bluuebunny/crossref_metadata_2025 huggingface dataset:
A review of neuroendocrine neoplasms of the larynx: update on diagnosis and treatment
Authors: Ferlito Alfio , Barnes Leon , Rinaldo Alessandra , Gnepp Douglas R. , Milroy Christopher M.
Published: November 2007

Neuroendocrine neoplasms of the larynx have been divided into those of epithelial or neural origin. The latter consist of paragangliomas while the epithelial origin group can be divided into the typical and atypical carcinoids and small cell neuroendocrine carcinomata, the latter consisting of the oat cell type, the intermediate cell type and the combined cell type. There are now over 500 cases of neuroendocrine neoplasms of the larynx in the literature.

The diagnosis is primarily based on light microscopy, and, in some instances, it may be supported by special histochemical studies. It should be confirmed by immunocytochemical and/or ultrastructural investigation. The different biological behaviour of neuroendocrine neoplasms of the larynx makes a specific diagnosis of paramount importance, since treatment depends on diagnostic accuracy.

Typical carcinoid is an extremely rare lesion. It is treated preferably by conservative surgery; elective neck dissection is not necessary because of the lack of lymph node metastases at diagnosis. Chemotherapy and/or radiotherapy have not been effective in the limited number of patients treated thus far. Prognosis is excellent with cure following surgery.

Atypical carcinoid is the most frequent non-squamous carcinoma of the larynx. The mainstay of treatment is surgery. Elective neck dissection should be performed because of the high likelihood of cervical lymph node metastases. Primary radiation therapy with adjuvant chemotherapy is not indicated. The survival rate is 48 per cent at five years and 30 per cent at 10 years.

Although the larynx is one of its most common extrapulmonary sites, small cell neuroendocrine carcinoma is still a rare tumour. Surgical results for this tumour have been disappointing and is reserved for cases of local relapse with no evidence of metastasis. Chemotherapy and radiotherapy currently appear to offer the least disabling and most effective forms of therapy. The two- and five-year survival rates are 16 per cent and five per cent, respectively.

Paraneoplastic syndromes have occasionally been reported in association with carcinoid tumours (typical and atypical) and small cell neuroendocrine carcinoma. There have been also rare reports of an elevated neuropeptide serum level.

Paraganglioma is the only laryngeal neuroendocrine neoplasm with a female preponderance (3:1). Confusion with atypical carcinoid has led to incorrect diagnosis and inappropriate classification schemes, erroneously suggesting that laryngeal paraganglioma has the potential for aggressive behaviour. Conservative surgery represents the treatment of choice; elective neck dissection is not necessary, and the prognosis is excellent.
Bacteriology of the maxillary and ethmoid sinuses in chronic sinusitis
Authors: Jiang Rong-San , Hsu Chen-Yt , JANG Jinq-Wen
Published: November 2007

The bacteriology of chronic sinusitis was studied by using swab and mucosalspecimens from both the maxillary and ethmoid sinuses. The specimens of the maxillary sinus were taken through translabial antroscopy. The specimens of the ethmoid sinus were taken after removing the ethmoid bulla during functional endoscopic sinus surgery (FESS). Eighty-six samples of each type of specimen were collected. Among the maxillary sinus samples, the culture rate was 60.5 per cent from the swab specimens and 36 per cent from the mucosal specimens. Among the ethmoid sinus samples, the culture rate was 58.1 per cent from the swab specimens and 75.6 per cent from the mucosal. The p-value by the Chi-Square test is higher than 0.01 (p =0.015). As there were more isolates ofStaphylococcus epidermidisfrom the mucosal specimens, they are not a better choice of specimen for sampling the ethmoid sinus than a swab specimen.
Primary study in experimental antiangiogenic therapy of nasopharyngeal carcinoma with AGM-1470 (TNP-470)
Authors: Qian Chao-nan , Min Hua-Qing , Lin Han-liang , Hong Ming-Huang , Ye Yan-li
Published: November 2007

Objective

To evaluate the efficacy of the angiogenesis inhibitor AGM-1470 for the experimental treatment of nasopharyngeal carcinoma (NPC).

Methods

A NPC human tumour model was built by tumour-bearing nude mice using the NPC cell line CNE-2. Twenty-one BALB/c nude mice bearing CNE-2 xenografts were randomized into a treatment group and a control group. In the treatment group, AGM-1470 was injected 30 mg/kg subcutaneously every other day; while the vehicle (three per cent ethanol solution in 0.9 per cent saline) was given to the mice in control group. Tumour volumes and animal weights were measured every third day. Autopsy was performed after 18 days of treatment. The tumour tissue as well as the murine tissues of heart, kidney, and liver in each mouse were removed for formalin fixation and routine HE staining. Pathological evaluation was performed in these tissues.

Results

There was a significant difference in tumour volume between the two groups at day 9 of treatment and this increased thereafter. At day 15 of treatment, the tumour volume was 4251 ± 559 mm3 (n = 10) in the control group versus 3122 ± 967 mm3 (n = 11) in the AGM-1470 treated group (p = 0.004); and T:C ratio (mean tumour volume of treated/mean tumour volume of control) was 0.73, resulting in a 27 per cent decrease in tumour growth. Central necrosis and consequential shrinkage of tumours occurred in both groups at the end of experiment. Physical toxicity and histological toxicity of heart, liver, and kidney did not result from AGM-1470 therapy.

