bluuebunny/crossref_metadata_2025 huggingface dataset:
The nasal valve: a physiological and clinical study
Authors: Jones A. S. , Wight R. G. , Stevens J. C. , Beckingham E.
Published: November 2007

Fifteen subject underwent nasal pressure gradient studies to determine the resistance profile of the nose. Seventy-nine per cent of nasal resistance to airflow occurred in the segment 0 cm.−2.8 cm. from the posterior margin of the anterior nares. The greater part of this resistance (43 per cent) occurred in the segment 1.5 cm.−2.8 cm. within the nose, and this area approximated to the site of the pyriform aperture.

Eighteen patients underwent a trial of radical trimming of the turbinates (12 patients) versus anterior trimming of the inferior turbinates (6 patients). Both operations produced a similar fall in nasal resistance to airflow, confirming that the region of the pyriform aperture was the site of maximum nasal resistance.

Whereas the radical operation significantly reduced the sensation of nasal obstruction, the anterior operation did not.

The results of the study are discussed with reference to previous work on the subject.
The effects of different fixations on the distribution and numbers of mast cells in patients with nasal polyps
Authors: Drake-Lee A. B. , Chevreton E. , Lowe D.
Published: November 2007

Mast cells in rats have been categorized into mucosal and connective tissue mast cells by properties which include their fixation characteristics and their distribution in tissues. There are a number of factors which make his classification unsatisfactory including the variability of fixation, intensity of background staining and the application of animal studies to man. Seasonal allergic reactions in the nose of man occur both in the surface metachromatic cells and in those within the epithelium; the latter are presumed to be mucosal mast cells. The aim of this study was to look at the distribution and the fixation characteristics of mast cells in inferior tubinates and nasal polyps. Both techniques show that cells are more abundant in the submucosa and the fact that Carnoy's fixative shows them better and this may be due to the lack of intensity in the background staining. There is no evidence that mast cells are more frequent in the epithelium. These findings would suggest the nasal polyps are not an allergic disease.
Study of the nasopharynx in man by scanning electron microscopy
Authors: Gulisano M. , Polli G. , Biondi G. , Pacini P.
Published: November 2007

To date only few and often disagreeing studies about human nasopharynx are available.

The present research has the purpose to give a contribution to the knowledge of nasopharyngeal epithelium using S.E.M The study was carried out on biopsies taken from 20 healthy volunteers.

The surface of nasopharynx is covered by ciliated cells, microvilli provided cells and goblet cells.

Areas covered with squamous epithelium and presumably transitional epithelium were observed.

The possibility that ciliated become microvilli provided cells is discussed.
Acromegaly—the mucosal changes within the nose and paranasal sinuses
Authors: Skinner D. W. , Richards S. H.
Published: November 2007

The presence of upper respiratory tract obstruction in patients with acromegaly has been described. The main sites for obstruction were previously thought to be laryngeal and oropharyngeal. This reviews 65 patients with acromegaly and 27 patients with a prolactinoma treated by trans-ethmoidal hypophysectomy. The results confirmed a very high incidence of polyp formation and mucosal hypertrophy within both the sphenoid (88 per cent) and ethmoidal (62 per cent) sinuses of the acromegalic patients. The histological appearances of the mucosal hypertrophy and polyposis confirmed no specific features attributable to acromegaly. Patient age and serum H.G.H. level do not appear to be significance factors. These findings within the para-nasal sinuses have never previously been reported.
The role of the carbon dioxide laser in treatment of carcinoma of the tongue
Authors: Williams S. Rhys , Carruth J. A. S.
Published: November 2007

This paper present 35 patient with carcinoma of the tongue who have been treated in Southampton using the Carbon laser. The treatment programme for each individual patient was determined by radiotherapists and surgeons in a combined head and neck/oncology clinic. T1 carcinomas were treated by primary laser excision biopsy whereas larger tumours were treated first by conventional radiotherapy unless there was a significant contraindication to this treatment modality.

Of 10 patients with T1 lesions nine are alive and well and disease free, but one patient died of other causes with no sign of recurrence. The minimum follow-up period has been two years. Of 25 patients with T2 and T3 lesions treated either before or after radiotherapy, nine are alive and disease-free, eleven died of disease and five patients died of other causes with no evidence of recurrence.
Angiomyolipoma of the nasal cavity
Authors: Dawlatly E. E. , Anim J. T. , El-Hassan A. Y.
Published: November 2007

Vascular tumours of the nasal cavity are uncommon and are either hamartomas or ture neoplasms, mostly benign. We present an unusual case of angiomyolipoma of the nasal cavity. The harmartomatous lesion is often described in the kidney and may be associated with tuberous sclerosis. To our knowledge, there is no previous report of the lesion in the nasal cavity, and no association with tuberous sclerosis has been demonstrated in this case.
Haemangiopericytoma of the nasal septum
Authors: Al-Khalifa S. , Paulose K. O. , Shenoy P. , Sharma R. K.
Published: November 2007

Haemangiopericytoma is a rare vascular tumour originating from pericytes which are cells surrounding the capillaries. Only 23 cases of haemangiopericytoma arising from the nose and sinuses have been reported in the literature, of which three are from the nasal septum. We are pleased to report one more case.
Rhabdomyosarcoma of the nasopharynx a case with recurrence of tumour after 20 years
Authors: Wight R. G. , Harris S. C. , shortland J. R. , Shaw J. D.
Published: November 2007

