bluuebunny/crossref_metadata_2025 huggingface dataset:
Glycerol and ichthammol: medicinal solution or mythical potion?
Authors: Nilssen E. , Wormald P. J. , Oliver S.
Published: November 2007

Glycerol and ichthammol (G & I) has been used for generations by otologists. However, there is a paucity of information on both its mode of action and its anti-bacterial properties. The aim of this paper was to ascertain firstly, what the most common organisms found in discharging ears were and secondly, what antibacterial activity G & I had against these organisms. All ear swabs from 1992–1994 in our unit were reviewed to ascertain the prevalence of the commonly isolated organisms. Fresh isolates of these organisms were collected and plated onto agar with wells of glycerol, ichthammol and a combination of both as used in clinical practice. The diameters of the zones of inhibition observed after incubation were measured in millimetres. Common isolates were:Pseudomonas aeruginosa,Staphylococcus aureus,Proteus mirabalis,Streptococcus pyogenesin descending order of frequency. Pure glycerol showed no significant zones of inhibition against any of the organisms tested. The average zones of inhibition for G & I and ichthammol alone were forStaphylococcus aureus15 mm and 18 mm and forStreptococcus pyogenes: 16 mm and 23 mm. Ichthammol alone was significantly more effective than G & I (p<0.001). There was no significant activity againstProteus mirabalisandPseudomonas aeruginosa. The therapeutic benefit of G & I is due in part to the inherent anti-bacterial activity of ichthammol against the Gram positive organisms as well as its anti-inflammatory action and the dehydrating effect of the glycerol.
Craniometaphyseal and craniodiaphyseal dysplasia, head and neck manifestations and management
Authors: Richards Aurelia , Brain Caroline , Dillon M. J. , Bailey C. M.
Published: November 2007

Craniometaphyseal and craniodiaphyseal dysplasia are rare genetic disorders of bone due to modelling errors of long bones and skull bones. These syndromes present with multiple ENT symptomatology from an early age. The diagnostic distinction can now be made radiologically by serial skeletal survey which is important for prognosis. We review the clinical, radiological, computed tomography (CT) scan, otological, audiological and histopathological findings in two cases with craniodiaphyseal, and two cases with craniometaphyseal dysplasia, and report our experiences of medical and surgical treatment to date.

In the craniodiaphyseal dysplasia, the hearing abnormality progressed from an initial conductive to a mixed loss on serial audiometric follow up. Temporal bone CT scans showed narrowing of the middle ear cavity, internal auditory meatus, and facial nerve canal at the geniculate ganglion. Benefits from choanal stenosis surgery, craniofacial remodelling and dacrocystorhinostomy were shortlived. Calcitriol therapy with a low calcium diet did not alter the clinical course of progression in our cases. The underlying defect, causing net bone formation in these phenotypically similar syndromes, appears to be different when based on the differing biochemical responses to calcitriol and bone biopsy findings. Increased numbers of osteoblasts were found in bone biopsies from both cases with craniodiaphyseal dysplasia.

Early recognition is crucial in these conditions as therapy directed at the underlying bony defect has the best chance of success if initiated in infancy (Cole et al., 1988; Fanconi et al., 1988; Key et al., 1988).
Bilateral ventricular neurofibroma of the larynx
Authors: Koc Can , Luxenberger Wolfgang , Humer Ursula , Friedrich Gerhard
Published: November 2007

Laryngeal neurofibroma (LNF) is an unusual tumour and only approximately two dozen cases have been reported previously. Isolated LNF not associated with von Recklinghausen's disease is even more unusual. According to a review of the available literature, the case presented is the first bilateral one and the first originating from the ventricles. The tumour was removed completely by microlaryngoscopy without tracheostomy. The macroscopic and light macroscopic findings are presented and a review of the literature on neurogenic tumours in the larynx is presented.
Endoscopic control of posterior epistaxis
Authors: Elwany Samy , Abdel-Fatah Hesham
Published: November 2007

Control of bleeding vessels by suction cautery under endoscopic vision was used on 38 patients suffering from posterior epistaxis. Twelve patients also required the insertion of nasal tampons at the end of the cautery procedure. Eight patients, six of them hypertensive, had recurrent epistaxis post-operatively. Five patients needed further cautery in order to control the bleeding. Three patients required temporary balloon tamponade, and a single patient had internal maxillary ligation. Temporary palatal numbness in three patients was the only post-operative complication. Otherwise, the technique has the potential advantages of simplicity, safety, effectiveness and simplified post-operative care.
Expression of Ki-67 antigen and proliferative cell nuclear antigen in benign and malignant epithelial lesions of the larynx
Authors: Zidar Nina , Gale Nina , Cör Andrej , Kambič Vinko
Published: November 2007