Conclusions

AGM-1470 suppresses the growth of the human NPC cell line CNE-2. Treatment by AGM-1470 has no physical nor histological toxicity. Angiogenesis inhibitors may be effective in the treatment of the local lesion of NPC.
Malignant schwannoma of the parapharyngeal space
Authors: Al-Otieschan A. A. , Saleem M. , Babu Manohar M. , Larson S. , Atallah A.
Published: November 2007

We present a case of malignant schwannoma (MS) of the parapharyngeal space which completely encircled the internal carotid artery in close proximity to the skull base and required resection of the internal carotid artery along with the excision of the tumour. There have been three previous case reports in the literature of malignant schwannoma of the parapharyngeal space of which one case was associated with neuroflbromatosis. Our patient did not exhibit any feature of neurofibromatosis.
Lipomatosis of the minor salivary glands
Authors: Saleh H. A. , Ram B. , Harmse J. L. , Michie B. A. , Blair R. L.
Published: November 2007

Lipomatosis has not previously been reported in minor salivary glands. Its occurrence in the parotid gland is well recognized. We present the first reported case of lipomatosis of the minor salivary glands in the nasal cavity. We also review the tumours of the minor salivary glands, lipomas and lipomatosis of the parotid, and the few reported cases of lipomas of the sinonasal tract.
The antibacterial activity of acetic acid and Burow's solution as topical otological preparations
Authors: Thorp M. A. , Kruger J. , Oliver S. , Nilssen E. L. K. , Prescott C. A. J.
Published: November 2007

At present there are no topical otological preparations on the World Health Organisation's essential drug list, largely due to the ototoxic potential of preparations containing aminoglycoside antibiotics. Acetic acid and Burow's solution have long been used in the treatment of the discharging ear. The aim of this study was to ascertain the antibacterial activity of these two preparations against the most commonly occurring bacteria isolated from discharging ears in our department. Twenty fresh isolates of each of the following organisms – Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis and Streptococcus pyogenes – were plated onto blood agar and tested against one per cent, two per cent and three per cent acetic acid and Burow's solution (13 per cent aluminium acetate). The activity of each agent was ascertained by the size of the zone of inhibition of bacterial growth. Burow's solution showed significantly larger average zones of inhibition than acetic acid (p < 0.001). The two per cent and three per cent acetic acid as well as the Burow's solution were active against all the organisms tested.
The role of endoscopic stapling diverticulotomy in recurrent pharyngeal pouch
Authors: Koay C. B. , Commins D. , Bates G. J.
Published: November 2007

Endoscopic stapling diverticulotomy is an increasingly popular treatment option for pharyngeal pouch. It has been our treatment of choice for the condition for over three years. Of the over 50 cases treated using the technique, three were performed for recurrent pouches – two following previous endoscopic stapling diverticulotomy and one following previous external excision. We describe these three cases to highlight the advantages and effectiveness of the technique in recurrence cases.
KTP laser assisted excision of glomus tympanicum
Authors: Molony N. C. , Salto-Tellez M. , Grant W. E.
Published: November 2007

A 39-year-old female with a two-year history of mild hearing loss and discomfort on air flight descent was found to have a pulsatile mass behind an intact tympanic membrane. A suspected diagnosis of glomus tympanicum was confirmed by computed tomography (CT) scan imaging. The lesion filled the mesotympanum and hypotympanum but the jugular bony plate was intact, confirming the tympanic site of the lesion. This very vascular tumour was exposed by a tympanomeatal flap and the KTP laser used to shrink and coagulate the tumour progressively with minimal haemorrhage and blood loss. Complete excision of the lesion was achieved without the need for bony removal, and with minimal blood loss. The use of the KTP laser to coagulate this vascular lesion allowed safe removal of the tumour and avoided the need for extended facial recess or hypotympanotomy surgery.
Double epiglottis in Weyer's acrofacial dysostosis
Authors: Wittig F. J. , Hickey S. A. , Kumar M.
Published: November 2007

While evaluating a 61-year-old patient for stridor we incidentally detected a double epiglottis. The patient was also diagnosed of having Weyer's acrofacial dysostosis which is characterized by hexadactyly affecting all four extremities, small and deeply set nails, dental deformities with small, conical teeth and mandibular hypoplasia. The double epiglottis was not the cause for the stridor. Because of the covert symptomatology of double epiglottis it is suggested that the association with Weyer's syndrome is common. Embryological evidence and a review of the literature on laryngeal abnormalities is discussed.
Admission and discharge policy for paediatric adenoidectomy and tonsillectomy – a rural perspective
Authors: Murthy P. , Laing M. R.
Published: November 2007

Adenoidectomy and tonsillectomy are amongst the most common surgical procedures carried out in children. We undertook a prospective audit in the Highlands of Scotland to document the views of general practitioners, parents, nursing staff and anaesthetists on admission and discharge policy. Of responses from 149 general practitioners, 119 (80 per cent) were in favour of change to same day admission and 22 (15 per cent) were not in favour. For change to same day discharge for adenoidectomy, 55 (37 per cent) were in favour and 81(54 per cent) were not in favour. For change to next day discharge for tonsillectomy, the figures were 51(34 per cent) and 89 (60 per cent) respectively. Responses from 14 trained paediatric nurses comprised 13 not in favour of same day admission, six in favour and seven not in favour of same day discharge for adenoidectomy and all 14 not in favour of same day discharge for tonsillectomy. All eight Consultant anesthaetists approached were happy with a change in policy to same day admission for children who were otherwise fit and well. Thirty-seven parents (70 per cent) preferred previous day admission and 14 (29 per cent) were happy with same day admission for their children. On the basis of these results, day-case adenoidectomy or tonsillectomy is not being considered in this area. Moves have been made, however, toward a policy of same day admission and next day discharge.
Hypoparathyroidism after the treatment of laryngopharyngeal carcinoma
Authors: Mortimore S. , Thorp M. A. , Nilssen E. L. K. , Isaacs S.
Published: November 2007