A case of embryonal (botryoid) rhabdomyosarcoma of the nasopharynx originally occurring in a two year old male, with late recurrence in the neck 20 years after treatment by combined surgery and radiotherapy is presented. The histological diagnosis of rhabdomyosarcoma, and the significance of late recurrence are discussed.
Repair of tympanic membrane perforations using hyaluronic acid: An alternative to myringoplasty
Authors: Stenfors Lars-Eric
Published: November 2007

Fifteen dry, small or medium-sized tympanic membrane perforations were treated by local application of 1 per cent hyaluronic acid after excision of the perforation rim. The duration of the perforations ranged from two months to ten years. Fourteen of the perforations were covered within 15±7.4 (S. D.) days and 5 ± 2.4 (S.D.) applications were needed to achieve closure. Hyaluronic acid treatment of dry tympanic membrane perforations not exceeding one quadrant seems to be an alternative to surgical myringoplasty.
Localized middle ear effusions: Three unusual acute cases in adults
Authors: Parker D. A. , Reid A. P. , Patel P. J.
Published: November 2007

Three cases of acute, non-suppurative otitis media in adults are described. They are unusual in that the effusion was confined to the upper middle ear, whilst the lower middle ear was aerated. The aetiology of such localized effusions, is probably related to the anatomy of the middle ear compartments, the mucosal folds forming them and the apertures allowing communication between them. The compartments are relatively constant and are a result of the embryological development of the middle ear. The localization of these effusions, demonstrates the segmental anatomy of the middle ear.
Transpalatal approach to the petrous apex:
Authors: Davis A. E. , Robin P. E.
Published: November 2007

A case is described in which a transpalatal, transpharyngeal approach was used for access to a cyst of the petrous apex.

Although its indications are limited, in selected patients this conservative procedure has advantages over the more invasive lateral routes.
Carbohydrate content of the endolymphatic sac. A histochemical and lectin-labelling study in the mongolian gerbil
Authors: Barbara M.
Published: November 2007

A secretory activity has recently been attributed to the endolymphatic sac (ES), as a possible way to contribute to the fluid balance of the entire endolymphatic compartment. Previous histochemical studies have indicated the existence of carbohydrate complexes in the secretory product, both neutral and acidic in nature.

A thorough analysis of these compounds in the gerbilline ES was carried out using both transmission electron microscopic (TEM) histochemistry, using dialyzed iron and periodic acid—chromic—silver staining techniques, as well as immunoflourescence with fluorescein-labelled lectins (FITC-lectins).

N-acetylglucosamine was found to be one of the major carbodhydrate components both of the epithelial layer of the ES and of the luminal precipitate. Proofs for a local secretory activity and its intracellular pathway are presented, suggesting to be involved in the regulation of pressure and volume of inner ear fluids.
Effect of weather conditions on acute laryngotracheitis
Authors: Fielder C. P.
Published: November 2007

The aim of the study was to examine the incidence of croup in the Swansea area and to determine whether meteorological factors have any effect on the incidence of acute laryngotracheitis requiring hospitalization.

447 patients with a diagnosis of acute viral croup were admitted to the Ear, Nose and Throat Department of Singleton Hospital, Swansea, between January 1st 1980 and December 31st 1984.

There was no significant difference between days with and without croup admissions, with respect to barometric pressure or relative humidity. Maximum and minimum temperatures were significantly lower on days with croup admissions (p>0.001).

Wind direction appeared to influence the number of admissions, which were increased when the wind was from the south-east (p>0.01).
Breast metastasis from a pharyngeal carcinoma
Authors: Nunez D. A. , Sutherland C. G. C. , Sood R. K.
Published: November 2007

The reported incidence of metastatic disease in head and neck cancer is increasing. The most common site of metastatic involvement in squamous carcinoma of the head and neck is the lung followed by liver, mediastinal nodes and bone. The breast is rarely infiltrated by metastatic disease, 2 per cent or less of clinically detected breast lumps being of nonmammary origin, most frequently malignant melanoma, lymphoma/leukaemia and primary lung carcinoma.

A 73-year-old female presented with a primary posterior pharyngeal wall squamous carcinoma and bilateral enlarged neck nodes. She developed an isolated breast metastasis while receiving palliative radiotherapy and died seven months after presentation.

Clinically detected breast metastasis in head and neck squamous cell carcinoma was first documented by Toombs and Kalisher in 1977. This is the first report of such a case originating in the posterior pharyngeal wall. The prognosis is invariably poor.
Bifid uvula: Prevalence and association in otitis media with effustion inchildren admitted for routing otolaryngological operations
Authors: Rivron R. P.
Published: November 2007

Over a six month period, 709 children admitted for routine ENT operations were surveyed with regard to the presence of a bifid uvula as seen whilst under a general anaesthetic. The prevalence was found to be 7.5 per cent (53:709) which is higher than other published figures for a Caucasian population. There was a statistically significant male predominance (2.5:1). Comparision between those children found to have otitis media with effusion at operation and those having dry myringotomies, or operations not including myringotomy, revealed a similar prevalence of bifid uvula. Thus, this data does not support the hypothesis that bifid uvula as a microform of cleft palate is associated with an increased incidence of otitis media with effusion.
Ethmoidal mucocoeles in children
Authors: Timon C. I. , O'Dwyer T. P.
Published: November 2007

Children presenting with ethmoidal mucocoeles are rare. Five children are presented with such findings, and the diagnosis, treatment and possible aetiology discussed.

