bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncommon malignant tumours of the larynx A 35 year review
Authors: Hamlyn Peter J. , O'Brien Christopher J. , Shaw Henry J.
Published: November 2007

Sixty-five primary malignant laryngeal tumours, other than simple squamous cell carcinomas, treated at the Royal Marsden Hospital between 1949 and 1984 are presented. Of the 11 histological types pseudosarcomas (24 cases), verrucous carcinomas (9 cases) and lymphoreticular tumours (9 cases) predominated. Determinate three-year follow-up data were available in 50 cases. Sixteen patients (32 per cent) died of their neoplasms but survival was strongly related to histology. Only one death occurred among 24 determinate cases of pseudosarcoma and verrucous carcinoma. Radiotherapy was effective treatment for these two tumour types and for reticuloendothelial tumours. However, combined therapy yielded poor results with the other histological types.
Hearing-loss and calciferol deficiency
Authors: Irwin J.
Published: November 2007

Vitamin D (calciferol) dehciency has recently been claimed to cause cochlear hearing-loss (Brookes and Morrison, 1981; Brookes, 1983, 1984). In view of the therapeutic and pathophysiological implications of this finding, a confirmatory study was undertaken in the Department of Neuro-otology at The Royal National Throat, Nose and Ear Hospital.

Screening of 112 consecutive new referrals revealed 32 patients with biochemical abnormalities compatible with vitamin D deficiency. Of these, 26 agreed to serum vitamin D assay and normal values were obtained in all of these cases. This study does not support the claim that vitamin D deficiency is a cause of hearing-loss.
A simple and inexpensive method for laryngeal photography with the operating microscope
Authors: Kambič Vinko , Fajdiga Igor , Fischinger Janez
Published: November 2007

Alter a bnet review ot the history or laryngeal photography, a simple and inexpensive method as used at the ENT Clinic of Ljubljana is described.

The equipment consists of a standard 35 mm Olympus OM-1 camera attached to the Olympus OME-J operating microscope and an Olympus T-32 flash unit connected via a large bore flexible light cable to a specially designed laryngoscope.

With the equipment described excellent photographs can be obtained even in inexperienced hands without interference with endoscopic procedures.
Craniocervical chordomas in the Mersey Region
Authors: Ataya N. L.
Published: November 2007

The clinical presentation and management of craniocervical chordomas in the Mersey Region between 1974 and 1984 are presented, and compared to those in previously published series. A review of the current modalities of treatment is also discussed.
Infratemporal fossa lesions
Authors: Parker D. A. , Robin P. E.
Published: November 2007

Three cases of malignant lesions in the infratemporal fossa are presented to illustrate the insidious nature of the symptoms, the delay in diagnosis and the difficulty in both diagnosis and treatment. Attention is drawn to the deficiencies in diagnostic radiology in this area, and to the possible surgical approaches for diagnosis, assessment and excision.
Anatomical characteristics of the fossula fenestrae vestibuli
Authors: Djerić D. , Savić D.
Published: November 2007

Anatomical characteristics of the fossula fenestrae vestibuli were tested and analysed precisely on 200 samples of temporal bones. The fossula is usually ovoid and shallow but can be, exceptionally, elongated, narrow and deep. It is surrounded by four walls. In 45.5 per cent of cases the upper wall is formed only by the facial canal and in 54.5 per cent of cases a bony lamella is found beneath the facial canal; the promontory forms the lower wall; the front wall is formed by the bony lamella and part of the processus cochleariformis; the back wall is clearly defined in only 22.8 per cent of cases and is formed by the bony lamella of the medial wall of the tympanic cavity. In 13.2 per cent of cases the floor of the fossula partially covers the prominence of the facial canal and in two per cent the eminentia pyramidalis. Bony recesses in this region occur fairly frequently: sinus subfacialis in 60 per cent, sinus retrofenestralis in 77.2 per cent, and sinus subrostralis in 25 per cent of the cases. These anatomical variations can influence the result of surgical intervention.
Irresectable tumours of the temporal bone
Authors: Quiney R. E. , Flood L. M.
Published: November 2007

Sporadic case reports and the few published series of expanding lesions of the deep petrous temporal bone propose a variety of surgical approaches to ensure excision. All such surgery represents a compromise between exposure adequate for total removal and avoidance of further neurological deficit. Unfortunately pathology in the petrous apex evolves relatively silently and diagnosis is delayed. In many cases total excision is impossible. We present a series of patients presenting with advanced tumours of the deep petrous temporal bone in order to illustrate the spectrum of disease encountered, the limited role of surgery and the natural history of irresectable pathology in this remote and inaccessible area.
Benign paroxysmal positional vertigo Clinical observations by vestibular habituation training and by posturography
Authors: Norré M. E. , Forrez G. , Beckers A.
Published: November 2007

Vestibular Habituation Training (VHT) is the treatment of choice for paroxysmal positional vertigo (ppv). The origin of the disturbance is peripheral and the data observed in the cases treated confirm that it is not located in horizontal canal function. However, canal dysfunction can be present together with ppv. Usually a separate course is observed for the phenomena attributed to horizontal dysfunction and those to the ppv lesion.

The specificity of the Dix-Hallpike manoeuvres linked to the typical ppv is also confirmed by the data obtained by testing for VHT (VHT-test-battery).