In an attempt to analyse the proliferative activity in benign and malignant laryngeal epithelial lesions, and to determine the relationship to their histologic grade, we studied the expression of proliferative cell nuclear antigen (PCNA) and Ki-67 antigen on 20 squamous carcinomas, and on 30 biopsies of epithelial hyperplasia categorized according to the Kambiˇ-Lenart classification into simple, abnormal, and atypical hyperplasias. In simple hyperplasia, both antibodies stained the nuclei of the occasional cells in the basal layer. In abnormal hyperplasia (mild dysplasia), positive cells occupied up to a third, and in atypical hyperplasia (moderate and severe dysplasia) they occupied from two-thirds to the entire epithelial thickness. In squamous carcinoma, we have found a statistically significant correlation between its grade and the percentage of Ki-67-(p<0.01) and PCNA-(p<0.00001) positive cells. Our results suggest that the proliferative fraction progressively increases with the degree of epithelial hyperplasia and the grade of carcinoma. We conclude that the patterns of immunoreactivity to PCNA and Ki-67 antigen correspond to the histologic grade of both benign and malignant epithelial lesions of the larynx. This method should be regarded as a useful adjunct to traditional histological techniques allowing more objective grading of benign and malignant epithelial lesions.
Intraoral sebaceous carcinoma
Authors: Abuzeid M. , Gangopadhyay K. , Rayappa C. S. , Antonios J. I.
Published: November 2007

Sebaceous carcinoma arising from the buccal mucosa is very rare. Only one such case has been reported in the English literature. We report a second case arising in an 11-year-old girl.
Per-operative antibiotic/steroid prophylaxis of tympanostomy tube otorrhoea: chemical or mechanical effect?
Authors: Shinkwin C. A. , Murty G. E. , Simo R. , Jones N. S.
Published: November 2007

The per-operative instillation of ototopical antibiotic/steroid drops reduces the incidence of early otorrhoea after tympanostomy tube insertion. Whether this is due to the chemical properties of the antibiotic/steroid or simply the mechanical instillation of fluid is unclear. In this paired matched study of 161 subjects Gentisone HC was shown to significantly reduce the otorrhoea rate compared to normal saline (1.24 per cent compared with 9.32 per cent, p<0.005, difference 8.07 per cent, 95 per cent confidence interval for difference 3.21 per cent to 12.93 per cent). Capillary viscosimetry proved Gentisone HC to be more viscous than normal saline. The benefits are due to Gentisone HC's chemical properties, and Gentisone HC rather than normal saline instillation per-operatively is recommended when tympanostomy tubes are inserted.
Evaluation of the microbiology of chronic sinusitis
Authors: Şener Burçin , Hasçelik Gülşen , Önerci Metin , Tunçkanat Ferda
Published: November 2007

Chronic sinusitis is one of the most common diseases treated in outpatient centres. In this prospective study, 49 patients with the diagnosis of chronic maxillary sinusitis were evaluated microbiologically by using sinus swab, irrigation fluid and sinus mucosal tissue specimens obtained during endoscopic sinus surgery. There was no bacterial growth in seven cases. In the remaining 42 cases a total of 89 bacteria were isolated, 28 of them being classical pathogens and 61 being non-classical pathogens. Among the classical pathogensStaphylococcus aureuswas the most common one. The correlation between the isolates obtained from maxillary sinus and isolates obtained from throat, nose and nasopharynx did not have a predictive value. Since the overall rate of classical pathogen isolation from patients with chronic sinusitis was not significantly high, the possible role of factors other than bacterial growth should be identified in the pathogenesis of chronic sinusitis.
Use of nebulized adrenaline to aid expulsion of intra-nasal foreign bodies in children
Authors: Douglas Adam R.
Published: November 2007

Foreign bodies in the noses of children may often be expelled by simple nose blowing. Success of this manoeuvre depends on how firmly the object is lodged, and on the co-operation and skill of the child. Attempts at direct removal using instruments frequently result in the patient becoming distressed and resort to general anaesthesia is sometimes required. This short communication describes a series of cases in which nebulized adrenaline helped loosen firmly impacted foreign bodies, thereby facilitating removal, minimizing upset for the child, and avoiding anaesthetic risk.
Oculopharyngeal myopathy with sensorineural hearing loss
Authors: Alusi G. H. , Grant W. E. , Quiney R. E.
Published: November 2007

A Case Is reported of a 59-year-old Caucasian male with oculopharyngeal myopathy and sensorineural hearing loss. He presented with progressive ptosis, sensorineural hearing loss over several years and symptoms of mild dysphagia. Further enquiry into his family history revealed that every male member in his family that lived beyond the age of 60 exhibited identical symptoms. Symptoms of ptosis and dysphagia are consistent with the rare autosomal dominant condition of oculopharyngeal myopathy, believed to be due to mitochondrial disease. The combination of ptosis, dysphagia and sensorineural hearing loss with normal distant muscle group biopsy has not been described before.
A puzzling paediatric parotid haematoma
Authors: de Carpentier J. P. , Hargreaves S. , Zarod A. P.
Published: November 2007

An unusual case of an intra-parotid haematoma is presented. The history was misleading and the ultrasound and CT results apparently contradictory. The investigations are explained in the light of the natural process of haematoma evolution. It is recommended that all radiological investigations be correlated by a single radiologist, and suggested that repeated ultrasound scans, at appropriate time intervals, might be used to confirm the diagnosis and follow the process of clot resolution.
Three-dimensional imaging of ENT diseases with helical computed tomography
Authors: Muraoka Hideki , Tsunoda Atsunobu , Kojima Masahiro , Tokano Hisashi , Komatsuzaki Atsushi
Published: November 2007

We have employed helical computed tomography (CT) to evaluate ear, nose and throat diseases, and present herein seven typical cases: middle ear surgery, osteoma of the external ear canal, maxillary fracture, tripod fracture, submandibular gland calculus, epiglottic abscess and vocal fold palsy. Helical (CT) facilitates the assessment of these diseases and its high diagnostic value is described.
Heterotopia of the tonsil
Authors: Bhargava Deepa , Raman R. , Al Abri Rashid Khalfan , Bushnurmath Bharti
Published: November 2007

