bluuebunny/crossref_metadata_2025 huggingface dataset:
Recurrent respiratory papillomatosis – the Manchester experience, 1974–1992
Authors: Hartley C. , Hamilton J. , Birzgalis A. R. , Farrington W. T.
Published: November 2007

A series of 59 patients of all ages with recurrent respiratory papillomatosis (RRP) treated over an 18-year period is presented. A number of these patients were initially diagnosed in childhood but required treatment throughout adult life. The frequency of laser treatment was not related to either disease duration or age at onset. In 28 patients, the HPV type was identified, showing that HPV type 11 was more common in children and ran a more protracted clinical course. The requirement for tracheostomy in this series was small, whereas the incidence of malignant change in adult patients was significant
Bilateral internal jugular vein ectasia: a report of two cases
Authors: Gendeh B. S. , Dhillon M. K. , Hamzah M.
Published: November 2007

Internal jugular vein ectasia is a venous anomaly commonly presenting as a unilateral neck swelling in children and adults. Literature reports of bilateral presentation are rare. Bilateral Doppler ultrasonography is the diagnostic investigation of choice. The possible pathology, aetiology and management are discussed. Conservative management of bilateral cases is recommended in uncomplicated cases
Difference in the height of the right and left ethmoidal roofs: a possible risk factor for ethmoidal surgery. Prospective study of 150 CT scans
Authors: Dessi P. , Moulin G. , Triglia J. M. , Zanaret M. , Cannoni M.
Published: November 2007

A prospective study of 150 CT scans showed that the right ethmoidal roof was lower than the left in 8.6 per cent of cases. The reverse situation, i.e. the right higher than the left, was observed in only 1.2 per cent of cases. This finding could account for the higher reported incidence of endocranial complications associated with right ethmoidectomy. Coronal CT scans allowing comparison of the right and left ethmoidal roofs should always be made before undertaking intranasal ethmoidectomy
Endotoxic damage to the stria vascularis: the pathogenesis of sensorineural hearing loss secondary to otitis media?
Authors: Guo Yangchun , Wu Yiqin , Chen Wenlie , Lin Jizhen
Published: November 2007

This study presents animal experiments on endotoxin (lipopolysaccharides: LPS) damage to the inner ear with special reference to the stria vascularis. The experimental group animals (albino guinea pigs) were injected with LPS into the perilymphatic space. Pyrogen-free saline (PFS) was injected into the control group. Strial structural evaluation and hearing tests were carried out before and one, three and five days after treatment. In PFS-treated (control) ears, no significant change was found either in hearing or structure. However, thresholds of Nl/Pl were elevated and latencies prolonged in LPS-treated ears. They had severe strial damage mainly to the cellular organelles. The mitochondria became swollen with a disordered, broken, degenerated or absent crest. Secondary lysosomes and autophagosomes increased in number with the presence of medulative inclusions. Na+-K+-ATPase reactant was obviously diminished. It is concluded that LPS-induced strial ototoxicityproduces ion imbalance, causing changesin endolymph composition and energy failure in the organ of Corti and is also responsible for the pathogenesis of inner ear sequelae secondary to otitis media.
Bilateral vocal fold Paralysis in infants: tracheostomy or not?
Authors: Murty G. E. , Shinkwin C. , Gibbin K. P.
Published: November 2007

Tracheostomy has, in the past, been performed in the majority of children under one year with bilateral vocal fold paralysis. We present our experience of 11 cases over a ten-year period during which tracheostomy was avoided whenever possible. Ten cases were managed conservatively but in the youngest a tracheostomy was required. Full bilateral vocal fold mobility developed in all cases at a mean age of 11.5 months (range 5–26 months). Our experience suggests that the airway can commonly be managed expectantly without a tracheostomy.
Temporomandibular joint dislocation and deafness from a cricket ball injury
Authors: Murthy P. , Bandasson C. , Dhillon R. S.
Published: November 2007

Cricket is a national sport in some countries and can be potentially hazardous. We report an incident of a cricket ball impact to the chin, which resulted in posterior dislocation of both temporomandibular joints and bilateral mixed deafness. There appear to be no similar case reports in the literature.
Palatine tonsillar metastasis from carcinoma of the colon
Authors: Low W. K. , Sng I. , Balakrishnan A.
Published: November 2007

Metastatic carcinoma of the palatine tonsil is rare, with only 92 cases reported in the world literature. We report a case of tonsillar metastasis from the colon. This is an unusual case not only because it is the first case report of tonsillar metastasis from this site but also because the tonsillar secondary is the first sign of the primary disease.
Isolated agenesis of the mastoid antrum
Authors: Saleh H. A. , Murty G. E. , O'Donoghue G. M.
Published: November 2007

The first isolated case of agenesis of the mastoid antrum, previously only described in association with the congenital syndromes trisomy 13 and mandibulofacial dysostosis, is reported. The loss of this important surgical landmark may result in disorientation and iatrogenic trauma. The surgeon must be aware of its existence, and where it is suspected the middle fossa dura should be exposed and followed posteriorly until the lateral sinus is encountered.
Cervical osteomyelitis and cord compression complicating pharyngeal myotomy
Authors: Hosni Asaad A. , Rhŷs-Evans Peter
Published: November 2007