Ppv can have a repercussion upon the vestibulospinal reflex. That the same ppv disturbance can coincide with normal as well as with abnormal posturographic data, pleads for the intervention of central adaptive mechanisms. The effect of VHT is due to stimulation of these central adaptive mechanisms and not to any impact upon the peripheral lesion.
Clinical aspects of pseudodysphagia
Authors: Bradley P. J. , Narula A.
Published: November 2007

Pseudodysphagia is the description of the sensation of a feeling of a lump in the throat—commonly known as the globus symptom. A prospective analysis of 145 consecutive patients with this symptom seen by an Otolaryngologist has provided confirmation that a high proportion of these patients have a treatable basis for their complaints and that most can be successfully managed without time-consuming and expensive investigations—provided clinical evaluation includes thorough visualisation of the oropharynx and supraglottis. The explanation for the symptomatology in patients who suffer from reflux oesophagitis is probably referred pain from the region of the lower oesophageal sphincter rather than spasm of the upper sphincter. The expression globus hystericus is outdated and should be discarded, and we recommended describing the symptoms as primary globus pharyngeus when there is no evident cause and secondary globus pharyngeus when the aetiology is detectable.
Serum enzymes in head and neck cancer. II Aliesterase
Authors: Lal Harbans , Madan H. C. , Kohli G. S. , Yadav S. P. S.
Published: November 2007

Serum aliesterase levels have been estimated in 38 patients with head and neck cancer. The mean value was significantly lower than in controls. The decrease in activity was greater in patients with ulcerative growths and it progressed with advancement in the stage of cancer.

With radiotherapy, a progressive and significant increase in serum aliesterase activity was observed. In patients with non-malignant growths the activity was comparable with that in controls.
Preservation of neck dissection for histological study
Authors: Rhys Evans P. H. , Morgan D. , Smallman Lesley
Published: November 2007

Dissection of lymphatic nodes in the neck—whether radical or partial, functional or prophylactic—forms an integral part of the surgical management of cancer of the head and neck. Accurate orientation and fixation of the surgical specimen is a prerequisite for correct histopathological study of the extent of the disease and for a complete clinicopathological interpretation, which is of significant therapeutic and prognostic importance.
Paediatric tracheostomy
Authors: Newlands W. J. , McKerrow W. S.
Published: November 2007

Fifty-seven operations on 53 patients represents the total experience of tracheostomy in children under 13 years during 1964–1985 in an area with half a million inhabitants. No complications occurred during surgery and no deaths were related to the operations. Complications followed 16 out of 30 (53%) operations on children under three years and four out of 27 (15%) of the remainder, an overall complication rate of 35%. Many fewer operations have been required since 1973 because of the successful employment of nasotracheal intubation in the treatment of upper and lower airway obstruction caused by acute infection. Obstruction by-pass remains the commonest function of tracheostomy, with congenital lesions and trauma now the commonest causes of obstruction as opposed to acute infection in the earlier years. Despite the successful use of nasotracheal intubation there were absolute indications for tracheostomy—blockage of the nasotracheal tube; inability to intubate a child with epiglottitis; and necessity for an artificial airway of long duration.
Antroscopy via the inferior meatal route under local anaesthetic:
Authors: Pfleiderer A. G.
Published: November 2007

Antroscopy has been shown to have a significant role to play in the management of chronic sinus disease. A technique, performed via the inferior meatus, is described which has been used successfully in 103 patients under local anaesthetic. Particular attention has been paid to the practical problems and pitfalls which may be encountered and how they may be overcome. Vasovagal symptoms were the commonest adverse effect, occurring in 15 patients; otherwise the associated morbidity was encouragingly low. It is concluded that antroscopy performed with a good technique can be a rewarding procedure suitable for use in the outpatient department.
The successful closure of a colono-cutaneous fistual in the neck
Authors: Morrison G. A. J. , Breach N. M.
Published: November 2007

A case is presented of the successful closure of a colono-cutaneous fistula in the neck, which developed twenty-one years after pharyngo-laryngectomy. A pectoralis major muscle flap and a delto-pectoral skin flap were used.
The value of computerized tomography (CT) in the evaluation of the anatomic structure of the attic
Authors: Savi´ D. , Jašović A. , Djerić D.
Published: November 2007

By the use of computerized tomography (CT) the authors have examined and precisely defined the radiological anatomical characteristics of the attic and its relation to other structures of the middle and inner ear. The identification of individual morphological structures has been made on axial, semi-axial and frontal CT sections. Each type of original CT section has been compared with the corresponding original anatomical section.
Minitracheotomy and laryngeal function
Authors: Campbell J. B. , Watson M. G. , Povey L. , Shenoi P. M.
Published: November 2007

The ‘minitracheotomy’ i.e. an indwelling narrow-bore endotracheal tube which is inserted via the cricothroid membrane to provide access for the removal of secretions from the tracheobronchial tree following major thoracic and abdominal surgery, has recently been developed. In order to investigate whether its use may be injurious to the larynx, a prospective study was carried out assessing laryngeal function pre- and post-operatively in 14 patients, No permanent changes in laryngeal function were found and it was concluded that, when used for shourt post-operative periods, the larynx is not adversely effected.
Verrucous carcinoma of the larynx: problems of diagnosis and treatment
Authors: Olu Ibekwe A. , Duvall E.
Published: November 2007