The histopathological finding of heterotopias or choristoma is rare. This paper describes two patients who presented with chronic recurrent tonsillitis and underwent tonsillectomy. Histological examination revealed heterotopic cartilage in the tonsil of one patient and bone in that otthe other.
Incidental paranasal sinus inflammatory changes in a British population
Authors: Patel K. , Chavda S. V. , Violaris N. , Pahor A. L.
Published: November 2007

A retrospective study was carried out to determine the prevalence of abnormality in the paranasal sinuses in a British population having magnetic resonance imaging (MRI) scans for neurological signs and symptoms. The T2-weighted scans of 130 patients were studied. Abnormalities in the paranasal sinuses show as high signal on the T2-weighted scans and thus are clearly seen. Abnormalities included mucosal thickening, fluid levels, sinus opacification and retention cysts/polyps. Of the patients studied, 49.2 per cent showed one or more abnormality. Mucosal thickening was the most common abnormality noted and the ethmoid sinuses the most commonly affected.
A Complication of indoor pistol shooting
Authors: White S. A. , Narula A. A.
Published: November 2007

The aetiology of chronic rhinitis and nasal obstruction is often elusive and obscure. Many different causes have been documented including allergens, cigarette smoke, cold dry air, viruses, sulphur dioxide and industrial pollutants. This is the first case we have been able to identify of rhinitis associated with exposure to high levels of lead through indoor pistol shooting.
An unusual foreign body in the larynx
Authors: Hammerlin S. , Kapadia R.
Published: November 2007

A case of a needle lodged in the larynx is reported. The needle had been inhaled via an asthma inhaler.
Oesophageal strictures in children: balloon or bougie dilatation?
Authors: Allsager C. M. , Banerjee A. R. , Bolia A. , Moir A.
Published: November 2007

The management of oesophageal strictures in neonates and infants is often by bougie dilatation. We report two cases in which balloon dilatation was used successfully and suggest that this may be a preferable technique in this age group.
A clinicopathological and immunohistochemical study of the calcifying epithelial odontogenic tumour (Pindborg tumour) in Malaysians
Authors: Ng K. H. , Siar C. H.
Published: November 2007

We reviewed the clinicopathological characteristics of 13 cases of calcifying epithelial odontogenic tumour (CEOT) (Pindborg tumour) diagnosed in the Division on Stomatology, Institute for Medical Research, Kuala Lumpur, over a 29-year period. There were eight female and five male patients. These consisted of eight (61.5 per cent) Malays, three (23.1 per cent) Chinese, one (7.7 per cent) Indian and one (7.7 per cent) Melanau. Their ages at presentation ranged from 19–61 years (mean age, 31.8 years). There were 12 central and one peripheral CEOT. Of these, 76.9 per cent of cases were located in the maxilla, the remaining in the mandible. The commonest clinical diagnosis was a dentigerous cyst (66.7 per cent). Enucleation was the main mode of treatment. Histologically, sheets and strands of polyhedral epithelial cells containing eosinophilic, homogeneous globules with Liesegang rings were observed. One case also showed extensive calcification and clear cell differentiation. Immunohistochemistry revealed a variable keratin staining of the CEOT epithelium, confirming its heterogeneity.
Middle ear teratoma in a newborn
Authors: Cunchillos Manuel Navarro , Calvo Bonachera María Dolores , Cunchillos Myriam Navarro , Cassinello Elisa , Lizana Julio Ramos , Esteban José Oña
Published: November 2007

Teratomas are tumours that rarely exist in children. Their location in head and neck is, however, an unusual finding.

A strange case of middle ear congenital teratoma reaching the cervical area is presented here. In the last 20 years it is only the second case to be published in the English literature. The tumour was revealed by the presence of a peripheral congenital facial palsy.
Otolaryngological manifestations of factitious disorders—a case and literature review
Authors: Gadre Arun K. , DeSautel M. Gregory , Senders Craig W.
Published: November 2007

Otolaryngological manifestations of factitious disorders are rare. The case of a health care worker who injected her face and orbits with air in order to masquerade as facial cellulitis is presented. The literature and treatment strategies are reviewed.
High tracheostomy and other errors – revisited
Authors: Bennett John D. C.
Published: November 2007

Timely cricothyrotomy may be life-saving, but it is not without its complications. Together with tracheostomy performed too high, there are high incidences of stenosis and voice changes afterwards – often neglected because the patient has so many other problems. Jackson warned of these problems over 70 years ago – his message is still relevant.
The developing role of a paediatric voice clinic: a review of our experience
Authors: Papsin B. C. , Pengilly A. J. , Leighton S. E. J.
Published: November 2007

Objective

We report our experience in developing a paediatric voice clinic within a tertiary otolaryngology department and describe the emerging role of this specialized clinic.

Materials

Currently our referral base is divided between other otolaryngologists within our department who require voice assessment as part of the pre- or post-operative management of laryngeal disorders (e.g. cysts, webs, vocal fold palsies, laryngo-tracheal reconstruction) and other professionals within our hospital who require characterisation of voice within the broader task of defining medical conditions in which voice abnormalities exist (e.g. mucopolysaccharidoses, functional dysphonias).

