bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain stem auditory evoked potentials and blink reflexes in multiple sclerosis
Authors: Ferguson I. T. , Ramsden R. T. , Lythgoe M.
Published: November 2007

Brain stem auditory evoked potentials (BAEP) and the blink reflex (BR) were recorded from 50 patients with a wide spectrum of multiple sclerosis, to determine whether the combination of the two tests of brain stem function would yield a higher rate of abnormality than each test performed alone. Sixty-four per cent of patients had a BAEP abnormality and fifty-two per cent had an abnormal BR, but when the results were combined, seventy-six per cent were abnormal. The blink reflex was abnormal in all patients with symptoms suggestive of trigemino-facial pathology.
Flexible fibreoptic rhinolaryngoscopy
Authors: Lancer J. M. , Jones A. S.
Published: November 2007

Flexible fibreoptic rhinolaryngoscopy has been shown to be an accurate, reliable, inexpensive and safe method of examining the upper aero-digestive tract (Lancer and Moir, 1985).

The result of 338 consecutive examinations are reported.
The role of fibreoptic nasopharyngoscopy in nasopharyngeal carcinoma (NPC)
Authors: Shanmugham M. S.
Published: November 2007

With the introduction of the flexible fibreoptic nasopharyngo-laryngoscope, we have a sophisticated instrument for examination of the nasopharynx and larynx. It is also useful for obtaining biopsies from the nasopharynx and has many advantages over other methods. The most important is that it is possible to take biopsies from selected sites under direct visualization and the biopsy results are therefore more reliable.
Relationships between acoustic reflex patterns elicited by unfiltered white noise and narrow band white noise stimuli of different duration but of the same intensity
Authors: Rossi Giovanni , Solero Paolo , Rolando M.
Published: November 2007

For the purpose of this study, acoustic signals were generated by an Amplaid MK VI. An Amplaid 702 impedence meter was connected to its averaging section and to its computer. The stimuli were bursts of unfiltered white noise (UWN) and of narrow band white noise (NBWN; 30 db./oct/slope; central frequencies 1,000, 2,000, 4,000 Hz.) lasting 3–1,000 msec, at intensity of 105 db. SPL p.e. The following parameters were evaluated: stapedius contraction latency, amplitude, duration and recruitment time. It was found that latency was independent of the spectrum of the stimulus and its duration. Amplitude and recruitment time, on the other hand, were related to spectrum and duration, while duration of contraction was directly related to the duration of the stimulus only.
Squamous odontogenic tumour: Review of the literature and a new case
Authors: Kristensen S. , Andersen J. , Jacobsen P.
Published: November 2007

Squamous odontogenic tumour (SOT) is a rare benign odontogenic neoplasm, apparently arising from rests of Malassez. It was first described in 1975 and since then only 17 cases have been recorded in the literature.

A new, not previously reported, characteristic case of SOT is presented in connection with a review of the literature.

It is concluded that the lesion occurs with equal frequency in the maxilla and mandible and now and then multifocally. Maxillary lesions seem to grow more aggressively than do mandibular ones. The symptoms are modest.

SOT has a characteristic pathologic picture which differs decisively from ameloblastoma and which, in connection with its benign nature, warrants the classification of SOT. Although most cases have been treated by conservative surgical therapy without recurrence, there are cases, especially in the maxilla with diffuse lesions, which have required en bloc resection or hemimaxillectomy.

The diagnostic problems are stressed and recommendations are made for the pathologist and the surgeon to pay attention to this rare but benign tumour.
Aural tuberculosis: a series of 25 patients
Authors: Ramages L. J. , Gertler R.
Published: November 2007

Twenty-five patients with thirty ears affected by tuberculosis of the middle ear cleft were diagnosed and treated at Groote Schuur Hospital, Cape Town, during the years 1972 to 1983. This series is a sequel to the series of 1967 to 1971 and reported by Sellars and Seid (1973). The classical disease presentation will be reviewed and compared to that found in our patients. The modern trends in diagnosis and management will be discussed. The emphasis is on early diagnosis and treatment in an eminently curable disease.
Scanning electronic mircroscopy of sialit-preserved total middle-ear grafts
Authors: Zeneva I. , Betow C.H.
Published: November 2007

Twelve middle ears from human cadavers, prepared for total grafting and preserved in sialit (1:5000) for more than 10–12 months, were studied with the aid of a scanning microscope. Such investigations have not been reported before in the medical literature.

The observed de-epithelialization of most of the membrance and of the ossicles and the distortion of the joints in the transmission apparatus are considered to be results of the prolonged preservation in sialit. The mesenchymal structures are well preserved and this may indicated that, after grafting, revasuclarization occurs along the lumina of the ‘empty’ vessels.