The first report of a case of verrucous carcinoma from Africa is presented. Problems of diagnosis and treatment are highlighted and the need for co-operation between the clinician and the pathologist for an accurate diagnosis is emphasized.
Acute and acute-on-chronic mastoiditis
Authors: Mathews T. J.
Published: November 2007

One hundred and thirty patients with acute-on-chronic mastoiditis were managed by the ENT Department of Groote Schuur Hospital between 1980 and 1984 inclusive. Seventy-four patients had cholesteatomas, of whom 78.4 per cent had intracranial extension and 44.6 per cent had intradural extension of the infection. In contrast, of the 56 patients without cholesteatomas, only 23.2 per cent had intracranial extension of the infection. These may be rare conditions in some privileged parts of the world but their lethal potential requires all ENT surgeons to be competent in their management.
An improved technique for the study of immunofluorescence using non-decalcified frozen guinea pig cochlea
Authors: Soliman A. M.
Published: November 2007

A technique for producing frozen sections from the non-decalcified guinea pig cochlea is described. The sections can be utilised or various immunofluorescent studies, including the detection of humoral anti-bodies against different cellular elements in patients with cochleo-vestibular disorders. The technique assures the preservation of the cochlear architecture and the tissue antigenicity, and it avoids damage to the fine cochlear structural details.
Cushing' syndrome due to the abuse of betamethosone nasal drops
Authors: Stevens D. J.
Published: November 2007

Cushing's syndrome due to the abuse of Betamethasone nasal drops has not been described before. This report presents such a case and emphasises the care which oe must take in prescribing topical sterioids.
Tracheostomal reconstruction using a fenestrated deltopectoral skin flap
Authors: East Charles A. , Flemming A. F. Stewart , Brough Michael D.
Published: November 2007

Tracheostomal stenosis following laryngectomy can prevent satisfactor rehabilitation of a patient, and may be difficult to correct. A reconstructive technique using a flap within a deltopectoral flap to treat this condition is described.
Local rifampicin in treatment of rhinoscleroma
Authors: Gamea A. M.
Published: November 2007

Many antibiotics, chemotherapeutic agents and other chemicals have been tried in the treatment of scleroma without much success (Toppozada et al, 1967). The most popular of these drugs are streptomycin and aureomycin (Botros et al, 1954; Zwiefach, 1955; El-Mofty, 1962), terramycin and chloromycetin (Hoover and King, 1953) and ampicillin, septrin and vibramycin (Ssali, 1975).

El-Mofty and Attia (1957) attributed considerable value to the use of 20 per cent aureomycin ointment locally in treating the disease. Nigonol in the form of a local injection was tried by Toppozada et al. (1967) and they claimed good results. Shaer et al. (1981) reported that local application of 2 per cent acriflavine solution over an eight-week period was an effective and safe remedy for rhinoscleroma.

Rifampicin has been used systemically with success as a new antibiotic for the treatment of scleroma (Riad, 1982). The aim of the present study was to evaluate the response of rhinoscleroma to local medication with rifampicin.selected for this study. The cases were diagnosed by clinical, histopathological (Fig. 1) and bacteriological data. Twelve cases were in the atrophic stage while eighteen were in the granulomatous stage of the disease. Rifampicin was applied locally into the nose in two forms:

1. Nasal instillations: used mainly in the atrophic cases. One ampoule of rifampicin (Rifocin-Lepetit®) 125 mg. diluted in 20 ml. saline solution was used and 2 ml. of the solution was applied twice daily.

2. Nasal infiltration: used mainly in the granulomatous cases. One ampoule of rifampicin (Rifocin-Lepetit®) 125 mg. was infiltrated into the granulomas every other day.

Treatment was continued for eight weeks. Punch bio-spies were taken from the nasal lesions after four and eight weeks during the course of therapy and six months after the cessation of treatment. Biopsies were fixed, dehydrated, embedded in paraffin, sectioned and stained with H and E. Part of each specimen was submitted to bacteriological studies for the isolation of K. rhi-noscleromatis (Levine, 1951).
Posterior cleft larynx associated with hamartoma:
Authors: Lyons T. J. , Variend S.
Published: November 2007

Posterior cleft larynx associated with a local hamartoma is a rare malformation complex. Clinical diagnosis may be elusive. We report such a combination in a newborn infant dying soon after birth with upper airways obstruction.
Chronic labyrinthine ischemia
Authors: Rubinstein Moshe , Hildesheimer Minka , Muchnik Chava
Published: November 2007

The purpose of the present study was to describe the audiological and vestibular deficit in patients presumed to suffer from chronic impairment of the blood supply to the labyrinth. Thirty-nine subjects affected by various pathologies often impairing systemic blood circulation, which also presented labyrinthine damage of unclear origin, were evaluated for a possible relationship between these two conditions. At the time of this study 80 per cent of the subjects showed also a certain degree of increased blood viscosity. The most common finding in the group was slow and progressive bilateral sensorineural loss of hearing. In most of the subjects the labyrinthine damage began with high-tone loss which, in time, became a flat curve. Less common, but still found in many patients, was a fluctuation in threshold. Short periods of spontaneous subjective improvement in hearing were accompanied by a better result in the Pure Tone Audiogram and Speech Reception Threshold. The discrimination scores remained generally lower than expected. Vestibular examination revealed pathological results for all the subjects in at least some of the tests. The mild subjective complaints concerning equilibrium could be explained by a central nervous system compensation.
The effects of D and L Isomers of menthol upon nasal sensation of airflow
Authors: Eccles R. , Griffiths D. H. , Newton C. G. , Tolley N. S.
Published: November 2007

