bluuebunny/crossref_metadata_2025 huggingface dataset:
Young's procedure in the treatment of epistaxis
Authors: Brooker D. S. , Cinnamond M. J.
Published: November 2007

Intractable epistaxis associated with septal perforation is a difficult problem to treat, particularly if nose-picking appears to be associated. Two such cases are presented in which Young's procedure of nasal closure was used to prevent epistaxis. Although the procedure was fully successful in only one patient. we feel the procedure has a part to play in the management of such cases of epistaxis.
Papillary adenocarcinoma of the nasopharynx
Authors: Van Hasselt C. Andrew , Ng H. K.
Published: November 2007

The first case of low-grade papillary adenocarcinoma of the nasopharynx is described from an area where carcinoma in the nasopharynx is endemic. Clinicopathological features are detailed and differences between the prevalent nasopharyngeal cancer and low-grade nasopharyngeal papillary adenocarcinoma are emphasized. This tumour requires positive identification as surgical management is necessary to avoid the possibility of future recurrence.
Human temporal bone feedings in acquire hypothyroidism
Authors: Hald J. , Milroy C. M. , Jensen K. Damkjær , Parving A.
Published: November 2007

Histological studies of the auditory organ in patients with acquired hypothyroidism are scarce. Thus the aim of the present study was to examine the temporal bones and the brain is subjects with hypothyroidism. Four temporal bones and two brains from clinically and biochemically hypothyroid subjects were removed and evaluated by light microscopy determine to the morphological changes and deposition of neutral and acid glycosaminnoglycans. An audiogram from one of the patients showed a sensorineural hearing loss. Which could be ascribed to occupational noise exposure. The study revealed histological changes compatible with age and infectious disease. No accumulation of neutral or acid glycosaminoglycans could be demonstrated in the temporal bones, or in the brains.
Laryngeal preservation in cases of advanced laryngeal cancer treated with platinum based induction chemotherapy befire local treatment
Authors: Nikolaou A. , Fountzilas G. , Kosmidis P. , Banis C. , Sobolos K. , Danilidis J.
Published: November 2007

In this study we analyse our preliminary results after treating 28 patients with locally advanced laryngeal cancer with platinum based induction chemotherapy followed by radiation therapy or surgery.

The median age of our patients was 60 (46–75) years and median performance status was 80 (60–100). In 18 of the 28 patients locoregional treatment was radiation therapy with an overall response of 94.4 per cent.

After a median follow-up of 26 (15–40) months 39.3 per cent of the whole group of patients are alive and disease-free and six (21.4 per cent) patients are alive and disease-free preserving their larynx.

We conclude that although more extensive studies with large groups of patients and longer follow-up is needed to reach definite conclusions, it seems that platinum based induction chemotheraophy can be used successfully in locally advanced laryngeal cancer followed by radiotherapy. In those cases who respond well. the patient's larynx is preserved without compromizing the overall survival.
Orf of the pinna
Authors: Shinkwin C. A. , Holmes A. H. , Freeland A. P.
Published: November 2007

A case of orf affecting the pinna is discussed. This is an unusual presentation of aninfection that is common in farming communities.

At the initial presentation the diagnosis was not suspected, the management therefore was inappropriate and probably gave rise to the secondary infection that ensued. The history described is classical.

Orf affecting the external auditory canal has been reported once, but orf affecting the pinna has not been described before.
Adenoidectomy in a girl with haemophilia
Authors: Harrison H. C. , Lammi A.
Published: November 2007

Haemophilia A is a sex-linked inherited disease in which those affected are usually males, and females are usually asymptomatic carriers. This paper presents a haemophilia A carrier who has a low factor VIII level first, to remind readers that females can have low factor VIII levels with consequent increased tendency to bleed; second, to stress the importance of routine questioning regarding a bleeding tendency in the patient or the patient's family and third, to illustrate the importance of pre-operative diagnosis to allow adequate correction of the defect so that surgery such as adenoidectomy can be undertaken with safety in such a patient.
Effect of middle ear effusion on the vestibular labyrinth
Authors: Golz Avishay , Westerman S. Thomas , Gilbert Liane M. , Joachims Henry Z. , Netzer Aviram
Published: November 2007

Although middle ear effusion was once described as the most common cause of vestibular disturbance in children, the association between glue ear and symptoms of dysequilibrium has never been quantified objectively.

In this study the effect of middle ear effusion on the vestibular system of the inner ear was studied in a select group of children suffering from long lasting effusion in the middle ear with no evidence of infection at least one year prior to the study. The results were compared with results obtained from otitis free children, as well as from examinations of children after the insertion of ventilating tubes.

The results of this study confirm the assumption that middle ear effusion has an adverse effect on the vestibular system, which can be resolved following the insertion of ventilation tubes.

This effect may also contribute to the adverse effect that otitis media has on a child's development.
Calvarial bone grafts for augmentation rhinoplasty
Authors: Baser Brajendra , Shahani Rekha , Khanna Shalini , Grewal D. S.
Published: November 2007

A large variety of graft materials have been used for augmentation rhinoplasty. To date there has been no graft material which can be regarded as completely satisfactory. The modern trend is to prefer autologous material to new biological material. The membranous bones of the calvarium are extremely suitable for augmenting moderate to severe saddle nose deformities. Calvarial bone grafts can be harvested easily, with minimum donor site morbidity and disfigurement. Our experience with calvarial bone grafts for augmentation rhinoplasty is presented.
Primary mucosal malignant melanoma of the middle ear
Authors: Sherman I. W. , Swift A. C. , Haqqani M. T.
Published: November 2007

Only one case of primary malignant melanoma of the middle ear has been reported in the literature to date.

