bluuebunny/crossref_metadata_2025 huggingface dataset:
Lateral temporal bone resection for extensive pinnal malignancy. Has anything changed in forty years?
Authors: Shotton J. C. , Sergeant R. J. , Tanner N. S. B. , Allen J. P.
Published: November 2007

Abstarct

This paper offers an account of the contemporary surgical approach to advanced tumours of the external ear based on a series of 11 patients. There were eight squamous, two basal cell carcinomas and one mucoepidermoid tumour. The traditional method of excision was slightly modified by performing microsurgical dissection of the lateral part of the temporal bone rather than chisel osteotomies, and then including it en bloc with the involved soft tissues. The defect was then closed using a scalp or myocutaneous flap and this combination of otological and reconstructive expertise has proved satisfactory. Four patients are alive with no evidence of disease a mean of 4.2 (range 1.0–7.0) years from surgery: two patients who remained free of disease have subsequently died of unrelated conditions 12 and 24 months post-operatively, and in three cases death from recurrent disease occurred a mean of 1.4 (range 0.9–2.1) years after our surgery. There were two postoperative deaths. Based on the actuarial survival of 36 per cent and a successful disease clearance rate of 54 per cent, our conclusion is that the outlook of this condition has not dramatically improved since the original descriptions of the management of this problem first appeared, although intervention remains justifiable because of the potential curability and relief of symptoms.
Autosuture GIA gun: a new application in the treatment of hypopharyngeal diverticula
Authors: Martin-Hirsch D. P. , Newbegin C.J.R.
Published: November 2007

Abstarct

A new surgical technuque for the tratementof mederate to large hypopharyngeal diverticula is described, The procedure particularly useful in debilitated patients that it is quick and guarnties closure of the party wall between the pouch and upper oesophagus.
Cortical evoked potential criteria in the objective assessment of auditory threshold: a comparison of noise induced hearing loss with Ménière's disease
Authors: Prasher Deepak , Mula Mohamed , Luxon Linda
Published: November 2007

Amplitude of the Nl component of the cortical response was used to objectively determine threshold of hearing at 1 kHz and 4 kHz in a series of consecutively referred medicolegal cases with alleged occupational noise induced hearing loss and a control group of patients with Ménière's disease who were not seeking compensation for their hearing loss. The cortical response thresholds were compared with the subjective pure tone audiometric (PTA) thresholds at the same frequencies. The cortical and PTA thresholds were ‘;within 10 dB’; for 84 and 92 per cent of the cases of noise induced hearing loss (NIHL) and Ménière's disease respectively, confirming the validity of CERA as a means of denning accurately the frequency specific thresholds and the audiometric configuration. Of the remaining 16 per cent of NIHL, 13 per cent exaggerated their PTA thresholds at 1 kHz and 10 per cent at 4 kHz whilst the error in cortical threshold estimation was beyond the 10 dB level for three and six per cent of cases at those frequencies respectively. The median exaggeration of threshold was 25 dB. For eight per cent of the Ménière's patients, thresholds exceeded 10 dB at both 1 and 4 kHz, four per cent of whom exaggerated their PTA thresholds and four per cent had a test error greater than 10 dB. A similar percentage (four per cent) of both groups revealed a cortical test error greater than 10 dB whereas three times as many cases of noise induced hearing loss (13 per cent) revealed exaggeration of their subjective audiometric thresholds compared with the Ménière's group (four per cent).

The value of latency criteria in the assessment of cortical threshold was established. The latency of Nl close to threshold was invariably greater than 150 ms and at 30 dB above threshold, irrespective of absolute levels, it was within 10 ms of 100 ms, thereby providing another criterion for the improved measurement of threshold.
A comparison of speech audiometry and pure tone audiometry in patients with secretory otitis media
Authors: Pringle M. B. , Thompson A. , Reddy K.
Published: November 2007

Speech audiometry was performed on 15 children with secretory otitis media pre-and post-operatively and the findings compared with the pre-and post-operative pure tone audiograms. The results showed that in 30 per cent of cases pre-operatively the speech audiogram suggested a significantly worse hearing ability than that suggested by the pure tone audiogram (PTA). Where a PTA gives a borderline threshold disproportionate parental concern should be taken seriously as the hearing ability may well be worse than the PTA suggests.
External ear canal schwannoma: an unusual case report
Authors: Wu Che-Min , Hwang Chung-Feng , Lin Chin-Hao , Su Chih-Ying
Published: November 2007

To the best of our knowledge, this is the first report of external ear canal schwannoma in the English literature. Several detailed clinical and pathological features were demonstrated. We suggest that if a tender, encapsulated mass is found in the external ear canal, the diagnosis of schwannoma should be taken into consideration.
Nasal leishmaniasis
Authors: Vernham G. A. , Sadiq H. , Mallon E. A.
Published: November 2007