Objective and subjective measurements of nasal airflow were made before and after inhalation of Vanilla, D-Menthol and L-Menthol separately. Despite the fact that the menthol isomers were mirror images of one another, only L-Menthol produced the sensation of increased nasal airway patency. No objective change in resistance was found after inhaling either D-Menthol, L-Menthol or the vanilla control. These findings demonstrate that L-Menthol exerts a specific action upon nasal sensory nerve endings, which are responsible for the subjective appreciation of nasal airflow.
Contact sensitivity to gentamicin-hydrocortisone ear drops
Authors: Robinson P. M.
Published: November 2007

Patch testing of ten patients who had been treated with gentamicin-hydrocortisone ear drops for active chronic suppurative otitis media showed evidence of contact sensitivity in five. Positive skin tests correlated with failure to respond to treatment.
Comparison of cocaine and lignocaine as intranasal local anaesthetics
Authors: Jonathan D. A. , Violaris N. S.
Published: November 2007

The relative efficacy of Cocaine and Lignocaine as local anaesthetic agents in the nose were compared. Twenty-five patients undergoing bilateral intra-nasal antroscopy under local anaesthetic were used as their own controls when one nasal cavity was anaesthetised with Cocaine and the other with Lignocaine. On 56 per cent of occasions the patients experienced no difference in the level of discomfort. However, on 36 per cent of occasions Cocaine was noted to give better subjective anaesthesia as compared with 8 per cent of occasions when Lignocaine was superior.
Leiomyoma of the nasal cavity
Authors: Tang S. O. , Tse C. H.
Published: November 2007

A case of rare leiomyoma of the nasal cavity is reported. The pathological and clinical characteristics of this tumour are discussed.
Total laryngotracheal hypoplasia in a case of G syndrome
Authors: Buckley J. G. , Hinton A. E. , Penter G. , Fardon P. A.
Published: November 2007

We report a case of congenital hypoplasia of the larynx and trachea in the presence of an essentially normal cartilaginous structure. To knowledge this abnormality is not recognized in the literature. Previously reported hypoplasitc laryngeal anomalies have all shown anatomical defects ranging form clefts to atresia (Smith and Bain 1965, Gatti et al.,1987). Similarly total congenital tracheal stenosis is accompanied by abnormalities of the cartilaginous structure, usually complete tracheal rings. These types of anomaly typically present either at, or soon after, birth and are associated with other congenital abnormalities. In this particular case the largngotracheal hypoplasia occurred in the context of a hereditary condition of multiple congenital abnormalities known as G syndrome (also known as Opitz-Frias syndrome or the Opitz-G syndrome).
Nasal involvement in systemic amyloidosis
Authors: Dubey S. P. , Mehra Y. N. , Banerjee A. K. , Mann S. B. S. , Garg K. , Nehru V. I.
Published: November 2007

A localized amyloid deposit in the nose is extremely rare and involvement of the nose involvement in systemic amyloidosis is presented.
Vascular leiomyoma of the inferior turbinate–report of a case and review of the literature
Authors: Hanna G. S. , Akosa A. B. , Ali M. H.
Published: November 2007

Leiomyoma of the nose and paranasal sinuses is rare. It constitutes about 1 per cent of all benign tumours. This is due to the paucity of smooth muscle in the nose.

In this paper, the authors present one case of vascular leiomyoma which arose in the inferior turbinate in a 64-year-old lady. It was treated by partial turbinectomy with the relief of her symptoms of nasal obstruction, epistaxis and facial pain.

The English literature on the topic is reviewed.
Strategy and benefits of acoustic neuroma searching
Authors: Moffat D. A. , Hardy D. G. , Baguley D. M.
Published: November 2007

Advances in audiological, radiological and microsurgical techniques have enabled otologists to diagnose and excise very small acoustic tumours with a low morbidity and mortality. Is this cost effective?

In an attempt to answer this question, an analysis of 66 cases of surgically treated acoustic neuromas is presented. This represents part of a series of skull base procedures carried out at Addenbrooke's Hospital over the last five years. As a result of this work an investigative protocol is suggested. By studying the relative morbidity of early and late surgical intervention in these cases, and by costing the exercise, the justification for early diagnosis and treatment is presented both in financial and human terms.
Role of post-operative electroneuronography in predicting facial nerve recovery after acoustic neuroma removal: a pilot study
Authors: Croxson G. R. , Moffat D. A. , Hardy D. G. , Baguley D. M.
Published: November 2007

Complete clinical facial paralysis immediately after acoustic neuroma removal occurs in between 40 to 90 per cent of patients despite the fact that the facial nerve has been preserved anatomically. Some of these patients improve rapidly with adequate cosmetic and functional recovery. Others however, have incomplete or no return of useful function.