Becuase of this finding it might be considered that the maximum duration of preservation in sialit should be no longer than 10–12 months.
Congenital pleomorphic adenoma of the nasopharynx
Authors: Har-El Gady , Zirkin Howard Y. , Tovi Ferit , Sidi Jack
Published: November 2007

A case of congenital salivary gland tumour occurring in the nasopharynx is reported. Congenital neoplasms of the head and neck (of any histological type) and congenital tumours of the nasopharynx are discussed and the literature is reviewed.
Oral malignant melanoma (A case report and review of literature)
Authors: Sooknundun Mukhesh , Kacker S. K. , Kapila K. , Verma K. , Narayan P.
Published: November 2007

Oral malignant melanoma is rare and has a poor prognosis. We report a case of melanoma of the lower alveolus with rapid spread to the cervical lymph nodes and breast. Metastasis was diagnosed by fine needle aspiration cytology. The literature on oral melanoma is also reviewed.
The migration theory of cholesteatoma formation. Some experimental observations
Authors: O'Donoghue Gerard M.
Published: November 2007

The migration theory of cholesteatoma formation considers that stratified squamous epithelium from the external auditory meatus migrates into the middle ear, giving rise to cholesteatoma. To test the ability of squamous epithelium to migrate in this manner, 73 stains were placed in relation to 23 chronic perforations. In no instance did epithelium migrate into the middle ear cleft. The limitations of the migration theory are discussed.
Middle ear adenoma: A case report with ultrastructural findings
Authors: Bailey Quentin R. , Weiner John M.
Published: November 2007

A 56-year-old woman presented with unilateral tinnitus and hearing loss for 18 months. A middle ear mass was detected clinically. At operation, the tumour was found to have eroded the stapes. The light and electron microscopic features of the tumour were those of a middle ear adenoma. This rare benign tumour has an excellent prognosis. Erosion of an ossicle has not been previously associated with this tumour.

Benign adenomatous tumours arising from middle ear mucosa are rare (Mills and Fechner, 1984). The term adenoma of middle ear was proposed by Hyams and Michales (1976), and their review of 20 cases emphasized the benign behaviour of these tumours. We report a case of middle ear adenoma in which ossicular erosion occurred.
Serum phosphohexose isomerase levels in patients with head and neck cancer
Authors: Goel Harish , Kohli G. S. , Lal Harbans
Published: November 2007

Serum phosphohexose isomerase (PHI) levels were estimated in 28 patients with head and neck cancer. The mean value was significantly higher when compared to the controls. There was no difference in mean PHI value with respect to the character of the lesion or with the histopathological type of growth. The activity was increased with the advancement of the stage of cancer.

With radiotherapy, a gradual and significant decrease in serum PHI activity was observed.
Development of the crista ampullaris in the mouse
Authors: Takumida M. , Harada Y. , Tagashira N.
Published: November 2007

The process of development of the crista ampullaris has been investigated in the mouse using SEM.

Cristae ampullaris of the CBA/CBA mice, from the 13.5th gestational day to the day 2 weeks by were studied.

On the 13.5th gestational day, there were numerous microvilli and a primary cilium on the crista ampullaris. Sensory hairs first appeared on the 14.5th gestational day. The kinocilium and stereocilia were short and the length of the stereocilia was almost constant. The formation of the cupula, which had fine networklike structures, started on the 14.5th gestational day.
Vestibular nerve section and saccus decompression: An evaluation of long-term results
Authors: Primrose W. J. , Smyth G. D. L. , Kerr A. G. , Gordon D. S.
Published: November 2007

The 1972 AAOO committee (Alford, 1972) guidelines brought some uniformity into the evaluation of therapy for Meniere's Disease. We have adhered to its recommendations in this long-term follow-up report of 21 saccus decompressions and 29 vestibular nerve sections performed on 46 patients between 1968 and 1977. Comparisons between these and other groups have been possible with regard to: 1. control of vertigo; 2. hearing; 3. tinnitus; and 4. development of hydrops in the contralateral ear. All the vestibular nerve section group have enjoyed sustained relief from vertigo. Class D results (recurrent vertigo) account for 14 per cent of the saccus decompression group at one year and 29 per cent at eight to 10-year follow-up. Hearing levels in both groups deteriorated in parallel as time progressed but tinnitus became less noticeable. Nineteen per cent of the long-term review patients showed evidence of developing cochlear hydrops in the contralateral ear. Conservative surgical procedures should be employed whilst any useful hearing exists, though the emphasis remains on controlling vertigo. Saccus decompression, despite its controversial therapeutic basis, will remain the first-line surgical procedure for many otologists. However, in the fit young Meniere's cripple or saccus decompression failure with serviceable hearing, vestibular nerve section remains the treatment of choice.
The role of radiography in the management of nasal fractures
Authors: Clayton M. I. , Lesser T. H. J.
Published: November 2007

The role of radiographs in the management of nasal fractures is assessed. The inj ury is common and the total cost of radiographs significant. A retrospective study concluded that radiographs were not definitive in the management of nasal fractures. This prompted a prospective study, in which 54 patients were assessed clinically, radiologically and under anaesthesia. At each stage they were grouped into treatment and pathological categories and the contribution of each type of assessment studied. Radiographs were not found to be useful in the routine management of nasal fractures.
Marble bone disease in a child
Authors: Chaudhuri J. N. , Banerjee S. , Kashnia B. R. , Chatterji P. , Soni N. K.
Published: November 2007

A rare case of marble bone disease in a child is presented. The salient features of the disease are discussed in the light of available literaute.
Computed tomographic evaluation of multiple mucocoeles of paranasal sinuses
Authors: Nakashima Tsutomu , Watanabe Yusuke , Arao Harumi
Published: November 2007

There are some cases in which mucocoeles of the paranasal sinuses are multiple and their structures are complicated. When the mucocoeles are multiple, pre-operative evaluation is especially important for correct surgical management. We describe the usefulness of computed tomography for the evaluation of multiple mucocoeles of the paranasal sinuses.
An improved morphological technique for the study of cochleotoxicity in guinea pigs
Authors: Yung M. W. , Wright A.
Published: November 2007