Cervical spine osteomyelitis is rare. Haematogenous spread is the usual method by which organisms reach the spine. A review of the English literature reveals very few reported cases of local spread of infection to the spine. Here we present the case of a 68-year-old woman with cervical spine osteomyelitis and cord compression complicating pharyngeal myotomy.
The enlarged translabyrinthine approach for removal of large vestibular schwannomas
Authors: Naguib Maged B. , Saleh Essam , Cokkeser Yasar , Aristegui Miguel , Landolfi Mauro , Taibah Abdel Kader , Mazzoni Antonio , Sanna Mario
Published: November 2007

This study was carried out to validate the enlarged translabyrinthine approach for the surgical management of large vestibular schwannomas. A retrospective review of the charts of 53 patients with large tumours removed via the enlarged translabyrinthine approach at the Gruppo Otologico, Piacenza, Italy, during the last five years was carried out. The ability to control large tumours and the achievement of total removal with low morbidity and very few complications, demonstrate that tumour size does not influence the use of the enlarged translabyrinthine approach for managing large tumours.
Recurrent lower motor neurone facial paralysis in four successive pregnancies
Authors: Gbolade Babatunde A.
Published: November 2007

Recurrent lower motor neurone facial paralysis in successive pregnancies is a rare phenomenon of which there are few case reports in the literature. There have been two previous reports of recurrent Bell's palsy in two and three successive pregnancies respectively, but it is felt that these should have more appropriately been reported as recurrent lower motor neurone facial paralysis in pregnancy as, by definition, any facial paralysis that recurs should not be classified as Bell's palsy even though Bell himself commented on the association between facial paralysis and pregnancy. We report the first case of recurrent lower motor neurone facial paralysis in four successive pregnancies and review the literature.
Crohn's disease of the larynx
Authors: Gianoli Gerard J. , Miller Robert H.
Published: November 2007

Extraintestinal involvement of Crohn's disease is becoming more readily identified. Laryngeal involvement by Crohn's disease, however, has been reported in only five cases in the medical literature. We present the sixth case as well as an analysis of the prior reports.
Uvulopalatopharyngoplasty: the Leicester experience
Authors: Prichard A. J. N. , Marshall J. , Ahmed A. , Thomas R. S. A. , Hanning C. D.
Published: November 2007

Twenty-nine patients undergoing uvulopalatopharyngoplasty (UPPP) for snoring are presented. Ninety per cent expressed an overall improvement in their symptoms: 21 per cent had complete abolition of snoring. Postoperative complications included nasal regurgitation of food/fluids and hyponasal speech development.
Serum leucine aminopeptidase in head and neck cancer
Authors: Garg L. N. , Yadav S. P. S. , Lal Harbans
Published: November 2007

Serum leucine aminopeptidase (LAP) activity was assayed in patients with head and neck cancer. The levels were found to be significantly higher than the controls. However, the rise in serum LAP was nearly the same in all the patients studied, irrespective of the character or histopathology of the lesion but varied with respect to the site involved, i.e. from about 40 per cent in cancer of the hypopharynx to more than 100 per cent in cancer of the nasopharynx. Serum LAP activity was found to increase with the extent of the lymph node spread. After treatment the levels were found to be reduced.
Myxoma of the paranasal sinuses
Authors: Gregor R. T. , Loftus-Coll B.
Published: November 2007

Myxomas of the paranasal sinuses are rare but well described in the literature. They may be related to dental malformations or missing teeth, but may also occur without any such abnormalities. Their local aggressiveness and ability to erode bone should not be underestimated, and they should be totally removed whenever possible. A case of myxoma of the sinuses is described, in which recurrence followed several local removals. The patient was only cured by radical maxillectomy. The operation is described, and the literature on the subject reviewed.
Ethmoidal sarcoidosis
Authors: Tay H. L. , Vaughan-Jones R. , Qureshi S. S.
Published: November 2007

Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Nasal sarcoidosis commonly affects the mucosa of the septum and the inferior turbinates. These patients may present with nasal discharge, crusting, obstruction, epistaxis or anosmia. We present an unusual case of nasal sarcoidosis involving the ethmoid sinus causing recurrent eyelid swelling and discuss its management.
Laryngeal involvement in mitochondrial myopathy
Authors: Hartley C. , Ascott F.
Published: November 2007

A patient with a slowly progressive mitochondrial myopathy is presented. Mitochondrial myopathies are a diverse group of disorders both clinically and at the cellular level. In common with other neuromuscular disorders, bulbar symptoms may occur. However, though pharyngeal symptoms have been documented in all forms of the disorder, no previous account has described problems at the laryngeal level. We discuss the clinical findings and comment on the therapeutic options.
Schwannoma of the larynx: case report, and review of the literature
Authors: Jamal Musa N.
Published: November 2007

A case of schwannoma of the larynx is reported. It originated from the left ventricular fold submucosally and extended to the left side of the neck outside the larynx near the carotid sheath. It presented with stridor. CT scan showed a mass in the larynx which had fractured the left thyroid lamina and extended into the neck. An external surgical approach was used and the mass was removed in toto without laryngofissure. Left vocal fold paralysis was noticed during laryngoscopy at the time of the operation. The possibility that the tumour originated from the recurrent laryngeal nerve is discussed. Histopathological photomicrographs and a CT scan are presented.
Spontaneous tonsillar haemorrhage in acute tonsillitis
Authors: Jawad J. , Blayney A. W.
Published: November 2007