C. T. scanning was found to be the investigation of choice, while plain sinus X-rays correlated poorly with the presence of disease. Exenteration through an external approach was found to be satisfactory. In two cases drainage obstruction due to congenital abnormality was thought to be the underlying cause, while in four cases there was a strong history of atopy, indicating allergy as a possible reason for mucocoele formation.
Septic arthritis of the temporomandibular joint complicating otitis externa
Authors: Thomson H. G.
Published: November 2007

Septic arthritis of the temporomandibular joint is an uncommon condition. As a complication of otitis externa it is extremely rare. Two cases are reported and the aetiology, diagnosis and management discussed.
Rare case of obscure haemorrhage in the upper digestive tract (epiglottis).
Authors: Manni J. J. , Schaafsma H. E. , Westerbeek G. F. , Yap S. H.
Published: November 2007

An exceptional case of obscure bleeding in the upper digestive tract caused by an arteriovenous haemangioma of the epiglottis is presented. The clinical details and surgical findings are described.
The ENT consultation: A prospective study of the doctor's and the patient's perceptions
Authors: Sim D. W.
Published: November 2007

In this prospective study of 126 patients attending the ENT outpatient clinic the doctor's and the patient's perception of the consultation were evaluated by questionnaire; 96 patients completed the questionnaire correctly. The results were analysed by scattergram plot and Wilcoxon's matched-pair signed ranks test. There was a statistically significant difference between the doctor's and the patient's perception of the ‘history’ (p<0.01) and the ‘explanation of diagnosis and treatment’ (p<0.05) in the consultation. There was no statistically significant difference between the doctor's and the patient's perception of the ‘examination’ in the consultation. The results are discussed.
Bacteriology of chronic otitis media with effusion
Authors: Diamond C. , Sisson P. R. , Kearns A. M. , Ingham H. R.
Published: November 2007

Samples of middle ear effusions from 102 children with serous and mucoid otitis media were cultured for mycoplasmas and bacteria. No sample yielded mycoplasmas but bacteria were cultured from 48 (47 per cent). Organisms commonly regarded as pathogens were present in 25 samples (Haemophilus influenzae17,Streptococcus pneumoniaefour, other streptococci four). The only sample from which anaerobic bacteria were isolated was from a patient with cholesteatoma.
Nasopharyngeal bacterial flora before and after adenoidectomy
Authors: Talaat A. M. , Bahgat Y. S. , El-Ghazzawy E. , Elwany S.
Published: November 2007

Fifty patients (23 males and 27 females), with chronically hypertrophied and infected adenoids were subjected to adenoidectomy. Pre- and post-operative nasopharyngeal swabs were taken to study bacterial colonization of the nasopharynx both quantitatively and qualitatively. Twenty healthy controls were included in this study. The swabs were cultured on MacConkey's and Columbia blood agar plates. The rate of isolation of potentially pathogenic microorganisms decreased markedly following operation, while normal inhabitant organisms showed notable increase in their numbers post-operatively to reach a near normal level. It is concluded from this work that adenoidectomy produces a physiological effect on the nasopharyngeal microflora by conversion of an abnormal flora to a nearly normal one.
Kaposi's sarcoma of the head and neck in patients with AIDS
Authors: Stafford N. D. , Herdman R. C. D. , Forster S. , Munrot A. J.
Published: November 2007

Over a 40 month period, 219 patients with AIDS were seen at St. Mary's Hospital, London. Kaposi's sarcoma, one of the criteria for diagnosing the syndrome, was the presenting feature in 62 patients. Eighty four patients developed Kaposi's sarcoma at some stage of their disease and the head and neck region was involved in 56 of them.

Although Kaposi's sarcoma is rarely life threatening in AIDS, potential airway obstruction, pain or cosmetic disfigurement may justify treating the lesion. Whilst cutaneous tumours may be managed by using radiotherapy (16 Gray in four fractions over four days), this treatment produces a sever mucositis when used to treat mucosal disease; we, therefore use a combination of vincristine and bleomycin for this.
Wildervanck's syndrome—unilateral Mondini dysplasia identified by computed tomography
Authors: West P. D. B. , Gholkar A. , Ramsden R. T.
Published: November 2007

We present a case of the Wildervanck (cervico-oculo-acoustic) syndrome exhibiting congenital deafness, Klippel-Feil anomaly and lateral rectus palsy with enophthalmos. Audiometry indicated a predominantly conductive loss which, because of masking difficulties, was assumed to be bilateral: an erroneous assumption supported by results of conventional petrous bone tomography which failed to demonstrate any abnormality of the inner ears. Computed tomography (CT), however, revealed a severe Mondini dysplasia of one ear, a condition which must be assumed to be associated with severe sensorineural hearing loss. Reconstructive middle ear surgery for the conductive loss on the other side was therefore contraindicated.
Metastatic renal carcinoma to the parotid gland
Authors: Günbay M. U. , Ceryan K. , Küpelíjogülu A. A.
Published: November 2007