Thirty patients with squamous cell carcinoma of the laryngopharynx were treated with surgery (total laryngectomy and hemithyroidectomy) and radiotherapy. Group 1 (n = 7) patients had surgery only; Group 2 (n = 7) had radiotherapy followed by salvage surgery while Group 3 (n = 16) had surgery followed by radiotherapy.

Parathyroid hormone and calcium levels were measured pre- and post-operatively and pdstradiotherapy. In Group 1 no patients were hypoparathyroid. In Group 2, 29 per cent of patients preoperatively and 57 per cent post-operatively, were hypoparathyroid. In Group 3, no patients were hypoparathyroid pre-operatively, while 25 per cent were hypoparathyroid post-operatively and postradiotherapy. Parathyroid honnone and calcium levels were averaged and compared within and between each group. There was no significant difference within each group, when comparing levels postoperatively and post-radiotherapy from those of pre-operatively. There was no significant difference in levels between each of Groups 1, 2 or 3 (p>0.05).
Pharyngeal pouch following anterior cervical fusion
Authors: Sood S. , Henein R. R. , Girgis B.
Published: November 2007

A case of an acquired pharyngeal pouch which formed as a consequence of previous anterior cervical fusioins reported. This is a rare cause of pharyngeal pouch formation with only one such case previously reported in the English language literature. In our case adhesions had formed between the posterior pharyngeal wall and the area around the screw used to hold the Senegas plate on the anterior aspect of the fifth to seventh cervical spinal vertebrae.
An unusual complication of Cloward's procedure presenting to the otolaryngologist
Authors: Nair Salil B. , Flood Liam M. , Nath Fred
Published: November 2007

We present the case of a 51-year-old lady who developed a CSF leak following a Cloward's procedure (anterior cervical surgery with fusion), which settled with conservative management. Two months following the surgery she was assessed by an otolaryngologist for persistent dysphagia and a swelling in the anterior triangle of her neck. A computed tomography (CT) scan identified a fluid-filled mass displacing the trachea and communicating with the anterior cervical vertebrae, thus confirming th e persistence of a CSF leak.
Intra-operative ultrasound-guided drainage of parotid abscess
Authors: Graham Scott M. , Hoffman Henry T. , McCulloch Timothy M. , Funk Gerry F.
Published: November 2007

Parotitis complicated by parotid abscess remains a potentially life-threatening problem. Conventional surgical treatment involves incising the parotid parenchyma in the direction of the facial nerve until the abscess is located and evacuated. Intra-operative ultrasound greatly assists in localizing the abscess and in ensuring' its complete drainage. Expeditious and exact localization of the abscess reduces operative time. Equally importantly, ultrasound-assisted drainage reduces surgical dissection and the potential for facial nerve damage.
An aggresive and invasive growth of juvenile papillomas involving the total respiratory tract
Authors: Petersen Bodil Laub , Buchwald Christian , Gerstoft Jan , Bretlau Poul , Lindeberg Henning
Published: November 2007

A malignant course of juvenile laryngeal papillomatosis has rarely been reported. In the present case the patient had had laryngeal papillomas since the age of three years. The papillomas gradually spread to the entire respiratory system, and during 30 years the patient was operated on more than 80 times. At present an invasive tumour spreading from the tongue into the parapharyngeal space, extending to the cranial base, has been demonstrated by magnetic resonance imaging (MRI).

Intralesional therapy with Cidofovir, a promising antiviral drug against human papillomavirus (HPV) infection, was started with some clinical effect, although only on the superficial tumour growth. Histology of removed tumour tissue has demonstrated a mixture of exophytic and inverted growth pattern, and has mainly been interpreted as benign, in spite of a focally high mitotic index and an intermittent lack of maturation in the epithelium. In the most recent biopsies a verrucous carcinoma has been diagnosed. Expression of p53 was noted to increase in papillomas with time. All samples have been shown to harbour HPV 11, but no other HPV types.
Bones of contention. The supply of temporal bones for dissection: the legalities, problems and solutions
Authors: Morris D. P. , Luff D. A. , Hargreaves S. P. , Rothera M. P.
Published: November 2007

Temporal bone dissection is considered to be an important aspect of the otological training of the Specialist Registrar with dissection skills being formally assessed in the Intercollegiate Fellowship Examination. However the procurement of cadaveric specimens suitable for dissection may be fraught with difficulties. The authors take an historical perspective to clarify the existing legal issues and outline the means available to improve supply.
A simple reconstructive procedure for radiation-induced necrosis of the external auditory canal
Authors: Hill D. S. , Gaze M. N. , Grant H. R.
Published: November 2007

Localized necrosis of the bone, cartilage, and soft tissue of the external auditory canal is an uncommon side effect of radiotherapy to the parotid region. Five patients developed late onset skin necrosis of a quadrant of the ear canal secondary to an underlying osteoradionecrosis of the tympanic ring. We report a one-stage procedure to excise the necrotic tissue and replace it with a local rotational flap derived from the post-auricular skin. Otological side effects of radiotherapy are discussed.
Bone and temporal fascia graft for the closure of septal perforation
Authors: Núñ;ez-Fernández David , Vokurka Jan , Chrobok Viktor
Published: November 2007

Objectives

To assess the reliability of temporal fascia and bone graft for the closure of septal perforation.

