bluuebunny/crossref_metadata_2025 huggingface dataset:
Paradoxical vocal fold movement: a case report
Authors: Lloyd R. V. , Jones N. S.
Published: November 2007

Paradoxical vocal fold movement leads to marked inspiratory stridor with adduction of the vocal folds on inspiration. A patient is presented who illustrates some of the difficulties in diagnosis and management. A range of treatments were tried including tracheostomy, laser arytenoidectomy and vocal fold lateralization.
The clinical significance of the communicating branches of the somatic sensory supply of the middle and external ear
Authors: Grey Philip
Published: November 2007

The sensory supply of the middle and external ear is complicated by multiple neural communications. The anatomy of these communications and their clinical significance will be described in this paper.
Tympanic neurectomy in the management of parotid sialectasis
Authors: Daud A. S. , Pahor A. L.
Published: November 2007

The term sialectasis refers to dilatation of the salivary ducts. Parotid sialectasis presents itself as recurrent painful swellings during mastication and/or swallowing. Our results with 10 cases treated by tympanic neurectomy over a period of nine years, from 1983 to 1992, were encouraging as seven cases had improvement of their symptoms.

Anatomy of the tympanic plexus and surgical procedure are discussed as well as a review of the literature.

We recommend extensive interruption of the secreto-motor nerve fibres by thoroughly drilling into the hypotympanum and below the basal turn of the cochlea. We also recommend that this be carried out by an experienced otologist to avoid possible complications.
Leiomyomatous hamartoma of the posterior tongue: a case report
Authors: Goldsmith P. , Soames J. V. , Meikle D.
Published: November 2007

A case of a rare leiomyomatous hamartoma arising in the posterior tongue of a sixteen-month-old male is reported. There has been no recurrence following simple excision and presenting symptoms of choking on swallowing have resolved. Most other leiomyomatous hamartomas in the upper aerodigestive tract have been reported in Japanese patients and have involved the maxillary gingiva and hard palate.
The paranasal sinuses before and after radiotherapy for nasopharyngeal carcinoma: a computed tomographic study
Authors: Porter M. J. , Leung S. F. , Ambrose R. , Cheung H. S. , van Hasselt C. A.
Published: November 2007

A study comparing the pre- and post-radiotherapy computed tomographic scans of patients treated for nasopharyngeal carcinoma revealed that the incidence of major mucosal abnormality was significantly increased and approximately doubled after radiotherapy. The most significant factor predicting major mucosal abnormality after radiotherapy was the presence of tumour in the sinus before treatment. In the maxillary sinus there was significant association of major mucosal abnormality before and after radiotherapy although this was not so for the other sinuses. The mucosal changes observed were evident as early as six months after radiotherapy.
Pleomorphic adenoma of the external auditory canal: a case report and review of the literature
Authors: Haraguchi Hidetoshi , Hentona Hitoshi , Tanaka Hidekazu , Komatuzaki Atsushi
Published: November 2007

Pleomorphic adenoma arising in the external auditory canal is rare. We report the case of a 38-year-old man. To better grasp the clinical features and natural history of this uncommon tumour, we also reviewed the world wide literature and found 24 similar cases, which we analysed together with our own.
Leiomyoma of the nasal septum: report of a case and review of the literature
Authors: Llorente J. L. , Suárez C. , Seco M. , Garcia A.
Published: November 2007

Leiomyomas of the nasal cavity are very rare. A case of leiomyoma arising in the nasal septum is presented. The tumour was removed by endoscopic sinus surgery. The literature on the topic is reviewed.
Recurrent laryngeal papillomatosis developing into laryngeal carcinoma with human papilloma virus (HPV) type 18: a case report
Authors: Sakakura Atsushi , Yamamoto Yuzo , Takasaki Tomohiko , Makimoto Kazuo , Nakamura Masahiro , Takahashi Hiroaki
Published: November 2007

We report a case of recurrent laryngeal papillomatosis which developed into laryngeal squamous cell carcinoma 11 years after the first diagnosis. Interestingly, we could identify HPV type 18 DNA in the carcinoma tissue using the polymerase chain reaction (PCR). Other known risk factors of irradiation, smoking, exposure to chemical agents, or a hereditary tendency to malignant tumours were not present in this case. Our finding suggests that HPV type 18 is another aetiological agent for laryngeal carcinoma.
Staphylococcus aureusperitonsillar abscess in an 11-week old infant
Authors: Akhtar Mustansar J. , Shinefield Henry R.
Published: November 2007

A case ofStaphylococcus aureusperitonsillar abscess in an 11-week-old infant is described. The importance of peritonsillar abscess culture and its changing management is discussed.
Lipoma of the parotid gland presenting with facial palsy
Authors: Srinivasan V. , Ganesan S. , Premachandra D. J.
Published: November 2007

Facial palsy in the presence of ipsilateral parotid tumour is considered to be pathognomonic of malignancy. However, benign neoplasms and inflammatory lesions of the parotid gland have been reported to present with facial palsy. A case of lipoma of the parotid gland associated with partial facial paralysis is reported. Lipomas are very rarely seen in this site. To our knowledge, a lipoma of the parotid producing facial paralysis has not been described previously. This report highlights the difficulties in pre-operative diagnosis and management of such a lesion.
Client centred hypnotherapy in the management of tinnitus – is it better than counselling?
Authors: Mason J. D. T. , Rogerson D. R. , Butler J. D.
Published: November 2007

The aim of this study was to assess whether client centred hypnotherapy (CCH) which required three sessions with a trained therapist was superior to a single counselling session in reducing the impact of tinnitus.