A pilot study to assess the prognostic value of electroneuronography (ENOG) in 14 patients following acoustic neuroma removal was performed. The results suggest that post operative ENOG is of value in dividing those patients with anatomically intact facial nerves yet complete clinical paralysis post-operatively into groups: one with rapid improvement to an acceptable functional and cosmetic result and one with prolonged paralysis with incomplete or no recovery. Electroneuronography may thus be used to predict the initial recovery profile in patients with complete facial paralysis after surgery.
Cholesteatoma of the external auditory canal in hemifacial hypertrophy (hyperplasia)
Authors: Gadre Arun K. , Gadre K. C.
Published: November 2007

Congenital hemifacial hypertrophy is an extremely rare condition. At the time of writing this article, there have been 37 cases reported in the literature. Of these, only two have appeared in the otolaryngologic literature. Cholesteatoma of the external auditory canal (EAC) in hemifacial hypertrophy has not been reported before. This article reports one such case, and discusses the classification of hemihypertrophies. A review of the literature is included in the discussion. Management of cholesteatomas of the external auditory canal is also touched upon. A new theory for the peculiar site selection of cholesteatomas of the external auditory canal is postulated.
Morphology of a columellaform stapes
Authors: Maelea C. Vande , Cauwenberge P. Van , Kluyskens P. , Vakaet L.
Published: November 2007

A columellaform stapes found in male patient 18 years old with a conductive hearing loss, has been examined by SEM and light microscopy. The ossicle was smaller than a normal stapes. The head was linked to the base by a crural plate, probably formed by the fusion of the material of the two crura. Microscopy showed a slightly less interwoven structure of the fibrillar bone present mainly at the cranial aspect of the crural plate. Honeycomb-like bone was confined to the caudal part of the crural plate. Microscopy revealed a cavity in the centre of the stapes at the transition between the base and the plate. During surgery, a bony structure was found linking the posterior side of the head of the stapes to the pyramidal eminence. Post-operative audiograms revealed improved hearing with some residual conductive loss of about 10 dB. This case illustrates that a columellaform stapes may occur without forming part of a syndrome.
Mycotic aneurysm of the petrous portion of the internal carotid artery
Authors: Samuel J. , Fernandes C. M. C.
Published: November 2007

A case of a mycotic aneurysm of the petrous portion of the internal carotid artery is presented. This entity is extremely rare and the problems associated with the diagnosis and clinical management are discussed.
Post-traumatic asymptomatic saccular aneurysm of the internal carotid artery
Authors: Vanlierde M. J. R. R.
Published: November 2007

A patient presented with mild upper airway obstruction after being shot from behind through the neck and soft palate. Two days later he developed palsies of the IXth to XIIth cranial nerves inclusive on the traumatised side. These palsies resolved spontaneously after three weeks. Further investigation revealed the presence of a saccular aneurysm of the internal carotid artery. The internal carotid artery was ligated after gradual closure for three days using a Preston clamp.
Aberrant reinervation of the stapedius muscle following facial palsy
Authors: McFerran D. J. , Baguley D. , Moffat D. A.
Published: November 2007

This case report describes the clinical course of a patient with Ramsay Hunt Syndrome. Partial recovery of the lower motor neuron facial palsy was associated with decreased hearing and a reduction of the middle ear compliance on voluntary contraction of the facial musculature. It is suggested that this is due to misdirection of regenerating nerve fibres, normally destined for facial muscles, to stapedius muscle.
Out-patient examination of the upper airway: A survey of current practice in the UK
Authors: Albizzati C. , Mills R.
Published: November 2007

Questionnaires have been sent to all ENT Consultants practising in the UK in an attempt to establish current practice with regard to out-patient examination of the upper aerodigestive tract. Seventy-eight per cent of these were returned completed. The results indicate that mirror examination remains the most widely used method, though the fibreoptic rhinolaryngoscope and/or the Hopkins rod telescope are now used by many specialists. Mirrors are most frequently warmed by a spirit lamp, despite the fact that 125 respondents reported having had a fire in their departments. Other methods of warming mirrors are discussed.
Nasal endoscopy in chronic maxillary sinusitis
Authors: Kamel R. H.
Published: November 2007

The role of the anterior ethmoids in the pathogenesis of chronic maxillary sinusitis is still a subject of controversy. Although the symptoms of maxillary sinusitis may be clinically dominant, many previous studies have showed that the origin of this disease was, in most cases, located within the anterior ethmoid region.

This study included 100 Egyptian patients, suffering from chronic maxillary sinusitis (confirmed by maxillary sinoscopy), who were subjected to ‘systematic nasal endoscopy’. It was found that all cases of chronic maxillary sinusitis were associated with anatomical variations and/or pathological abnormalities of ‘the ostiomeatal area’. It is recommended, therefore, that during the diagnosis and treatment of chronic maxillary sinusitis, attention should be given to the region of the middle meatus and anterior ethmoid complex (or ‘ostiomeatal area’) for any anatomical variations and/or pathological abnormalities in order to avoid recurrence of maxillary sinusitis. This is the basis of the procedure of functional endoscopic sinus surgery.
Use of a Braunula® for maxillary sinus irrigation
Authors: Zohar Y. , Talmi Y. P. , Finkelstein Y. , Shem-Tov Y.
Published: November 2007