Study design

Prospective longitudinal non-randomized.

Methods

The repair of septal perforation was performed using endonasal dissection; suture of the borders of the perforation on at least one side, and interposition of a graft of temporal fascia with bone, either a perpendicular plate of ethmoid (six) if available or mastoid cortex (three) if not.

Results

All patients had closure without re-perforation. Eight out of nine patients had complete closure of the perforation (88.8 per cent). These patients had perforations of less than 3 cm in diameter. The ninth patient had a perforation of more than 3 cm diameter (3.5 × 2.5 cm), and obtained a closure of about 80 per cent of the original perforation. The remaining perforation was in the posterior part of the nose. The patient was relieved of his symptoms (crusting and bleeding). This incomplete closure was most probably due to migration of the graft immediately after surgery. There was no morbidity of the donor site or the ear in the mastoid cortex graft group of patients. This is to our knowledge the first report of the use of the mastoid cortex as a graft in septal perforation.

Conclusions

We consider that the graft of temporal fascia with bone is very reliable, and the use of bone ensures closure while avoiding the complications of a lax septum in large perforations. The technique is suitable for perforations up to 2.5 cm diameter. Perforations larger than 3 cm in diameter are more difficult to close, but closure of the anterior part of the perforation will relieve the patient from the most annoying symptoms.
Drainage after thyroid surgery: a prospective randomized study
Authors: Debry Christian , Renou Guy , Fingerhut Abe
Published: November 2007

Between November, 1996 and May, 1997 a series of 100 consecutive unselected patients undergoing all types of thyroid surgery – including even those inducing large dead space e.g. substernal goitre and carcinoma thyroid with recurrent nerve dissection – were randomly allotted to either receive drainage (n = 43) or not (n = 57). Patients with cervical dissection for lymph node metastasis were not included. Severe intra-operative haemorrhage was not a reason for exclusion. No complications such as haematoma or seroma were found in the undrained group whereas only minor complications such as haematoma (n = 4) were noted in the drained group. Whatever the group, none of the patients required reexploration. The difference in overall hospital stay (1.72 days in the group of undrained patients versus 2.09 days in the drained group) was not statistically significant.
An aneurysm of the petrous internal carotid artery
Authors: Reece Philip H. , Higgins Nicholas , Hardy David G. , Moffat David A.
Published: November 2007

Internal carotid artery aneurysms are a rare cause of pulsatile tinnitus and conductive hearing loss but should be borne in mind when there is a suspected diagnosis of glomus jugulare or high-riding jugular bulb. Most cases are congenital. We present a case of otorrhagia which was initially thought to be a glomus jugulare, the diagnosis of internal carotid artery aneurysm was made at angiography and treated by balloon embolization.
Parathyroid cyst: a rare cause of an anterior neck mass
Authors: Jha Bhal Chandra , Nagarkar Nitin M. , Kochhar Suman , Mohan Harsh , Dass Arjun
Published: November 2007

Parathyroid cysts are rare. Most of them present in the anterior neck as cystic neck swellings. A case of cervical parathyroid cyst is presented, along with a brief review of the literature regarding the aetiology, clinical features, diagnosis and management of this condition.
Tonsillectomy: assessment of quality by consultation rate after discharge
Authors: Rungby Jeanne A. , Rømeling Frans , Borum Peter
Published: November 2007

The aim of this prospective study was to establish a measure of short-term quality of treatment after tonsillectomy/adenotonsillectomy. One hundred and thirty-four questionnaires, returned after 14 days, from 41 children and 93 adults were analysed. Forty-seven per cent had one or more consultations with health-care professionals. Eighty-three consultations by telephone and 33 consultations in person were made. Two recent studies reported higher consultation rates in person to doctors compared to this study. The predominant reason for consulting health-care professionals was pain. Maximum pain scores were significantly higher among those with consultations vs. no consultations (p = 0.0001). Additionally, the intensity as well as the duration of maximal pain increased with the number of contacts per patient (p = 0.0001, p = 0.0045). Sixty-four per cent felt relieved after consultation by telephone and 83 per cent felt relieved after consultation in person. The present study suggests consultation rate as a parameter of quality of treatment and quality of information.
Radiological staging of the chest and abdomen in head and neck squamous cell carcinoma – are computed tomography and ultrasound necessary?
Authors: Nilssen E. L. K. , Murthy P. , McClymont L. , Denholm S.
Published: November 2007