We report a case of middle ear and nasopharyngeal malignant melanoma where the primary is likely to have arisen in the middle ear and discuss the relevant literature.
Post-irradiation leiomyosarcoma of the maxilla
Authors: Martin-Hirsch D. P. , Habashi S. , Benbow E. W. , Farrington W. T.
Published: November 2007

Primary malignant smooth muscle tumours of the maxilla are extremely rare. A case of leiomyosarcoma of the maxilla associated with previous irradiation is presented. The aetiology, pathology and clinical aspects of this tumour are reviewed.
Bipolar diathermy or ligation for haemostasis in tonsillectomy? A prospective study on post-operative pain
Authors: Choy A. T. K. , Su A. P.
Published: November 2007

Forty-nine children for tonsillectomy were entered in a prospective controlled single blind study to compare the post-tonsillectomy morbidity of bipolar diathermy as opposed to ligation for haemostasis. We found no significant difference in post-operative discomfort nor reactionary or secondary haemorrhage in the two methods used. This is the first controlled trial where bipolar, rather than unipolar diathermy is used, and compared with ligation in the operation of tonsillectomy
The laryngeal mask airway in ENT surgery
Authors: Daum R. E. O. , O'Reilly B. J.
Published: November 2007

We report our experience of using the laryngeal mask airway (LMA) over a period of 18 months in 217 patients undergoing a variety of otorhinolaryngological operations. Advantages over conventional intubation for both patient and surgeon are suggested in both safety, speed and economy. An inadequate airway, necessitating replacement of the LMA, only occurred on two occasions whilst two known cases of difficult intubation easily had their airways secured by use of the LMA. Protection of the lower airways from secretions, fluid or blood, arising above the LMA, would appear to be confirmed
Chondrosarcoma of the maxilla
Authors: Anwar R. , Ruddy J. , Ghosh S. , Lavery K. M. , Wilson F.
Published: November 2007

A patient was referred to us with a mass in her upper jaw. This was diagnosed to be a chondrosarcoma of the maxilla. The mass was removed surgically. We present the case here and discuss the salient features.
Carcinoma of the soft palate
Authors: Tandon D. A. , Bahadur S. , Rath G. K.
Published: November 2007

During a 10 year period 30 patients with carinoma of the soft palate were treated. There were 22 cases in stages I and II. A curative dose of irradiation was used in 25 cases, fourof whom required surgical salvage. Another five cases were treated by a combined modality of surgery and postoperative radiation. Seven cases had nodal metastases. A mean two-year disease-free survival of 83 per cent was obtained. The probability of five-year disease free survival was 65 per cent.
Salvage surgery following irradiation with different fractionation regimes in the treatment of carcinoma of the laryngo pharynx: experience gained from a British Institute of Radiology Study
Authors: Alcock C. J. , Fowler J. F. , Haybittle J. L. , Hopewell J. W. , Rezvani M. , Wiernik G.
Published: November 2007

The 10-year follow-up of patients in a clinical trial involving the comparison of treatment by three fractions per week versus five fractions per week in radiotherapy of squamous carcinoma of the larynx and hypopharynx has now been completed. The trial involved an intake of 734 patients between 1966 and 1975. No statistically significant differences have been found between the two trial arms in terms of overall survival, age corrected survival, local recurrence, laryngectomy-free rates or effects on the normal tissues. Local recurrence was found in 320 of the 713 evaluable patients (45 per cent). Salvage laryngectomy was performed in 151 of the 320 patients with recurrence (47 per cent). Survival at 10 years for all node negative patients was 50 per cent in those patients without primary recurrence, compared with 40 per cent in those undergoing salvage laryngectomy.
Primary neuroendocrine carcinoma of the skin arising from the post aural region
Authors: Kacker A. , Thaker A. , Singh M. , Bahadur S.
Published: November 2007

Neuroendocrine carcinoma of the skin is an uncommon neoplasm. A case of one such tumour in the head and neck region is being presented. This case is the youngest known patient. The literature has been reviewed. The current concepts in diagnosis and management of this tumour are discussed.
Squamous cell carcinoma of the nasal vestibule
Authors: Patel Piyush , Tiwari R. , Karim A. B. M. F. , Nauta J. J. P. , Snow G. B.
Published: November 2007

We reviewed 30 patients with squamous cell carcinoma of the nasal vestibule to present our experience of their management and to evaluate the prognostic factors that may influence their outcome. For T1 lesions radiotherapy remains the treatment of choice, because of the superior cosmetic result. Fifteen (68 per cent) out of 22 patients with T2 lesions were treated with primary radiotherapy. Surgery however, was eventually required in 16 (72 per cent) out of 22 patients, either as a primary treatment (seven patients) or as salvage surgery (nine patients). For the larger T3 lesions the treatment of choice is surgery followed by post-operative radiotherapy where appropriate. Regional nodal metastases at the time of presentation were a significant indicator of local and regional recurrence and of prognosis. The cause specific five-year survival for patients with an uninvolved neck (22 patients) was 100 per cent compared with 38 per cent forpatients with nodal metastases at presentation (eight patients). Elective treatment for uninvolved regional nodes is not considered necessary.
Detection of occult nasopharyngeal primary tumours by means of in situ hybridization
Authors: Feinmesser R. , Feinmesser M. , Freeman J. L. , Noyek A. M. , Livni N.
Published: November 2007