Patients were randomly allocated to receive either counselling (n = 42) or CCH (n = 44). The outcome measures were: tinnitus loudness match, subjective tinnitus symptom severity score, trend of linear analogue scale, request for further therapy and whether the patient had an impression of improvement in their tinnitus after treatment.

CCH was no better than counselling in reducing the impact of tinnitus using the three quantative measures of tinnitus, and requests for further follow up.

The only significant difference between the two therapies was that 20 (45.5 per cent) of the CCH group reported a general sense of improvement compared to six (14.3 per cent) in the counselling group, this is significant p<O.Ol. The study did not demonstrate whether this was a genuine hypnotic effect or simply a response to the additional attention from the therapist.
Laser-Doppler blood flowmetry measurement of nasal mucosa blood flow after injection of the greater palatine canal
Authors: Gurr Paul , Callanan Vincent , Baldwin David
Published: November 2007

Laser-Doppler blood flowmetry was used to measure the mucosal blood flow of the inferior turbinate before and after injection of the greater palatine canal with 2 ml of a 0.5 per cent bupivicaine hydrochloride solution. Injection of the greater palatine canal is a useful technique in the control of posterior epistaxis. The arterial blood supply to the inferior turbinate is via a single descending branch of the sphenopalatine artery. We conjectured that injection of the pterygopalatine fossa, via the greater palatine canal, would result in a reduction of blood flow to the inferior turbinate. In this study injection of the pterygopalatine fossa caused only a 4.7 per cent decrease in blood flow to the inferior turbinate mucosa (p0.571). Elevation of the head by an angle of 20 degrees reduced nasal mucosal blood flow by 38.3 per cent (p<0.0001). Depression of the head by an angle of 20 degrees increased nasal mucosal blood flow by 74.7 per cent (p<0.0001). We conclude that there is an adequate collateral blood circulation to the anterior portion of the inferior turbinate.
The deep parotid lymph nodes: an anatomical and oncological study
Authors: Pisani Paolo , Ramponi Antonio , Pia Francesco
Published: November 2007

In order to better define the anatomical and clinical importance of the deep parotid lymph nodes, the surgical specimens obtained from a series of 18 total parotidectomies were evaluated. In 10 cases primary parotid pathology was found, whereas in the remaining eight cases metastases to glandular lymph nodes were present.

One hundred and forty-nine lymph nodes, in all, were identified (range 3–14, average 8.2, mean 8), 118 located in the superficial parotid lobe (range 3–11, average 6.5, mean 7), and 31 in the deep lobe (range 0–5, average 1.7, mean 2).

In the group of patients with oncological pathology, of the total 64 lymph nodes examined, 21 were found to be sites of metastasis, 11 in the superficial lobe, and 10 in the deep lobe.

The above findings confirm the anatomical and oncological importance of the deep parotid lymph nodes, and highlight the necessity of a total parotidectomy in all cases in which intraglandular spread of lymph node metastases is certain or suspect.
Non-Hodgkin's lymphoma presenting as an isolated temporal soft tissue swelling
Authors: Benson-Mitchell R. , Warwick-Brown N. , Chappell M. E.
Published: November 2007

Non-Hodgkin's lymphoma (NHL) of the head and neck has been described in several sites including the larynx, the pharynx, Waldeyer's ring, the nose and paranasal sinuses. NHL of the temporal region has not been previously described. We describe a 65-year-old woman with a diffuse swelling of the right temporal region. A histological diagnosis of NHL was made following complete excision of the lesion. No further treatment was given and there was no evidence of recurrence at six months.
Post-stapedectomy reparative granuloma: a misnomer
Authors: Fenton J. E. , Turner J. , Shirazi A. , Fagan P. A.
Published: November 2007

The pathophysiology of so-called ‘reparative granuloma’ occurring after stapedectomy has not been determined and universally accepted management of this rare complication has not yet been established. A case is presented in which a mass developed in the middle ear after the use of a fat/wire prosthesis in a stapedectomy. Histological assessment revealed nonspecific granulation tissue and fat necrosis. It is suggested that ‘reparative granuloma’ is a misnomer as there is no microscopic evidence in this case nor in the literature of granulomatous formation. The condition may follow stapedectomy or stapedotomy. Furthermore, the name leads to confusion with a different condition, giant cell reparative granuloma, which involves the jaws and rarely the temporal bone. An alternative name, ‘Stapes surgery induced granulation tissue’ (SSIG) is therefore suggested for this condition.
Intraductal papilloma as a cause of a parotid duct cyst. A case report
Authors: Alho Olli-Pekka , Kristo Aila , Luotonen Jukka , Autio-Harmainen Helena
Published: November 2007

A case is presented of a rare intraductal papilloma being found simultaneously with a parotid duct cyst, which is a relatively common parotid disorder. The papilloma most probably played a significant role in the obstruction of the duct and thus caused the ductal cyst. Intraductal papillomas have been mostly described in minor salivary glands, but are rare in the parotid gland.
Bilateral phrenic nerve injury after neck dissection: an uncommon cause of respiratory failure
Authors: Yaddanapudi Sandhya , Shah S. C.
Published: November 2007