The need for, and choice of, radiological staging investigations for distant metastases in the management of head and neck squamous cell carcinoma is a contentious issue. To address this problem a retrospective audit of routine computerized tomography (CT) and ultrasound scanning of the chest and abdomen respectively was undertaken. The records of 103 patients who, over a six and a half year period, underwent major surgery for head and neck squamous cell carcinoma were reviewed. A total of 57 patients (59 per cent) had CT scanning of the chest of whom two were identified as having synchronous tumours. In both cases, the lesions were identified on chest X-ray prior to scanning. Seventy patients (68 per cent) had routine ultrasound scanning of the abdomen. In none of these was metastatic disease identified. As a result of the audit findings routine CT and ultrasound scanning of the chest and abdomen has been discontinued.
Solitary adult myofibroma of the pinna
Authors: Balakrishnan R. , Pujary Kailesh , Shah Parul , Hazarika Produl
Published: November 2007

Solitary myofibroma is a recently described benign neoplasm of the skin or superficial soft tissue and it represents the adult counterpart of infantile myofibromatosis. This new clinicopathological entity is being recognized increasingly. A case of solitary myofibroma occurring in the pinna of a 50-year-old woman is presented. Such a lesion occurring in the pinna of an adult has not been reported in the literature.
Para-incisional tattooing with electrocautery
Authors: Hussain Akhtar , Lee Michael S. W.
Published: November 2007

The authors present a technique using electrocautery diathermy to make surgical tattoos. This method has been used in over 300 patients who underwent head and neck surgery at Aberdeen Royal Infirmary and Albany Medical College, New York, over a period of five years. A wide variety of operative procedures such as total laryngectomies and neck dissections were performed. The electrocautery surgical tattoos have a major advantage of persisting until the end of the operative procedure by which time other types of tattoos have faded. The technique is widely available, inexpensive, and has to date been complication free.
Angiocentric T-cell lymphoma: an extensive lesion involving the posterior tongue, hypopharynx and supraglottis
Authors: Thorp M. A. , Langman G. , Sellars S. L.
Published: November 2007

Angiocentric T-cell lymphoma, which in the past has been grouped with a variety of granulomatous diseases, occur uncommonly as a destructive condition of the posterior nasal space and midface. We report on a patient with a chronic granular ulcerative lesion involving the posterior tongue, hypopharynx and supraglottis.
Sequential magnetic resonance imaging analysis of the maxillary sinuses: implications for a model of gene therapy in cystic fibrosis
Authors: Graham Scott M. , Launspach Janice L. , Welsh Michael J. , Zabner Joseph
Published: November 2007

Serial maxillary sinus aminoglycoside lavage is an adjunctive technique increasingly employed in a variety of areas in cystic fibrosis (CF). It may be helpful in reducing revision rates for sinus surgery, in lowering rates of bronchial pseudomonal colonization after lung transplantation and in the evolving field of gene therapy for CF. The goal of this study was to assess the utility of the maxillary sinus as a model for gene transfer in cystic fibrosis. We performed serial maxillary sinus lavage, in accordance with published protocols, using tobramycin in a randomized series of five CF subjects. Lavage was performed for up to 10 days and sequential magnetic resonance imaging (MRI) scans were taken at zero, 10, 30, 60, 120 and 180 days. The 30 MRI scans were blindly scored by two examiners on the parameters of maxillary sinus aeration, averaged over the five time intervals, was significantly improved (p<0.05) in the lavaged sinus. This study provides the first systematic image-based measure of efficacy of maxillary sinus aminoglycoside lavage, a major element of a number of clinical protocols used in the treatment of CF. The prolonged increase in aeration after lavage suggests that any further improvement potentially achievable after gene transfer would be difficult to detect, limiting the value of this system as a model of clinical efficacy of gene transfer in CF.
A new method for evaluating and reporting the severity of snoring
Authors: Lim Paul V. H. , Curry Alan R.
Published: November 2007

We propose a new questionnaire-based method for evaluating and reporting the severity of snoring, the snoring scale score (SSS), which provides an assessment of the loudness, frequency and periodicity of snoring sound. Ninety-nine patients with snoring problems were assessed and the results of 19 patients who underwent surgery to reduce snoring were reported using the SSS and the linear analogue score (LAS) at six weeks and six months after surgery. All patients reported reduction of snoring on both the SSS and LAS after surgery although minor discrepancies of reporting were found in six patients when comparisons were made between reporting of outcome using the SSS and LAS. Our study suggested that the SSS offers a uniform, comprehensive and simple to understand method for the evaluation, grading and reporting of snoring which is not currently available.
Cochlear implantation of a deaf blind patient with mitochondrial cytopathy
Authors: Cullington Helen E.
Published: November 2007

Genetic defects of the mitochondrial DNA often cause sensorineural hearing impairment, accompaniment by disorders of organs within the body. This case report describes cochlear implantation of a 33-year-old deaf blind female with mitochondrial cytopathy. The outcome was very successful, and vastly improved quality of life for this patient. Many cases of mitochondrial cytopathy cause progressive deafness; it is, therefore, likely that other patients with this unusual disorder will present for cochlear implant assessment.
Topical inhalant steroid (budesonide, Pulmicort® nasal) therapy in intubation granuloma
Authors: Roh Hwan-Jung , Goh Eui-Kyung , Chon Kyong-Myong , Wang Soo-Geun
Published: November 2007

Intubation granuloma of the larynx is an iatrogenic disease which is induced by endotracheal intubation. It has basically been managed by conservative medical treatment with observation. Surgical excision can be considered as a last resort due to the high recurrence rate which subjects the patients to repeated anaesthesia. The purpose of this study is to evaluate the therapeutic effect of topical steroid in intubation granuloma, comparing the results of conservative medical treatment with, or without, surgery (Group I, 14 patients) and inhalant therapy with topical budesonide (Group II, 20 patients).