Scanning electron microscopy is commonly used to study the normal or pathologically altered cochlear epithelium. It is especially useful for the study of ototoxicity in humans or animals. A cochlear microdissection technique in the guinea pig is presented which permits examination of the whole membranous cochlea with little artefactual damage to the sensory structures under study.
Experience with bilateral congenital atresia of the posterior nasal choanae
Authors: Prescott C. A. J.
Published: November 2007

Atresia of the posterior nasal choanae is an unusual congenital condition. The embryological explanation is uncertain, that felt to be the most probable being presented here. Bilateral choanal atresia tends to be associated with neonatal airways obstruction and steps to be taken in its diagnosis and management are outlined. The definitive treatment of the condition is surgical excision, by either a trans-nasal or a trans-palatal approach. The conclusions arrived at as to the most effective method of management of these cases from a personal series of fourteen cases are detailed. A preference for the trans-nasal surgical approach is indicated and surgical details for this method are given, some aspects of which have not been previously reported.
Arterial embolization for control of bleeding in advanced head and neck carcinoma
Authors: Bhansali Sanjay , Wilner Harvey , Jacobs John R.
Published: November 2007

There are a number of patients with unresectable recurrent carcinoma of the head and neck who continue to lead a relatively functional life despite advanced local disease. For these patients bleeding from tumor represents a devastating complication that can abruptly terminate the course of an otherwise chronic disease, albeit a uniformly fatal one. The technique we describe renders a relatively safe and effective treatment that seems to control this problem.

We report on our experience with three patients whose tumor bleeding was controlled by permanent intra-arterial embolization with Ivalon, a polyvinyl alcohol-based foam. The technique, indications, and complications are discussed.
Ceravital in ossiculoplasty: experimental studies and early clinical results
Authors: Blayney A. W. , Bebear J.-P. , Williams K. R. , Portmann M.
Published: November 2007

The biocompatibility of the bioactive glass-ceramic Ceravital was investigated experimentally both in vivo and in vitro. In the former, ceramic discs were interposed in 30 rat middle ears for periods ranging from 6 weeks to 12 months. In the latter, Ceravital otological prosthesis were placed in human fibroblast culture.

Reactions to the biomaterial were assessed by means of scanning electron microscopy (SEM) with chemical analysis facilities (EDAX, WDAX) and light microscopy.

The interface reactions were similar in both in vivo and in vitro studies and confirmed the findings of other authors regarding the implants& biocompatibility and bioactivity. The technique of ion etching, however, enabled clear demonstration of this bioactivity on the implant surface, exposed merely to the middle-ear secretions, thus questioning the necessity of placing bone pate on the implant head at surgery, in order to encourage bioactive bonding with the overlying drum.

A clinical trial of Ceravital in 128 patients with an average follow-up period of 2 years is reported. Forty per cent of these patients underwent a type II tympanoplasty, 60 per cent a type III. Though relatively short-term, the results to date have been encouraging: 88 per cent of the implants have been well-tolerated; 70 per cent of the cases have yielded a satisfactory hearing result; and only 3 per cent of the implanted prostheses have been extruded.
Rigid endoscopy in ENT practice
Authors: Wilson Janet A. , Murray J. A. M. , von Haacke N. P.
Published: November 2007

A 10-year retrospective survey of 204 elective rigid oesophagoscopic examinations in the ENT unit of a District General Hospital is reported. One Hundred and Forty Five (71 per cent) were normal and there was marked preponderance of normal endoscopy in patients under 60 years old. Clinical examination was usually unhelpful but barium studies were found to complement oesophagoscopy in reaching a diagnosis. There were six complications of oesophagoscopy, two following normal examinations.
The use of a small fenestra technique with the Fisch piston in the surgical treatment of otosclerosis
Authors: Pedersen Christian Brahe
Published: November 2007

The modern surgical treatment of otosclerosis consists of replacement of the sound conducting function of the stapes by a prosthesis. The results obtained in 100 consecutive patients using the small fenestra technique and a 0.4 mm. Teflon and steel wire prosthesis are reported. The surgical technique is described. The hearing was improved in all patients. In 92 per cent of the patients an optimal hearing gain was found after an observation time of 1 to 4 years. Five patients required re-operation during the observation time. The small fenestra technique and the Fisch prosthesis were considered optimal in respect to technical difficulty, hearing improvement and complication rate. There was no sensorineural hearing loss in this series of patients. The absence of serious complications makes it reasonable to operate on both ears in patients with bilateral hearing loss. The results are as good in elderly people as in younger people. Therefore the operation can be offered for patients in all age groups.
Rediscovering the importance of nasal breathing in sleep or, shut your mouth and save your sleep
Authors: Lavie P.
Published: November 2007

Recent research, stimulated by the growing awareness of the sleep apnea syndrome, has shown that nasal breathing plays a major role in the regulation of respiration in sleep. These observations are not new; they confirm century-old clinical findings on the importance of nasal breathing in sleep. The earliest account of the deleterious effects of mouth breathing in sleep was made by Lemnious Levinus towards the end of the sixteenth century. Two hundred years later, Catlin dedicated an entire book to the superiority of nasal breathing over mouth breathing in sleep; and in the late 1800's, Cline, Wells, Griffin and others showed that obstructed nasal breathing causes sleep disorders.
Entering the pharynx in total laryngectomy
Authors: Wei W. I. , Lau W. F. , Lam K. H.
Published: November 2007