A case of renal carcinoma metastatic to the left parotid gland is presented. A 60-year-old male patient developed a painful mass in his left parotid region one and a half years after he had undergone a left nephrectomy operation for renal carcinoma. The mass was excised surgically. The histopathological diagnosis was metastatic renal carcinoma. From a review of the literature, it is apparent that unlike most of the cases reported, this one had a very aggressive nature. The clinical presentation of the metastasis, and the factors determining the prognosis in cases of metastatic renal carcinoma to the head and neck are discussed.
A case of jaw locking
Authors: Morrissey M. S. C. , Alun-Jones T.
Published: November 2007

An unusual case of symptomatic enlargement of the hyoid bone is reported. The patient's main complaint was of pain on swallowing and opening of the jaw.

Partial excision of the greater cornu of the hyoid on each side, resulted in a complete remission of the symptoms.
Airgun pellet injuries of the neck
Authors: Cook J. A. , Dawkins R. S.
Published: November 2007

Penetrating injuries of the neck are a cause of retropharyngeal abscess. Should a foreign body become lodged in the retropharyngeal tissues its removal may avoid this complication, but surgery can in itself be hazardous. Between 10 and 15 per cent of cases of retropharyngeal cellulitis resulting from whatever cause do not progress to abscess formation if treated conservatively. Consequently, it is important to have evidence of abscess formation before surgery is undertaken, as illustrated by this paper in the form of a case report and a review of the current literature.
Round window reflex and oval window fistulae
Authors: Grewal D. S.
Published: November 2007

The round window reflex is normally absent in stapedial fixation. In this study, six cases of oval window fistula are described in which the round window reflex was absent. This is probably because there is insufficient pressure transmitted to the round window membrane through the perilymph because of leakage from the oval window. This is considered as an important diagnostic sign of oval window/stapes footplate ligament disruption.
Results of surgery to the damaged facial nerve
Authors: Fagan P. A. , Loh K. K.
Published: November 2007

Neurological surgery of the paralysed face can be rewarding if performed early using appropriate surgical techniques. The results of 32 operations are analyzed. Excellent restoration of facial function is achieved with early surgical intervention but some results are poor. The reasons for failure are analyzed.
Surgical reduction of the inferior turbinate in children: extended follow-up
Authors: Thompson A. C.
Published: November 2007

The effectiveness and safety of surgical reduction of the inferior turbinate was assessed in 22 children of 15 years and below. All were interviewed and assessed by means of a questionnaire seven to 51 months post-operatively. Sixty-eight per cent of the children reported a sustained improvement in their nasal airway. There were no significant post-operative complications in this series. In particular there were no cases of serious post-operative haemorrhage, excessive dryness or crusting of the nose. It is concluded that surgical reduction of the inferior turbinate is a safe and effective option in the treatment of children with severe nasal obstruction.
Manipulation of the fractured nose using topical local anaesthesia
Authors: El-Kholy A.
Published: November 2007

Simple fracture of the nasal bone can be reduced under local or general anaesthesia. A combination of topical anaesthetic (EMLA cream) and cocainization of the nasal mucosa was used successfully in manipulation of fractured nasal bones in twelve patients without discomfort.
Can post-tonsillectomy pain be reduced by topical bupivacaine? Double blind controlled trial
Authors: Violaris N.S. , Tuffin J.R.
Published: November 2007

A double blind controlled prospective trial investigated the analgesic effect of topical Bupivacaine in 15 adult patients undergoing bilateral tonsillectomy. Each patient had one tonsillar fossa exposed to Bupivacaine 0.5 per cent solution and the other to normal saline. When visited four to six hours post-operatively, 12 out of 15 patients (80 per cent) stated that the Bupivacaine exposed side to be more uncomfortable than the saline exposed side. On the first post-operative mornning 9 out of 15 patients (60 per cent) confirmed the same. The remaining patients were unable to detect a significant difference and no patient found the Bupivacaine side to be more comfortable.

These results suggest that topical Bupivacaine 0.5 per cent solution has no place in providing post-operative analgesia in adult tonsillectomy.
Aural Schistosomiasis mansoni
Authors: Bhatia P. L.
Published: November 2007

Schistosoma mansoni is common in Nigeria as well as in other countries of West Africa (Edington, 1979). The eggs are laid in the small venules of the submucosal layer of the intestinal wall and pass out usually in the faeces but some may enter the blood stream to be found in any organ of the body (Edington et al., 1975). However, a careful search of the available literature failed to reveal any report of schistosomiasis in the ear and hence it was decided to publish this rare case.
Metastatic squamous cell carcinoma of the paranasal sinuses from a primary squamous cell carcinoma of the urinary bladder
Authors: Kawai N. , Asakura K. , Sambe S. , Kataura A. , Enomoto K.
Published: November 2007

Metastatic tumours of the paranasal sinuses from primary lesions of the urogenital tract are rare, with about 50 cases so far being reported in the literature. The most frequent primary lesions is a renal carcinoma. We have experienced a case of paransal sinus malignancy. There were no symptoms of urinary tract carcinoma preceding those in the paranasal sinuses. This case was later revealed at autopsy to be a metastasis from a diverticulum of the urinary bladder.
Hypopharyngeal involvement by thyroid cancer
Authors: Timon C. I. , Leen E. , Doyle-Kelly W.
Published: November 2007

Direct upper airway infiltration by thyroid neoplasia is a rare occurrence, a unique case of papillary thyroid neoplasia presenting as a pyriform fossa mass is described and the management of these problem patients is discussed, emphasising the controversy between radical and conservative surgery.