The case of a patient with carcinoma larynx who developed diaphragmatic paralysis and post-operative respiratory failure due to bilateral phrenic nerve injury is reported. The use of portable ultrasonography for an early diagnosis of diaphragmatic paralysis is discussed.
Spindle-cell carcinoma of the nasal septum
Authors: Ahluwalia Hemant , Gupta S. C. , Gupta S. C.
Published: November 2007

Spindle-cell carcinoma of the nasal septum is an extremely rare malignancy. Such a case along with the salient features of this variant of squamous cell carcinoma and a review of literature on carcinoma of the nasal septum is depicted.
Effect of aerobic bacteriology on the clinical presentation and treatment results of chronic suppurative otitis media
Authors: Vartiainen Eero , Vartiainen Jukka
Published: November 2007

The effect of aerobic bacteriology on the clinical presentation, complications of the disease and long-term results of surgical treatment was assessed in a cohort of 368 patients with chronic suppurative otitis media. Bacteriological findings showed no significant difference between child and adult patients.Staphylococcus aureuswas isolated in cholesteatoma ears more frequently thanPseudomonas aeruginosa, in chronic ears without cholesteatoma the situation was reversed. Bacteriological findings had no significant effect on the incidence of complications caused by the disease. Failures after surgical treatment were most common inPseudomonasears. The bacteriology had no significant effect on pre-operative hearing levels nor postoperative hearing results. It was concluded that, in order to improve results of chronic ear sugery, more attention should be paid to pre-operative conservative treatment of chronically discharging ears, especially those infected byP. aeruginosa.
Unknown primary of the head and neck
Authors: Talmi Yoav P. , Wolf Gregory T. , Hazuka Mark , Krause Charles J.
Published: November 2007

The occurrence of metastases to the cervical lymph nodes from an unknown primary tumour is seen in approximately three to six per cent of patients with cervical adenopathy and the primary tumour commonly remains elusive. Single modality treatment is occasionally advocated but combined treatment seems to obtain the best results.

A retrospective analysis of patients' charts with unknown primary of the head and neck in theUniversity of Michigan Medical Center was undertaken for the years 1978–1992. Forty-eight records met study criteria and were reviewed.

Our series' size and heterogeneity prevents drawing conclusions regarding treatment effectiveness. The majority (67.5 per cent) of our patients were treated by surgery followed by irradiation. Our overall survival rates compare favourably with the general statistics although it should be noted that longer follow-up in our first group of patients may alter our results. Extracapsular spread did not adversely affect survival in our small series of five cases. We discovered six primary sites within one year and three additional cases within four years. The primary site was included in the radiation fields in all instances of squamous cell tumours that were eventually found. It has been suggested that eventual manifestation of the primary site adversely affects prognosis, which is in agreement with our results.
An audit of prophylactic antibiotic treatment following tonsillectomy in children
Authors: Lee W. C. , Duignan M. C. , Walsh R. M. , McRae-Moore J. R.
Published: November 2007

A prospective audit study was undertaken to assess the effect of two different management policies following tonsillectomy in children in this hospital, one of which requires a prophylactic five-day course of oral antibiotics and the other does not. A total of 95 children were entered into the trial: 54 received post-operative antibiotics and 41 did not. The post-operative recovery was assessed by completion of a parent questionnaire which included the following parameters: degree of patient distress, nausea and vomiting, otalgia, halitosis, pharyngeal bleeding, analgesic requirement, day of return to a regular diet and General Practitioner consultation. There was no significant reduction in any of the morbidity measures in patients treated with antibiotics. In fact, the analgesic requirement and the incidence of otalgia and irritability on Days 6 and 7 and secondary haemorrhage were significantly higher in the antibiotic-treated patients. Although the number of patients included in this study are small, the results suggest that post-operative antibiotics do not improve the outcome of uncomplicated tonsillectomy. Our previous practice of routinely administering antibiotics to post-tonsillectomy children has been discontinued as the consequence of this audit.
Vocal fold palsy after use of the laryngeal mask airway
Authors: Daya Hamid , Fawcett William J. , Weir Neil
Published: November 2007

We report two cases of left vocal fold palsy following use of the laryngeal mask airway. In both cases anaesthesia was uneventful with a duration of about 60 minutes. It is proposed that high intra-cuff pressures induced during anaesthesia resulted in distension of the hypopharynx and subsequent neuropraxia of the motor branches of the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve.
Anisakiasis of the tonsils
Authors: Bhargava Deepa , Raman Rajagopalan , El Azzouni Mervat Z. , Bhargava Kamlesh , Bhusnurmath Bharthi
Published: November 2007

A six-year-old Indian girl presenting with clinical features of chronic recurrent tonsillitis, had a tonsillectomy. Histopathology revealed a cross-section of an Anisakis worm in the tonsil. This report documents a new location in the human host for this rare parasite.
Glossal abscess presenting as unilateral tongue swelling
Authors: Hehar S. S. , Johnson I. J. M. , Jones N. S.
Published: November 2007

Glossal abscesses are extremely rare, only 29 cases having been described in the last 28 years. Clinical and ultrasound examination should establish the diagnosis, and treatment should be by surgical incision and drainage. We report a case of glossal abscess presenting as a unilateral swelling of the tongue.
Fourth branchial arch fistula
Authors: Johnson I. J. M. , Soames J. V. , Birchall J. P.
Published: November 2007

A case is presented of a rare congenital anomaly of the fourth branchial arch, which presented as an abscess in the anterior triangle, related to a fistula communicating with the pyriform fossa. Histopathological examination showed the fistula to be associated with thyroid tissue supporting the hypothesis that the ventral wing of the fourth pouch contributes to the thyroid gland.
Day-stay myringoplasty
Authors: Benson-Mitchell R. , Kenyon G. S. , Gardiner Q.
Published: November 2007

Grafting of the tympanic membrane (myringoplasty) has traditionally been performed as an in-patient procedure in the UK. We have performed day-stay myringoplasty on 21 consecutive patients (15 adults and six children) under general anaesthesia using an underlay temporalis fascia graft. In 18 cases there was complete healing of the tympanic membrane and in three cases the patients developed perforations at four weeks. This success rate is consistent with previously reported studies. All patients were discharged on the day of admission with no major complications.