In performing total laryngectomy for carcinoma of the larynx, the pharynx should be entered at sites away from the tumour. When the tumour is supraglottic in location, the entry should be through the lateral pharyngeal wall; and when the tumour is located in the postcricoid area, entry above the hyoid bone is preferred.
Diffuse idiopathic skeletal hyperostosis with dysphagia
Authors: Eviatar E. , Harell M.
Published: November 2007

Dysphagia due to cervical osteophytes is not common. However, diffuse idiopathic skeletal hyperostosis (DISH) with cervical involvement which causes dysphagia is even rarer. The otolaryngologist is not generally familiar with this entity. The diagnosis can be made by plain cervical X-ray films, a barium swallowing esophagogram and or a CT scan of the neck. When doubt still exists, further extra-axial X-ray films can be helpful. Although most patients have been treated surgically, there may be a role for conservative therapy initially, as surgery in elderly DISH patients is often morbid and even fatal.

A 79-year-old patient with DISH (Forestier's disease) is reported. Non-steroidal antiinflammatory therapy was successfully implemented. DISH is compared with other disorders of the cervical spine which may cause dysphagia.
Human endolymphatic sac: possible mechanisms of pressure regulation
Authors: Wackym Phillip Ashley , Friberg Ulla , Bagger-Sjöbäck Dan , Linthicum Fred H. , Friedmann Imrich , Rask-Andersen Helge
Published: November 2007

The ultrastructure of the normal human endolymphatic sac (ES) has been observed by transmission electron microscopy (TEM). The role of the epithelium, the various regions of the subepithelial space and the general anatomy of the ES in pressure regulation were morphologically studied to generate testable hypotheses of human ES function. Light microscopic (LM) and TEM evidence of pressure regulatory mechanisms by endolymph resorption, mechanical factors, and secretory activity are presented. These mechanisms may be useful in designing experimental studies of the ES, and in interpretation of retrospective LM and TEM studies of patients with Meniere's disease.
Soft tissue reaction to ceramic ossicular replacement prosthesis
Authors: Yamamoto Etsuo , Iwanaga Michitaka
Published: November 2007

Soft-tissue reaction to ceramic ossicular replacement prostheses (CORP) has been evaluated histologically in rabbits and humans. One week after implantation, severe inflammatory and foreign body reaction was observed in the fibrous connective tissue surrounding the prosthesis. Though some inflammatory response was seen after one month, after three months the CORP was surrounded by a layer of fibrous connective tissue without any foreigh body giant cell, histiocyte or inflammatory cell infiltration. Our satisfactory clinical results in humans without placing a cartilage between the CORP and the fascia graft may be due to the excellent softtissue compatibility of CORP, as demonstrated in this study.
Necrotizing sialometaplasia of major salivary glands
Authors: Batsakis John G , Manning John T.
Published: November 2007

Major salivary glands have been rarely reported as sites of necrotizing sialometaplasia, a disease primarily affecting minor salivary tissue, particularly that of the palate. Eight cases of necrotizing sialometaplasia of the parotid and submandibular glands are presented and added to six reported earlier by Donath (1979). The clinical and pathologic findings in the 14 cases give strong support to the vascular-based-infarct genesis of necrotizing sialometaplasia.
Inflamed adenolymphoma with cholesterol granuloma
Authors: Bundgaard Niels , Eriksen Hakon Ellermann , Greisen Ole
Published: November 2007

Twelve cases of adenolymphoma with inflammation are described. Pre-operatively, three of these patients presented clinical signs of inflammation in the parotid gland. In ten cases purulent exudate could be aspirated from the tumour. Rupture of the cyst may cause an aseptic inflammation in the surrounding tissue. It is concluded that adult patients with clinical or cytological signs of inflammation in the parotid gland must be supervised until the gland is normal in order not to miss an underlying tumour.
Serum enzymes in head and neck cancer III
Authors: Lal Harbans , Munjal S. K. , Wig Umesh , Saini A. S.
Published: November 2007

Serum adenosine deaminase (ADA) levels were estimated in a group of 40 patients with head and neck cancer. The mean value was significantly higher in patients compared to controls. The increase was higher in cases of ulcerative growths than of proliferative growths, and activity was increased with advancement in the stage of the cancer. After radiotherapy, a gradual and significant decrease in serum ADA activity was observed.
The surgical management of childhood cholesteatoma
Authors: Sanna Mario , Zini Carlo , Gamoletti Roberto , Delogu Peppina , Russo Alessandra , Scandellari Roberta , Taibah Abdel
Published: November 2007

The results of treatment of 124 cases of childhood cholesteatoma are reported in the present study and compared with an adult group of patients.

Intact canal wall tympanoplasty was performed in over 90 per cent of cases in children and the procedure was staged in nearly 80 per cent of cases.

The children had a 43.8 per cent incidence of residual cholesteatoma and an 8.8 per cent incidence of recurrent cholesteatoma in intact canal wall tympanoplasty cases.