In Group I, complete disappearance of granuloma occurred in six cases within a year (42.8 per cent) with conservative therapy only. Microlaryngeal surgery was performed on the eight cases of persisting granuloma after conservative therapy for a year, resulting in two cases of recurrence. In Group II, the granuloma disappeared completely in 85 per cent within six months and in 95 per cent within 12 months without any remarkable side-effects. We concluded that intubation granuloma of the larynx could be treated with topical inhalant steroid as the first choice of therapy rather than other medical treatment or surgical intervention.
Role of polysomnography in tracheostomy decannulation in the paediatric patient
Authors: Mukherjee Bakul , Bais Arvind Singh , Bajaj Yogesh
Published: November 2007

Tracheostomy in infants and children has been the subject of controversy in the medical literature, but decannulation in the paediatric patient is even more controversial. Various approaches and techniques have been used for decannulation, however in spite of all efforts it continues to be a problem. The objective of our study was to assess the role of polysomnography (PSG) in predicting readiness for decannulation. All subjects (n = 31) of the study were less than 12 years of age, and tracheostomized for periods of at least six months to ensure a minimum period of dependence on the tube. All had clinical, radiological and endoscopic clearance before PSG was performed. Twenty-one out of 22 patients with favourable PSG data were successfully decannulated. Attempts to decannulate all the nine patients with unfavourable PSG failed. The conclusion of the study was that PSG is a useful adjunct to the many methods of evaluating readiness for decannulation in children with long-term tracheostomy tubes.
The suprahyoid neck: normal and pathological anatomy
Authors: Chong V. F. H. , Mukherji S. K. , Goh C. H. K.
Published: November 2007

The suprahyoid neck can be divided into fascia-bound spaces. These spaces, which are readily demonstrated on computed tomography (CT) and magnetic resonance imaging (MRI), form the anatomical framework for generating differential diagnosis and assessing disease extent. By correlating the radiological features with clinical information, the diagnostic possibilities of demonstrated lesions could be narrowed down considerably. Multiple space involvement is common in inflammatory and neoplastic processes and the full extent of these lesions should be outlined to facilitate surgical or radiotherapy planning.
Evaluation of Eustachian tube function with ventilation scintigraphy by using133Xe gas
Authors: Karaşen R. Murat , Varoǧlu Erhan , Yildirim Mustafa , Eryilmaz Kerim , Sütbeyaz Yavuz , Şirin Süleyman
Published: November 2007

The aim of this study was to evaluate Eustachian tube function by ventilation scintigraphy. In 13 patients with normal tube function and 16 with one-sided tube dysfunction, 50 MBq133Xe was applied into the nasopharyngeal space through a tube inserted into the nasal cavity. Immediately after the insufflation, the patients were asked to perform three Valsalva manoeuvres.

The visualization of the middle ear was possible in 10 of the 13 patients (77 per cent) with normal tube function. Decreased uptake of the middle-ear region in the side of dysfunction was demonstrated in 11 of the 16 patients (68.7 per cent) with one-sided tube dysfunction. Quantitative evaluation by region of interest technique revealed that by using percentage retention of activity and uptake rates, there were significant differences between the sides of dysfunction and sides of normal tube function (p<0.05) and also between sides of dysfunction and both sides of controls (p<0.05). There was no significant differences between normal sides of patients and both sides of controls (p>0.05).

As a conclusion, this method is non-invasive, easy-to perform and has a low radiation burden in the evaluation of Eustachian tube function. Although the number of patients is limited, the test seems to be applicable with a success rate of about 74 per cent.
Management of the clinically negative cervical lymph nodes in patients with non-conventional squamous carcinoma of the larynx
Authors: Ferlito Alfio , Rinaldo Alessandra , Devaney Kenneth O. , Carbone Antonino
Published: November 2007

This paper discusses the indications for neck dissection in those patients with laryngeal tumours which prove to be, on pathologic examination, not conventional squamous carcinomas but rather fall into the category either of one of the uncommon histological subtypes of carcinoma, or another type of unusual histological variant of laryngeal malignancy, a mesenchymal tumour. It appears as though these unusual laryngeal malignancies may manifest both biological behaviours and propensities to metastasize to regional lymph nodes that differ from those of the more commonly encountered conventional squamous carcinomas of the larynx. This heterogeneous group of tumours accounts for about 10 per cent of all malignant tumours of the larynx.
The shift in the indications for the tracheotomy between 1940 and 1955: an historical review
Authors: Graamans K. , Pirsig W. , Biefel K.
Published: November 2007

In the period between 1940 and 1955 the indications for tracheotomy were extended. For centuries tracheotomies were performed to treat obstructive diseases of the upper airway (hypopharynx, larynx, trachea). With the end of the second World War tracheotomy was indicated more and more for the therapy of lower airway disturbances.