We have compared the results with a group of patients having the same operation as an in-patient and have concluded that day-stay myringoplasty under general anaestheia is as safe and effective as in-patient surgery for the majority of patients.
Solitary fibrous tumour arising in the nasal cavity: report of a case
Authors: Stringfellow H. F. , Khan I. A. , Sissons M. C. J.
Published: November 2007

The nasal and the paranasal sinuses are a rare site for solitary fibrous tumours. There have been no previously reported cases in the English literature, with eight cases in the world literature (Witkin and Rosai, 1991; Zuckerberg et al., 1991). We present a case of a solitary fibrous tumour arising in the nasal cavity and review the previous reports.
Epithelial-myoepithelial carcinoma of the parotid gland. An unusual cause of ear canal stenosis
Authors: Lau D. P. C. , Goddard M. J. , Bottrill I. D. , Moffat D. A.
Published: November 2007

Epithelial-myoepithelial carcinoma (EMC) accounts for approximately one per cent of salivary gland tumours. This tumour is gaining wider recognition following inclusion into the WHO histological classification of salivary gland tumours in 1990. Salivary gland tumours characteristically present with an enlarging mass. We describe an unusual presentation of a salivary gland tumour with stenosis of the external ear canal in the absence of a palpable mass. EMC usually arises from the salivary glands but isolated cases have been described arising primarily from the paranasal sinuses, trachea and lacrimal gland. The management of this tumour is still evolving with surgical excision being the main-stay of treatment. The efficacy of radiotherapy has not yet been established but high local recurrence rates despite apparently adequate excision and the possibility of a multicentric origin of the tumour may herald an increasing role for radiotherapy in the future. We stress the importance of awareness of adjacent structures when considering the cause of cartilaginous canal stenosis.
Prenatal sonographic diagnosis of upper airway obstruction: a challenge that can be achieved
Authors: Golan-Porat Noga , Lipitz Shlomo , Porat Moshe , Achiron Reuwen
Published: November 2007

Congenital upper airway obstruction presents a life-threatening situation when encountered in the delivery room. We present a case in which inuterodiagnosis of this malformation was suspected, but unfortunately the neonate did not survive due to the inability to provide adequate ventilation. The prenatal sonographic features of this rare malformation are outlined, and the literature reviewed.
Giant primary amyloidoma of the tonsil
Authors: Amado Manuel López , Patiño María José Lorenzo , Blanco Gonzalo López , Monreal Francisco Arnal
Published: November 2007

A case of giant amyloidoma in the left tonsil with extensive osseous metaplasia and a scanty and patchy monoclonal population of IgG Kappa plasma cells, is presented.

Localized tumoral amyloidosis is a rare, benign tumour of the upper aerodigestive tract. Organ-limited amyloidosis has been shown to be confined to various systems but, since the lesion was first described, only four cases situated in the tonsils have been reported in the English literature, and none of these had either osseous metaplasia or a monoclonal population of IgG Kappaplasma cells.
Facial nerve schwannoma: nerve fibre dissemination
Authors: Hajjaj Mutawakel , Linthicum Fred H.
Published: November 2007

Biopsy of a middle ear mass can lead to facial paralysis when the mass is a facial nerve schwannoma. Immunostaining techniques were used to determine if nerve fibres might be present within the tumour mass. Nerve fibres were found to be widely disseminated throughout the tumour in eight of 23 facial nerve schwannomas. Antibodies to neurofilaments demonstrated single fibres, or small groups of fibres, that are very difficult to see with routine haematoxylin and eosin stains. The presence of fibres throughout some tumours makes biopsy of them likely to result in facial dysfunction.
Coherence analysis of EEG changes during odour stimulation in humans
Authors: Harada Hirofumi , Shiraishi Kimio , Kato Toshihiko , Soda Toyoji
Published: November 2007

In a pilot study, EEG changes during odour administration were evaluated by coherence analysis. Ten normal adults were studied. Simultaneous recordings of 16 EEG channels with, and without, odour administration were stored on magnetic tape for further processing. EEG signals were analysed using a signal analyser. Coherence spectra were calculated between all possible channel pairs on the scalp. The amount of data was reduced by extracting broad band coherence values for five frequency bands: delta (2–3.9 Hz), theta (4–7.9 Hz), alpha 1 (8–9.9 Hz), alpha 2 (10–12.9 Hz), and beta 1 (13–17.9 Hz). Coherence values extracted from the control EEG recordings and those during odour administration were compared to evaluate the presence of any significant differences.