Methods

The patients were assessed by a team consisting of a paediatric laryngologist and a speech and language therapist. Each patient underwent a perceptual voice assessment and qualitative voice assessment using electrolaryngography. Direct visualisation was attempted and methods of and suitability for, such examination are discussed.

Results

Our experience is reviewed and guidelines for the establishment of a paediatric voice clinic are presented.
Conductive deafness in aglossia
Authors: Higashi Koichiro , Edo Masataka
Published: November 2007

Aglossia is a rare anomaly often accompanied with several congenital defects including varying degrees of limb deficiency, micrognathia and oral synechiae. We report on a girl with aglossia and persistent anterior buccopharyngeal membrane. Other anomalies observed on the patient were oesophageal atresia, hypoplastic epiglottis, ptosis of the left eyelid, and conductive deafness which is probably an additional symptom of this syndrome group.
Otological lesions in pachyonychia congenita syndrome
Authors: Bento Ricardo Ferreira , Guatimosim Maria Heleba , de Leão Bensadon Rogério , Sanchez Tanit Ganz , Voegels Richard Louis
Published: November 2007

The authores report a case of patient with pachyonychia syndrome, a rare genedermatosis inherited as an autosomal dominant trait, who also had otological lesions beyond the other classic signs and symptoms of the syndrome. Many kinds of treatment have already been proposed, but all failed to show satisfactory results. A new, cheap and easy-to-use treatment was developed in this study, using keratoplastics interpolated with humectant lotion for 90 days. The results after three years of follow-up are still thoroughly satisfactory.
Sudden sensorineural deafness and hormone replacement therapy
Authors: Strachan David
Published: November 2007

Whilst the oral contraceptive pill (OC) has been implicated on a number oif occasions as a cause of sensorineural hearing loss, there are no published reports linking hormone replacement therapy (HRT) to otological symptoms. A case of sensorineural loss with tinnitus following commencement of HRT is described, followed by a discussion outlining the fundamental differences between the OC and HRT, thus expaining why a vascular aetiology is unlikely. It is hypothesized that otological symptoms in such cases may be due to the effect of oestrogens on electrolyte balance disturbing inner ear function and also a direct effect on the auditory pathways mediated in part by alterations in neurotransmitter receptor concentrations.
Bone anchored hearing aid wearers with significant sensorineural hearing losses (borderline candidates): patients' results and opinions
Authors: Hartland S. H. , Proops D. W.
Published: November 2007

Bone anchored hearing aids (BAHA) have been implanted in Birmingham since 1988. Since this time confidence has grown in the fitting and rehabilitation of BAHA wearers, with a corresponding increase in the implantation and rehabilitation of more difficult and borderline candidates.

This study analyses the results of 16 borderline BAHA candidates who have been assessed and fitted with a BAHA at Birmingham Children's Hospital and Queen Elizabeth Hospital, and who have had at least one post-fitting review. All of these subjects had mean bone conduction (BC) thresholds, in the better hearing ear, in excess of 45 dBHL in the frequency range 0.5–4 kHz, when initially assessed. The age range at the time of the study was 10–84 years, with a mean age of 60 years. The study demonstrates the benefits that these patients achieved with the BAHA compared to their previous aid, both audiologically and in terms of comfort and reduction in ear discharge.
A topographical analysis of the post-natal bone growth in the cochlea of the dog
Authors: Roberto M. , Favia A. , Lozupone E.
Published: November 2007

The distribution of post-natal bone deposition was examined in the cochlea of 10-, 25-, 50- and 90-day-old dogs that had been intraperitoneally injected with tetracycline (20 mg/kg) five days before sacrifice. The temporal bones were embedded in methylmethacrylate and sectioned in a single mid-modiolar section 30 μm thick. The post-natal bone deposition occurs both on the periosteal surfaces and on the vascular canals of the endochondral layer until the age of 90 days. Scattered bone deposition is also shown on the endosteal layer of the three turns and on the spiral lamina until the age of 25 and 10 days respectively. The percentage extension of the osteogenetic fronts shows a higher value at the periosteal layer than at the endochondral or endosteal layers.
p53 and bcl-2 expression and argyrophilic nucleolar organizer regions in patients with malignant maxillary sinus tumours
Authors: Nakashima Torahiko , Nakashima Tadashi , Masuda Muneyuki , Komiyama Sohtaro
Published: November 2007

To investigate the relation between the clinicopathological findings, and the survival of patients with malignant tumours of the maxillary sinus, and the tumour's biological parameters, we examined the expression of p53 and bcl-2 and the number of silver-stainable nucleolar organizer regions (AgNORs) in 23 paraffin-embedded specimens from primary tumours. Fifteen of 23 (65 per cent) maxillary tumours expressed p53 and two of 23 (nine per cent) tumours expressed the bcl-2 gene product. The mean number of AgNORs per nucleus was 5.2 ± 2.4. There was no relationship between the expression of p53 or bcl-2 and the patient's clinical course. In contrast, there was a statistically significant difference in the survival of patients with a high (>6) number of AgNORs and patients with a low (<6) number of AgNORs. These data suggest that the number of AgNORs may be useful in evaluating the prognosis of patients with malignant maxillary sinus tumours.
Oral botryomycosis: a case report
Authors: Devaiah Anand K. , Hoffman Henry T. , Robinson Robert A. , Carter Keith
Published: November 2007