Medical empiricism is thought to be responsible for the gradual shift in the indications during that period from upper to lower airway disturbances. Knowledge about the underlying principles of respiratory physiology was, however, already present at the end of the 19th century, but the shift in the indications did not occur until relatively recently. For many victims of World War II the discovery of the beneficial effect of a tracheotomy in a variety of traumatic disorders may have come too late.
Chemical labyrinthectomy and cochlear implantation for Menière's disease – An effective treatment or a last resort?
Authors: Morgan M. , Flood L. , Hawthorne M. , Raje S.
Published: November 2007

The surgical management of Menière's disease presents a difficult and controversial problem and includes various procedures ranging from ‘placebo operations’ to vestibular nerve section. The situation is even more complex in the case where the only hearing ear is affected. We present a case of severe debilitating vertigo due to Menière's disease that was treated by chemical labyrinthectomy and cochlear implantation. This unique management strategy allowed restoration of useful hearing and relief of vertigo.
The one-stage rhinoplasty septal perforation repair
Authors: Foda Hossam M.T.
Published: November 2007

A combined septal perforation repair and rhinoplasty was performed in 20 patients (12 males, eight females; age range 16–36, mean age 29.6) presenting with septal perforations (size 1–4 cm) and external nasal deformities. The external rhinoplasty approach was used for all cases and the perforation was repaired using bilateral intranasal mucosal advancement flaps with a connective tissue interposition graft in between. The perforation was totally closed in 18 cases (90 per cent) with complete resolution of the pre-operative symptoms occurring in 16 (80 per cent). Cosmetically, 19 cases (95 per cent) were very satisfied with their aesthetic result. The exposure provided by the external approach proved to be very helpful in the process of septal perforation repair. Our results show that septal perforation repair could safely be combined with rhinoplasty and that some of the rhinoplasty manoeuvres used could even facilitate the process of septal perforation repair.
Nasolabial cyst: a report of eight cases and a review of the literature
Authors: Abou El-Hamd Kamal El-Din A.
Published: November 2007

Nasolabial cyst is a cystic ectodermal developmental swelling which occurs as a cyst on the lateral half of the floor of the nasal vestibule at the base of the alae of the nose. Although, it is a rare disease, this is a report of eight cases in a population of 500,000 in one year. Seven of the patients were female aged between 25–50 years. Seven cysts were left-sided and one was bilateral.

The purpose of this paper is to present an additional example of patients with nasolabial cyst. It may be a more common disease than previously thought.
Medial orbital protrusion - a potentially hazardous anomaly during endoscopic sinus surgery
Authors: Lim J. C. , Hadfield P. J. , Ghiacy S. , Bleach N. R.
Published: November 2007

We report the case of a 57-year-old patient with a presumed developmental anomaly of the medial orbital wall. The resultant protrusion of orbital contents into the ethmoidal complex was clearly demonstrated on coronal computed tomography (CT) scans of the paranasal sinuses. This anomaly presents a high risk of iatrogenic injury to the medial rectus and orbit during functional endoscopic sinus surgery and has not previously been described.
The use of inhalers in patients with tracheal stomas or tracheostomy tubes
Authors: Mirza S. , Hopkinson L. , Malik T. H. , Willatt D. J.
Published: November 2007

Patients with chronic obstructive airways disease (COAD) or asthma who have a tracheostomy tube or tracheal stoma have difficulty using metered dose inhalers (MDIs) because of a failure to achieve a good seal between the tracheostomy tube or stoma and the MDI or spacer device mouthpiece. Many such patients therefore utilize nebulizers. MDIs in comparison to nebulizers have the advantages of being more compact, portable, easy to use, less time-consuming, and cheaper. We present the case of a 74-year-old man who underwent a laryngectomy with tracheal stoma formation who had a poor response with nebulizers and required oral steroids. He was subsequently, with the help of a number of attached devices, able to use his MDIs to good effect. We describe a number of devices and adaptors to enable patients with laryngectomy stomas or tracheostomy tubes to utilize MDIs and undergo respiratory function tests. We recommend that all such patients should have the benefit of a consultation with a dedicated respiratory nurse who can provide the appropriate MDIs, devices and adaptors to optimize the treatment of their lower respiratory tract condition.
Turban tumour with involvement of the parotid gland
Authors: Jungehülsing Markus , Wagner Matthias , Damm Michael
Published: November 2007

Familial autosomal dominant cylindromatosis (FADC, turban tumour syndrome, Brooke-Spiegler-syndrome and many more, MacKusick catalogue numbers 123850, 313100) is a rare hereditary disease usually presenting in the second or third decade. With female preponderance dermal cylindromas predominantly arise in hairy areas of the body with approximately 90 per cent on the head and neck. Transformation to malignancy seems to be scarce. Although cylindromas of the skin resemble basal cell adenomas of the salivary gland, there is usually no salivary gland involvement. On the other hand, patients with basal cell adenomas of a salivary gland usually do not show dermal lesions. We report one of the rare cases of FADC combined with multiple basal cell adenomas of the parotid glands and present a review of the literature.
Deafness as self-representation of a 16th century poet
Authors: Dürrigl Marija-Ana , Fatović-Ferenčić Stella
Published: November 2007

In his best poems, the Renaissance poet Sabo Bobljević Glušac emphasizes his hearing impairment, placing his deafness at the centre of attention. These works are not only a poignant expression of an individual artist's suffering, but they may also add to our understanding of the situation of deaf persons. This self-reflection can be seen as a detail that will enhance our ability to communicate with deaf people in order not only to help them hear us, but also to make us hear them as well.
Bilateral congenital cholesteatoma in branchio-oto-renal syndrome
Authors: Worley George A. , Vats Archana , Harcourt Jonathan , Albert David M.
Published: November 2007