The possibility that the thyroid tumour resulted from previous radioactive iodine prescribed for thyrotoxicosis is also considered.
Fibrosarcoma of the ethmoid
Authors: Smith Michaei C. F. , Soames James V.
Published: November 2007

Fibrosarcoma may involve the ethmoid sinus by extension from the maxillary antrum or, more rarely arise as a primary neoplasm.

A case of a well differentiated primary fibrosarcoma of the ethmoid sinuses is reported which presented in a 24-year-old male. The tumour was treated by wide local resection. From a review of similar cases in the literature together with their treatment modalities and outcome. It is concluded that wide local resection is the treatment of choice.
Management of achalasia and laryngo-tracheal compression
Authors: Barr G. D. , MacDonald I.
Published: November 2007

A case of severe airway obstruction due to laryngo-tracheal compression associated with achalasia is presented. Local anaesthetic tracheostomy has an important role in some cases.
Patulous Eustachian tube syndrome: The relationship with sensorineural hearing loss Treatment by Eustachian tube diathermy
Authors: Robinson P. J. , Hazell J. W. P.
Published: November 2007

The patulous Eustachian tube syndrome has previously been regarded as a troublesome but benign condition. Nine out of 13 patients reported here had evidence of cochlear damage similar to that caused by acoustic trauma. These patients also had vestibular symptoms which improved with treatment of the patulous tube.

It is postulated that abnormal patency of the Eustachian tube may allow excessive middle ear pressure changes to occur which may be transmitted by abnormal ossicular movement to the cochlea.

Eustachian tube diathermy using a ureteric diathermy probe is a safe and effective method of treating this condition.
Diagnosis of frontal sinusitis: One-dimensional ultrasonography versus radiography
Authors: Suonpää J. , Revonta Matti
Published: November 2007

In a series of 407 patients suffering from acute frontal sinusitis, 159 sinues of 134 patients were trephined. Initial radiography of the operated sinues pointed out a slight tendency to overdiagnosis; 19 (12 per cent) of the 157 sinuses with positive radiographic signs did not yield secretion. Radiography missed only two true cases of fluid retention. Accuracy of diagnosis by radiography was 87 per cent.

Initial ultrasonography gave a sign of retained secretion in 127 cases, of which 122 (96 per cent) were true positive However, 18(13 per cent) tracings of the 140 sinuses with secretion gave wrong negative findings. Accuracy of diagnosis by ultrasonography was 86 per cent. It seems evident, that ultasonography measures better retained secretion (excluding very small amounts) and radiography shows better mucosal swellings.
Rheumatoid nodule of the temporal bone
Authors: Hoffman Ronald A. , Horten Bruce
Published: November 2007

A 69-year-old woman with severe rheumatoid arthritis presented with a history of chronic otitis and a facial nerve paralysis. She was found to have a rheumatoid nodule involving the mastoid and mesotympanum. This is believed to be the first reported case of a rheumatoid nodule involving the temporal bone.
Primary chondroid chordoma of the base of the petrous temporal bone
Authors: Rupa V. , Rajshekhar Vedantam , Bhanu T.S. , Chandi Sushil M.
Published: November 2007

The authors describe an unusual case of a primary chondroid chordoma arising from the base of petrous temporal bone. The patient, a young male, presented with a left sided jugular foramen syndrome. The CT findings of a tumour arising from the base of the left petrous temporal bone were confirmed at infratemporal exploration. The clinical and histopathological and immunohistochemical differences between classical (typical) chordoma and its chondroid variant are highlighted. The rarity of primary chordomas at this site is stressed.
Co-existent inverted papilloma and squamous carcinoma of the nasal septum
Authors: Sim David W.
Published: November 2007

Inverted papilloma is an uncommon benign nasal tumour which usually occurs on the lateral nasal wall and is prone to recurrence and malignant change. Inverted papilloma of the nasal septum is rare. A case of inverted papilloma and coexistent squamous carcinoma of the nasal septum in an adult male is described. The biology and treatment of these lesions are discussed.
Cholesterol granuloma of the paranasal sinuses
Authors: Bütler S. , Grossenbacher R.
Published: November 2007

Cholesterol granulomata of the middle ear occasionally accompany chronic middle-ear diseases with diminished ventilation. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature.

Disordered ventilation and impaired drainage are decisive pathogenic factors in the causation of cholesterol granuloma. Views remain divided on the source of the cholesterol and on the importance of bleeding in the development of cholesterol granuloma. Two patients with a cholesterol granuloma of the frontal sinus are presented and discussed.
Paediatric laryngeal tuberculosis presenting with stridor
Authors: Rupa V. , Mathew John , Bhanu T. S. , Date A.
Published: November 2007

A rare case of laryngeal tuberculosis in a 15-month-old Indian child is described. The unusual mode of presentation with stridor, suspicious radiological signs and papillomatus nature of the laryngeal lesion are highlighted.
Anthropological study of the mastoid air cell system in Pakistani races
Authors: Zaidi Shabih H.
Published: November 2007

This is an anthropological study of the development of the mastoid process in the four ethnic groups of Pakistani races: Turko-Iranian, Indo-Aryan, Scytho-Dravidian, and Aryo-Dravidian.

