment in the last 40 patients. Thirty healthy controls were included.

It was found that coagulase positiveStaphylococcus aureus, β-haemolytic streptococci, Candida albicans, B.proteus, andPseudomonas aeruginosa, were significantly increased at the end of irradiation, whileKlebsiellawas increased significantly in the period after irradiation. Culture and sensitivity was performed for the organisms isolated in the last 40 patients.

From this study it is evident that irradiation has a significant effect on oropharyngeal flora.
Hibernoma in the parotid region
Authors: Vinayak Bippon C. , Reddy Krishna T. V.
Published: November 2007

Hibernoma is a benign tumour, arising from vestigial remnants of brown adipose cells, which have persisted from embryonic life. Although it is a well recognized entity, it is an extremely rare tumour. Recent reports estimate 81 cases in the world literature, only seven being in the neck. To our knowledge, it has never been reported in the parotid region. We report such a case and discuss the historical background of a hibernoma, along with its pathological and clinical behaviour.
Retropharyngeal haematoma: a diagnosis for concern?
Authors: Dingle Ann F. , Clifford Kevin M. A. , Flood Liam M.
Published: November 2007

Three cases of retropharyngeal haematoma are described. In one case there was underlying aneurysm of the carotid artery which could have led to significant morbidity if undetected.
Hearing impairment and ear pathology in Nepal
Authors: Little Paul , Bridges Alison , Guragain Rajendra , Friedman Del , Prasad Rakesh , Weir Neil
Published: November 2007

A stratified random cluster sample of 15,845 subjects was performed in two regions of Nepal to determine the prevalence and main causes of hearing impairment (the most common disability) and the prevalence of ear disease. Subjects reporting current ear pain, or ear discharge, or hearing impairment on direct questioning by a Nepali health worker (primary screening failed), had otoscopy and audiometry (using the Liverpool Field Audiometer) performed, and a questionnaire administered relating to past history. In every fifth house subjects who passed the primary screening (1,716 subjects) were examined to assess the false negative rate of screening. An estimated 16.6 per cent of the study population have hearing impairment (either ear worse than 30 dB hearing threshold level (HTL) 1.0–4.0 kHz, or 50 dB HTL 0.5 kHz), and 7.4 per cent ear drum pathology, equivalent to respectively 2.71 and 1.48 million people extrapolated to the whole of Nepal. Most hearing impairment in the school age group (55.2 per cent) is associated with otitis media or its sequelae. Probably at least 14 per cent of sensorineural deafness is preventable (7 per cent infectious disease, 3.9 per cent trauma, 0.8 per cent noise exposure, 1 per cent cretinism, and 1 per cent abnormal pregnancy or labour). Most individuals reporting current ear pathology (61 per cent) had never attended a health post, and of those receiving ear drop treatment, 84 per cent still had serious pathology. Of subjects who reported ear drop treatment at any time, 31 per cent still had serious pathology. The use of traditional remedies was prevalent.

In conclusion this study shows high prevalences of hearing impairment and ear drum pathology. To reduce hearing impairment in Nepal, particularly in the school age group, a priority should be the effective treatment of otitis media.
Parapharyngeal abscess associated with the second pharyngeal pouch
Authors: Takimoto T. , Itoh M.
Published: November 2007

Peritonsillar or parapharyngeal abscess is not at all a rare disease. Usually the abscess is recognized as the underlying consequence of acute tonsillitis. However, the abscess may be caused by an internal fistula related to the second pharyngeal pouch. Presented here are the clinical, radiological and pathological aspects of an internal fistula with a parapharyngeal abscess related to the second pharyngeal pouch.