Puncture and lavage of the maxillary sinuses is a common procedure in ENT practice. Repeated irrigations are required in chronic sinusitis refractory to treatment. In our department we use a No. 14 gauge Braunula® for such cases. Over 100 patients have been treated over the past two years with no significant complications. This device is inexpensive, sterile, safe and easy to use and we recommend its use for patients with chronic maxillary sinusitis requiring repeated irrigations.
Idiopathic fibrosis of the upper aero-digestive tract.
Authors: Violaris N. S. , Windle-Taylor P. C.
Published: November 2007

Idiopathic fibrosis of different areas of the body such as retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, Reidel's thyroiditis and pseudo-tumour of the orbit are well recognised entities that manifest individually or in combination. A case of idiopathic fibrosis of the upper aerodigestive tract is presented, which caused dense fibrosis of the floor of mouth, tongue, pharynx and larynx leading to aphonia and severe dysphagia. A permanent tracheostomy was performed and regular bouginage is necessary. This is the first such case reported in the literature.
Combined treatment of large head and neck capillaro-venous malformation by a fibrosing agent
Authors: Fradis M. , Podoshin L. , Simon J. , Lazarov N. , Shagrawi I. , Boss J. H.
Published: November 2007

We report our experience of seven cases suffering from capillaro-venous malformation localized in the head and neck area, treated preoperatively by a fibrosing agent—ETHIBLOC. Four of the cases are presented and analysed.

We suggest the pre-operative injection of Ethibloc as the treatment of choice for capillaro-venous malformations in the head and neck region
Surgery for otitis media with effusion in children and its relationship to parental smoking
Authors: Hinton A. E.
Published: November 2007

A study was conducted to ascertain whether there is any relationship between parental smoking and various factors in children undergoing surgery for otitis media with effusion.

Information was recorded on 115 children admitted to hospital for grommet insertion. Details of parental smoking habits, previous surgery for ottis media with effusion and operative findings were noted. A group of 36 children with healthy ears attending an orthoptic clinic were used as controls.

Those children with at least one parental smoker were found to have a higher chance of being admitted to hospital for grommet insertion and were more likely to have had previous surgery for otitis media with effusion.
Maxillary antral lavage—infiltration and surface anaesthesia compared
Authors: Paulose K. O. , Khalifa S. Al , Shenoy P. , Sharma R. K.
Published: November 2007

A prospective study on 210 patients was conducted to determine the relative efficacy of infiltration anaesthesia as against surface anaesthesia for antral lavage. The patients were categorized into three groups and comparisons were made on patient response and our observations. This study confirms that infiltration technique is superior to surface anaesthesia and is, also, less time consuming.
Snoring as a presenting feature of the Shy-Drager syndrome
Authors: McGlashan J. A. , Golding-Wood D. G.
Published: November 2007

A 67-year-old man with a progressive snoring habit is presented. Fluctuant bilateral abductor vocal cord paralysis was later recognized together with autonomic features suggesting a diagnosis of Shy-Drager syndrome. Snoring as a presenting feature of this condition has been infrequently described. This case highlights the importance of careful assessment of snorers.
Nasopharyngeal Warthin's tumour: A metaplastic lesion
Authors: Kristensen S. , Tveterås K. , Friedmann I. , Thomsen Per
Published: November 2007

Warthin's tumour arising from minor salivary glands of the nasopharynx is described in a patient with eosinophilic rhinitis and nasal polyposis. The microscopical features of this lesion were indistinguishable from those of Warthin's tumours of the parotid gland. The present case supports the histogenetic theory that the epithelial component of extraparotid Warthin's tumours represents reactive oncocytic metaplasia and hyperplasia induced by chronic inflammation rather than genuine neoplasia. It is suggested that the term Warthin's tumour is preferable to designations indicating neoplasia of these extraparotid lesions which are indistinguishable histologically and ultrastructurally from parotid and juxtaparotid adenolymphomas.
Glial teratoma thought to be a lingual thyroid
Authors: Tumushime-Buturo C. G. , Nkanza N. K.
Published: November 2007

A case of a glial teratoma occurring in the tongue of a twelve week old male child is presented. This lesion was thought clinically to be a lingual thyroid. Histopathological examination revealed the true nature of the lesion. The mother had noticed the lesion since birth but only sought medical attention when the child developed difficulty in breathing.

Teratomas in the head and neck region are uncommon and are commonly diagnosed wrongly as lingual thyroid. These lesions are usually benign.
Vocal cord paralysis with Ebstein's anomaly
Authors: Krishnamurthy S. N. , Paulose K. O.
Published: November 2007

Left recurrent laryngeal nerve runs a long intrathoracic course in close relationship to the aortic arch and adjacent heart structures and, hence, is liable to be injured by diseases affecting the heart and its great vessels.