The presentation and management of four cases of spontaneous haemorrhage from the tonsil in association with acute tonsillitis are reported and discussed. Interestingly, younger patients presented with haematemesis. This is a newly recognised, rare, but potentially dangerous complication of acute tonsillitis. Its possible aetiology, pathophysiology and treatment options are discussed.
Two malignant salivary gland tumours of different type in one patient
Authors: Hosni A. , Fisher C. , Rhŷ-Evans P.
Published: November 2007

The synchronous or metachronous occurrence of two tumours of the salivary glands in one patient is rare. These are mainly benign and of the same histological type. Here we report a 56-year-old man who developed a mucoepidermoid tumour of the left parotid gland four years after diagnosis of adenoid cystic carcinoma of the right submandibular gland. This combination of neoplasms has not to our knowledge been reported before.
Cervicofacial actinomycosis presenting as acute upper respiratory tract
Authors: Balatsouras Dimitris G. , Kaberos Antonios K. , Eliopoulos Panayotis N. , Kandiloros Dimitris , Economou Costas N.
Published: November 2007

An unusual case of cervicofacial actinomycosis presenting as acute upper airway obstruction and demanding urgent tracheostomy is reported. Diagnosis was established by microscopic examination of the pus and culture of Actinomyces israelii. Repeated surgical drainage of the purulent foci and prolonged treatment with penicillin obtained resolution of the disease. Clinicians dealing with acute head and neck swellings should always consider actinomycosis as a possible diagnosis.
Hearing thresholds in insulin-dependent diabetic patients
Authors: Virtaniemi Jukka , Laakso Markku , Nuutinen Juhani , Karjalainen Seppo , Vartiainen Eero
Published: November 2007

Hearing thresholds were studied in 53 patients with insulin-dependent diabetes mellitus (IDDM) and 42 randomly selected non-diabetic control subjects, aged between 20 and 40 years. The hearing level tended to be worse in diabetic patients than in control subjects, but the differences were statistically significant only at frequencies of 6000 and 8000 Hz. Microvascular complications (retinopathy and nephropathy), and the duration of diabetes were associated with the elevated hearing thresholds. In contrast, poor metabolic control (high fasting blood glucose and glycated haemoglobin Alc) was not associated with increased hearing thresholds. The changes caused by diabetic neuropathy appeared simultaneously with microvascular complications and a long duration of the diabetes, and thus a causative role of diabetic neuropathy in the pathogenesis of elevated hearing thresholds remained unsolved. It was concluded that elevated sensorineural hearing thresholds at the frequencies of 6000 and 8000 Hz in patients with IDDM are probably caused by the long duration of diabetes and the microvascular complications associated with it.
A pneumatic artificial larynx popularized in Hong Kong
Authors: Chalstrey S. E. , Bleach N. R. , Cheung D. , van Hasselt C. A.
Published: November 2007

The ‘Taiwan tube’ is an inexpensive pneumatic artificial larynx made in Taiwan. The device, which is a tracheo-oral shunt containing a resonator, is popular with laryngectomees in Hong Kong. This paper reports its use and describes its working dynamics which compare favourably with those of other forms of voice restoration.
Sedation with a target-controlled propofol infusion system during assessment of the upper airway in snorers
Authors: Connolly A. A. P. , Martin J. , White P.
Published: November 2007

The ability of a target-controlled propofol infusion system to provide sedation for patients undergoing assessment of the upper airway during snoring is presented. This technique provides the desired sedation level for induction of snoring and is short acting and readily controllable. We advocate its use in sedation nasal endoscopy.
Angiosarcoma of the hypopharynx
Authors: Pisani Paolo , Krengli Marco , Ramponi Antonio , Olina Massimo , Pia Francesco
Published: November 2007

Angiosarcoma is a tumour of endothelial origin rarely found in the head and neck. A case of angiosarcoma of the pyriform sinus, treated by surgery and post-operative radiotherapy, is reported, providing a cue for discussion of the diagnostic, clinical and pathological pecularities of the tumour in the light of personal experience and the published data.
Fenestration and occlusion of posterior semicircular canal for patients with intractable benign paroxysmal positional vertigo
Authors: Hawthorne Maurice , El-Naggar Mohamed
Published: November 2007

A series of 15 patients with intractable benign paroxysmal positional vertigo (BPPV) who had fenestration and occlusion of the posterior semicircular canal (FOP) surgery commencing in December 1990 are reported. Follow-up was from 14 to 40 months. All patients reported a cure of their positional vertigo. No patient regretted having the surgery. All patients had a negative Dix-Hallpike test post-operatively and the test remained negative for the duration of follow-up. Eight patients had a mild high frequency sensorineural hearing (SNHL) loss post-operatively which had almost recovered six months later. No patient reported any change in their hearing following surgery. Of the 10 patients who did not have pre-operative tinnitus, developed tinnitus but it was not considered significant by them. All patients developed mild unsteadiness following surgery which gradually improved with mobilization and physiotherapy if necessary.

The operation preserves hearing, is technically straightforward, well-tolerated and effective.
Sarcomas of nasal cavity and paranasal sinuses: chondrosarcoma, osteosarcoma and fibrosarcoma
Authors: Koka V. , Vericel R. , Lartigau E. , Lusinchi A. , Schwaab G.
Published: November 2007

Forty-two patients were treated for sarcoma of the nasal cavity and paranasal sinuses at the Institut Gustave Roussy, Paris, between 1960 and 1993. Twelve patients had chondrosarcoma (CS), 14 had osteosarcoma (OS) and 16 had fibrosarcoma (FS). Ten patients had grade I, six grade II and 26 grade HI tumours.