Intact canal wall tympanoplasty remains the technique of choice in our hands for the treatment of childhood cholesteatoma; pre-planned staging of the operation is mandatory for the detection and elimination of residual cholesteatoma which occurs more frequently in children.
Excision of benign larygeal lesions: comparison of carbon dioxide laser with conventional surgery
Authors: Robinson P. M. , Weir A. M.
Published: November 2007

Twenty-six cases of patients presenting with benign laryngeal lesions treated by laser excision were compared with age and sex matched controls treated by conventional surgery. There was no statistically significant difference post-operatively between the groups in analgesic requirement, length of hospital stay, voice quality or laryngoscopic appearance.
The role of the fibreoptic bronchoscope in otorhinolaryngological practice
Authors: Wei W. I. , Lau W. F. , Lam K. H. , Hui Y.
Published: November 2007

Abstract Flexible fibreoptic bronchoscope has been employed in the examination of the nasopharynx, pharynx, larynx, trachea, bronchus and intrathoracic oesophagus under local anaesthesia. It is used either for diagnostic or therapeutic purposes. A total of 1690 procedures have been performed with no complication. The indications and findings in these procedures are listed. The advantages and limitations of the use of flexible fibreoptic bronchoscope as a ‘panendoscope examination’ instrument are discussed.
Relation between histological age-changes in the carotid body and atherosclerosis in the carotid arteries
Authors: Lowe Patrick , Heath Donald , Smith Paul
Published: November 2007

Abstract Histological changes in the human carotid body associated with increasing age are accompanied by occlusive atherosclerotic lesions in the arteries of the carotid bifurcation, and are probably ischaemic in origin. The carotid sinus, however, is unusually susceptible to the development of atheroma and its occlusion appears to have little influence in compromising blood flow through the glomic arteries.
Relief of pain and trismus in patients treated with naproxen or acetylsalicylic acid after tonsillectomy
Authors: Kristensen S. , Tveteraas K. , Hein P. , Poulsen H. B. , Outzen K. E.
Published: November 2007

The pain-relieving efficacy of naproxen and acetylsalicylic acid (ASA) in tonsillectomized patients was compared in a double blind parallel clinical trial comprising 83 patients, among whom 42 were treated with naproxen and 41 with ASA. The patients were treated post-operatively for two days with either naproxen suppositories 500 mg. twice, or ASA effervescent tablets 1000 mg. three times, daily.

The therapeutic gain was evaluated by recording the intensity of pain, reduced ability to open the mouth (trismus), consumption of supplementary analgesic (parcetamol), and pain-related sleep disturbances.

The statistical analysis of the results revealed no differences in pain intensity, consumption of additional analgesics or pain-related sleep disturbances in the two treatment groups. A considerable degree of trismus was demonstrated in most of the tonsillectomized patients. This reduced ability to open the mouth was gradually overcome in the naproxen group while it remained unchanged in the ASA group, however, no statistical significant difference could be demonstrated. Additionally, no significant positive correlation between pain intensity and trismus was proven. The pain-relieving effect, however, was unsatisfactory in both the naproxen and the ASA group, and clinical controlled trial studies of alternative analgetics in tonsillectomized patients are still to be encouraged.
Haemangiopericytoma of the submandibular gland
Authors: Pagliaro G. , Poli P. , Ralza G. , Grandi G.
Published: November 2007

A case of haemangiopericytoma of the submandibular gland is reported. The clinical, surgical and histological features are described.
Angiolymphoid hyperplasia of the head and neck
Authors: Vallis R. C. , Davies D. Garfield
Published: November 2007

Angiolymphoid hyperplasia is a rare benign condition affecting the skin and subcutaneous tissue of the head and neck. Superficial (intradermal) lesions frequently affect the external ear and such a case presenting to an otolaryngologist is described. Clinically the disease is characterized by single or multiple plum-coloured nodules or plaques which are often itchy and may bleed with mild trauma. Histologically the lesions are composed of proliferating capillary vessels associated with a heavy inflammatory infiltrate including eoosinophils and mast cells.

The cause remains obscure. The lesions often persist for many years and may regress spontaneously. Several forms of treatment have been used, including cryosurgery, curettage and diathermy, radiotherapy and intralesional steroid injections. In this case the Argon laser was employed.
Lateral sinus pathology
Authors: Mathews T. J.
Published: November 2007

One hundred and thirty patients with acute and acute on chronic mastoiditis were managed at Groote Schuur Hospital between 1980 and 1984. Twenty-two (16.9 percent) had pathology of the lateral (sigmoid) sinus and 19 of these patients had cholesteatomas. Nine patients (40.9 per cent) had concomitant intradural sepsis and there were two deaths.

The modern literature is reviewed and the pathology, presentation and management of lateral sinus pathology is discussed. This condition is rare and clinical features may range from subtle signs to gross toxaemia, torticollis and evidence of septic embolization. The otolaryngologist must be competent in diagnosing and treating this condition in all forms of its wide spectrum of presentation.
Localization of salivary amylase and epithelial membrane antigen in salivary gland tumours by means of imunoperoxidase and immunogold-silver techniques
Authors: Egan M , Crocker J , Nar P
Published: November 2007

A series of 87 salivary glands was examined using an immunogold-silver technique for salivary gland amylase (SGA) and epithelial membrane antigen (EMA) and an indirect immunoperoxidase technique for both antigens. The specimens comprised 21 pleomorphic adednomas, 3 monomorphic adenomas, 25 adenolymphomas, 5 mucoepidermoid carcinomas, 3 acinic cell tumours, 8 adenoid cystic carcinomas, 2 adenocarcinomas and 8 undifferentiated carcinomas. In addition 5 normal salivary glands and 6 salivary glands showing benign lymphoepithelial lesions were included.
Giant cementoblastoma simulating a peridental infection
Authors: Puterman M. , Fliss D. M. , Sidi J. , Zirkin H.
Published: November 2007