We present a 42-year-old male with botryomycosis initially presenting with left-sided proptosis due to an infraorbital mass. A biopsy through an anterior orbitotomy yielded indeterminate histopathology. The patient later developed a similar oral lesion which was biopsied and found to be botryomycosis. The oral lesion recurred after initial surgical treatment, but responded to antibiotic therapy. Discussion of this case along with a review of the literature is presented to offer guidelines for recognition and managment of this rare disorder.
Use of interferon-α in laryngeal papillomatosis: eight years of the Cuban national programme
Authors: Deuñas L. , Alcantud V. , Alvarez F. , Arteaga J. , Benítez A. , Bopuza M. , Carniege L. , Cartaya B. , Comas C. , Cotayo R. , Escobar H. , Fernández H. , Fernández M. , Fernández R. , García M. , Iznaga N. , la O F. , Márquez J , Nordet D. , Pérez J. , Quintero J. , Redonavich A. , Robeleco M. , Rodríguez H. , Ruíz P. , Seijas R. , Villavicencio E. , Viera D. , Damas F. , López-Saura P. , Haglund S. , Strander H.
Published: November 2007

Laryngeal papillomatosis is one of the first diseases where interferon (IFN) was found to be effective. In 1983, a programme for the treatment of all such cases started in Cuba. Up to December 1991, 125 patients (92 children, 33 adults) have been treated: 102 with leucocyte IFN-α, 12 with recombinant IFN-α-2b, and 11 have received both preparations. Case management consisted of surgical removal of the lesions followed by an IFN schedule starting with 105IU/kg of weight in children or 6 × 106IU in adults, i.m. daily. The dose was progressively reduced, as long as no relapses occurred. At the end of the one-year schedule the doses were reduced to 5 × 104IU/kg in children or 3 × 106IU in adults, weekly. If there was a relapse, it was removed surgically and the patient returned to a higher dose level. Most cases (89; 71 per cent) have not relapsed after the treatment; 60 of them have been followed for more than three years. In those with relapses, the frequency of recurrence decreased in all but four patients. The treatment seemed to be more effective if initiated less than three months after the disease onset. The tracheostomy could be removed in five out of seven patients who needed it before the IFN treatment and was necessary in only three new cases during IFN treatment. In two of these, decannulation was possible later on. In a total of 14 patients relapses persisted after several cycles of IFN treatment. They were considered resistant to such treatment. No severe side effects were reported. The most frequent ones were fever, drowsiness, increased bronchial secretion, chills and headache. The establishment of this programme has maintained the disease under control in Cuba.
Hamartoma of the larynx causing neonatal respiratory distress
Authors: Linder Arne
Published: November 2007

A new-born boy with severe stridor was found to have a laryngeal hamartoma. The airway was secured by means of a tracheostomy, and the hamartoma was subtotally resected endoscopically using a carbon dioxide laser. A good functional result was achieved, even though decannulation was delayed until the age of 33 months. This is the ninth known case of hamartoma of the larynx and the sixth presenting with stridor in the neonatal period.
Primary ectopic meningioma of the palatine tonsil – a case report
Authors: Kaur Amandeep , Shetty Subhash Chandra , Prasad Devi , Nirmala Vadakkepat
Published: November 2007

Meningiomas can occur at excranial and extraspinal sites such as the nose, nasopharynx and paranasal sinuses. Meningioma of the tonsil has seldom been described. We report a case of ectopic meningioma of the left palatine tonsil, in a 50-year-old male with no clinical or radiological evidence of an intracranial lesion. Follow-up at six months revealed no evidence of recurrence.
Peritonsillar haematoma
Authors: Fergie N. , Murray A. , Kell R. A.
Published: November 2007

We present one patient who was admitted with a peritonsillar haematoma as a complication of acute tonsillitis and concomitant warfarin therapy for prosthetic aortic valves. While tonsillar haemorrhage as a result of acute tonsillitis has been well described, no cases of isolated haematoma formation have been documented, nor has it been recognized previously as a complication of long-term anticoagulant therapy. We discuss establishing the diagnosis, the likely aetiology and implications of this complication.
Sensorineural hearing loss and ulcerative colitis
Authors: Kumar B. N. , Walsh R. M. , Wilson P. S. , Carlin W. V.
Published: November 2007

The association of sensorineural hearing loss and ulcerative colitis is well documented and it is speculated that this is autoimmune in origin. A case in a 12-year-old boy is described, that initially responded to steroid therapy, but four years later resulted in bilateral, profound sensorineural hearing loss in spite of good control of his bowel disease. Immunological tests may provide a clue as to the aetiology of suspected cases of autoimmune inner ear disease. Immediate treatment with steroids with or without immunosuppressive therapy is essential as delay may lead to irreversible hearing loss.
An unusual complication of T-tubes
Authors: Green K. M. J. , de Carpentier J. P. , Curley J. W. A.
Published: November 2007

The morbidity of long-term ventilation tubes (Goode T-tubes) is often discussed with reference to otorrhoea, tympanosclerosis and long-term perforation. We report three cases of the T-tube slipping into the middle-ear cleft. In two of the three patients this was asymptomatic and the T-tubes were left in situ. In the third patient this complication was documented on three occasions when the T-tube was removed and reinserted for recurrent effusions. We are unaware of this complication being previously reported in the literature.
Otolaryngological manifestation of Gorlin Goltz syndrome
Authors: Al-Anazy Fatma Homood , Zakzouk Siraj M.
Published: November 2007