Detection of nasopharyngeal carcinoma primaries in patients presenting with neck node metastases may sometimes demand considerable efforts. By using the ‘ in situ hybridization’ technique, wemanage to identify the Epstein-Barr virus in neck metastases secondary to nasopharyngeal carcinomas. We propose that such identification in neck node metastases where the primary lesion is unknown indicates a nasopharyngeal primary.
Use of a portable manometer as a screening procedure in voice rehabilitation
Authors: Morgan D. W. , Hadley J. , Willis G. , Cheesman A. D.
Published: November 2007

Abnormal tone in the pharyngo-oesophageal (PO) segment may lead to failure in developing oesophageal speech. Videofluoroscopy may give a qualitative assessment of the PO segment but is expensive, time consuming and lacks quantification. A custom built PO segment manometer was therefore assessed as a means of predicting eventual oesophageal speech outcome. Two groups of patientswere studied. In group 1(18 patients) the PO segment pressures were compared to their videofluoroscopy findings. Videofluoroscopy categorized the patients into four groups. The PO pressurescorresponded to this grouping, pressures above 20 mmHg being associated with voice failure. Ingroup 2 (12 patients) the PO pressures in the early post-operative period were compared to their eventual speech outcome. In all cases the pressures predicted the eventual speech outcome. The pressure manometer is a simple, cheap and portable device which is a reliable screening testto predict the potential for oesophageal speech.
Angiosarcoma of the nasal cavity
Authors: Kimura Yasuyuki , Tanaka Saichiro , Furukawa Mitsuru
Published: November 2007

Angiosarcoma of the nasal cavity is extremely rare. We present a case of angiosarcoma of the nasal cavity in an eight-yearold boy. He was treated with medial maxiUectomy via lateral rhinotomy. The histological diagnosis was confirmed by immunohistological stain with Factor Vlll-like antigen. Magnetic resonance imaging (MRI) was useful in determining the extent of the tumour.
Necrobacillosis—an unusual cause of cervical abscess
Authors: Chalstrey S. E. , Williams H. O. L. , Reilly G.
Published: November 2007

Necrobacillosis is a rare infection which may be fatal if inadequately treated. We present a case demonstrating the classical clinical picture upon which correct diagnosis depends. The need for a high index of suspicion is highlighted and appropriate management is discussed.
Nasal septal haematoma in Nigeria
Authors: Chukuezi A. B.
Published: November 2007

A prospective study of 46 consecutive patients with nasal septal haematoma admitted at the General Hospital, Owerri, Nigeria over a five year period is presented. The disease was commoner in males than females. The majority of the cases (65.6 per cent) were of unknown cause and were therefore grouped as spontaneous haematoma while 30.4 per cent were due to trauma. Trauma was more common in patients below the age of 15 years while spontaneous haematoma was common in patients above that age. All the patients with septal haematoma represented 0.2 per cent of total attendances to the ENT clinic over the period. Most of the patients presented with severe and threatening symptoms necessitating intense aggressive management. All the patients were managed by surgical incision and drainage, four had marked nasal abnormalities. Three patients died from a brain abscess as a complication of infected haematoma.
Informed consent: the assessment of two structured interview approaches compared to the current approach
Authors: Dawes P. J. D. , O'Keefe L. , Adcock S.
Published: November 2007

We prospectively studied 190 patients undergoing tonsillectomy or nasal surgery to assess the value of two structured interview techniques. There were four groups: Group A did not have a consent interview during the study period. Group B had an informal interview. Group C had a structured interview and Group D had a structured interview and were given an information sheet. Anxiety assessments were made and patients' recall of the operation name, details of the operation and its complications was assessed.

Patients had higher than normal anxiety levels when admitted, but several hours after the interview anxiety was normal for Groups B, C and D. Group A maintained a higher anxiety level.

Only 37 per cent correctly recalled the operation name, where as 87 per cent of all groups recalled the explanation of the operation. However, Groups C and D recalled a higher mean number of complications per patient.

A structured interview when obtaining informed consent increases the number of complications recalled without increasing pre-operative anxiety.
Giant parotid calculus—an unusual presentation
Authors: Iqbal S. Md. , Murthy J. G. , Sharma Neeta
Published: November 2007

We describe a case of a giant sialolith of Stensen's duct in a 48-year-old woman. The patient was investigated and treated with a mistaken diagnosis of chronic inflammation until the clue to the diagnosis was provided by plain radiography. This is an unusual presentation of a salivary calculus and to our knowledge such a huge parotid calculus has not been reported so far in the literature.
Fibromatosis of the head and neck
Authors: El-Sayed Yousry
Published: November 2007

The purpose of this paper is to focus attention on this rare disorder. Two cases are reported: one involving the neck and the other the nose and paransal sinuses. The treatment of choice is wide surgical excision wherever possible.
Cervical meningocoele presenting as a neck mass in a patient with neurofibromatosis 1
Authors: Freund Brian , Timon Conrad
Published: November 2007