A case of giant cementoblastoma of the maxilla in young female is reported. An unusual painful swelling of the gingivolabial area led to an initial misdiagnosis of a peridental infection and consequently to inappropriate trcatment.
Vocal cord paralysis as a presenting sign in the Shy-Drager syndrome
Authors: Martinovits Giora , Leventon George , Goldhammer Yochanan , Sadeh Menachem
Published: November 2007

A 70-year-old patient with bilateral vocal cord paralysis, accompanied by inspiratory stridor and increased snoring, is presented. Respiratory dysfunction, deteriorating over 18 months, necessitated permanent tracheostomy. Only two and a half years after the onset of symptoms the patient developed extrapyramidal signs combined with severe autonomic failure, duggesting a diagnosis of Shy-Drager syndrome. Vocal cord palsy preceding any other neurological or autonomic manifestations of that syndrome has been infrequently described. This diagnosis should be considered in cases of vocal cord palsy of undetermined etiology, especially when associated with increased snoring or episodes of sleep apnea.
Long-term ototoxic effects of neomycin applied topically in the middle ear: A morphological study in the guinea pig
Authors: Morais Darí , Gonz´lez Miguel , Villar Rosario Del , Gayoso Manuel J.
Published: November 2007

Neomycin was instilled daily, uni-or bilaterally, into the middle ear of guinea pigs for three months. The cochleae were examined, by light and electron microscopy, six months after the end of treatment. The organs of Corti of the treated ears were completely destroyed, and in the most advanced lesions, were substituted by a single layer of very thin flat cells. In the spiral ganglion only some glial cells and a few neurons could be observed. All surviving neurons were myelinated, and their ultrastructure was greatly altered, with disappeared, losing it amorphous and filamentous components. The spiral limbus and the stria vascularis were atrophic and were also covered, in the final stages, by flat elongated cells. In view of its morphological characteristics, this epithelium may arise from the displacement of the interdental cells and perhaps from the cochlear surface of Reissner's membrane.
Moebius' syndrome: a report of two cases
Authors: Jamal Mousa N. , Samara Nabil S. , Al-Lozi Mohammed T. A.
Published: November 2007

Two patients with Moebius' syndrome are described, a brother and a sister. In addition to bilateral congenital facial nerve paralysis, both had deafness, an external deformity of the auricles, and a latent squint. The deafness in both cases was sensorineural in type; although there was paralysis of the motor part of the facial nerve, taste and lacrimation were intact. This report shows that not all components of the facial nerve are always effected in this syndrome.
Acquired tracheo-oesophageal fistula (A case report)
Authors: Dev Arjun , Ghosh P , Deka R. C
Published: November 2007

A case of acquired tracheo-oesophageal fistula in a 16-year-old boy, caused by a bullet wound, is presented. The fistula was located just below the cricoid cartilage and was successfully treated by excision of the fistula followed by enterposition of the sternomastoid muscle.
Idiopathic facial nerve palsy
Authors: Prescott C. A. J.
Published: November 2007

Eight hundred and seventy-nine patients with Bell's Palsy were seen over a 10-year period. There was a distinct female preponderance and the peak incidence occurred in the second to fourth decades. There did not appear to be an increased incidence of either hypertension or diabetes but there was a definite increased risk during pregnancy. Half of the patients had an incomplete palsy and they all recovered within a few weeks of onset. Those patients with complete palsy but without evidence of degeneration also all recovered but took longer to do so. If degeneration was evident the chance of recovery was only 50 per cent. Steroids did not appear to influence the outcome of Bell's Palsy.
Reopening of the closed nostril in atrophic rhinitis
Authors: Gadre Arun K. , Savant Renuka , Gadre K. C. , Bhargava K. B. , Juvekar R. V.
Published: November 2007

Closure of the nostril in atrophic rhinitis is a simple operation. Opening the obturated nose by excising the obturator membrane very often causes stenosis. A new and effective method for opening the nostrils, by meant of flaps, is suggested.
The use of sputum-trap in the collection of antral washout specimen during antroscopy
Authors: Violaris N. S. , Bridger M.
Published: November 2007

Antroscopy of the maxillary sinus has become an established and proven procedure in the diagnosis and treatment of sinus disease. Below we outline the use of the sputum-trap in the collection of antral washout specimens for microbiological culture during antroscopy.
Atypical histiocytic granuloma with eosinophilia
Authors: Ankjæergaard O. , Lawaetz K. D. , Andreassen U. K.
Published: November 2007

Atypical histiocytic granuloma in the oral mucosa has recently been described as a benign non-neoplastic ulcero-proliferative lesion of histiocytic origin with eosinophilia. The disease is confined to the oral mucosa where the lesion is solitary. These lesions, which heal spontaneously, are not associated with systemic disease or dissemination.

This report deals with such a case, and it stresses the benign nature of the lesion despite the worrying clinical and microscopic appearance.