Leishmaniasis is an uncommon condition in Western Europe, except around the Mediterranean coast. However, it may occasionally be seen in the United Kingdom, in patients who acquired the infection in foreign lands. An unusual case of localized cutaneous leishmaniasis recidiva affecting the nose after septal surgery is presented.
Transnasal endoscopic surgery of sphenoid sinus aspergillosis
Authors: Lin W. S. , Hung H. Y.
Published: November 2007

Aspergillus sp. are the most common contaminants of the paranasal sinuses with the maxillary sinus as the site most frequently involved. Fungal sphenoid sinusitis can be a life-threatening situation, thus aggressive therapy is indicated. The treatment is primarily surgical. The transnasal endoscopic technique offers excellent visualization and an atraumatic approach to the sphenoid sinus. Surgical exteriorization and aeration of the involved sinus, without using antifungal chemotherapeutic agents is curative. A rare case of sphenoid sinus aspergiUosis which was successfully treated by transnasal endoscopic sphenoidotomy is reported.
Melanotic neuro-ectodermal tumour of infancy arising from the squamous and occipital bone
Authors: Kacker A. , Bahadur S. , Singh M.
Published: November 2007

The melanotic neuro-ectodermal tumour of infancy is an uncommon benign tumour of neural crest origin occurring in infants with a predilection for the anterior maxilla. This lesion shows a good response to conservative surgical excision with few recurrences but it should be followed up for long periods of time because of the rare malignant change possible in the tumour.
Pigmented villonodular synovitis of the temporomandibular joint
Authors: Syed Alan , Van Hasselt C. A. , To K. F
Published: November 2007

The first case of pigmented villonodular synovitis of the temporomandibular joint in a Chinese patient is reported. The dinicopathological features are described and the presentation as a parotid mass is emphasized. This rare tumour requires a high clinical suspicion for diagnosis. For removal, meticulous dissection of tumour and facial nerve is necessary.
The prognostic value of mucociliary clearance in predicting success in tympanoplasty
Authors: Giménez F. , Marco-Algarra J.
Published: November 2007

Mucociliary and equipressive eustachian tube functions have been studied, using saccharin solution (five per cent sodium saccharinate) and tubal manometry respectively, in 58 ears with chronic disease undergoing tympanoplasty. The position of the perforation site determines the results as the poorest results are obtained from the posterior ones, positive cases (47 per cent) and mean transport time (37.7 minutes), compared to the greater percentage of positive cases (86 per cent) and mean transport time (22.2 minutes) for anterior perforations.

When both parameters are analysed together there is a direct relationship between normal equipressive function and normal mucociliary transport time and between negative transport time and tubal blocking. Significant differences in transport times have been found for the anterior and posterior perforations being shorter for the anterior ones.

When surgical outcome is correlated with mucociliary transport, the normal transport time percentage is seen to be considerably higher in the success group (50 per cent) than in the failure group (22 per cent).
Inferior turbinate resection: the need for a nasal pack
Authors: El-Silimy Osama
Published: November 2007

A random prospective study of 180 patients with chronic nasal obstruction who underwent inferior turbinate resection as a part of a multinasal surgical procedure is presented. The aim of our study was to examine the influence of nasal pack on the incidence of post-operative haemorrhage following inferior turbinate resection.

The haemorrhage rate in Group 1 (no nasal pack), Group 2 (nasal pack retained for 24 hours) and Group 3 (nasal pack retained for 48 hours) was 11.7, 8.3 and 0 per cent respectively.

We recommend that a nasal pack should be retained for 48 hours following inferior turbinate resection.
External laryngeal trauma: analysis of thirty cases
Authors: Cherian T. A. , Rupa V. , Raman R.
Published: November 2007

A retrospective analysis of thirty patients with external laryngeal trauma was performed to assess the type and extent of injuries commonly seen as well as the outcome following treatment. Outcome was assessed both in terms of voice and airway. Major laryngeal injuries (19 cases) outnumbered minor injuries (11 cases). A good correlation exists between the symptoms of haemoptysis and stridor at presentation and severity of the injury (p = 0.002). Early surgical intervention is associated with better outcome (p = 0.01). However there is no statistically significant difference in outcome between major and minor injuries (p = 0.3) indicating that other factors are operative in determining outcome. Based on our findings a management strategy for patients with external laryngeal trauma is outlined.
Predictive factors of a complete response to and adverse effects of a CDDP-5FU combination as primary therapy for head and neck aquamous carcinomas
Authors: Bachaud J. M. , David J. M. , Shubinski R. E. , Perineau D. , Boussin G. , Serrano E. , De Forni M. , Pessey J. J. , Daly-Schveitzer N. J.
Published: November 2007