The results demonstrated significant changes in the EEG coherence between the two control recordings (control before and control after) in the theta and beta 1 bands. These frequency bands were therefore excluded from the examination. During odorant stimulation with methyl-cyclopentenolone, the coherence in the delta band decreased in the frontal region, while that in the alpha 1 and alpha 2 bands increased in the temporal region. During odorant stimulation with scatol, the coherence in the delta band decreased in the frontal region, while that in the alpha 1 and alpha 2 bands increased between the longitudinal electrode locations. It was suggested that EEG coherence mapping may provide the basis for the development of an objective test of olfactory function in humans.
Papillary and follicular thyroid carcinoma: the treatment results of 357 patients at the National Kyushu Cancer Centre of Japan
Authors: Yasumoto Kimimasa , Miyagi Chisato , Nakashima Tadashi , Baba Hideo , Katsuta Yasaburoh
Published: November 2007

During the period from April 1974 to March 1993, 357 patients received surgical treatment for papillary and follicular carcinoma of the thyroid gland at the Department of Head and Neck Surgery of National Kyushu Cancer Centre, Japan. In this paper, we review the various clinico-pathological features of these patients and analyse their influence on patient survival. While the majority of the patients' ages ranged from the third through seventh decade, only the patients older than 40 years old died. In papillary carcinomas, there was a statistically significant difference in the survival rate between younger (less than 45 years old) and older (45 years of age or older) patients. The rate of patients who died of thyroid cancer also increased in the cases with extra-thyroidal tumour invasion, and metastasis to distant organs. A multivariate analysis also showed that the age, extrathyroidal invasion and distant metastasis are significant prognostic factors. However, sex, histology and lymph node metastasis were not prognostic factors for survival.
Pitfalls in the determination of intracranial spread of complicated suppurative sinusitis
Authors: Conlon B. J. , Curran A. , Timon C. V.
Published: November 2007

We present two cases of suppurative sinusitis that presented to our casualty department over a one-week period. Both patients suffered complications of the disease secondary to extension of the inflammatory process beyond the bony confines of the sinus. Neither of the patients had a previous history of sinus disease. The first patient deteriorated suddenly 24 hours after admission. The initial computed tomography (CT) scan failed to demonstrate a developing subdural empyema. This complication was confirmed following repeat scanning 24 hours later and the patient required urgent neurosurgical intervention and drainage. The second patient presented with periorbital cellulitis secondary to sinusitis and suffered a grand mal seziure on admission. Once again initial CT scan changes were subtle and significant intracranial extension was not noted until the subsequent magnetic resonance imaging (MRI) scan was performed.

The purpose of this paper is to highlight the potential dangers over reliance on CT scanning in diagnosing early intracranial spread of sinus disease and we emphasise that the clinician must interpret any radiological investigations in light of the associated clinical findings.
Polymorphous low-grade adenocarcinoma of the tongue
Authors: de Diego J. I. , Bernaldez R. , Prim M. P. , Hardisson D.
Published: November 2007

Primary adenocarcinomas of the oral cavity in minor salivary glands are distinctive lesions which can be subclassified according to their growth patterns or histomorphology. Polymorphous low-grade adenocarcinoma (PLGA) of minor salivary tissue has been recognized as a distinct entity. We report an unusual case of PLGA of the tongue. Only a few previous cases have been reported in the English literature. The treatment is discussed and a review of the current literature concerning this tumour is included.
Human papillomavirus and p53 oncoprotein in verrucous carcinoma of the larynx
Authors: López-Amado Manuel , García-Caballero Tomás , Lozano-Ramírez Ascensión , Labella-Caballero Torcuato
Published: November 2007

The incidence of p53 antigen and human papillomavirus (HPV) expression in archival formalin-fixed, paraffin-embedded tissue sections from verrucous carcinoma of the larynx was determined using immunohistochemistry.

The p53 oncoprotein was detected in four of 10 tissue samples (40 per cent). The same number of tumours had HPV antigen, and three cases had both p53 oncoprotein and HPV antigen. All positive cases were from heavy smokers and drinkers.

After surgical treatment, no tumour recurrence was present in our series. Four patients developed a second head and neck neoplasm and death occurred in three. Three of the patients with second tumour had p53 positive immunoreactivity and two had p13 and HPV expression.

Verrucous carcinoma of the larynx presented with overexpression of p53 antigen in a similar percentage to other head and neck cancers. The p53 immunohistochemical determination is well correlated with HPV detection and could have prognostic value in these tumours, but no statistical evidence was present.
Post-irradiation liposarcoma of the temporal bone
Authors: Coatesworth A. P. , Martin-Hirsch D. P. , MacDonald A.
Published: November 2007

The first reported case of liposarcoma of the temporal bone is presented. Its association with previous irradiation for benign parotid disease is discussed.
Paraffinoma revisited: a post-operative condition following rhinoplasty nasal packing
Authors: Montgomery P. Q. , Khan J. I. , Feakins R. , Nield D. V.
Published: November 2007

Paraffin impregnated tulle is frequently used as a post-operative dressing after surgical repair of wounds, on skin-donor sites and in packing of tissue cavities. Historically, paraffin has been injected into various sites of the body and paraffinoma is a well-described complication. Despite this, nasal packing with paraffin gauze is still common after rhinoplasty. We report a case of paraffinoma occurring after rhinoplasty and discuss the avoidance of this rare but serious complication and suggest silicon mesh as an alternative dressing.
Mass in the post nasal space and acquired immune deficiency syndrome
Authors: Drake-Lee Adrian , Stevenson Mary , Donaldson Ivor
Published: November 2007