The morphological diagnosis was substantiated by the use of a series of immunohistochemical reactions.
Rhabdomyosarcoma of the middle ear and mastoid in children
Authors: Said H. , Phang K. S. , Razi A. , Khuzaiyah R. , Patawari P. H. , Esa R.
Published: November 2007

Three cases of embryonal rhabdomyosarcoma in the middle ear and mastoid in children are presented. Diagnosis was confirmed by histopathology. A multidisciplinary approach employing surgery, chemotherapy and radiation therapy is the method of choice in the management of this rare and highly lethal condition.
Middle-ear damage caused by a defective portable headphone.
Authors: Arndal Helge , Bomholt Axel
Published: November 2007

We report a case in which a defective portable headphone caused ablation of the malleus and removal of the drum.

In addition to the warnings already given against the risk of noise-induced hearing loss, a warning should be given against the use of headphones of poor quality.

Alternatively, headphones consisting of ear-plugs and electric wire without a metal holder should be recommended.
‘Otology at the crossroads’
Authors: Morrison A. W.
Published: November 2007

It is an honour for an otological surgeon to be asked to deliver the second Sir Morell MacKenzie address. Thank you for the invitation and for that honour. Exactly 100 years ago MacKenzie, with Norris Wolfenden, founded ‘The Journal of Laryngology and Rhinology’. ‘Otology’ was not added to the title until 1892, the year MacKenzie died. I shall return to this theme later. It is also exactly 100 years since, in 1887, MacKenzie was asked by Queen Victoria to examine her son-in-law, Frederick, Crown Prince of Germany. The controversy and subsequent recrimination which flowed from the management of Frederick's laryngeal lesion I shall leave to future lecturers to assess. It is as the founder of British laryngology that he should be remembered. As early as 1863 he had started the Metropolitan Free Dispensary for Diseases of the Throat and Loss of Voice, the first institution of its kind in the world. He wrote authoritatively on diseases of the throat and invented many instruments for the difficult art of indirect laryngeal and pharyngeal surgery. He received his Knighthood, also in 1887.
Ruthenium red staining of the endolymphatic sac in the guinea pig
Authors: Takumida Masaya , Bagger-Sjöbäck Dan , Rask-Andersen Helge
Published: November 2007

The ultrastructure of the guinea pig endolymphatic sac was studied, using the ruthenium red staining technique. The dye stained the apical cell surface coat and the homogeneous substance in the luminal space of the endolymphatic sac, when introduced from the luminal side of the epithelium. It is suggested that the surface coat and homogeneous substance may play an important part in the endolymph regulatory mechanism in the endolymphatic sac. When ruthenium red was introduced from the subepithelial side, the basolateral surface of the epithelial cells usually became brightly stained in the absence of staining of the apical cell surface, due to the presence of the tight junctions. In some instances, however, the dye penetrated beyond the level of the tight junctions. Pinocytotic vesicles and larger vacuoles in the epithelial cells were also sometimes stained, both apically and near the lateral cell surface. These findings suggest that endolymph efflux mechanisms in the endolymphatic sac may involve the combined actions of a paracellular and transepithelial flow as well as a transcellular, vacuolar bulk flow.
Myringoplasty with three meatal flaps
Authors: Zaman K. , Borah K.
Published: November 2007

A preliminary report on a technique of myringoplasty is presented with the idea of minimizing graft rejection, and to combat anterior blunting and lateralization of the graft. The grafts were generally stable and mobile. Out of 200 cases there was only a 2 per cent rate of graft rejection, with no evidence of anterior blunting or lateralization. The hearing improved considerably. The technique is simple and relatively quick.
Prognostic factors in labyrinthectomy
Authors: Willatt D. J. , Yung M. W.
Published: November 2007

Labyrinthectomy for unilateral Meniere's disease may be complicated by persistent unsteadiness post-operatively. The aim of this study is to identify the unfavourable factors in recovery following labyrinthectomy. Twenty-one patients gave a detailed history and underwent neuro-otological, opthalmic and cardiovascular examination, as well as psychological and psychiatric assessment. Sedentary occupations, external health locus of control, extraverted personality, and an anxious and/or depressed psychiatric state were associated with poor post-operative recovery. These factors therefore should be taken into consideration in the pre-operative assessment and post-operative rehabilitation of labyrinthectomy patients.
The safety and efficacy of intra-nasal ethmoidectomy
Authors: Watson D. J. , Griffiths M. V.
Published: November 2007

Each of the three types of ethmoidectomy: intra-nasal, trans-antral and external, has its supporters and detractors who argue about the efficacy and safety of the procedures. One hundred and five ethmoidec-tomies for nasal polyps are reviewed retrospectively. Regardless of the approach used, approximately half of these had recurrence of polyps and some patients had several revision operations. There were six complications specific to the surgery. None was serious but most occurred with external ethmoidectomy. The limitations of ethmoidectomy for nasal polyps, the reasons for the good safety record and the best means of training juniors in the procedures are discussed.
Nasopharyngeal angiofibroma: (A nine-year experience)
Authors: Tandon D. A. , Bahadur S. , Kacker S. K. , Goulatia R. K.
Published: November 2007