Abstract: Retrospective analysis of detailed patient and tumour factors associated with a complete response to combination inductive chemotherapy with CDDP-5FU (96 or 120 hour continuous infusion) was performed using data from 147 patients with a previously untreated squamous cell carcinoma of the oral cavity, oropharynx or pharyngo-larynx following completion of two (29 patients) or three (118 patients) cycles. Adverse reactions to chemotherapy were documented for all 164 patients included in the study. Eight drug-related deaths occurred due to: acute myocardial infarction (five patients), peptic ulcer disease (two patients) and severe neutropenia with sepsis (one patient). Severe non-lethal complications included marrow depletion (14 patients), peptic ulcer (two patients), thrombophlebitis (seven patients), angina pectoris (two patients), stroke (one patient), pulmonary oedema (one patient) and convulsions (one patient). Six patients refused further treatment because of untoward side effects and tumoral progression was observed in three cases. Separate response rates for the primary site and nodes were determined and analysis of respective predictive factors of response was performed. Complete response was obtained in 31 per cent at the primary site versus 18 per cent for the nodes (p<0.05). The combined (primary site + nodes) overall complete response rate was 22 per cent. Among 11 factors studied (age, sex, performance status, primary site, tumour differentiation, initial resectability, 5FU dosage per cycle, number of cycles, T, N and TN stages), only performance status, N stage, resectability and number of cycles were associated with a combined complete response. Multivariate analysis showed performance status, N stage, TN stage and resectability to be significant predictive factors of a combined complete response. Optimum use of inductive chemotherapy will ultimately rely upon a better knowledge of predictive factors in order to avoid drug-related complications in patients not expected to respond.
Primary cerebral lymphoma presenting with bilateral cerebellopontine angle lesions
Authors: Garth R. J. N. , Coddington R. , Brightwell A. P.
Published: November 2007

A case is described of a primary cerebral lymphoma which presented with bilateral cerebellopontine angle lesions. No similar case has been reported in the English language in the last 25 years. The literature is reviewed and discussed.
Implantation metastasis following percutaneous endoscopic gastrostomy
Authors: Laccourreye Ollivier , Chabardes Eric , Mérite-Drancy Agnés , Carnot Françoise , Renard Philippe , Donnadieu Stéphane , Brasnu Daniel
Published: November 2007

Since it was first described, the original percutaneous endoscopic gastrostomy (PEG) technique has proved to be a valuable adjunct in patients with head and neck tumours. This procedure is being increasingly utilized in the face of swallowing impairment related to head and neck carcinoma. Although generally well tolerated, it may be associated with complications. In this report, we document tumour implantation at the percutaneous endoscopic gastric site and review the report cases. It appears that implantation metastasis does alter prognosis.
Altered dental sensation following intranasal surgery
Authors: MacDougall G. , Sanderson R. J.
Published: November 2007

Some patients complain of altered sensation in the mouth following nasal surgery. A prospective study of 60 consecutive patients who underwent a total of 83 intranasal procedures revealed that this was a common complication, particularly following submucous resection (SMR) or intranasal antrostomies.

The area affected by painlparasthesia appears to be anatomically related to the surgical procedure(s) performed.
Melanotic neuroectodermal tumour of infancy
Authors: Irving R. M. , Parikh A. , Coumbe A. , Albert D. M.
Published: November 2007

The melanotic neuroectodermal tumour of infancy is a rare, pigmented neoplasm that most frequently arises from the anterior maxillary alveolar ridge. It presents in the first few months of life, and usually follows a benign course. A classical case is presented and the clinical, radiological and pathological characteristics are discussed. The importance of early conservative surgical excision is emphasized with, in general, a good prognosis.

This tumour, which many otolaryngologists may not be familiar with, should be included in the differential diagnosis of head and neck neoplasms in infants and young children.
Histiocytosis: an unusual cause of dysphagia, hoarseness and stridor
Authors: Nicol J. W. , Stables G. I. , Mackenzie K.
Published: November 2007

We present a patient with established histiocytosis who developed dysphagia, retching, regurgitation, hoarseness and stridor. These symptoms were managed with carbon dioxide laser vaporization, electively on three occasions, and once as an urgent procedure, while awaiting radiotherapy, to control her airway.

Histiocytosis is a rare cause of a number of otolaryngological syndromes, but there has been no previous record of this disease causing laryngopharyngeal symptoms. This paper discusses the classification of histiocytosis, and describes our management of this rare and intriguing case.
Squamous cell carcinoma of the tonsillar region and the base of the tongue: a morphological and immunohistochemical comparative pilot study
Authors: Mak-Kregar Sanja , Mooi Wolter J. , Balm Alfons J. M. , Hilgers Frans J. M.
Published: November 2007

Sixteen squamous cell carcinomas of the tonsillar region and 13 carcinomas of the base of the tongue were studied in a search for significant differences between the tumours of these two oropharyngeal subsites, which are known to carry a significantly different prognosis. The characteristics of the tumour cells and the tumourhost relationship were scored on H & E-stained slides, as well as on slides stained with a panel of antibodies. The results obtained were cross-tabulated and analysed with respect to the subsite. Ten variables were tested: cytonuclear pleomorphism, mitotic activity, the presence of atypical mitoses, keratinization, tumour grade, presence of eosinophils, severity of inflammatory response, and the expression of keratin-10, blood group antigens and collagen IV. When split up by site, only cytonuclear pleomorphism revealed a significant difference, tonsillar carcinomas more often exhibiting marked pleomorphism (p=0.04).