We report a case of an anterolateral cervical meningocoele presenting as a neck mass in a patient with neurofibromatosis 1. This lesion was diagnosed with the aid of computerized tomography and radionucleide scanning. The presentation, behaviour and treatment options of this uncommon lesion are briefly discussed.
Use of protein electrophoresis in the diagnosis of cerebrospinal fluid rhinorrhoea
Authors: Porter M. J. , Brookes G. B. , Zeman A. Z. J. , Keir G.
Published: November 2007

The diagnosis of CSF rhinorrhoea on clinical grounds alone can be difficult. We describe how the use of noninvasive electrophoretic analysis of nasal secretions for tau protein (asialotransferrin) helped in the management of cases where the existence of a CSF leak was in doubt. Patients were thus saved unnecessary invasive investigations or surgery. A modification of the method of analysis, which improves diagnostic accuracy, is described.
Multiple glomus tumours
Authors: Balatsouras Dimitris G. , Eliopoulos Panayotis N. , Economou Costas N.
Published: November 2007

A patient with multiple, synchronous, non-familial head and neck paragangliomas is reported. There were three primary neoplasms, a glomus tympanicum and glomus vagale on the right side and a glomus tumour of the carotid body on the left. Such a combination has never been reported previously.

The reports of all the series with paragangliomas in the literature, as well as the reports of single cases with multiple tumours during the last three decades, are reviewed. Specific problems in diagnosis and management of multiple glomus tumours are discussed.
Chordoma of the parapharyngeal space
Authors: Hampal S. , Flood L. M. , Jones R. A.
Published: November 2007

An unusual case of a chordoma of the parapharyngeal space is presented with no direct involvement of the axial skeleton. Diagnosis was confirmed with the aid of immunocytochemical tests.
Clear cell neoplasm
Authors: Nichols Chris , Geist Rose Yin , Nichols Kara M.
Published: November 2007

We are reporting four cases of clear cell neoplasm. Local infiltration and destruction was observed in one case while in a second case, originating in the sublingual gland, metastasis to the lymph nodes occurred. The behaviour of these neoplasms has prompted the suggestion that these tumours be designated carcinomas rather that noncommittally tumours or neoplasms (Batsakis and Regezzi, 1977).

The histopathological characteristics of our four cases conform to those that have been articulated and believed to be the distinctive features of these tumours (Batsakis and Regezzi, 1977). It is hoped that ours and similar reports will be helpful towards clearing the diagnostic and taxonomic confusion regarding these tumours.
Acute phase reactant proteins—an aid to monitoring surgical treatment of laryngeal carcinoma
Authors: Krecicki T. , Leluk M.
Published: November 2007

The serum concentration of four acute phase reactant proteins (haptoglobin, sialic acid, α, 1-antitripsin, ceruloplasmin) were determined in 160 patients with laryngeal cancer. In 50 cases treated by surgery serial determinations were performed. The control group included healthy persons and patients with non-neoplastic diseases. The levels of haptoglobin, α 1-antitripsin and sialic acid were significantly higher in cancer patients than in control group. The levels of ceruloplasmin reveals no statistically significant difference between particular groups of patients. The serum concentrations of haptoglobin, α 1-antitripsin and sialic acid correlated with the clinical status of cancer patients. We suggest that serial determination of certain acute phase reactant proteins may be useful as a prognostic acid in following patients with laryngeal carcinoma.
Nucleolar organizer regions (NORs) and myoepitheliomas: a comparison with DNA content and clinical course
Authors: Carrillo Rosario , El-Naggar Adel K. , Luna Mario A. , Rodriguez-Peralto Jose L. , Batsakis John G.
Published: November 2007

Nucleolar organizer regions (NOR) were studied in 15 salivary gland myoepitheliomas by an argyrophilic staining technic (AgNOR). The AgNOR data were then compared with flow cytometric DNA content of the neoplasms and also with selected clinicopathologic parameters. We conclude that AgNOR's: (1) do not correlate well with DNA cytometric indices and (2) at best, provide redundant information.
Transitional papilloma of the middle ear
Authors: Kaddour H. S. , Woodhead C. J
Published: November 2007

We present a rare case of a transitional papilloma of the middle ear, occurring several years after excision of a similar lesion from the nose. There was no continuity between the two lesions suggesting that these tumours can be multicentric in origin.
Salivary gland choristoma of the middle ear
Authors: Bottrill I. D. , Chawla O. P. , Ramsay A. D.
Published: November 2007

A salivary gland choristoma is an extremely uncommon tumour in the middle ear space. It appears to be a developmental abnormality and may be associated with abnormalities of adjacent structures.

It usually presents with unilateral conductive deafness which may be long–standing and the tumour often pursues a benign, slow growing course. It is usually possible to excise it, but problems may arise as there may be variable associated anatomical abnormalities of the middle ear.

We present the nineteenth recorded case, review the literature and discuss the management of this condition.
Laryngeal stridor in myasthenia gravis
Authors: Job Anand , Raman R. , Gnanamuthu C.
Published: November 2007

Two patients with laryngeal stridor secondary to myasthenia gravis are reported. The cause of bilateral abductor weakness in myasthenia is discussed; anticipation of the stridor in myasthenic patients is highlighted.
A clinico-pathological classification of laryngeal paraganglioma
Authors: El-Silimy Osama , Harvy Leonard
Published: November 2007

A case of metastatic laryngeal paraganglioma is presented. We have reviewed the current world literature on this entity and thereby identified two apparently distinct types of this rare lesion (type I and type II).