We report a case of Ebstein's anomaly causing left recurrent laryngeal nerve paralysis in a neonate. To our knowledge, this is the first reported case of vocal cord paralysis associated with this condition.
Rare submandibular swelling (Capillary haemangioma)
Authors: Slack R. W. T. , Milroy C. , Parker A.
Published: November 2007

The diagnosis of submandibular lumps is usually straightforward, using a combination of history, examination and simple investigation. Most will turn out to be submandibular salivary gland enlargement or lymph node swellings. We present a case in which conventional investigation failed to help in the diagnosis, and was eventually found to be what we believe is the first capillary haemangioma described in the anterior belly of the digastric muscle.
Acinous cell carcinoma of the larynx
Authors: Kallis S. , Stevens D. J.
Published: November 2007

Acinous cell tumours of the larynx and trachea are extremely rare. A recent review of the literature has only found four reported cases. This short report describes such a patient and discusses her management in the light of previous articles. In view of its rarity in the laryngotracheal area and the uncertainty in the way in which the tumour should be managed, we thought the following case report and review of the literature would be of interest.
Prevention of post-operative intra-nasal adhesions
Authors: Eliopoulos P. N. , Philippakis C.
Published: November 2007

A new material, the wax paper enveloping the Fucidin® gauze which is routinely used to pack the nose post-operatively, was utilized in 120 cases considered as ‘high-risk’ for the formation of post-operative nasal adhesions. This proved to be an inexpensive, simple and effective method when the prevention of the formation of nasal adhesions was the primary goal.
Surgical management of drooling in the neurologically damaged child
Authors: O'Dwyer T. P. , Timon C. , Walsh M. A.
Published: November 2007

Continuous drooling after infancy is rarely seen in normal children. Neurologically damaged children are more likely to continue to drool, and it may be so severe in some cases as to require surgical correction. Submandibular duct relocation is a procedure with minimal morbidity and excellent results. This procedure has been carried out on 16 children at the Eye and Ear Hospital and Temple Street Children'hospital, Dublin, between the years 1982 to 1987. An overall improvement occurred in 13 cases with only one post-operative complication. Such surgery has transformed the lives of these children as well as being a great source of relief for the parents.
Two malignant melanomas in skin and tonsil during consecutive pregnancies
Authors: Walsted Alice , Thomsen Jens , Nielsen P. L.
Published: November 2007

A patient is described with two primary malignant melanomas which developed during consecutive pregnancies four years apart. The first melanoma was of the cutaneous nodular type located on the arm. The second, of the superficial spreading type, was located in the oral mucosa near the right tonsil. The influence of pregnancy on the development and outcome of malignant melanomas is discussed, and the risk of a subsequent pregnancy is emphasised.
Clear cell carcinoma arising in pleomorphic adenoma of the minor salivary gland
Authors: Klijanienko Jerzy , Micheau Christian , Schwaab Guy , Marandas Patrick , Friedman Sam
Published: November 2007

Malignant change arising in pleomorphic adenoma of the salivary glands is uncommon, with a reported incidence of 2–10 per cent.

Only one case where a pleomorphic adenoma became a clear cell carcinoma appears to have been published in the English literature. An additional case of clear cell carcinoma arising in pleomorphic adenoma of a minor salivary gland is reported and the relevant literature discussed.
Diagnostic vetting of individuals with asymmetric sensorineural hearing impairments
Authors: Swan I. R. C.
Published: November 2007

Audiological and vestibular tests were administered conjointly in a neurological or general ORL clinic to exclude cerebellopontine angle (CPA) tumours. This study aimed to assess the efficiency of various tests in achieving that exclusion with the minimum of unnecessary investigations. All patients received the full battery of auditory brainstem responses, acoustic reflex thresholds and decay, alternate binaural loudness balance and ENG and caloric testing. All patients who did not have normal auditory brainstem responses proceeded to high resolution CT scanning. One hundred and fifteen patients were investigated and four acoustic neuromas were diagnosed. The efficiency of these tests in a general ORL clinic is very much poorer than often suggested, due largely to the number of occasions on which the tests cannot be done, and to the very small proportion of the test population who have CPA tumours.
Laryngeal tuberculosis in the eighties—an Indian experience
Authors: Rupa V. , Bhanu T.S.
Published: November 2007

Laryngeal tuberculosis is one of the rarer forms of extrapulmonary tuberculosis. A retrospective analysis of 26 patients seen in the last nine years in our hospital was conducted to illustrate the various modes of clinical presentation. Of the 26 patients, twenty were male and six female. The average age of presentation was 47 years with an age range of 15 months to 71 years. Hoarseness (92.3 per cent) was the commonest symptom. The laryngoscopic appearances often simulated malignancy. Most patients (69.2 per cent) outnumbered ulcerative ones (38.5 per cent). Laryngeal oedema was infrequent (7.7 per cent). Diagnosis was based on a laryngeal biopsy in 18 patients and on evidence of associated pulmonary tuberculosis and response to anti-tuberculous therapy in eight. Chest X-rays showed apical cavitation and infiltration as the commonest findings. Three patients had miliary tuberculosis and one had no pulmonary lesion. Diabetes mellitus was present in seven (26.9 per cent) patients. Four illustrative cases are described. The problems in diagnosis and management of laryngeal tuberculosis are discussed.
Factitious illness and the ENT surgeon
Authors: Thomas M. R.
Published: November 2007

‘Factitious illness’ is a recently classified group of diseases characterized by repeated purposeful simulation of physical or mental illness in order to obtain medical or psychiatric treatment. ‘Münchausen Syndrome’ is a classical example of this group.