All but 10 patients had surgery for the primary tumour. A significantly increased risk of local failure was associated with the male sex (p<0.01), grade III tumours (p<0.02) and patients excluded from surgery (p<0.04). The overall incidence of local and distant failure was 76 and 12 per cent respectively. Overall survival was 28 per cent at three years and 23 per cent at five years. Eight patients (20 per cent) were alive more than 10 years later. The factors significantly influencing survival were sex (p<0.01), grade (p<0.05) and local failure (p<0.01).
Large vestibular aqueduct syndrome and stapes fixation
Authors: Shirazi A. , Fenton J. E. , Fagan P. A.
Published: November 2007

An abnormally large vestibular aqueduct has a well recognized association with inner ear anomalies and it has been assumed previously to be a variant of a Mondini type of deformity (Shuknecht, 1980; Emmett, 1985). The sole radiological finding in some patients with progressive sensorineural loss has been a large vestibular aqueduct (Valvassori and Clemis, 1978; Valvassori, 1983), which is now accepted as a separate clinical entity, i.e. the large vestibular aqueduct syndrome (LVAS).

A case is presented which is believed to be the first reported with unilateral LVAS and stapes fixation and also the first stapes gusher described in association with LVAS.
Coexistence of MALT-type lymphoma and squamous cell carcinoma of the larynx
Authors: Hisashi Kazutaka , Komune Shizuo , Inoue Hisashi , Komiyama Sohtaro , Sugimoto Takuya , Moyoshi Makoto
Published: November 2007

A 66-year-old Japanese man was diagnosed as having a MALT-type lymphoma by histopathological examination. The lesion involved the vocal folds bilaterally, occupying the larynx and extending beyond it, as shown by computed tomography (CT). A course of radiation therapy with moderate doses was given. Six months later, a squamous cell carcinoma was found in the larynx and total laryngectomy was then performed. The patient remained well, without recurrence, 46 months after the operation, thus, MALT-type lymphoma may coexist with a squamous cell carcinoma of the larynx.
Solitary fibrous tumour arising from sublingual gland: report of a case
Authors: Günhan Ömer , Yildiz F. Rüstü , Celasun Bülent , Ünder Turgut , Finci Rifki
Published: November 2007

A solitary fibrous tumour is a pleural tumour which may rarely be detected at non-pleural sites. In this report, the case of a solitary fibrous tumour arising from the sublingual salivary gland is described.
Laryngeal leishmaniasis
Authors: Grant Alison , Spraggs P. D. R. , Grant H. R. , Bryceson A. D. M.
Published: November 2007

A patient suffering from persistent hoarseness was eventually shown to have laryngeal leishmaniasis. The incubation period for the disease must have been at least 16 years, following infection in Southern Europe. Mucosal leishmaniasis is rare in the Eastern hemisphere, and laryngeal leishmaniasis has not previously been reported in the UK. Previous Mediterranean cases have run a similar chronic course and have caused diagnostic difficulty, in particular being mistaken for malignancy. Treatment with aminosidine was ineffective, but the patient responded to liposomal amphotericin.
Laryngeal leishmaniasis as initial opportunistic disease in HIV infection
Authors: Cánovas Diego Luis , Carbonell Jaime , Torres Jose , Altés Jordi , Buades Juan
Published: November 2007

A case of laryngeal leishmaniasis, with symptoms of hoarseness and odinophagia which had developed over the past year, is presented. Clinical features and histological findings are discussed. Visceral leishmaniasis is increasingly associated with HIV infection and some authors have suggested the possibility of including it as a diagnostic criterium for AIDS in HIV-positive patients.

When any case of leishmaniasis presents atypical clinical features, localization or treatment response in endemic areas, HIV infection should be ruled out.
Metastasis in tongue from carcinoma of bronchus: a case report
Authors: Shehab Zaid , Desousa Sylvana , Pahor Ahmes L.
Published: November 2007

A case of carcinoma of the lung with a metastasis on the tongue is presented. The case is of interest because, although primary carcinomas of the tongue are fairly common accounting for 50 per cent of all oral carcinomas, metastatic tumour represents only one per cent of all malignant tumours of the oral cavity and of these only 0.2 per cent metastasize to the tongue.
The diagnosis of inflammatory sinonasal disease
Authors: Roberts D. N. , Hampal S. , East C. A. , Lloyd G. A. S.
Published: November 2007

A prospective study was carried out on 25 consecutive patients referred to an outpatient clinic at The Royal National Throat, Nose and Ear Hospital, with a medical letter suggestive of sinusitis, to test the hypothesis that the diagnosis of inflammatory sinus disease could be made simply and accurately by employing systematic nasal endoscopy and a series of plain sinus X-rays.

The study compared the diagnostic yields of the history, rigid nasal endoscopy and plain sinus films with computed tomography. All the investigations were performed on the same day. The interobserver variability between consultant ENT surgeon, senior registrar and registrar were compared.