The histopathological features are unhelpful in discriminating these two types and this is instead based on clinicoepidemiological differences. The latter are annotated and discussed with respect to prognosis and management. A true estimate of the frequence of type II (potentially malignant) awaits the utilization of the recent improvements in diagnostic. techniques.
Plexiform neurofibroma of the cervical portion of the vagus nerve
Authors: Galli J. , Almadori G. , Paludetti G. , Rosignoli M. , Corina L. , Ieraci A.
Published: November 2007

The authors describe a rare case of plexiform neurofibroma of the cervical portion of the vagus nerve, and discuss its aetiopathogenesis, clinical, histological and therapeutic features, emphasizing the difference from other benign tumours of the vagus nerve.

The clinical characteristics of the mass, ultrasound tomography, CT scanning and digital subtraction angiography were useful in defining its extension and relationships with the surrounding structures.

Surgery is the treatment of choice. After mentioning the most commonly employed surgical approaches, they emphasize the advantages of the lateral-cervical approach which allows a wide exposure of the possible sites of origin of the tumour and its complete removal.

Finally they stress the need of an accurate histological and immunohistochemical examination in order to differentiate neurofibromas from neurilemmomas.
Unusual multiple metastases from malignant pleomorphic adenoma of the parotid gland
Authors: Cherian T. , Sebastian P. , Abraham Elizabeth K. , Ahmed Iqbal M. , Jayakumar K. L. , Sivaramakrishnan P.
Published: November 2007

A case of malignant pleomorphic adenoma of the left parotid gland which metastasized to the kidney and multiple subcutaneous sites is presented. The patient presented as an acute emergency due to spontaneous rupture of the kidney containing metastasis. All the distant metastatic lesions were confined to the right side of the body.
Primary haemangiopericytomas of the parotid gland
Authors: Carrillo Rosario , Rodriquez-Peralto Jose L. , Batsakis J. G. , El-Naggar Adel K.
Published: November 2007

Haemangiopericytomas involving the parotid gland are uncommon and those arising from the gland itself are rare. Three examples of primary parotid gland hemangiopericytoma are presented. The biological course of parotid or periparotid haemangiopericytomas does not differ from that manifested by their counterparts arising from somatic soft tumours.
Flexible nasopharyngoscopy for fish bone removal from the pharynx
Authors: Choy A. T. K. , Gluckman P. G. C. , Tong M. C. F. , Van Hasselt C. A.
Published: November 2007

The use of flexible nasopharyngoscopy with biopsy forceps for the removal of fish bones found in the oropharynx and hypopharynx is described. One hundred and sixty-eight patients with ingested fish bones in the upper aero-digestive tract were studied over a 12-month period. Of these, 73 percent were removed per-orally, or by indirect laryngoscopy. Fifteen percent were removed using the fibreoptic nasopharyngoscope. Twelve percent required a general anaesthetic and rigid oesophagoscopy for removal of fish bones at or below the level of the cricopharyngeus muscle. The technique has proven to be quick, well tolerated and low in morbidity. It is invaluable in patients in whom indirect laryngoscopy is unsatisfactory.
Few surgical complications after 5,000 to 6,500 cGy pre-operative irradiation for carcinoma of the tongue
Authors: Joensuu H. , Grenman R. , Suonpää J. , Aitasalo K. , Puhakka H. , Nordman E.
Published: November 2007

Twenty-four patients with squamous cell carcinoma of the tongue were treated with 5,000 cGy to 6,500 cGy pre-operative irradiation. Surgery usually consisted of resection of the tongue, possibly the floor of mouth, and modified or radical neck dissection. Musculocutaneous flaps for reconstruction were used in three cases and a forearm flap in one case. Despite the high radiation dose, no major difficulties were encountered at surgery or during the convalescence period, except for one osteoradionecrosis of the mandible, which was successfully treated by microvascular osteomyocutaneous grafting. Residual carcinoma was seen on histological examination of the excised tissue in 9 out of 18 (50 percent) patients who received ≥6,000 cGy, and in 4 out of 6 (67 percent) patients who received about 5,000 cGy tumour dose. The 2-year crude survival rate was 65 percent. The data suggest that high dose pre-operative irradiation is feasible and does not compromise surgical treatment.
Complications of treatment of recurrent laryngeal papillomatosis with the carbon dioxide laser in children
Authors: Saleh Ezzat M.
Published: November 2007

A retrospective study of the complications of treatment with the carbon dioxide (CO2) laser of 17 patients diagnosed to be suffering from recurrent laryngeal papillomatosis is presented. No immediate complications occurred except one case of laryngospasm and failure to intubate during anaesthesia leading to hypoxic encephalopathy. Three patients were completely free from disease and complications. Another patient was free from laryngeal lesions but developed a papilloma in the right tonsillar pillar. Five other patients showed one or more multiple sites of involvement in addition to the larynx. Laryngeal scarring developed in ten patients. Six patients (35.29 percent) developed scarring as anterior glottic webs while in two scarring (11.7 percent) occurred as posterior glottic webs. One developed scarring in the supraglottic region. The remaining one had scarring in both the glottic and supraglottic regions. One patient developed tracheal scarring necessitating laryngo-tracheal separation. Two patients were psychologically disturbed during treatment requiring psychiatric consultation and therapy.
The open access ENT casualty service
Authors: Agrawal R. , Hampal S. , Flood L. M.
Published: November 2007