Cephalometric studies have established that the majority of Pakistanis are brachio to ultrabrachiocephalic (Cephalic Index 82–x). Radiological evaluation of normal mastoids and their planimetric measurements show that the mastoid process is smaller (Av: 10.24 sq.cm. ± 0.8) than the Caucasian Western races (Av: 12–15 sq.cm.).

Neither combined approach tympanoplasty, nor mastoid obliteration technique may be required, nor technically possible in a small mastoid. Natural epithelization of a small ‘peanut size’ mastoidectomy cavity does not justify these procedures. A modified radical mastoidectomy and tympanoplasty reconstruction provides a satisfactory result in chronic discharging ears.
Subarachnoid fat embolism complicating autologous fat grafting following translabyrinthine excision of acoustic neuroma
Authors: Reece A. T. , O'Reilly B. , Teasdale E. , Todd N. V.
Published: November 2007

A 64-year-old man had complete excision of an acoustic schwannoma via the translabyrinthine route and the mastoid cavity was packed with fat. Post-operatively there were two episodes of aseptic meningitis and CT scanning demon strated migration of fat into the basal subarachnoid CSF spaces. This unusual complication should be recognized and differentiated from both true infective meningitis and aseptic meningitis from other causes.
Primary malignant melanoma of the oral cavity
Authors: Calabrese V. , Cifola M. , Pareschi R. , Parma A. , Sonzogni A.
Published: November 2007

Primary mucosal melanomas of the upper aero-digestive tract are uncommon and represent only 1.7 to 3 per cent of all primary melanomas. The most frequent localization are the nasal fossae, the paranasal sinuses and the oral cavity where melanomas most often arise from the palate and alveolar ridge, buccal mucosa, lips, tongue and floor of mouth.

The authors describe a case of malignant melanoma of the uvula, review the literature and discuss the aetiology, pathology and diagnostic and therapeutic problems.
Complications in head and neck surgery and how to avoid trouble
Authors: Evans P. H. Rhys
Published: November 2007

Increasing litigation in recent years has made it more and more necessary for the surgeon to be aware of the problems, pitfalls and complications which may arise as a result of surgery. The risks are compounded in the head and neck not only because of its complex anatomy but also because of additional difficulties relating to surgery of the upper aero-digestive tract.

Some problems are unavoidable. The potential risks of surgery and its complications should be carefully weighed against the natural history of the pathological process and a realistic expectation of the surgical outcome compared with alternative treatments. Other problems may result from genuine mistakes, but a number of complications are caused through actions or omissions which are avoidable and which in certain circumstances may be construed as professional negligence. Some of the more common pitfalls and complications in head and neck surgery are discussed with particular reference to their causation and possible avoidance.
Lingual abscess: the value of ultrasound in diagnosis
Authors: Osammor J. Y. , Cherry J. R. , Dalziel M.
Published: November 2007

A case of lingual abscess is presented. The sparsity of physical signs made ultrasound imaging an invaluable investigation in the diagnosis.
Congenital cysts of the larynx
Authors: Bais A. S. , Uppal K. , Logani K. B.
Published: November 2007

Two cases of congenital cyst of larynx which is a rare condition, are reported.
Laryngeal chondrosarcoma: is conservative surgery adequate treatment?
Authors: Kambič V. , Žargi M. , Gale N.
Published: November 2007

A case of laryngeal chondrosarcoma in a 63-year-old woman is presented. The report illustrates most of the features of this rare neoplasm, the difficulties in the histopathological evaluation and supports the previous ones that recommend an initial conservative attitude towards low grade laryngeal chondrosarcomas.
Mastoid ache in acoustic neuroma
Authors: Moffat D. A. , Baguley D. M. , Evans R. A. , Hardy D. G.
Published: November 2007

In a series of 100 patients with unilateral acoustic neuroma the incidence of mastoid aching was found to be 25 per cent, though none of the patients reported this as their principal symptom. Mastoid ache was not related to tumour size, hydrocephalus, or duration of symptoms. However, there was a significantly higher incidence of facial numbness and diminished facial sensation, but not facial weakness, compared with the whole series. Since motor fibres are more resistant to pressure than sensory fibres, mastoid ache may signify the pressure of an expanding cerebellopontine angle tumour.
Liposarcoma in the pharynx
Authors: Nofal F. , Thomas M.
Published: November 2007

A rare case of an atypical lipoma in the pyriform sinus is described with an unusual presentation and some difficult histological features. Excision was performed endoscopically, there has been no evidence of recurrence for over a year. External surgical excision is reserved in case of recurrence of the tumour.
Early ossification within the human fetal otic capsule: morphological and microanalytical findings
Authors: Declau F. , Jacob W. , Dorrine W. , Appel B. , Marquet J.
Published: November 2007