With heightened concern over the radiation exposure patients are receiving for medical investigations, the radiation exposure was determined for a selected group of patients. This study demonstrated that in the diagnosis of inflammatory sinonasal disease the clinical assessment correlated with the CT findings in over 90 per cent of cases. This accuracy was dependent on the experience of the clinician in using rigid nasal endoscopy. Interobserver variability ranged from 71 to 90.4 per cent in the correct diagnosis of underlying sinus disease. Close agreement was seen with the interpretation of CT scans. The concordance rate between plain films and CT scans was 87 per cent when reported by a consultant radiologist. This is in close agreement with previously reported studies. The average radiation exposure of coronal CT scanning was 218 times the dose for plain sinus X-rays.
Expression of Fos-protein activated by tactile stimulation on the laryngeal vestibulum in the cat's lower brain stem
Authors: Tanaka Yasumasa , Yoshida Yoshikazu , Hirano Minoru
Published: November 2007

To demonstrate morphologically the neurons participating in the4aryngeal reflex, Fos-expression, activated with tactile stimulation of the laryngeal vestibulum, was mapped in the cat's lower brain stem utilizing immunohistochemistry. In the stimulation group, many Fos-immunoreactive (ir) neurons were recognized in the nucleus tractus solitarii (NTS) from the level of the most rostral portion of the dorsal motor nucleus of the vagus to the level of the most caudal portion of the inferior olivary nucleus (IO), and in the nucleus ambiguus (NA) from the level of the rostral end of the hypoglossal nucleus to the level of the caudal end of the IO, bilaterally. While some Fos-ir cells were found in the spinal nucleus of the trigeminus, they were also found in the reticular nuclei bilaterally. In the control group, Fos-ir cells were distinctly fewer in number than those in the stimulation group. The results suggested that in the brain stem, the laryngeal reflex pathways have more than two synaptic relays through the interneurons in between the NTS and the NA.
Mycobacterium avium-intracellulare cervical lymphadenitis in siblings: a case report and review
Authors: Cumberworth V. L. , Robinson A. C.
Published: November 2007

We report two cases of cervical mycobacterium avium-intracellulare lymphadenitis in siblings which developed within one month of each other. There was no underlying immunodeficiency but the children lived in close proximity to a pigeon loft.
Amplification of the Int-2 gene in head and neck squamous cell carcinoma
Authors: Rubin John S. , Qiu Lucy , Etkind Polly
Published: November 2007

Cellular oncogenes have been implicated in head and neck cancer development since 1986. More recently interest has focused on chromosome 11q13; oncogenes therein undergoing ongoing investigation include Bcl-l/Prad-1, Hst-1 and Int-2.

Our laboratory has studied the Int-2 oncogene for several years, primarily in the breast. This paper presents our investigations of Int-2 in the head and neck. Thirty-four paraffin-embedded primary squamous cell carcinomas were studied for Int-2 gene amplification using a carefully controlled method of sequence quantification by DNA dot blots. Amplification, mostly low level, was identified in 62 per cent of samples studied. No clinical correlation to amplification could be found.

Further studies are underway looking for evidence of expression of Int-2 in fresh tissues and for amplification and expression of other oncogenes on this amplicon.
Smooth muscle tumours of the larynx
Authors: McKiernan D. C. , Watters G. W. R.
Published: November 2007

Two cases of laryngeal smooth muscle tumours are reported: one a benign leiomyoma, the other a malignant leiomyosarcoma. These tumours may present diagnostic difficulties and immunocytochemistry is helpful in distinguishing smooth muscle tumours from other connective tissue neoplasms and spindle cell squamous carcinoma. Primary treatment in both cases should be surgical resection with small (T1, T2) malignant tumours suitable for partial laryngectomy. Postoperative radiotherapy may have a role in allowing a more limited surgical resection.
Adenoids in school-aged children
Authors: Haapaniemi Jorma J.
Published: November 2007

A total of 687 school children, aged six to 15 years, were examined clinically, radiologically and audiometrically. Lateral radiological examination of paranasal sinuses was carried out in 663 (96.5 per cent) children for evaluation of the size of adenoids. The size of the soft tissue shadow (adenoids) was assessed as normal or large. It was large in 133 (25 per cent) children, three times more frequently in seven-year-old than in 14-year-old children. The occurrence of adenoidal symptoms (blocked nose, mouth breathing, snoring, snuffling or rhinitis) varied from 14.3 to 30.1 per cent in children with large adenoids compared to 7 to 9.8 per cent in children with normal adenoids. Logistic regression analysis revealed that only recurrent snoring and the child's age were significantly associated with radiologically large adenoids. The hearing thresholds were 1.1 to 4.2 dB poorer and mean middle ear pressure values were 60 to 70 mmH2O lower in children with large adenoids compared to those with normal size adenoids. Large adenoids have an influence on the hearing level of a child, but probably via the negative middle ear pressure.
Post-laryngectomy pharyngocutaneous fistula – a still unresolved problem
Authors: Fradi Milo , Podoshin Ludwig , David Jaacov Ben
Published: November 2007

Fifty-six total laryngectomy cases are presented with special reference to post-operative fistula formation. All these patients were operated upon at the Department of Otorhinolaryngology at the Bnai Zion Medical Centre by one surgeon over a 16-year period, from 1976–1992. The incidence of fistula was 12.5 percent. This paper could not verify reports that any specific factors were significantly related to fistula formation, although there was a preponderance of fistulas in patients presenting with late stage tumours. No relationship was found with rate of infection, age, or between previous neck irradiation (ranging from 5500 to 7000 cGy) and fistula formation in the patient population.