We report a case of previously undiagnosed acquired immunodeficiency syndrome (AIDS) who had a mass in the post-nasal space causing almost complete nasal obstruction. Histology showed both respiratory and squamous epithelium covering an active chronic inflammatory infiltrate. Lymphoma, Kaposi's sarcoma and infiltrative fungal sinusitis were excluded. There was no evidence of the common viruses associated with lesions in AIDS. Unlike adenoid hypertrophy, the lesion was an exuberant growth with an additional chronic inflammatory reaction due to ulceration of the surface epithelium.
Foreign body in the throat migrating through the common carotid artery
Authors: Osinubi O. A. , Osiname A. I. , Pal A. , Lonsdale R. J. , Butcher C.
Published: November 2007

We present a 55-year-old lady who swallowed a 3 cm pointed metal foreign body whilst eating a sardine salad. The foreign body migrated from the hypopharynx through the parapharyngeal space and traversed the common carotid artery over a period of 12 days. The foreign body was removed by exploration of the neck.
Pierre Robin syndrome: characteristics of hearing loss, effect of age on hearing level and possibilities in therapy planning
Authors: Handžić-Ćuk Jadranka , Ćuk Višeslav , Rišavi Ranko , Katić Vladimir , Katušić Damir , Bagatin Marijo , Štajner-Katušić Smiljana , Gortan Damir
Published: November 2007

Hearing loss was studied in 22 patients with Pierre Robin syndrome (PRS) aged three to 12 years (median 5.0 years). The results were compared to those obtained in 62 patients with isolated cleft palate (ICP) aged one to 27 years (median 5.5 years). Hearing loss was more frequently found in PRS (73.3 per cent) than in ICP (58.1 per cent) patients (p = 0.02). PRS patients had more ears with moderate (21–40 dB) and severe (>40 dB) hearing loss, disturbing their social contact, with no tendency to normalization with age (Spearman r = 0.065). In contrast to PRS, ICP patients showed a significant tendency to hearing level normalization with ageing (Spearman r = −0.453; p = 0.001). Planigraphs of temporal bones showed inadequately developed pneumatization of the mastoid bone in all PRS patients and in most ICP patients. No malformation of the inner or middle ear was found in either group. PRS patients have a significantly higher risk of conductive hearing loss than those with ICP. Use of tympanostomy (ventilation) tubes is therapy of choice in patients with Pierre Robin syndrome, and it should be introduced as early as possible, even at the same time as palatoplasty.
Papilloedema, an unusual complication of mastoidectomy
Authors: Harkness P. , Dossetor R. , Weighill J.
Published: November 2007

We report a very unusual case of a patient with a previously undiagnosed congenital absence of the left dural venous drainage system and a prominent system on the right. Due to its prominence it was at risk during a cortical mastoidectomy performed as part of an endolymphatic sac decompression procedure. Manipulation of the lateral venous sinus resulted in partial occlusion of the already compromised venous drainage. The result was a rise in intra-cranial pressure and papilloedema, from which the patient recovered. The abnormality was only detected on post-operative imaging.
Synergistic necrotizing cellulitis resulting from peri-tonsillar abscess
Authors: Hadfield P. J. , Motamed M. , Glover G. W.
Published: November 2007

This case demonstrates the rare but potentially fatal condition of synergistic necrotizing cellulitis of the head and neck. Although similar to necrotizing fasciitis, this is more extreme as it also destroys muscle. Peri-tonsillar abscess is a recognized cause, but has not previously been described in this country, however it is a condition commonly referred to otolaryngologists and awareness of the complication of synergistic necrotizing cellulitis is necessary to allow early recognition and prompt treatment. This should be by broad-spectrum intravenous antibiotics with extensive surgical debridement and drainage procedures repeated as necessary. Although this case had a successful outcome, many patients do not survive, particularly if treatment is delayed or inadequate.
Squamous cell carcinoma of the pharynx and larynx presenting as a neck abscess or cellulitis
Authors: Lee W. C. , Walsh R. M , Tse A.
Published: November 2007

Head and neck tumours presenting as a neck abscess or cellulitis are extremely rare. We report two cases of supraglottic squamous cell carcinoma which presented as an abscess in the site of metastatic neck nodes, one of which was occult and a third case of squamous cell carcinoma of the pyriform fossa which presented as cervical cellulitis. Biopsy of the abscess wall at the time of drainage and careful follow-up may lead to an earlier diagnosis of occult carcinoma.
Cervical lymph node metastatic patterns of squamous carcinomas in the upper aerodigestive tract
Authors: Li Xiao Ming , Wei William Ignace , Guo Xiao Feng , Yuen Po Wing , Lam Lai Kun
Published: November 2007

The radical neck dissection specimens of 384 ethnically Chinese patients with different primary squamous carcinomas in the head and neck region were studied. Over 50 per cent of the specimens showed metastatic disease at one level in the neck. For oral cavity carcinoma, the levels of metastasis frequently involved were I, II and III while for carcinoma of the oropharynx, hypopharynx and larynx, the levels were II, III and IV. Extracapsular spread was present in 112/384 of patients (29 per cent) and this increased with advancing N-stages. Based on these findings, different selective neck dissections could be used for patients harbouring different primary head and neck carcinomas with limited neck disease.
Cochlear implantation in a case of Wegener's granulomatosis
Authors: Abou-Elhmd K. A. , Hawthorne M. R. , Flood L. M.
Published: November 2007

Cochlear implantation is now a routine clinical procedure for deaf patients in many countries (Gibson, 1987). It replaces the function of damaged cochlear hair cells and, therefore, detects sound and by electrical stimulation produces an appropriate signal in the remaining cochlear nerve fibres (House and Berliner, 1991). Wegener's granulomatosis is an uncommon auto-immune disease. It has a peak incidence at the fifth decade with slight male predominance. Nasal problems are the predominant presentation with otological manifestations presenting rarely. We report a case of Wegener's granulomatosis presenting with total hearing loss and after right cochlear implantation a free field threshold of 40 dB and 20 per cent Bamford-Kowal-Bench (BKB) speech test.