The ENT specialist's experience of emergencies is usually influenced by a process of prior selection in the GP surgery or in a general Casualty Department. A survey of 1,000 consecutive patients presenting to a 24 hour open access ENT Casualty service is presented. For a variety of reasons, over half of these patients had never sought their G.P.'s advice for their ENT complaint but preferred the hospital service. The value of even a brief exposure to ENT casualty work for GP trainees is demonstrated.
Darier's disease of the external ear
Authors: Thompson A. C. , Shall L. , Moralee S. J.
Published: November 2007

Darier's disease is a hereditary dermatological condition characterized by crusted papules distributed over the seborrhoeic areas of the trunk and head. A case of Darier's disease presenting to the Otolaryngology department because of severe involvement of the pinna is reported. The typical histological appearances are described and treatment discussed.
Malignant parotid salivary gland peripheral nerve sheath tumour in a twelve-year-old girl
Authors: Athow Anna C. , Kirkham Nigel
Published: November 2007

A case of a malignant parotid salivary gland nerve sheath tumour is reported in a 12-year-old girl who developed a right parotid mass. Initial incisional biopsy showed a tumour with a mesenchymal spindle cell appearance. Immunohistochemical studies showed positive staining of tumour cells for vimentin and focally for S-100 protein. These features together with ultrastructural evidence of basal lamina material suggested that the tumour was of nerve sheath origin. After subtotal parotidectomy the tumour metastasised to cervical lymph node and lung. There was evidence of a partial response to chemotherapy. A detailed illustrated histopathological description of the tumour is given.
Long-term effects of topical corticosteroids in the nose
Authors: Bende M. , Mark J.
Published: November 2007

In a prospective study, biopsies were taken from the septal mucosa in 21 patients of whom 11 had been using topical nasal corticosteroids. In contrast to the effect of long-term treatment with corticosteroids in the skin, but in accordance with previous investigations of the nasal mucosa, no histopathological changes of significance were found, although the biopsies were taken from different sites. These findings do not suggest that topically corticosteroids are harmful to the nasal mucosa.
NasopharyngealCorynebacterium ulcerans: a different diptheria
Authors: de Carpentier J. P. , Flanagan P. M. , Singh I. P. , Timms M. S. , Nassar W. Y.
Published: November 2007

A case of toxigenicCorynebacterium ulceransinfection is presented. The diagnosis was delayed and no anti-toxin administered. A nasopharyngeal biopsy was complicated by severe haemorrhage necessitating a post nasal pack. A brief review of the pathology and treatment ofCorynebacterium ulceransis given.
Tragal cartilage inferior turbinate mucoperiosteal sandwich graft technique for repair of nasal septal perforations
Authors: Hussain A. , Kay N.
Published: November 2007

Ten cases of large nasal septal perforation were repaired with a tragal cartilage inferior turbinate mucoperiosteal sandwich graft technique with 70 per cent success rate over a follow-up period of up to 24 months. The technique is described in detail. The results are comparable to other techniques.
Metastatic choriocarcinoma of the maxilla: an unusual cause of severe intractable epistaxis
Authors: Singh Bharath
Published: November 2007

A fifth case of metastatic choriocarcinoma to the maxilla presenting an intractable epistaxis in a 24-year-old African female, is described.
Infra red coagulation for bleeding mucosal telangiectasia
Authors: Colver G. B. , Davies S. , Bullock J.
Published: November 2007

The technique of infra red coagulation is well suited to the destruction of superficial blood vessels in the skin and/or mucosal surfaces. A method is described here for the destruction of resistant bleeding telangiectasia of the palate and lip in Osier-Weber-Rendu syndrome.
Dyskeratosis congenita and nasopharyngeal atresia
Authors: Morrison D. , Rose E. L. , Smith A. P. , Lesser T. H. J.
Published: November 2007

Dyskeratosis congenita is a multisystem disorder with an increased incidence of neoplasia and opportunistic infections. A case is reported as a cause of complete nasopharyngeal atresia.
Inhalation of a Montgomery safe T-tube plug
Authors: Shinkwin C. A. , Murty G. E. , Gibbin K. P. , Bradley P. J.
Published: November 2007

The first case of an inhaled Montgomery Safe T-tube plug is reported. Both the surgeon and the patient should be aware of this possible complication and regular inspection of the plug is recommended. More than one plug should be provided with each T-tube.
Nasal polyps in identical twins
Authors: Drake-Lee Adrian
Published: November 2007

Nasal polyps are multifactorial in aetiology but are associated with respiratory diseases, particularly late onset asthma. Several members of a family may be affected with nasal polyps but there is little evidence for a genetic basis for this. Some evidence to support a genetic predisposition comes from the development of polyps in identical twins.
Cavernous haemangioma of the temporal bone
Authors: Buchanan D. S. , Fagan P. A. , Turner J.
Published: November 2007

Cavernous haemangioma of the temporal bone is a rare lesion and nearly always of limited extent. A case of a large and rapidly progressive temporal bone haemangioma in a child is presented.

Negative angiography led to biopsy at which profuse and troublesome haemorrhage was encountered. Subsequent Red Blood Cell labelled scan demonstrated blood pooling in the lesion. The combination of positive RBC labelled scan and negative angiography can only occur in lesions in which blood pooling takes place, enabling biopsy with its hazards to be avoided.