Branchio-oto-renal syndrome is a rare autosomal dominant condition characterized by hearing loss, branchial arch abnormalities and renal tract malformations. We present the first reported case of branchio-oto-renal syndrome associated with bilateral congenital cholesteatoma and ossicular chain abnormalities. The pathogenesis of this syndrome is described and the literature is reviewed.
Carotico-cavernous fistula following septorhinoplasty
Authors: Pothula Vijay B. , Reddy Krishna T. V. , Nixon T. E.
Published: November 2007

Septorhinoplasty is a very common operation in otolaryngological practice. We report the second case of a carotico-cavernous fistula following septorhinoplasty. This case presented with very severe epistaxis before the appearance of the typical pulsating exophthalmos, ophthalmoplegia, headache and engorged veins on the right side of the face. Our case was treated by endovascular thrombosis with electrolytically detachable coils.
Mucus circulation between accessory ostium and natural ostium of maxillary sinus
Authors: Chung S. K. , Dhong H. J. , Na D. G.
Published: November 2007

We report a case of one asymptomatic 28-year-old male with mucus circulation between the natural ostium and the accessory ostium of the maxillary sinus. Computerized tomography (CT) revealed a recirculating mucus ring between the two ostia of the maxillary sinus.
Further experience with fat graft obliteration of mastoid cavities for cochlear implants
Authors: Gray R. F. , Ray J. , McFerran D. J.
Published: November 2007

Obliteration of old mastoids and wet middle ears with autologous abdominal fat seems to be a reliable technique to render chronically discharging mastoid cavities or open middle ears dry and closed. This paper is the third in the series and looks at the intermediate results at five years. Of the 16 patients (one bilateral) 94.1 per cent of the ears are still dry and uninfected with closed external meati. Recurrent cholesteatoma was found in two patients at implantation and removed.
The role of midfacial degloving in modern rhinological practice
Authors: Howard David J. , Lund Valerie J.
Published: November 2007

The midfacial degloving approach has been available for twenty five years and is slowly increasing in popularity in the management of extensive benign lesions of the sinonasal region, for selected malignancy in this area and to afford access to the nasopharynx and infra-temporal fossa. The advantages, applications and low complication rate are presented in a cohort of 86 patients, ranging from three to 79 years of age with a mean follow-up of 5.5 years. Seventy-seven per cent of the group had benign pathology of which juvenile angiofibroma was the commonest (40 cases). The 20 cases of malignant disease were a heterogeneous group histopathologically including adenoid cystic carcinoma (four cases), malignant schwannoma (two cases), rhabdomyosarcoma (two cases) and squamous cell carcinoma (two cases). Five underwent bilateral radical maxillectomies combined with orbital clearance in one patient. Complications include oro-antral fistula (three cases) and epiphora (three cases) all of which were successfully treated.
The nasal manifestations of sarcoidosis: a review and report of eight cases
Authors: Fergie N. , Jones N. S. , Havlat M. F.
Published: November 2007

We report eight patients presenting to the Department of Otorhinolaryngology between 1990 and 1998 in whom a diagnosis of sarcoidosis was made. The most common presenting symptom was that of nasal obstruction and crusting and the most common site of involvement was the septum and inferior turbinate. These patients differ from the majority of patients who present with the other manifestations of sarcoidosis in that they are older. Where mucosal changes are present within the nose, biopsy gives a high diagnostic yield. The aim of treatment is to gain symptomatic control with the lowest dose of steroids. The majority of patient's nasal symptoms were managed with local measures and topical steroids. Nasal disease tends to follow a prolonged but benign course. Few had other organ involvement. While nasal sarcoidosis remains a rare cause of nasal obstruction, biopsy of abnormal nasal mucosa along with further investigations as dictated by history, examination and histological findings is important if delay in diagnosis is to be avoided.
Absence of Epstein-Barr virus encoded RNA and latent membrane protein (LMP1) in salivary gland neoplasms
Authors: Pollock A. M. , Toner M. , McMenamin M. , Walker J. , Timon C. I.
Published: November 2007

A series of 55 (42 benign and 13 malignant) salivary gland tumours were investigated by immunohistochemistry, to detect Epstein-Barr virus (EBV) latent membrane protein (LMP1) and byin situhybridization for EBV-encoded RNA. Non-neoplastic gland from all the patients with tumours and 15 control glands were also examined. All cases, both neoplastic and non-neoplastic were negative for LMP1 and failed to show any positive signal byin situhybridization for EBV RNA. One undifferentiated carcinoma from a European patient was included in the group. These results confirm previous reports of an ethnic association between EBV and undifferentiated carcinomas of the salivary gland. They do not support an aetiological role for EBV in other salivary gland tumours.
Haemangiopericytoma of the middle ear with benign histological features
Authors: Karasen R. Murat , Sutbeyaz Yavuz. , Gundogdu Cemal , Eren Suat , Sirin Suleyman
Published: November 2007

Haemangiopericytoma is a rare vascular tumour, particularly in the head and neck region. We described the first case of haemangiopericytoma arising from the middle ear in 1995. The present case is the second example of a primary middle-ear haemangiopericytoma with benign histological features. Clinical photography, computed tomography (CT) and magnetic resonance imaging (MRI) scans and histological photographs depict the findings.