We conclude that Wegener's granulomatosis is not an absolute contraindication for cochlear implantation.
Jugular foramen involvement in nasopharyngeal carcinoma
Authors: Chong V. F. H. , Fan Y. F.
Published: November 2007

Nasopharyngeal carcinoma (NPC) may spread posterolaterally with infiltration of the jugular foramen, jugular vein and the cranial nerves IX-XI. Cranial nerve palsies may be evident clinically but the extent of skull base infiltration is best assessed radiologically. Denervation atrophy is well demonstrated by both magnetic resonance imaging (MRI) and computed tomography (CT). Accurate delineation of the lesion is important in prognosis and radiotherapy planning.
The effect of surgical removal of the extraosseous portion of the endolymphatic sac in patients suffering from Menière's disease
Authors: Gibson William P. R.
Published: November 2007

Between April 1990 and June 1996, the extraosseous portion of endolymphatic sac has been removed from the affected ear in 77 patients suffering from Menière's disease. Removal of the extraosseous part of the endolymphatic sac without any drainage procedure did not increase the frequency or severity of the attacks of vertigo in any patient. The results of 43 patients with unilateral disease who had a follow-up period of two years are presented. Only eight of the patients had more than two recurrent attacks of vertigo lasting over two minutes within the two years after the surgery, and in three of these patients the severity of the attacks was greatly reduced. In 56 per cent of the operated ears, the hearing deteriorated at least 10 dBHL across five audiometric frequencies (250 Hz, 500 Hz. 1 kHz. 2 kHz and 3 kHz). To the author, endolymphatic sac removal appeared to provide better relief from vertigo than a simple drainage procedure with less tendency for recurrence several months or years after the initial surgery. At present, the statistical analysis of the results shows no significant difference between removal of the extraosseous portion of the endolymphatic sac and the ‘so called’ endolymphatic sac drainage procedures.
Olfactory neural tumours—the role of external beam radiotherapy
Authors: Slevin N. J. , Irwin C. J. R. , Banerjee S. S. , Gupta N. K. , Farrington W. T.
Published: November 2007

Olfactory neuroblastoma is an uncommon tumour arising in the nasal cavity or paranasal sinuses. We report the management of nine cases treated with external beam radiotherapy subsequent to sureery, either attempted definitive removal or biopsy only. Recent refinements in pathologicalevaluation of these tumours are discussed. Seven cases were deemed classical olfactory neuroblastoma whilst two were classified as neuroendocrine carcinoma. The clinical features, radirap technique and variable natural history are presented. Seven of eight patients treatecall were controlled locally, with a minimumfollow-up of two years. Three patients developedcervica lymph node disease and three patients died of systemic metastatic disease. Suggestios are made as to which patients should have en-bloc resection rather than definitive radiotherapy.
Post-operative pain control with topical steroid injection after hot dissection tonsillectomy
Authors: Liu Chih-Ming , Su Chih-Ying
Published: November 2007

Electrocautery excision (hot dissection) and scissor/snare dissection (cold dissection) are two popular methods used in tonsillectomy. The former causes relatively more post-operative pain but takes less time to perform and is associated with less intra-operative and immediate post-operative bleeding than the latter. To explore post-operative pain control in patients undergoing electrodissection tonsillectomy, a prospective, randomized, one-blind study was designed involving local injections of steroid into the pillar and tonsil bed. The pain levels among the topical injection, deltoid muscle injection and the control group were scored and analyzed. Local steroid injection was found to significantly abate the post-tonsillectomy pain.
Spontaneous retropharyngeal haematoma attributable to Epstein-Barr virus infection
Authors: Jones T. M. , Owen G. O. , Morar P.
Published: November 2007

Life-threatening sequelae of Epstein-Barr virus infection are uncommon but may present as: local pharyngeal manifestations, splenic rupture, neurological and haematological disorders and altered hepatic function. We present a case of retropharyngeal haematoma with posterior hypopharyngeal wall necrosis, thrombocytopenia and altered clotting function as a result of Epstein-Barr virus infection. A review of the literature on retropharyngeal haematoma reveals this to be the only recorded case which can be directly attributed to Epstein-Barr virus infection.
Vocal function following laser and conventional surgery of small malignant vocal fold tumours
Authors: Keilmann Annerose , Bergler Wolfgang , Artzt Martina , Hörmann Karl
Published: November 2007

In the disecribed study, 26 patients after conventional, and 27 patients after laser cordectomy were examined six months or more after the operation. Videolarybogstroboscopy revealed that patients after laser cordectomy more often phonate on a purely glottic level (81 per cent) in comparison to patienbts after conventional cordectomy (19 per cent). Webs were more frequent and more extended after conventional cordectomy compared to endoscopic laser surgery. The maximal phonation time showed a very wide range with a mean value of 9 to 10 sec; there was no statistical difference between the groups of patients. Using yanagihara's classification of sonograms, a better voice quality was measured after laser cordectomy than conventional cordectomy. The patients' estimation of their voice quality did not correlate with objective parameters.
Cochlear implantation in superficial siderosis
Authors: Irving Richard M. , Graham John M.
Published: November 2007