A 46-year-old Jordanian man was seen in ENT clinic complaining of progressive left nasal obstruction and hearing loss for the last five years with a history of multiple surgical removal of dental cysts. Clinical and radiological investigation revealed a cystic mass occupying the left maxillary sinus protruding to the nasal cavity, calcification of the falx cerebri and bifid ribs. On these findingsGorlin-Goltz syndrome was confirmed. The case is presented and the literature reviewed.
Correlation between retractions of the pars flaccida and the pars tensa
Authors: Luntz Michal , Fuchs Camil , Sadé Jacob
Published: November 2007

Retractions of the pars flaccida (PF) and the pars tensa (PT) were assessed in 250 atelectatic ears in an attempt to find out the way in which the differences in mechanical properties of the two parts of the tympanic membrane are reflected clinically. Retraction of PF was found in 217 ears (86.8 per cent) and retraction of PF in 150 (60 per cent). The concomitant presence of both types of retraction was observed in 117 ears (46.8 per cent) while 133 (53.2 per cent) had only one type, 100 of them (75.1 per cent) PF retraction and 33 (24.9 per cent) PT retraction. When only one type of retraction was present, the empirical probability of having a PF retraction was 75.1 per cent, while the probability of having a PT retraction was only 24.9 per cent. Clinically, the more frequent occurrence of PF retraction in the absence of PT retraction than vice versa reflects the greater collapsibility of the PF. When both types of retractions were present, we found a positive correlation between their severity.
Cochlear implantation in a district general hospital: problems and complications in the first five years
Authors: Collins Melanie M. , Hawthorne Maurice H. , El-Hmd Kamal
Published: November 2007

Fifty-three patients, 34 adults and 19 children have been implanted over the first five years of the cochlear implant programme at the North Riding Infirmary (NRI). For a small centre, based at a district general hospital, our complication rates compare favourably with others: 11.7 per cent adult and 10.5 per cent paediatric major complications. Data on all our patients was gathered prospectively as part of the national cochlear implant programme, and we report and discuss all complications from this centre.
A homemade modification of a spacer device for delivery of bronchodilator or steroid therapy in patients with tracheostomies
Authors: Nakhla Venice
Published: November 2007

Patients who have artificial airways and who concurrently suffer with chronic obstructive airways disease encounter problems when administering inhaled bronchodilator and corticosteroid drugs via the tracheostomy. This is because most of the devices are designed to deliver the metered dose of inhaled drugs via the oropharyngeal route and it is impossible to obtain an airtight seal from the inhaler device mouthpiece to the tracheostomy tube. The author describes a simple, effective and cheap modification of a spacer device designed by a creative patient to facilitate delivery of the aerosol via the tracheostomy tube to overcome this problem.
Cartilage-sparing otoplasty: a review with long-term results
Authors: Vuyk H. D.
Published: November 2007

Prominent ears are the most frequent congenital deformity in the head and neck region. Anatomy of normal and prominent ears as well as the psychological aspects of prominent ears are reviewed. Two types of surgical technique are described with emphasis on the cartilage-sparing technique.

A sound pre-operative analysis, focusing on all partsof the deformity, and surgical techniques which are gradually applied to these deformities should result in pleasing, permanent changes for the vast majority of patients. In our opinion, a combination of cartilage-sparing techniques augmented with cartilage-weakeningprocedures give predictable long-term results with a natural appearing ear and concomitant few, easily treated complications.
Day-case adenoidectomy: how popular and safe in a rural environment?
Authors: Siddiqui N. , Yung M. W.
Published: November 2007

In spite of previously favourable reports on day-case adenoidectomy, thereare still worries amongst otolaryngologists that such practice is unsafe, especially in arural environment. A national survey was therefore carried out which shows that only 41 per cent of respondents perform adenoidectomy routinely as day-case, and even fewer in rural areas. A regional audit on day-case adenoidectomy, covering five hospitals, was conducted in East Anglia. Between 1994 to 1995, 73 day-case adenoidectomies were performed and the outcome was compared to those of 183 in-patient adenoidectomies during the same period. The children in the day-case group recovered post-operatively even better than the in-patient group. None of them stayed overnight or required re-admission. There was no increased in post-operative consultation to the general practitioner. The parents in the day-case group were mostly in favour of the day-case arrangement (88 per cent). The results suggest that day-case adenoidectomy is safe and popular with parents even in a rural environment.
Distribution of the solitary adenoma over the parathyroid glands
Authors: Debruyne F. , Ostyn F. , Delaere P.
Published: November 2007

One hundred and ten patients with primary hyperparathyroidism were studied, in which a normal parathyroid gland was found on the same side as an adenoma (both confirmed by histological examination), and the upper or lower location could clearly be defined during surgery. The distribution of the adenomas over the upper and lower glands was unequal: 61.8 per cent in the superior versus 38.2 per cent in the inferior position. Statistical analysis revealed that this is not a random distribution (p= 0.013). The explanation of this relative predilection is unknown. The finding should not influence the surgical procedure for primary hyperparathyroidism
Sphenoid sinus mucocoele presenting with isolated oculomotor nerve palsy
Authors: Sethi Dharambir S. , Lau David P. C. , Chan Chumpon
Published: November 2007