Despite having some prognostic relevance for squamous cell carcinomas of the head and neck, the variables tested could not provide an explanation for the difference in biological behaviour of the tumours studied.
’The holiday plug‘: a temporary solution to the problem of the leaking voice prosthesis
Authors: Rogers Simon N. , Batch Andrew , Powell David , Radford Kaye
Published: November 2007

Tracheo-oesophageal prostheses are commonly inserted in patients following total laryngectomy to improve the quality of the voice. Unfortunately the device eventually fails and requires replacement. A valve change, although well tolerated by patients, necessitates an out-patient visit and delay in its replacement can lead to problems of pneumonia or dehydration. In this short paper we describe a simple temporary solution for a leaking valve and recommend its use in patients who are delayed in returning to the unit for example when on holiday.
Primary amyloidosis of the external auditory canal: case report
Authors: Panarese A. , Roland N. J. , Green B.
Published: November 2007

A case of primary amyloidosis of the external auditory canal is described. To the best of our knowledge this is the first case described in the literature.
Uvulectomy to prevent throat infections
Authors: Hartley B. E. J. , Rowe-Jones J.
Published: November 2007

It is common practice in many parts of Africa for traditional healers to remove the uvula to prevent infections and other disorders associated with the throat.

We report two cases of children presenting with recurrent tonsillitis. On examination both children showed complete absence of the uvula and prominent tonsils. It was later revealed that they both had undergone uvulectomy, performed by traditional healers in Eritrea. We report this because this practice, although commonly performed, is little known to otolaryngologists practising outside Africa. In addition, although velopharyngeal competence seems to be maintained after uvulectomy, it may theoretically be at risk if adenoidectomy is performed in these patients.
Acquired involution of the maxillary antrum
Authors: Kumar B. U. , Naisby G. , Flood L. M.
Published: November 2007

Maxillary sinus shrinkage can occur secondary to acquired benign osteomeatal disease. This may be associated with an external deformity and sinus wall sclerosis.
Adenocarcinoma arising in an oesophageal colonic interposition graft
Authors: Lee S. J. , Koay C. B. , Thompson H. , Nicolaides A. R. , Das Gupta A. R.
Published: November 2007

This case report describes the rare complication of an adenocarcinoma developing in a colonic interposition graft 20 years following surgical resection of a postcricoid squamous carcinoma. A free jejunal graft was used for further oesophageal reconstruction following resection of the colonic graft.
Surgical management of benign necrotizing otitis externa
Authors: Wordmald P. J.
Published: November 2007

Benign necrotizing otitis externa (BNOE) is a rare condition of unknown aetiology which is characterized by the formation of an avascular bony sequestrum of the tympanic plate. The vascular supply of the tympanic plate is easily compromized as demonstrated by the development of avascular necrosis in radionecrosis of the tympanic plate and malignant otitis externa. Recognition of BNOE as distinct from malignant otitis externa and carcinoma of the external ear is important as the treatment differs greatly. BNOE also forms an important part of the differential diagnosis of recalcitrant otitis externa.

Management of BNOE has been unclear with long-term medical treatment being advocated. In this series of five patients, the surgical management of four patients with BNOE is described. Surgery was successful in all these patients and is advocated as an alternative to medical management.
Solubilization of keratin debris in conservative treatment of middle ear cholesteatoma: anin vitrostudy
Authors: Gyo Kiyofumi , Sasaki Yasushi
Published: November 2007

A variety of solutions were testedin vitroto find a suitable solvent which could be used in clinical practice for cholesteatoma debris. Though a little weak as a solvent, a liquid soap composed mainly of plant oil did not cause irritation of the middle ear mucosa, and was thought to be a promising solvent with which to rinse away tenacious debris, especially when used in combination with hydrogen peroxide.
Indications for paediatric tonsillectomy GPversusConsultant perspective
Authors: Donnelly M. J. , Quraishi M. S. , McShane D. P.
Published: November 2007