If a fistula occurs, the administration of oral solid food keeping the nasogastric tube in place for administration of fluids may lead to spontaneous closure of the fistula, with no need for secondary surgical repair.
Carcinoma ex pleomorphic adenoma of the soft palate
Authors: Yoshihara Toshio , Tanaka Masayo , Itoh Mitsuko , Ishii Tetsuo
Published: November 2007

A case of carcinoma ex pleomorphic adenoma arising in the soft palate is reported. The tumour presented had enlarged gradually over 10 years and finally occupied the oral cavity. The patient was admitted to our hospital due to disturbance of her speech and swallowing, and a sudden haemorrhage from the tumour. The initial pathological diagnosis by open biopsy was benign pleomorphic adenoma. After total resection, histological examination revealed that the tumour was composed partly of benign pleomorphic adenoma and partly of an adenocarcinomatous component. The carcinoma cells with prominent nucleoli were spheroid or polygonal in shape, and frequently formed ductal structures with areas of necrosis. Mitoses were also found. These findings showed that this tumour was a secondary carcinoma which had developed in a preexisting pleomorphic adenoma.
Lymph node and distant metastases in patients with sinonasal carcinoma
Authors: Miyaguchi Mamoru , Sakai Schun-ichi , Takashima Hitoshi , Hosokawa Hironobu
Published: November 2007

A retrospective analysis of 34 cases of sino-nasal squamous cell or undifferentiated carcinoma in patients admitted between 1984 and 1992 was undertaken. Multimodality therapy incorporated radiation, surgery and chemotherapy. The five-year survival rate was 53 per cent. The local control rate was 82 per cent. Patients died of local failure (six), distant metastases (six), lymph node metastases (one) and other causes (three). Twenty-eight patients with local control were separated into groups: G1–2 (well and moderately differentiated) and G3–4 (poorly differentiated and undifferentiated) and evaluated to find the association between differentiation and metastasis. Lymph node metastasis was not related to the degree of differentiation. Distant metastasis was significantly related to the degree of differentiation (Fisher's exact test: p = 0.007). The result of the combination therapy is poor for patients with poorly differentiated or undifferentiated carcinoma because of distant metastases. Adjuvant chemotherapy may be necessary for them to prevent distant metastasis.
Nasal septal surgery: is routine follow-up necessary?
Authors: Murthy P. , Mckerrow W. S.
Published: November 2007

An audit project was undertaken to appraise the outcome of 95 cases of septal surgery over a 12-month period, taking into account the subjective alteration of symptoms, appearances at anterior rhinoscopy and complications. Seventy-three patients (76.8 per cent) attended the follow-up clinic three to six months (median four months) after surgery. There was an improvement in short-term nasal breathing and in the clinical appearance of the septum in 84.9 and 96.9 per cent respectively; a complication rate of 10.9 per cent and an overall satisfaction rate of 81.3 per cent were also noted. These results support those of other reported series and suggest that routine follow-up of uncomplicated cases of septal surgery is unnecessary.
The need for excessive dietary sodium chloride following tympanoplasty
Authors: Lauerma Hannu , Paalassalo Päivi
Published: November 2007

Loss of a single nerve function in the peripheral network responsible for taste perception is traditionally considered clinically insignificant. However, we report the case of a 27-year-old woman who experienced significant selective taste loss for salt after manipulation of the chorda tympani during tympanoplasty. This effect may be explained by disorder of the functional neuroanatomy of salty taste perception together with strong lateralization of mastication to the affected side in this patient. Recently described inhibition of cranial nerve IX by cranial nerve VII is hypothesized as contributing to the contradiction between this case and the commonly accepted role of the chorda tympani in taste perception.
Candida epiglottitis in an adult with acquired immunodeficiency syndrome treated with oral fluconazole
Authors: Israel Leslie , Sadigh Majid
Published: November 2007

Candida epiglottitis has been reported in immunocompromised patients, but in only one paediatric patient with human immunodeficiency virus. We present possibly the first reported case of Candida infection of the epiglottis in an adult with human immunodeficiency virus treated with oral fluconazole. We review the symptoms, diagnosis. and management of the published cases of Candida epiglottitis in patients without the human immunodeficiency virus. Laryngoscopy and culture are diagnostic.
Hearing preservation in vestibular schwannoma surgery: fact or fantasy?
Authors: Sanna Mario , Karmarkar Sandeep , Landolfi Mauro
Published: November 2007

This study reviews 57 papers dealing with the issue of hearing preservation in vestibular schwannoma surgery published in otolaryngologic and neurosurgical literature between theyears 1977 and 1994. The authors', in this review, have made an attempt to verify whether the claims of hearing preservation are real, whether there is a price to be paid in terms of morbidity and whether there are univocal criteria for reporting results. The review shows that there is a wide disarray in reporting hearing results and the claims of hearing preservation are often unreal and misleading. On retabulating the results of a few series according to the minimal prerequisites for normal hearing (PTA ≤3O dB and SDS ≥70 per cent) and according to other various commonly reported criteria, it became evident that rates of hearing preservation differeda lot depending upon criteria. While any measurable hearing could be preserved in many cases, only a few had normal hearing preserved.
Middle ear pressures in patients with nasopharyngeal carcinoma and their clinical significance
Authors: Low W. K.
Published: November 2007