We describe two cases of sphenoid sinus mucocoele. Both presented with isolated oculomotor nerve palsy. Mucocoeles involving only the sphenoid sinus are uncommon. They are probably under-diagnosed as they may be asymptomatic or cause non-specific symptoms. Nasal symptoms occur infrequently but the close relationship of the sphenoid sinus to the orbital apex means that ocular symptoms including cranial nerve palsies are a common presenting feature. Involvement of the third cranial nerve in isolation is rare but has important neurosurgical implications which must be excluded before this symptom is attributed to the sphenoid sinus.
Primary non-Hodgkin's lymphoma of the larynx
Authors: Kato Shingo , Sakura Mizuyoshi , Takooda Shoji , Sakurai Masaharu , Izumo Toshiyuki
Published: November 2007

Three cases of primary non-Hodgkin's lymphoma of the larynx are described. Histologically, two tumours belonged to the category of low grade B-cell lymphomas of the small cell type (extranodal marginal zone B-cell lymphoma and lymphoplasmacytoid lymphoma), and the third was classified as a peripheral T-cell lymphoma of unspecified type. The clinical stage was IE in two cases, and IV in another case. In two cases, complete remission was obtained with radical radiotherapy. But in the other case, which was histologically lymphoplasmacytoid lymphoma, the response to radiotherapy was poor, and surgery was required. There was no relapse subsequent to treatment. Primary non-Hodgkin's lymphoma of the larynx is rare. Several reported cases have clinical features similar to those of MALT-type lymphomas arising in other extranodal sites. Although most of the reported cases have been cured with radiotherapy, in some cases dissemination to other extranodal sites may occur. Therefore careful periodic evaluation is imperative.
Simultaneous occurrence of metastatic tonsillar squamous cell carcinoma and angioimmunoblastic T-cell lymphoma in a cervical lymph node
Authors: Habermann W. , Anderhuber W. , Humer-Fuchst U. , Stammberger H.
Published: November 2007

Non-Hodgkin's lymphoma (NHL) is a frequent head and neck malignancy. Squamous cell carcinoma of the tonsil is the second most common head and neck carcinoma. We report a case of a tonsillar carcinoma metastasis in an angioimmunoblastic-transformedlymph node. To our knowledge this is the first description and histopathological documentation of such a case in the literature.
Flexible transnasal endoscopy: is local anaesthetic necessary?
Authors: Singh V. , Brockbank M. J. , Todd G. B.
Published: November 2007

Prior to flexible transnasal endoscopy (FTE) topical intranasal agents such as cocaine or combinations of a local anaesthetic and vasoconstrictor agent are generally recommended for local anaesthesia, easier access, and better examination of the interior of the nose, especially the middle meatus. This double-blind study involved 60 patients. Each had five per cent cocaine sprayed in one nostril and normal saline in the other. The pain/discomfort and gag scores showed no statistical difference.

Forty-two (70 per cent) patients had a moderate/marked deviation of the nasal septum. A significant pain score (3–5) was obtained in 33.3 per cent of cases with the deviation towards the cocaine side and in 37 per cent of cases with the deviation towards the saline side. Ease of procedure scores for both sides were also comparable, when deviation of the nasal septum was taken into account.
Haemangioma of the maxillary sinus
Authors: Raboso E. , Rosell A. , Plaza G. , Martinez-Vidal A.
Published: November 2007

Haemangiomas of the maxillary sinus are very rare. In this paper we present one case with an inaccurate preoperative diagnosis which was treated by entire excision of the tumour. One year aftersurgery there is no evidence of recurrence. The literature on the topic is reviewed.
Laryngeal foreign body: an unusual complication of percutaneous tracheostomy
Authors: Kumar B. N. , Walsh R. M. , Courteney-Harris R. G.
Published: November 2007

Impaction of a foreign body in the larynx is a serious event. While inhaledforeign bodies may occasionally impact in the larynx especially in children, a laryngeal foreign body as a complication of percutaneous tracheostomy has not been reported in the literature. We describe the case of a fragment of a Seldinger wire retained in the larynxfor two years following a percutaneous tracheostomy and review the literature on the complications of this procedure.
Supraglottic laryngectomy–series report and analysis of results
Authors: Adamopoulos G. , Yotakis I. , Apostolopoulos K. , Manolopoulos L. , Kandiloros D. , Ferekidis E.
Published: November 2007

Between October 1987 and October 1993, 92 patients with squamous cell carcinoma of the supraglottis were treated by supraglottic laryngectomy and neck dissection in our department. There were 33 T1, 46 T2, six T3and seven T4cases. All patients with N+ necks and T3or T4tumours received post-operative radiotherapy (5,000–6,500 cGy). The patients were followed for a minimum of 36 months or until death. The incidence of local recurrence was 7.6 per cent. Neck recurrence was observed in 13 per cent of patients. Decannulation was achieved in 93.4 per cent of the cases with three patients undergoing gastrostomy because of aspiration. The average hospital stay was 26 days. The overall three-year survival was 83.6 per cent, with eight patients dying of unrelated causes. There was a significant difference in recurrence rate between patients in the N0and the N+ stage.
Misleading clinical features in Wegener's granulomatosis. A case report
Authors: Almadori Giovanni , Trivelli Maurizio , Scarano Emanuele , Cadoni Gabriella
Published: November 2007

Wegener's granulomatosis is a systemic vasculitis that may present with a Variety of findings and be difficult to diagnose. We report a case of a patient who presented with serous otitis media and subsequently developed a suspected primary lung tumour. Thoracotomy and pulmonary mass excision were required to establish the diagnosis. Otological manifestations of Wegener's granulomatosis, differential diagnosis, pathological findings and c-ANCA test role are discussed.
The pathophysiology of otitic hydrocephalus
Authors: Tomkinson A. , Mills R. G. S. , Cantrell P. J.
Published: November 2007

The pathophysiology of otitic hydrocephalus remains controversial. It has been argued that involvement of the superior sagittal sinus, by, at least, a mural thrombus is a necessary component of this disease.