In a nine-year period 50 nasopharyngeal angiofibromas, of whom 13 had recurrent tumour, were treated surgically at the All India Institute of Medical Sciences, New Delhi. A new staging system according to the regions involved was used; 31 patients in whom the tumour was limited to the nasopharynx (Stage I) and those with superior spread into the ethmoid or sphenoid sinuses (Stage IIA) had their tumours removed by a transpalatal route, alone or in combination with other approaches. Tumours with lateral extensions into the pterygopalatine or infratemporal fossae or the cheek (Stage IIB), and those with simultaneous superior and lateral spread (Stage HI) underwent a transmaxillary excision (19 cases). In two of the three cases with intracranial extension (Stage IV), the tumour was removed successfully from below. There was no mortality. The usefulness of the transmaxillary approach, especially in recurrent cases, is emphasized. No adjuvant modalities were employed in this series and blood loss was acceptable.
Post-tonsillectomy analgesia: The use of benzocaine lozenges
Authors: Dempster J. H.
Published: November 2007

Tonsillectomy frequently results in a significant degree of post-operative pain. Conventional management consists of the administration of intra-muscular opiates prior to the commencement of oral analgesia and is often inadequate, producing variable levels of pain relief.

One of the recommended uses of benzocaine lozenges is the relief of throat discomfort following tonsillectomy, but there are no clinical trials to support this claim. Therefore, a prospective placebo controlled trial was undertaken to compare the efficacy of benzocaine lozenges (10 mg.) with standard oral analgesia in the management of post-operative pain following tonsillectomy in an adult population.

Consecutive patients undergoing elective tonsillectomy were randomised to receive either benzocaine lozenges (10 mg.) or placebo. Intake of supplementary oral analgesia was recorded, and the level of postoperative pain was assessed by use of a visual linear analogue scale. There was no significant difference in analgesic intake or pain severity as measured by linear analogue between the two groups.

These results suggest that there is no benefit in administering benzocaine lozenges for the relief of post-tonsillectomy pain, and its use in this situation cannot be recommended.
Haemolytic streptococcus infection of chronic maxillary sinusitis An immunological study using the skin window test
Authors: Toppozada H.
Published: November 2007

The SWT was performed on 30 patients with chronic haemolytic streptococcus maxillary sinusitis, and 5 controls with no streptococcus in their nose and throat. Foreign and patient's own organism were used as antigen. The lymphoblastic transformation was higher in control streptococcus free patients than in chronic maxillary sinusitis, more when using foreign than patient's own organism. The failure of cellular immune response as a contributary factor tochronicity of maxillary sinusitis is discussed. The possible value of prepared foreign streptococcus vaccine in prevention and treatment ismentioned.
Non-Hodgkin's extranodal lymphoma: a clinico-pathological study of 24 cases involving head and neck sites
Authors: Wallace Colin , Ramsay Alan D. , Quiney Robert E.
Published: November 2007

A series of of 24 patients wtih a documented diagnosis of non-Hodgkin's extranodal lymphoma (ENL) involving head and neck sites (excluding the cranial cavity) has been studied. In view of recent advances in the diagnosis of lymphoma, a retrospective histopathological review has been undertaken to place all patients in standardized classifications for morphology (the working formulation) and immunology (Kiel). This resulted in a change of diagnosis from non-Hodgkin's lymphoma in four. The histopathology of these four cases, and the implication of such changed diagnoses are discussed. Of the 20 patients confirmed as having non-Hodgkin's ENL, 16 had primary ENL and four had an ENL focus secondary to disease elsewhere. Three patients in this series had an initial diagnosis made of another malignancy, but histopathological review prior to treatment changed the diagnosis to ENL. Details of presentation, pretreatment evaluation, immunohistochemistry, treatment and course have been analysed. The principal treatment policy for primary ENL has been radiotherapy. Of the 12 patients who received this treatment ten achieved a complete response (83 per cent). Eight remain free of disease at the time of writing. The role of adjuvant chemotherapy is also considered.
Laryngeal cysts: clinical relevance of a modified working classification
Authors: Ramesar Keith , Albizzati Claudio
Published: November 2007

Laryngeal cysts from 72 patients were examined and reclassified according to a modified working classification. In this series, 47 patients (66 per cent) had epithelial cysts, 11 patients (15 per cent) oncocytic cysts and 14 patients (19 per cent) tonsillar cysts. Epithelial cysts were commonest in the region of the epiglottis (20/47) and laryngeal ventricle (24/47). Oncocytic cysts tended to lie in the region of the ventricle whereas tonsillar cysts occurred almost exclusively in the valleculae, epiglottis and pyriform region (13/14).

The authors conclude that the modified working classification of laryngeal cysts is easy to apply, of clinical relevance, and allows classification of cysts where operative trauma to the specimen obscures the relationship of the cyst to the surface epithelium. The origin and significance of tonsillar cysts are discussed and a relationship to the lympho-epithelial cyst of the oral cavity is suggested.
Impedance screening for otitis media with effusion in Nigerian children
Authors: Ogisi F. O.
Published: November 2007

Tympanometry and acoustic reflex tests performed on 431 school children aged five to six years showed that eight per cent of the ears screened had type B or type C tympanograms suggestive of otitis media with effusion (1.2 per cent type B, and 6.8 per cent type C). Preliminary otoscopy revealed tympanic membrane appearances consistant with middle ear effusion in a correspondingly low proportion of ears (7.6 per cent), whilst acoustic reflex screening at 105 dB for three frequencies (0.5, 1 and 2 kHz) showed absent reflexes at one or more frequencies in 8.1 per cent of the ears. The findings indicate a relatively low prevalence of otitis media with effusion in children in Nigeria. Possible contributory factors are discussed.