The tumour was resected using a skull base, infratemporal approach. Morbidity was minimal. There was no evidence of recurrence at a 15 month follow-up.
Osteomyelitis of the cervical spine following laryngectomy
Authors: Ell S. R. , Parker A. J. , Limb D. , Clegg R. T.
Published: November 2007

Only one case of osteomyelitis of the cervical spine following laryngectomy for carcinoma of the larynx has been reported in the literature to date. We report an unusual case of osteomyelitis of the cervical spine following treatment of laryngeal carcinoma by radiotherapy (RT) and subsequent laryngectomy and discuss the relevant literature.
Foetal Warfarin Syndrome—a complex airway problem
Authors: Mason J. D. T. , Jardine A. , Gibbin K. P.
Published: November 2007

Premature cartilaginous calcification and nasal hypoplasia following first trimester exposure to warfarin are known as the Foetal Warfarin Syndrome (FWS). There are over 40 cases reported in the literature, many of which describe breathing and feeding difficulties in the first few months of life. We report a case where a child had had difficulties breathing and feeding in the first months of life. These had been attributed to nasal hypoplasia. After proper ENT assessment the child benefitted from adenoidectomy.

ENT surgeons should be aware of the syndrome as more women of child bearing age are taking warfarin following cardiac surgery and treatment of thromboembolic disease. ENT surgeons may be asked to review these children who often present with airway and feeding problems which have been attributed to nasal hypoplasia.
A case of Merkel-cell carcinoma metastatic to the tonsil
Authors: Tesei F. , Farneti G. , Cavicchi O. , Antonelli P. , Zanetti G. , Leone O.
Published: November 2007

Metastatic tumours are rare in the tonsil. We describe a 69-year-old male patient who had previously undergone a resection of a Merkel-cell tumour of the left forearm and subsequently presented with a left tonsillar tumour. Biopsy revealed a metastatic Merkel-cell carcinoma. Our patient is the first described case of Merkel-cell carcinoma metastasizing to the tonsil. The clinical and histopathological picture of this rare tumour is presented, along with a review of literature
Suction polypectomy forceps
Authors: Nigam Ajay , Johnson Alan P.
Published: November 2007

A new instrument is described which relies on suction for the precise removal of polyps and abnormal mucosa during nasal surgery
Two simultaneously occurring hypopharyngo-oesophageal diverticula
Authors: Boysen Morten , Aasen Steinar , Løtveit Torbjørn , Bakka Arne
Published: November 2007

We report a case of two simultaneously occurring hypopharyngeal-oesophageal diverticula. one apparent originating above. the other below the cricopharvngeal muscle. The radiological and clinical findings of tis rare condition are condition are presnted.
Histoplasmosis of the oral cavity, oropharynx and larynx
Authors: Rajah V. , Essa A.
Published: November 2007

A patient with oropharyngolaryngeal histoplasmosis is presented. He has been treated for disseminated tuberculosis (TB) for 10 months, with no improvement.

Repeat biopsy of a tongue ulcer, together with a swab of the ulcer base, confirmed the presence ofHistoplasma capsulatum.

Treatment with amphotericin B resulted in a rapid recovery.
Brachytherapy for recurrent nasopharyngeal and nasoethmoidal tumours
Authors: Russell J. D. , Bleach N. R. , Glaser M. , Cheesman A. D.
Published: November 2007

Recurrent or persistent carcinoma of the nasopharynx or naso-ethmoid region occurs even after combined surgery and radical external irradiation. The confined bony access and proximity of vital structures may compromise resection margins. Brachytherapy using implantable radioactive gold or iodine seeds is a useful adjunct to the skull base surgeon in eliminating residual microscopic disease. We report nine cases with recurrent or persistent disease of the nasopharynx or naso-ethmoid regions treated with brachytherapy with encouraging results.
Respiratory obstruction associated with the use of the Brighton epistaxis balloon
Authors: Davis J. P.
Published: November 2007

A case is reported where posterior displacement of a Brighton balloon catheter (Eschmann) is thought to have led to inhalation of clot from the nasal cavity with subsequent respiratory obstruction. Precautions in using this type of epistaxis balloon are discussed.
Renal derived epistaxis
Authors: Johnson I. J. M. , Ravi M. , Campbell J. B.
Published: November 2007

A solitary metastasis to the nose from a renal cell carcinoma is extremely rare. One such case is presented and the argument for aggressive therapy to these lesions is reviewed.
Malignant schwannoma arising in a paranasal sinus
Authors: Nagayama Ikuo , Nishimura Toshiro , Furukawa Mitsuru
Published: November 2007

A case of malignant schwannoma arising in a paranasal sinus is reported. In this case, histological hallmarks were lost because of the poorly differentiated nature of the tumour. Immunohistological techniques were applied to the diagnosis, confirming the neural origin of this tumour. Malignant schwannoma is a relatively rare disease in the nasal cavity and paranasal sinuses. For the treatment of this tumour, wide resection is recommended. In this patient, radical resection of the maxilla with orbital and ethmoid exenteration was performed. The patient recovered uneventfully with no evidence of disease three years after surgery.
Radiological diagnosis of spheno-choanal polyp
Authors: Spraggs P. D. R.
Published: November 2007