We present a case of otitic hydrocephalus where on magnetic resonance imaging (MRI) normal luminal and mural flow within the superior sagittal sinus is demonstrated. The presence of thrombus in the lateral venous sinus alone appears sufficient in this case to impede venous drainage of the intracranial contents into the neck and produce a rise in the cerebral venous pressure and a subsequent increase in the CSF pressure. The presence of a superior sagittal sinus mural thrombus is not required.
Laryngeal necrosis after combined chemotherapy and radiation therapy
Authors: Miyaguchi Mamoru , Takashima Hitoshi , Kubo Takeshi
Published: November 2007

Post-radiation necrosis of the larynx is a major complication after irradiation and has become rare. Recently, combined chemotherapy and radiation therapy has been introduced for head and neck tumours. The authors report a case of laryngeal necrosis after combination therapy for a patient with cervical lymph node metastases of nasopharyngeal carcinoma and review the literature on late laryngeal necrosis. Although radiation-induced laryngeal necrosis has become a rare complication, the combination of chemotherapy and radiation therapy may increase its incidence. We should always consider it as a possible late complication and treat it appropriately.
A study of mercuric oxide and zinc-air battery life in hearing aids
Authors: Sparkes Clive , Lacey Neville K.
Published: November 2007

The requirement to phase out mercuric oxide (mercury) batteries on environmental grounds has led to the widespread introduction of zinc-air technology. The possibility arises that high drain hearing aids may not be adequately catered for by zinc-air cells, leading to poor performance. This study investigated the hearing aid user's ability to perceive differences between zinc-air and mercury cells in normal everyday usage. The data was collected for 100 experienced hearing aid users in field trials. Users report 50 per cent greater life for zinc-air cells in high power aids and 28 per cent in low power aids. The average life of the zinc-air cells range from 15 days in high power to 34 days in low power aids. Users are able to perceive a difference in sound quality in favour of zinc-air cells for low and medium power aids. The hearing aid population is not disadvantaged by phasing out mercury cells.
Basal cell carcinoma of the external auditory canal and Gorlin-Goltz syndrome: a case report
Authors: Lobo C. J. , Timms M. S. , Puranik V. C.
Published: November 2007

A case of nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome) with basal cell carcinoma of the external auditory canal is reported. This is only the second such case.
Cavernous haemangioma of the facial nerve
Authors: Escada Pedro , Capucho Clara , Silva José Madeira , Ruah Carlos Bentes , Vital José Pratas , Penha Rui Silva
Published: November 2007

Facial nerve haemangiomas are probably the most frequent benign tumours involving the facial nerve in its intratemporal portion. Usually facial nerve dysfunction is present when these tumours are of extremely small size, the average tumour being less than 10 mm. We present a case of a 15 mm diameter cavernous haemangioma of the geniculate region, with histological findings of nerve infiltration, without facial nerve symptoms. The atypical clinical presentation justifies the report and subsequent literature review.
Topical levocabastine for the treatment of perennial allergic rhinitis
Authors: Elwany Samy , Bassiouny Mohamed
Published: November 2007

The ultrastructure of the nasal mucosa following theuse of intranasal levocabastine was studied in 20 patients suffering from perennial allergic rhinitis. The patients received twice daily 0.05 per cent levocabastine spray with a treatment duration of four weeks. At the end of the treatment period regression of the allergic process was evidenced by progressive reappearance of normal cilia and microvilli on the columnar cells, decrease of intercellular oedema andcytoplasmic vacuoles, increased number of mucous acinar cells, gradualdecrease of vascular congestion, as well as diminished oedema fluid formation. The drug, however, had no effect on mast cell degranulationnor on eosinophilic infiltration. Normalization of the ultrastructural features correlated well with clinical improvement.

Considering the results of the present study, levocabastine nasal spray appears to be an effective treatment for perennial allergic rhinitis and can be used with, or as an alternative to, other anti-allergic medications.
Lobular capillary haemangioma (pyogenic granuloma) of the nose
Authors: El-Sayed Yousry , Al-Serhani Awad
Published: November 2007

Objective

To present a number of cases with lobular capillary haemangioma (pyogenic granuloma) of the nose; and to discuss the clinical and histopathological diagnosis of this disorder.

Methods

A clinicopathological study of patients diagnosed with nasal lobular capillary haemangioma who were treated at King Abdel Aziz University Hospital, Riyadh from 1986 to 1995.

Results

The study group consisted of 12 patients (four males and eight females ranging in age from 17 to 65 years; mean 30.1 years). Clinically, most patients presented with epistaxis and a rapidly growing unilateral haemorrhagic mass. Most lesions were located on the septal mucosa. The clinical impression was misleading in some cases. The histological diagnosis was based on the lobular arrangement of capillaries. One case was initially misdiagnosed as angiofibroma. Excisional biopsy was the mainstay of treatment. One instance of recurrence was recorded.

Conclusion

This uncommon lesion should be considered in the differential diagnosis of a rapidly growing haemorrhagic lesion within the nasal fossa. Clinical and histological diagnostic pitfalls occur frequently.