There is a paucity of studies investigating middle ear pressures (MEPs) in patients with nasopharyngeal carcinoma (NPC). This paper prospectively examines MEPs in patients with nasopharyngeal carcinoma before and after radiotherapy and discusses their clinical significance. Newly diagnosed patients with nasopharyngeal carcinoma were studied before and at three to 12 months (mean 7.5 months) after radiotherapy. MEPs were measured by tympanometry. Thirty-three patients completed the study. The mean MEP before and after radiotherapy was −55.2 mm water(range −250 to 45 mm water) and −73.1 mm water (range −215 to 35 mm water) respectively. About two-thirds of assessable ears had an increase in negative MEPs after irradiation and the rest had less negative MEPs after irradiation. Those ears which developed post-irradiation middle ear effusions were found to have pre-irradiation negative middle ear pressures of at least −45 mm water. These findings provide possible explanations for some unexplained audiometric observations previously made in patients with nasopharyngeal carcinoma after radiotherapy. Tympanometry before radiotherapy may prove to be useful in identifying ears with a high risk of developing post-irradiation middle ear effusion.
Heterotopic pleomorphic adenoma in the neck
Authors: Tay H. L. , Howitt R. J.
Published: November 2007

Cervical heterotopic salivary tissues are rare and are predominantly found in the anterior triangle of the neck especially at the anterior border of the sternocleidomastoid muscl. We report a case of pleomorphic adenoma arising in the left posterior triangle of the neck.
Atypical carcinoid tumour of the larynx
Authors: Watters G. W. R. , Molyneux A. J.
Published: November 2007

The case of an atypical carcinoid tumour of the larynx is described in a 65-year-old man. Thisrare tumour may present diagnostic difficulties, but the diagnosis should be considered in a patient presenting with symptoms of local or referred pain and an apparently small, non-ulcerating supraglottic tumour. Immunocytochemistry has an important role in establishing the diagnosis. A very unusual feature of this case was positive staining for S-100 protein by sustentacular cells. Atypical carcinoid tumours do not respond well to radiotherapy so the primary treatment should be surgical resection.
Crown Prince Frederick of Prussia: Suez and syphilis. Un canard dévoilé
Authors: Laurenson Rae Duncan
Published: November 2007

Frederick III (Crown Prince of Prussia, and Emperor of Germany) died of cancer of the larynx in 1888. In Drame Imperial (1888) journalist Jean de Bonnefon asserted that the disease was not cancer but syphilis which the Crown Prince acquired in 1869 in Suez. What de Bonnefon wrote about the prince does not coincide with the prince's itinerary published in the London Times. This discrepancy is examined and the reason for de Bonefon's claim is considered. The report that Crown Prince Frederick of Prussia caught syphilis in Suez is a canard.
Improving the reproducibility of acoustic rhinometry: a customized stand giving control of height and angle
Authors: Fisher Edward W. , Boreham Adrian B.
Published: November 2007

Control and recording of the position of the acoustic rhinometer in relation to the nostrils is important for serial measurements. Several technical factors must be controlled, including the angle of the incident acoustic wave. We describe a simple, newly-designed, rhinometer stand which allows control of height and angle, and hence improves the reliability of serial measurements in clinical and physiological work.
One-stage procedure to establish osseointegration: a zero to five years follow-up report
Authors: Tjellström Anders , Granström Gösta
Published: November 2007

A cohort of 214 patients, who were operated on to insert implants in the mastoid process for the retention of bone-anchored hearing aids and auricular prostheses, was followed-up over a five-year period. About half the group were operated on using the conventional two-stage procedure allowing three to four months for osseointegration. In the second group (one-stage group) the skin penetrating coupling was connected at the time of the implant insertion. The success rate for stable implants was found to be the same in both groups. In the one-stage group four out of 161 implants inserted were lost and in the two stage group three out of 120. The cumulative success rate was also found to be the same. A ‘worst case’ table where patients lost to follow-up, patients who died during the study period, and patients who for some reason left the study is also included. The importance of this ‘worst case’ scenario when follow-up data are presented is discussed.
A study of alpha-amylase activity in tracheobronchial secretions of seriously ill patients with tracheostomies
Authors: Nandapalan V. , McIlwain J. C. , Hamilton J.
Published: November 2007

This study was undertaken to assess any salivary aspiration in seriously ill patients with tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheostomies in an Intensive Care Unit setting. The alpha-amylase activity in the tracheobronchial secretions of 15 such patients were analysed to evaluate the incidence of salivary aspiration. None of the patients had clinical or radiological evidence of lung disorder at the time of the commencement of the study. Six out of 15 patients showed very high levels of alpha-amylase activity in their tracheobronchial secretions on Day 3 and all six subsequently developed severe chest infections. The other nine patients showed a low level of amylase activity in their secretions. Two patients in the latter group developed severe pulmonary disease. This study demonstrates that a high level of alpha-amylase activity in the tracheobronchial secretions of tracheotomized, ventilated patients indicates that salivary aspiration may be taking place, and further suggests that progressively increasing levels may indicate the likelihood of a major pulmonary complication developing.
Neuralgia-like symptoms in a patient with an airgun pellet in the ethmoid sinus: a case report
Authors: Donald Paul J. , Gadre Arun K.
Published: November 2007