Tonsillectomy is a commonly performed operation in children. Although the justification for this procedure has been debatable in the past, more rigorous criteria in defining the need for tonsillectomies are becoming established. The role of the primary care physician in the management of tonsillar disease in children is important as the decision to refer a child for tonsillectomy is made by the general practitioner. A questionnaire survey of 400 general practitioners (GPs) and 31 consultant ENT surgeons was carried out to establish the important criteria used in deciding the need for paediatric tonsillectomy. We found that in general there was a good correlation between GP and Consultant indications for tonsillectomy. However there were two important areas of difference, while most of the GPs felt that recurrent ear infections and ‘glue ear’ were important indications for tonsillectomy, Consultants did not. Therefore we must be aware of the current recommendations for tonsillectomy and inform present and future GPs.
Lipoma of the hypopharynx: pre-operative diagnosis and transoral resection
Authors: Eckel H. E. , Jungehülsing M.
Published: November 2007

Clinically, lipomas of the hypopharynx may be confused with other benign or even malignant lesions. Barium flow radiography allows depiction of lesions cranial to the epiglottis, but often fails to be accurate for subepiglottic lesions. CT however has allowed a certain diagnosis to be made in many cases in the past. MRI is still more accurate, and allows not only a more specific diagnosis of the lesion, but also a better depiction of the origin of the pedunculated lesion and its extension in the parapharyngeal space. This paper adds three cases to the 52 cases in the literature already described and presents the typical features of hypopharyngeal lipoma by MRI for the first time.
Self-inflicted laryngopharyngectomy: a case report
Authors: Natarajan B. , Townsley P. , Irvine B. W. , Mansfield M. , Thomas M.
Published: November 2007

The clinical presentation and management of a case of self-inflicted laryngopharyngectomy in a 48-year-old male psychiatric patient with a paranoid disorder is described
Well-differentiated (oncocytoid) neuroendocrine carcinoma of the larynx with multiple skin metastases: a brief report
Authors: Schmidt U. , Metz K. A. , Schrader M. , Leder L.-D.
Published: November 2007

A 63-year-old woman presented with a history of increasing dysphagia of about two weeks duration. Laryngoscopy revealed a nonulcerated supraglottic epitheliomatous lesion that morphologically appeared well-differentiated and distinctly oncocytoid. Although the tumour lacked any criteria for malignancy such as cellular atypia, pleomorphism or necroses, it recurred twice after primary surgery and later gave rise to multiple painful skin metastases. The diagnosis of an oncocytoid differentiated neuroendocrine carcinoma of the larynx (laryngeal carcinoid) was made. Misinterpretation of laryngeal carcinoids is common, but can be avoided if one is familiar with this rare variant of laryngeal neoplasms
Primary malignant melanoma of the pharynx
Authors: Johnson Ian J. M. , Warfield Adrian T. , Smallman Lesley A. , Watkinson John C.
Published: November 2007

A case of primary malignant melanoma of the pharynx is presented. Mucosal melanomas of the upper respiratory tract are rare. They tend to present late and therefore the prognosis is generally poor. The initial mainstay of treatment is adequate surgical resection. Prognostic factors are less well documented than in cutaneous melanoma
An algorithmic approach to aspergillus sinusitis
Authors: de Carpentier J. P. , Ramamurthy L. , Denning D. W. , Taylor P. H.
Published: November 2007

The effective management of paranasal sinus aspergillosis requires early diagnosis, histological classification, surgery and where appropriate, chemotherapy. Fungal sinusitis may be easily missed unless a high index of suspicion is maintained and specific culture and histology requested. The disease is classified into invasive and noninvasive types, each being divided into two subgroups: invasive aspergillosis may be either fulminant or indolent and noninvasive disease localized or allergic. The literature is reviewed and an algorithmic approach to aspergillus sinusitis proposed. The importance of histologically differentiating invasive from noninvasive aspergillosis prior to selecting the appropriate treatment options is stressed. CT scan should precede definitive surgery, and be used in follow-up. Close and prolonged follow-up is essential.
Acoustic analysis of tracheo-oesophageal versus oesophageal speech
Authors: Debruyne F. , Delaere P. , Wouters J. , Uwents P.
Published: November 2007

In order to evaluate the vocal quality of tracheo-oesophageal and oesophageal speech, several objective acoustic parameters were measured in the acoustic waveform (fundamental frequency, waveform perturbation) and in the frequency spectrum (harmonic prominence, spectral slope). Twelve patients using tracheo-oesophageal speech (with the Provox® valve) and 12 patients using oesophageal speech for at least two months, participated.