Spheno-choanal polyp is a rare entity which presents in a similar manner to the more common antro-choanal polyp. There is often difficulty clinically in differentiating the two conditions, although their radiological characteristics are distinct. A case of spheno-choanal polyp is presented and the plain radiograph and the CT findings reviewed.
Hearing loss in diabetics
Authors: Cullen J. R. , Cinnamond M. J.
Published: November 2007

The relationship between diabetes and senbsorineural hearing loss has been disputed. This study compares 44 insulin-dependent diabetics with 38 age and sex matched controls. All had pure tone and speech audiometry performed, with any diabetics showing sensorineural deafness undergoing stapedial reflecx decat tests. In 14 diabetics stapedial reflex tests showed no tone decay in any patient, but seven showed evidence of recruitment. Analysis of vaiance showed the diabetics to be significantly deafer than the control population.The hearing loss affected high frequencies in both sexes, but also low frequencies in the male. Speech discrimination scores showed no differences. Further analysis by sex showed the males to account for most of the differences. Analysys of the audiograms showered mostly a high tone loss. Finally duration of disbetes, insulin dosage and family history of diabtes were not found to have a significant effect on threshold.
Severe radionecrosis of the temporal bone
Authors: Birzgalis A. R. , Ramsden R. T. , Farrington W. T. , Small M.
Published: November 2007

Severe radionecrosis of the temporal bone is a potentially lethal condition which still occurs despite improvements in radiotherapy.

A Series of seven such cases is presented to outline the varied clinical features and management of this disease.
Are haematological tests warranted prior to tonsillectomy?
Authors: Livesey J. R.
Published: November 2007

The use of phlebotomy for a full blood count (FBC) and group and serum storage (G&S) prior to tonsillectomy with or without adenoidectomy was assessed by means of a postal questionnaire sent to consultant otolaryngologists within the South West Thames region. This was compared with ‘countrywide’ practice assessed by means of questions to attenders at an otolaryngology course.

A postal response rate of 86 per cent was obtained with 67 per cent within the region requesting a FBC prior to tonsillectomy and 50 per cent to adenoidectomy alone. This was much greater than for the ‘countrywide’ group with 24 per cent and 6 per cent respectively. Requests for pre-operative G&S were 17 per cent and 6 per cent respectively.

This large difference in practice suggests that in the clinically healthy patient with no specific indications, pre-operative haematological investigations may be non-contributary, which has important financial implications. The maintenance of post-operative intravenous access is considered to be much safer, less traumatic and cheaper.
Fourth branchial arch anomaly: a rare incidental finding in an adult
Authors: Whitworth I. H. , Suvarna S. K. , Wight R. G. , Walsh-Waring G. P.
Published: November 2007

A rare finding of a fourth branchial arch anomaly discovered at laryngectomy is presented. Clinical and histological findings are documented. The incidence and presentation of fourth branchial arch anomalies is discussed.
Intrusion of an incisor tooth into the contralateral frontal sinus following trauma
Authors: Hara Akira , Kusakari Jun , Shinohara Akira , Yamada Yuzo , Sato Naoaki
Published: November 2007

Although intrusions of glass fragments into the frontal sinuses are not uncommon in traffic accidents, a case with a tooth in the frontal sinus has never been reported. We report a patient with traumatic inclusion of an incisor tooth in the contralateral frontal sinus. Radiographic investigations demonstrated the tooth in the frontal sinus though no skin damage was recognized on the upper face. The usefulness of CT scan in localizing the missing tooth after facial trauma and its route of entry into the contralateral frontal sinus is discussed.
Psychological assessment of multi-channel cochlear implant patients
Authors: Aplin D. Yvonne
Published: November 2007

The psychological effects of profound or total acquired deafness can impair cognitive and interpersonal functioning. A cochlear implant has important psychological implications for individuals and usually has a major impact on the lives of implantees and their families. Psychological assessment and monitoring has formed an integral part of the multi-channel cochlear implant programme at Manchester and contributes to team decisions made about the suitability of patients for implant and subsequent progress of implantees. In this paper the major reasons for carrying out psychological assessment on prospective implantees and for monitoring psychological status of implantees are discussed. The main assessment techniques used at Manchester are described. Group findings from the initial assessments of the first 30 cochlear implant patients (including three deaf-blind subjects) are reported.
Pilomatrixoma of the external auditory meatus
Authors: Vinayak Bippon C. , Cox Graham J. , Ashton-Key Margaret
Published: November 2007

Pilomatrixoma is a benign skin tumour arising from the outer hair root matrix. It is an uncommon tumour which favours the hair bearing area of the head and neck. The preauricular area is a well documented site, but to our knowledge, there are no reports of a pilomatrixoma arising in the external auditory meatus. We present such a case and discuss the historical background along with its pathological and clinical features.
Pneumatization of the uncinate process
Authors: Cumberworth V. L. , Russell J. , Colquhoun I. , Mackay I. S.
Published: November 2007

We report one case of extensive and two of partial pneumatization of the uncinate process from a consecutive series of 250 CT scans of the paranasal sinuses. The CT findings are illustrated and the literature reviewed.
Hamartoma of the tongue
Authors: Owen Gwyneth , Berry Jeremy , Bicknell Philip
Published: November 2007

A female infant nine months of age presented with a bilobed swelling at the base of her tongue. Histological examination showed it to be a hamartoma of the tongue. Lingual hamartomas are rare. There are fifteen case reports of lingual hamartoma in the world literature. Our case is presented and the previous case reports are reviewed.