The case reported is a 26-year-old Caucasian male who presented with recurrent facial swelling between December 1978 and November 1987. His true condition eluded diagnosis for so long because he presented repeatedly with overt clinical signs which appeared severe enough to justify the symptoms claimed.
A rational classification of angiofibromas of the post nasal space
Authors: Mishra S. C. , Shukla G. K. , Bhatia Naresh , Pant M. C.
Published: November 2007

Angiofibromas of the post nasal space have the potential to extend in all directions along predetermined pathways with a definite mode and chronological pattern. In order to understand their clinical behaviour, methods of treatment and prognosis, a system of clinical staging based on conventional and tomographic observations has been found useful in this series of cases. The classification has been evolved according to the extent of the tumour involvement but also the age of onset, duration, size and area of encroachement including the surgical approach and consequent prognosis. Deficiencies in the earlier classifications are discussed.
Klippel-Feil syndrome and conductive deafness
Authors: Stewart Eleanor J. , O'Reilly B. F.
Published: November 2007

The Klippel-Feil syndrome is usually associated with sensorineural deafness and reports of conductive or mixed deafness are rare. Four additional cases are presented in this paper. The middle ear anomalies found in this syndrome are discussed. The results of middle ear surgery are reviewed and found to be poor.
Sex ratios in otosclerotic families
Authors: James W. H.
Published: November 2007

The sex ratio (proportion of males) of offspring of otosclerotics is significantly and substantially below expectation. To account for this and other features of the condition, it has been suggested elsewhere that otosclerosis is subject to autosomal dominant transmission with intrauterine selection against male heterozygotes. To test this hypothesis, a search was made for published data on the sexes of sibs of otosclerotics. These sibs do not have an unusual sex ratio, thus casting doubt on the hypothesis. Accordingly it is suggested here that both the condition and the sex ratios are causally related to levels of steroid hormones.
Reliability of the House and Brackmann grading system for facial palsy
Authors: Evans Robert A. , Harries Meredydd Le. , Baguley David M. , Moffat David A.
Published: November 2007

The House and Brackmann grading system has been recommended as a universal standard for assessing the degree of facial palsy. This study examined the inter-observer reliability of this system. Three observers assigned a grade to each patient, examined independently, on the same day. Forty patients with a unilateral facial palsy of varying aetiology and severity were assessed. Of the 120 judgements, eight were in dispute, by a maximum of one grade, giving an inter-observer reliability of 93 per cent.

We conclude that the House and Brackmann grading system is a simple and robust method of assessing facial function.
Immunocytochemical identification of HIV (p24) antigen in parotid lymphoid lesions
Authors: Bruner J. M. , Cleary K. R. , Smith F. B. , Batsakis J. G.
Published: November 2007

Antibodies to specific human immunodeficiency virus (HIV) polypeptides are important laboratory markers of HIV infection. We have used an antibody to the major structural gag protein p24 of HIV-1 virus to immunochemically localize this capsid antigen in lymphoid cells from seven of eight patients at risk for HIV infection and who presented with parotid lymphadenopathy and lymphoepithelial cysts of the parotid gland. A clinicopathological assessment of these two manifestations as they relate to HIV infection is also presented.
Malignant fibrous histiocytoma of the nasopharynx
Authors: O'Reilly B. J. , Ryan J. , Reynard J. , Chevretton E.
Published: November 2007

Malignant Fibrous Histiocytomas (MFH) are uncommon in the head and neck and extremely rare in the nasopharynx. We report a case of MFH arising in the nasopharynx and describe its diagnosis and management. The literature is reviewed and the likely origins of the tumour and its behaviour are discussed.
Noise levels and exposure patterns to do-it-yourself power tools
Authors: McClymont L. G. , Simpson D. C.
Published: November 2007

The noise levels produced by a variety of do-it-yourself power tools were measured in a real-life situation. Most of the devices tested produced noise of 100 dB(A) or greater at the user's ear. A questionnaire was issued to 100 males who used these devices. The vast majority used the devices infrequently and therefore are unlikely to be directly at risk of hearing damage. A group of users who may be more at risk from using power tools in the home are those who are, or have been exposed to occupational noise.
Surgical management of large glomus jugulare tumours: infra-and trans-temporal approach
Authors: Moffat D. A. , Hardy D. G.
Published: November 2007

Surgery may have to be considered in the management of large glomus tumours since other modalities of treatment are not curative. The judicious use of surgical intervention is imperative since a neurological deficit involving the last four cranial nerves may ensue and consideration of the quality of life of the patient in the post-operative period is of paramount importance. A brief description of the historical aspects and pathology of these tumours is followed by an analysis of the clinical presentation, investigation and assessment of a series of 10 patients. Six patients underwent surgery and their tumours were removed by the infra-and trans-temporal approach. This is described and illustrated in detail and the surgical results presented.
Reccurrent multiple epidermoid inclusion cysts following rhinoplasty—an unusual complication
Authors: Grocutt M. , Chir B. , Fatah M. F.
Published: November 2007

Epidermoid inclusion cysts are a relatively common finding following superficial trauma. Inclusion cysts have previously been reported following rhinoplasty, but these have been mucosal cysts and one case of a paraffinoma. A case of multiple recurrent epidermoid inclusion cysts, developing in relation to rhinoplasty, is presented.
Fibromatosis of the larynx in the adult
Authors: De Rosa G. , Barra E. , Boscaino A. , Gentile R. , Di Prisco B.
Published: November 2007

We describe the fourth case of aggressive fibromatosis of the larynx arising in an adult. Most cases of laryngeal fibromatosis have been described in children. In the larynx it may behave the same as in other sites, with local aggressiveness but without metastatis. The possible differential diagnoses are discussed.