Besides the use of conventional techniques such as light and polarization microscopy, the present paper proposes the combined use of transmission electron microscopy, secondary and backscattered electron imaging, energy dispersive X-ray analysis and computed tomography for the diagnostic evaluation of ear pathology in the human fetus. These methods were used to revisit the primary calcification front of the fetal otic capsule between 16 and 23 weeks gestational age. Ultramicroscopic evaluation demonstrates similar fetal bone formation to that found in other bones of the human fetus. The formation of the endosteal and periosteal layers is a typical example of early intra-membranous ossification. The enchondral layer is made up of fibrillar bone, laid down around the calcified cartilage remnants. Microchemical analysis indicates a significantly higher Ca/P ratio in the endochondral layer with respect to the endosteum and periosteum. The consequences of a lower Ca/P ratio in the endosteal layer are discussed in view of calcium homeostasis and inner ear function.
Tinnitus in children with hearing loss
Authors: Viani Laura G.
Published: November 2007

There is scant literature relating to tinnitus in children. This may be due in part to the inability of the child to differentiate normal from abnormal, and also adults failing to communicate adequately with children to allow them to describe their observed symptoms.

One hundred and two children with severe to profound hearing loss between six to seventeen years of age were questioned as to the presence of tinnitus. The 24 children (23 per cent) who reported tinnitus, also completed a questionnaire, and were interviewed about their symptoms and then were compared to the non-tinnitus children regarding hearing level, age, sex and aetiology of the deafness.

No significant difference was found between the two groups. This study documents that tinnitus does exist in a significant number of children with severe to profound deafness and addresses the problem involved in its description and assessment.
Nature of spontaneous tympanic membrane perforation in acute otitis media in children
Authors: Berger G.
Published: November 2007

The study was undertaken to define the characteristics of spontaneous eardrum perforation in acute otitis media. Eighty (29.5 per cent) out of 271 children with acute otitis media had eardrums which perforated. An increased incidence of perforation was associated with a previous history of otitis media.

All perforations were small and limited exclusively to the pars tensa. In 85 per cent of the patients, the perforation was located in the anterior-inferior quadrant. It had smooth margins enabling free drainage of pus and was associated with a favourable clinical course. In the remaining 15 per cent of the cases, the perforation was located in the posterior-superior quandrant. It had a nipple-like shape with a tiny opening that did not allow pus to drain sufficiently from the middle ear.

The perforation closed in 94 per cent of the patients within one month. The healing process was gradual and following perforation closure, there was evidence of middle ear effusion for some time before normal aeration was regained.
Allergic aspergillus sinusitis—an overlooked diagnosis?
Authors: Jonathan D. , Lund V. , Milroy C.
Published: November 2007

Aspergillus infection of the nose and sinuses has been recognized for nearly 100 years but a variant, allergic aspergillus sinusitis, has recently been recognized. This non-invasive form causes chronic sinusitis characterized by thick green inspissated mucus in which eosinophils and Charcot-Leyden crystals are found. Fungal hyphae are scanty and are indentified with special stains. Consequently the diagnosis may frequently be overlooked. It has many similarities with allergic broncho-pulmonary aspergillosis and is treated by surgical debridement and aeration with or without cortico steroids, either topical or systemic.
Spontaneous pneumomediastinum with alteration in voice
Authors: Sleeman Duncan , Turner Robin
Published: November 2007

A case of spontaneous pneumomediastinum, with symptoms restricted to the neck is presented. The clinical details and complications are described.
Oncocytic metaplasia of the nasopharynx—unusual cause of secretory otitis media
Authors: Watson Carl
Published: November 2007

Unilateral secretory otitis media is a well recognized presenting feature of nasopharyngeal tumours. In the case described the underlying cause was of oncocytic metaplasia arising in the nasopharynx.
Diabetes insipidus and hypercalcaemia secondary to nasopharyngeal carcinoma
Authors: Christmas H. E. , Mills R. P. , Davies R.
Published: November 2007

We report a case of nasopharyngeal squamous carcinoma complicated by diabetes insipidus and hypercalcaemia. As there was no evidence of bony metastases we conclude that this latter finding was due to a humoral factor produced by the tumour. The management of these problems is discussed.
Per-Oral excision of a branchial cyst
Authors: Dilkes M. G. , Chapman J. , Stafford N. D.
Published: November 2007

The treatment of branchial cysts is by surgical excision. We describe a case where the cyst was medial to the pharyngeal constrictors, making a per-oral approach the safest, and easiest method of removal. The position of the cyst supports the theory that branchial cysts are congenital in origin.
Unusual laryngeal cyst
Authors: Wansa S. A. , Jones N. S. , Watkinson J.
Published: November 2007

We report a lateral saccular cyst of the larynx with both an internal and external component. The patient had a four year history of a cervical swelling and hoarseness. He presented acutely with stridor. The cyst was resected successfully without tracheostomy.
Visual dysfunction: Abnormal sign of benign spheno-ethmoidal lesions
Authors: Rifai Mohamed , Kenawi Beshr
Published: November 2007

Isolated visual dysfunction with or without proptosis is rarely described as a sign of benign sphenoethmoidal lesions. Five patients with benign swelling of the sino-orbital region and related visual defects are reported. Cases include one patient with fibrous dysplasia, two patients with mucocoeles and two patients suffering from aspergillosis of the sinuses. A review of the literature and discussion of the cases is presented.
Multiple submucosal out-fractures of interior turbinates
Authors: O'Flynn Paul E. , Milford Christopher A. , Mackay Ian S.
Published: November 2007

Nasal obstruction caused by the inferior turbinate is a common clinical problem. There are many surgical procedures which attempt to relieve it, but all of them have associated difficulties.