The main results were that tracheo-oesophageal voices more often showed a detectable fundamental frequency, and that this fundamental frequency was fairly stable; there was also a tendency to more clearly defined harmonics in tracheo-oesophageal speech. This suggests a more regular vibratory pattern in the pharyngo-oesophageal segment, due to the more efficient respiratory drive in tracheo-oesophageal speech. So, a better quality of the voice can be expected, in addition to the longer phonation time and higher maximal intensity.
The Scottish Otolaryngology Audit – Laryngeal Cancer Audit
Authors: Blair Robin L. , McKerrow W. S.
Published: November 2007

Regional otolaryngological societies offer a valuable mechanism for the conduct of medical audit. The experience of the audit subcommittee of the Scottish Otolaryngological Society over the last few years is reviewed and a description is given of the findings of an audit of the management of laryngeal cancer in Scotland. The data collection infrastructure currently employed is described and emphasis is placed on the importance of ‘ownership’ of audit by those participating.
Lingual thyroid presenting after previous thyroglossal cyst excision
Authors: Alderson D. J. , Lannigan F. J.
Published: November 2007

Lingual thyroid is a rare lesion caused by maldescent of the thyroid gland. It is an important cause of a mass on the posterior third of the tongue, and may coexist with other developmental abnormalities such as thyroglossal cyst. The diagnosis is made by radioisotope scan. Treatment is indicated in the presence of symptoms and consists initially of thyroxine. Severe or unresponsive cases require complete excision through a lateral pharyngotomy. Hypothyroidism is common postoperatively, but may be avoided in some cases by transplantation of excised tissue. We present a case report and review of the literature
Parapharyngeal solitary fibrous tumour: an incidental finding at ENT examination
Authors: Al-Sinawi A. , Johns A. N.
Published: November 2007

Extrapleural sites of solitary fibrous tumours have been identified. In a review of the literature 11 cases of solitary fibrous tumours of the upper respiratory tract have been reported. We report the second parapharyngeal solitary fibrous tumour which was discovered as an incidental finding emphasizing the importance of a full ear, nose and throat examination of all patients attending outpatient clinics
Unilateral anterior jugular phlebectasia
Authors: Natarajan B. , Johnstone A. , Sheikh S. , Palmer O. , Hari Madhavan K. N.
Published: November 2007

We present a rare case of unilateral anterior jugular venous phlebectasia in an 82-year-old female patient presenting as a soft cystic lump in the anterior aspect of the neck increasing in size during straining and valsalva manoeuvre. Although cases of internal and external jugular phlebectasia have been reported, as far as we are aware no case of anterior jugular phlebectasia has been reported in the literature previously.
Fast spin echo MRI in otology
Authors: Phelps Peter D.
Published: November 2007

Magnetic resonance imaging (MRI) using a fast spin echo protocol (FSE) gives greatly improved spatial resolution for the inner ear and its central connections. Excellent contrast resolution between bone, neural tissue and intracranial fluids is obtained on the heavily T2 weighted images. The contents of the internal auditory meatus (IAM) are shown more clearly than on Tl weighted images, even with gadolinium enhancement. Use of the technique for congenital, vascular, granulomatous and obliterative lesions of the inner ear is described. The cochlear and vestibular nerves can be seen side by side in the majority of cases thereby excluding the presence of even an intrameatal acoustic neuroma. This means that FSE can be used as a first line investigation to exclude small vestibular schwannomas without the need for gadolinium. Gadoliniumenhanced Tl weighted sequences are still necessary for confirmation of some tumours or for inflammatory lesions.
Oropharyngeal trauma during routine ear, nose and throat procedures
Authors: Connolly A. A. P. , Davis J. P. , Stafford N. D.
Published: November 2007

A prospective study of 122 adults undergoing routine ear, nose and throat (ENT) operations over a three-month period was carried out to determine the cause of oropharyngeal trauma seen in some patients. Those having tonsillar or palatal surgery were excluded from the study. Forty-five (36.9 per cent) patients complained of a mild sore throat post-operatively and six (4.9 per cent) of a severe sore throat. Five of these (4 per cent) had evidence of injury to the uvula and soft palate which delayed their discharge from hospital. No single cause of trauma was identified but possible factors included the use of laryngeal masks (two cases), throat packs (two cases) and blind suctioning with a plastic Yankauer sucker (one case). There is a relatively high risk of oropharyngeal trauma during routine otolaryngological procedures and we recommend that care should be taken to prevent this common cause of significant post-operative morbidity.
Suppurative labyrinthitis caused by anaerobic bacteria
Authors: Egelund Elisabeth , Bak-Pedersen Kristian
Published: November 2007

Two patients with labyrinthine fistulae following chronic otitis media are presented. Anaerobic bacteria, especiallyBacteroides spp. andBacteroides fragiliswere recognized as important pathogens in the disease.
Internal jugular vein blowout complicating head and neck surgery
Authors: Timon Conrad V. I. , Brown Dale , Gullane Patrick
Published: November 2007

Internal jugular venous rupture after head and neck surgery is a rare but important condition to recognize. The Toronto General Hospital experience of this condition, together with its identification and management is reported.