An unusual case of a retained airgun pellet in the ethmoid sinus is presented. The patient's only complaint was a severe neuralgic headache. Anatomical basis for this symptom, imaging and successful endoscopic removal of the foreign body are discussed. The philosophy for removal of innocuous foreign bodies, potential pitfalls in surgical management, and a review of the literature are included in the discussion.
Huge saccular cyst of the larynx: a case report
Authors: Raveh Eyal , Inbar Edna , Shvero Jacob , Feinmesser Raphael
Published: November 2007

Lateral laryngeal saccular cysts of the larynx that herniate through the thyrohyoid membrane are quite rare. We present a case of a huge midcervical cyst which occurred as a result of extreme neglect of a lateral saccular cyst. This case provided us with a unique opportunity to characterize the late stages of this pathology. The differential diagnosis of cervical cysts and treatment approaches are discussed.
Age and sex incidence of hypopharyngeal tumours in Upper Egypt: Assuit University experience
Authors: Saleh Ezzat M. , Abdullwahab Ahmed A. , Kammal Mohammed M.
Published: November 2007

Three hundred and seventeen patients with hypopharyngeal tumours presented at Assuit University Hospital and were studied retrospectively with regard to sex and age incidence. Postericoid tumours form the majority (50.1 per cent) followed by pyriform fossa tumours (26.5 per cent) and finally posterior pharyngeal wall tumours (23.4 per cent). Men form the majority (211 out of 317, i.e. 69.7 per cent). The age incidence shows two peaks at 31–35 years and 56–60 years. The first peak is formed mainly of women while the second peak is formed mainly of men.
Metastatic adenocarcinoma of the ethmoids in a patient with previous gastric adenocarcinoma: a case report
Authors: Owa A. O. , Gallimore A. P. , Ajulo S. O. , Cheesman A. D.
Published: November 2007

Metastatic carcinoma of the ethmoids is very rare. Of the few cases reported in the literature, the majority are renal in origin. Although metastases from the gastrointestinal tract have been reported. there are no known cases of metastases from the stomach.

We present a rare case of metastatic adenocarcinoma of the ethmoids in a patient previously treated for adenocarcinoma of the stomach and describe the possible mechanisms of spread. The patient had a craniofacial resection of the tumour but unfortunately died four weeks post-operatively from acute liver failure probably caused by a liver metastasis.
Excision of adenoid cystic carcinoma of the cervical trachea via an anterior castellated approach
Authors: Hartley B. E. J. , Fagan J. J. , Rhŷs-Evans P. H.
Published: November 2007

Adenoid cystic carcinoma of the cervical trachea is rare and its diagnosis and surgical management challenging. We report a case with an unusual presentation and discuss the diagnosis and management. The preferred surgical management is tracheal resection, however this is often not feasible and many alternative techniques have been used. Here an anterior castellated approach is described, a modification of that more commonly used for benign tracheal strictures. We found it gave excellent access to the posterior tracheal wall which we feel is superior to a straight vertical tracheal incision. It also facilitates a tracheal widening procedure if indicated, and safeguards the recurrent laryngeal nerves which are particularly vulnerable in the cervical part of the trachea.
Topical active H1-antihistamines and their effect on nasal airway resistance
Authors: van Houten R. J. , Premachandra D. J.
Published: November 2007

The introduction of a topically active H1-antihistamine nasal spray Azelastine, has given an extra dimension in the management of allergic rhinits. The drug acts rapidly and avoids the sustemic adverse effects of antihistimines. An objective prospective study was performed to detect the effect of Azelastine nasal spray on nasal airway resistance. Twelve healthy adult volunteers with no rhinological problems were included in the study. Nasal cavites were sprayed with 280 μg (two puffs) of Azelastine nasal spray and the nasal airway resistance was measured with anterior rhinomanometry at intervals of 30 minutes for up to two hours. Our study has shown statistically significant increase in the total nasal airway resistance following the use orf Azelastine nasal spray in the absence of a subjective change in nasal airway resistance. There are substances when inhaled which can cause subjective improvement in nasal airway patency without changing the measured nasal airway resistance. However this medication gives no subjective change in nasal airway patency in spite of increasing nasal airway resistance.
Punctate diathermy of the soft palate: a new approach in the surgical management of snoring
Authors: Whinney David J. , Williamson Peter A. , Bicknell Philip G.
Published: November 2007

We present our experience in the surgical management of 21 snorers, utilizing a new approach designed to stiffen the palatal musculature, without compromising its function. This was achieved by using a punctate patterna of intrapalatal diathermy to achieve fibrosis within the palate and hence the requisite stiffening. The initial results of this procedure are encouraging showing a subjective improvement in snoring in 85.7 per cent of patients and an increase in sleeping in the same room as their partner every night, from 14.3 per cent pre-operatively to 57.1 per cent post-operatively.
Intrapetrous carotid artery aneurysm presenting as epistaxis and otalgia
Authors: Banfield G. K. , Brasher P. F. , Deans J. A. J. , Barker P. G. , Taylor W. J.
Published: November 2007

Aneuroysm of the intrapectous carotis artery is an extremely rare and potentially serious occurence that presents diagnostic and therapeutic difficulties. Such aneurysms may follow trauma, atherosclerosis, mastoid surgery or most commonly can represent a developmental abnormality. We present the case of an 18-year-old female with a short history of recurrent left-sided otalifa and epistaxis who underwent successful endovascular ballon entrapment of a left intrapetrous carotid aneurysm.