Superficial siderosis is a rare central nervous system disorder characterized by deafness, ataxia, and pyramidal signs. The hearing loss is believed to be predominantly neural and is usuallly progressive and bilateral. Careful assessment is therefore necessary to determine the best approach to hearing rehabilitation. A case is presented of usperficial siderosis in a young woman who has benegited significantly from cochlear implantation using the Nucleus dvice.
Somatostatin receptor imaging of olfactory neuroblastoma
Authors: Ramsay Hans A. , Kairemo Kalevi J. A. , Jekunen Antti P.
Published: November 2007

Neural-crest tumours, including neuroblastomas, express somatostatin receptors. This can be shown by radionuclide labelling of octreotide, a somatostatin analogue. Studies on imaging with this substance have dealt with childhood neuroblastomas. Olfactory neuroblastoma (aesthesioneuroblastoma) is a rare tumour in which somatostatin receptor content has not been analysed, nor have radionuclide methods for diagnostic purposes been described. We report a case of olfactory neuroblastoma, in which scanning with m In-labelled octreotide was performed. A strong uptake was seen at the base of the skull. This was confirmed as a recurrent tumour by magnetic resonance (MR) imaging. Uptake was also observed in the neck and chest, indicating extensive spread of the disease.

Somatostatin receptor expression has been shown to correlate with prognosis in childhood neuroblastoma. The accuracy of labelled octreotide in the diagnosis of olfactory neuroblastoma indicates that it might be useful in radionuclide therapy of patients with advanced disease, when no other treatment modalities are available.
Spontaneous internal jugular vein thrombosis and recurrent laryngeal nerve palsy: a rare simultaneous presentation of an occult malignant neoplasm
Authors: Kalan Ali , Tariq Mohammed , Harar R. P. S. , Gatland David
Published: November 2007

Internal jugular vein thrombosis is an uncommon potentially life-threatening disorder caused by various conditions. Non-spontaneous internal jugular vein thrombosis is an uncommon condition associated in the preantibiotic area with deep-neck infections. Currently iatrogenic trauma to the internal jugular vein from catheterisation and repeated intravenous injections by drug abusers are the leading causes of thrombosis. Spontaneous internal jugular vein thrombosis may occur when there are no apparent pre-disposing mechanical or inflammatory causes although a few of these patients may harbour an occult malignant neoplasm. Hence, careful investigation and follow-up are vital. Thrombosis in Trousseau's syndrome is usually confined to the vascular system of the extremities and the viscera. However, secondary to the paraneoplastic hypercoagulable state, thrombosis can occur in the large veins of the head and neck region. We understand this to be the first case where spontaneous internal jugular vein thrombosis and ipsilateral recurrent laryngeal nerve paralysis were the only initial manifestations of an occult malignancy.
Intraparotid facial nerve schwannoma in a child
Authors: Kumar B. N. , Walsh R. M. , Walter N. M. , Tse A. , Little J. T.
Published: November 2007

Neoplasms of the facial nerve presenting as a parotid mass are uncommon. In the absence of a facial palsy their origin from the nerve is usually diagnosed intraoperatively. The majority of these neurogenic neoplasms are schwannomas, with neurofibromas occurring rarely. Although the Schwann cell is the key element in both, they have distinct histopathological characteristics, and their clinical course and management often differs. The first reported case of an intraparotid facial nerve schwannoma in a child in the English literature is presented.
Solitary plexiform neurofibroma of the submandibular salivary gland
Authors: Tsutsumi Takeshi , Oku Tsuneyuki , Komatsuzaki Atsushi
Published: November 2007

Neurofibroma affecting the major salivary gland is uncommon. This tumour is particularly rare in the submandibular and sublingual gland.

Here, a case of solitary plexiform neurofibroma of the submandibular gland without any other manifestations of von Recklinghausen's disease is presented. It is probably the first case report of this tumour invading the submandibular gland in a solitary form.
Oliver St John Gogarty
Authors: Clarke R. W.
Published: November 2007

Oliver St John Gogarty – Otolaryngologist to fashionable Edwardian Dublin – was a distinguished poet and a Senator in the fledgling Irish Free State after its establishment in 1922. He numbered amongst his acquaintances the poet William Butler Yeats, the novelist James Joyce and a host of political and literary persona who helped to shape modern Ireland. He was satirised as ‘stately plump Buck Mulligan’ in Joyce's novel Ulysses.
The Somjee-Crabtree temporal bone support clamp
Authors: Somjee Shehnaz
Published: November 2007

A new device is introduced for holding temporal bones during dissection. It is structurally very different, more practical and effective for securing the bone than the temporal bone holding bowl which has been in use so far.
Tuberculous otitis media – a case report
Authors: Farrugia Eric J. , Raza S. Ali , Phillipps James J.
Published: November 2007

Tuberculosis of the middle ear is a rare disease. Due to a change in the typical clinical signs in recent years and the fact that the index of suspicion is low, there is frequently a considerable delay prior to diagnosis. This can lead to irreversible complications. A case of tuberculous otitis media is reported, re-emphasising the fact that this entity must be considered in the differential diagnosis of persistent suppurative otitis media.