Jugular vein rupture should be considered in patients undergoing primary tumour excision with modified or functional neck dissection complicated by a pharyngo-cutaneous fistula. Typically, bleeding is venous and occurs repeatedly. However, haemorrhage may be substantial and life-threatening. Treatment requires exploration and ligation of the venous system. The carotid artery should be assessed and protected at surgery, since there is a likelihood of a carotid blowout as the conditions have a common aetiology. It is important to distinguish jugular vein haemorrhage from carotid arterial rupture, since the former has a far better outcome if treated properly.
Formal reintubation for incipient neonatal subglottic stenosis
Authors: Graham John M.
Published: November 2007

In a small prospective series of 10 children who presented with incipient subglottic stenosis following neonatal intubation a protocol of formal reintubation for two weeks, with sedation, enabled six of the children to avoid tracheostomy or other forms of surgery and in the remaining four it is unlikely that the trial of reintubation made the degree of laryngeal and subglottic damage worse.
A case of metastatic hepatocellular carcinoma of the sphenoid sinus
Authors: Sim R. S. T. , Tan H. K. K.
Published: November 2007

A case of hepatocellular carincoma with a solitary metastasis in the sphenoid sinus is described. The extreme rarity of the tumour and the problems of early diagnosis are underlined. The importance of endoscopic examination as a diagnostic procedure is emphasized.
Hazards of microwave cooking: direct thermal damage to the pharynx and larynx
Authors: Ford G. R. , Horrocks C. L.
Published: November 2007

A case of a direct burn to the pharynx and larynx is described. This occurred after a patient swallowed a microwaved treacle tart. The potential danger of excessive heating of food in microwave ovens is discussed.
Enlargement of salivary glands in bulimia
Authors: Vavrina Josef , Müller Werner , Gebbers Jan-Olaf
Published: November 2007

We report an unusual case of bulimia nervosa with bilateral swelling of parotid and submandibular glands as the only symptom of the underlying behavioural disorder. Histologically, sialadenosis was diagnosed in a parotid biopsy. The parotomegaly in bulimia may be a diagnostic primer as these patients often deny their eating disorder. B-scan ultrasonography is an important diagnostic tool to assess the nature of the parotid enlargement. Hyperamylasaemia occurs commonly in bulimic patients and may help to confirm the diagnosis. All patients with suspected bulimia should have a thorough medical history and physical examination to rule out other aetiologies of asymptomatic parotid swelling. As the enlargement is usually transient surgical intervention is only rarely required.
Intraoperative facial nerve monitoring: a description of a unique system
Authors: Wiet Richard J. , Bauer George P. , Stewart Don , Zappia John J.
Published: November 2007

Intraoperative facial nerve monitoring has become an integral adjunct in facial nerve identification and preservation for patients undergoing cerebellopontine angle surgery. Since the first description of EMG monitoring of facial nerve activity intraoperatively, many systems have been developed. These systems often rely on unilateral monitoring of the facial nerve with auditory feedback to the surgeon, and it is difficult to distinguish between artifact and significant stimulation of the facial nerve.

In this paper, we present the use of a bilateral, multialarm, facial nerve monitoring system that has multiple advantages over previous systems. Furthermore, we review our experience with this bilateral system, comparing a group of 50 monitored patients to a group of 50 unmonitored patients.
A comparison of packing materials used in nasal surgery
Authors: Garth R. J. N. , Brightwell A. P.
Published: November 2007

A prospective study was performed to compare Telfa,® paraffin gauze, Merocel® and BIPP used postoperatively following septal or turbinate surgery. Packs were assessed in terms of patient comfort, control of bleeding and ease of removal. There was little to choose between the packs while they were in situ and there was no significant difference in ease of removal. On removal the Telfa® and paraffin gauze were associated with less discomfort and less bleeding than BIPP or Merocel® (p<0.05).
Nasoantral window assessment by acoustic rhinometry
Authors: Marais J. , Maran A. G. D.
Published: November 2007

Twenty-five patients who had each had inferior meatal antrostomies performed were endoscopically examined and assessed with acoustic rhinometry six weeks and six months after surgery. No significant increase in nasal cross-sectional area could be demonstrated at the site of the antrostomy in the post-operative cases, although the nasoantral window was found to be patent in 44 of the 50 nasal cavities.
Bilateral transnasal vidian neurectomy in the management of chronic rhinitis
Authors: Fernandes Carlos M. C.
Published: November 2007

Bilateral transnasal vidian neurectomy was performed on 276 patients between 1983 and 1991. The indications for operation were intractable vasomotor rhinitis, resistant allergic rhinitis and recurrent nasal polyposis. Two hundred and fifty-eight patients were contacted and long-term results showed that 88 per cent of the patients had an excellent result.
Inflammatory pseudotumour of the trachea: report of a case in an eight-year-old child
Authors: Auaz Farrukh , Salam Anwar US , Muzaffar Suhail , Akbani Yasmin , Hasan Sheema H.
Published: November 2007