We describe, for the first time, a new method, namely multiple submucosal out-fractures of the inferior turbinates, which is both effective and free from serious complication.
Pseudotumour of the maxillary antrum
Authors: Hadley J. , Coady A. T. , Milford C. A.
Published: November 2007

Orbital pseudotumour is a non-specific inflammation of the orbit which forms a tumour-like mass composed of increased connective tissue and ground substance with vascular proliferation and an infiltrate of chronic inflammatory cells. No demonstrable aetiological agents are found locally, and there is no evidence of specific disease entities such as Hodgkins, SLE or temporal arteritis.

The condition may present in many different ways to the otolaryngologist, and is therefore a rare but important differential diagnosis to be born in mind. We report a rare case of orbital pseudotumour presenting initially with involvement of the maxillary antrum and in association with Riedel's thyroiditis.
Atypical peripheral ameloblastoma of the palate
Authors: Siar Chong Huat , Ng Kok Han , Ngui Chon Hee , Chuah Cheng Huat
Published: November 2007

Clinical, radiological and histological characteristics of the peripheral ameloblastoma are briefly outlined. A case found occurring in the palate and presenting with atypical histological features is reported. The differential diagnosis of this lesion, its treatment and histogenesis are discussed.
Acoustic schwannoma of traumatic origin? A temporal bone study
Authors: Lesser T. H. J. , Pollak A.
Published: November 2007

A tumour of the singular nerve was found on examination of the temporal bones of a child who died 13 months after meningitis. The tumour consisted of a main mass with the appearance of an acoustic neuroma but close by and not connected were some nests of tumour cells inside the vestibule. This very unusual finding raises questions of the aetiology of this tumour which may have a bearing on the aetiology of other tumours of the VIIIth. nerve.
Experiences with the sternocleidomastoid muscle and myocutaneous flaps
Authors: Tiwari Rammohan
Published: November 2007

The use of the sternocleidomastoid muscle and musculocutaneous flaps in the reconstruction of defects arising after surgery for cancer of the head and neck has been a subject of some discussion.

Experience with these flaps over a ten year period from 1980 until 1989 is presented. Attention is drawn to the various types of flaps in vogue, their indications to date, benefits and drawbacks. A new reliable compound musculocutaneous flap developed by the author for use in defects of the skull base after total temporal bone excision is presented.
Heterotopic brain tissue: A rare cause of adult recurrent meningitis
Authors: Whittet H. B. , Barker S. , Anslow P. , Leighton S.
Published: November 2007

Heterotopic brain tissue is a rare cause of symptoms in neonates in whom it may present with respiratory obstruction. In infants it may produce unilateral nasal obstruction due to a nasal ‘polyp’ or cerebrospinal fluid rhinorrhoea with an associated risk of meningitis. It is exceedingly rare in adults but may nevertheless be a cause of significant morbidity as this case demonstrates.
Oncocytoma of the larynx
Authors: Robinson Anthony C. , Kaberos Antonios , Cox Phillip M. , Stearns Michael P.
Published: November 2007

A case of oncocytoma of the larynx is presented. These lesions are rarely found in the larynx, and have been more commonly described in the salivary and thyroid glands. The histopathological diagnosis is often difficult and the light microscopy can be unreliable for oncocytic lesions. For a more accurate definition of these tumours, the use of histochemical stains together with electron microscopy are advocated. With adequate surgery, the prognosis is excellent, and tumours are unlikely to recur. This paper discusses the management of a patient with a benign oncocytoma of the true vocal cord, and presents a review of the world literature.
Thorotrast granuloma—a renascence
Authors: Plent S. , Shah S. , Path M.R.C. , Westmore G. A.
Published: November 2007

A case of cervical thorotrast granuloma and its surgical complications is presented. The properties and usage of thorotrast and its later complications are described, and the management of the complications is discussed. It is emphasized that there is usually a long latent period between thorotrast exposure and the advent of complications and perhaps more cases of similar difficulty may be anticipated in the future.
Hearing conservation in acoustic neuroma surgery via the posterior fossa
Authors: Baldwin D. L. , King T. T. , Morrisin A. W.
Published: November 2007

An increasing number of patients with an acoustic neuroma present with useful hearing in the tumour ear. Surgical removal of these tumours via the posterior fossa route may enable preservation of the cochlear nerve and otic capsule without increasing the morbidity to the facial nerve. The results of treating 51 cases of acoustic neuroma via the posterior fossa is presented. Forty four tumours measured less than 20 mm in diameter in the cerebellopontine angle and surgery was undertaken with hearing preservation as a principle objective. In 26 cases, the cochlear nerve was preserved anatomically and post-operative hearing at levels better than mean pure tone threshold of 50 dB or 50 per cent speech discrimination was recorded in 14 patients. The preservation of hearing represents a worthwhile surgical goal in selected patients with an acoustic neuroma without increasing the operative morbidity.