A polypoid inflammatory pseudotumour was diagnosed in the trachea of an eight-year-old child who presented with asthmatic symptoms. The tumour showed 80 per cent blockage of the lower trachea and consisted of proliferating spindly fibroblastic cells admixed with a variable number of inflammatory cells. The literature on childhood inflammatory pseudotumours is reviewed together with the differential diagnosis of other polypoid mesenchymal tumours of the trachea.
The possible association of pyoderma gangrenosum and progressive sensorineural deafness
Authors: Nigam Ajay , DasGupta Ashok R.
Published: November 2007

Deafness is known to be associated with certain autoimmune disorders. This article describes a hitherto unreported possible association between pyoderma gangrenosum and progressive bilateral sensorineural deafness.
Rhabdomyoma of the larynx: a rare cause of stridor
Authors: Roberts D. N. , Corbett M. J. , Breen D. , Jonathan D. A. , Smith C. E. T.
Published: November 2007

Rhabdomyomas of the larynx are rare tumours. In the literature to date 18 cases have been reported. They usually present with slowly progressive symptoms typical of their benign nature. We present a case that has many atypical features for an ‘adult’ type rhabdomyoma and discuss the relevant associated literature.
The stapedial reflex in cephalic tetanus
Authors: de Souza Chris , Karnad Dilip , de Souza Rosemarie , Raje A. , Mansukhani K. , Tilve G. H.
Published: November 2007

Three patients are presented with cephalic tetanus following injuries to the face. Two were adults and one a child. All three had bilateral VIIth cranial nerve involvement and one patient also presented with involvement of the IIIrd, IVth and VIth cranial nerves. The patients initially an ipsilateral VIIth cranial nerve weakness which later in the course of the illness developed into hyperactivity of the VIIth cranial nerve. The contralateral VIIth cranial nerve demonstrated a similar pattern. The stapedial reflex was tested serially. The stapedius muscle activity preceded that of the muscles of the face thus serving as an indicator of improvement or impending deterioration. Deflections measuring more than 1 cm, on stapedial reflex threshold testing, were indicative of stapedial reflex spasm. In the stapedial reflex decay test, both ill-sustained (intermittent) and sustained spasms of the stapedius muscle were seen.
Hereditary haemorrhagic telangiectasia: Young's procedure in the management of epistaxis
Authors: Hosni A. A. , Innes A. J.
Published: November 2007

Two cases of hereditary haemorrhagic telangiectasia are presented. Epistaxis was intractable in both patients. Young's procedure proved successful in controlling nose bleeds. One of the patients has been followed-up for 14 years. Methods of treatment are discussed with a review of the literature.
Application of the external perichondrium of the ala of the thyroid cartilage of the nondiseased side in laryngeal surgery
Authors: Lixiang Zhu , Zhanling Tan , Mingquan Bao
Published: November 2007

Since 1976, in our department, the external perichondrium of the ala of the thyroid cartilage of the nondiseased side has been successfully applied in repairing endolaryngeal defects and reconstructing the laryngeal wall in 22 cases. The post-operative result was good in the most cases.
Magnetic resonance imaging for aspirated peanut in the bronchus
Authors: Hisa Yasuo , Tatemoto Keigo , Dejima Kenji , Nishiyama Yasuyuki , Masuda Yukari , Ikuta Haruyasu
Published: November 2007

Peanut inhalation in the right main bronchus of a 15-month-old boy was diagnosed using a T1-weighted image produced by magnetic reasonance imaging (MRI) because of the high fat content of the peanut. The T1-weighted MRI image may also be useful in diagnosing other kinds of aspirated nuts with high lipid content as well as peanuts. This method does not involve any X-ray exposure.
Mastoid surgery and the Hong Kong Flap
Authors: van Hasselt C. Andrew
Published: November 2007

Critical evaluation of the outcome of surgery for cholesteatoma has favoured open cavity techniques. These methods have however been plagued by an inability to consistently produce healthy well healed cavities.

The strength and stability of the normal tympanic membrane depends upon the separation of squamous epithelium from the middle ear mucosa by a fibrous tissue layer. Traditional methods of dealing with the cavity fail to reproduce a similar anatomically stable arrangement.

In order to achieve the highest percentage of dry, stable disease-free ears after employing basic surgical principles of wide access to facilitate meticulous removal of all cholesteatoma, we have utilized a vascularized deep temporalis fascia flap for complete coverage of the cavity eliminating all raw areas. This fibrous layer provides the optimal substrate for epithelial resurfacing. Excellent healing even under unfavourable circumstances is ensured by the rich blood supply to the pedicled temporalis fascia flap.

Considering patient preferences and cost effectiveness, the optimal treatment for cholesteatoma must be one operation, provided it achieves a dry safe ear. Based upon rational concepts, the ‘Hong Kong Flap’ technique of reconstructing the mastoid cavity involves a straightforward procedure requiring no special technical skill that consistently achieves this ideal.
Button battery in the nose – an unusual foreign body
Authors: Palmer O. , Natarajan B. , Johnstone A. , Sheikh S.
Published: November 2007

We present two rare, but similar, cases of button batteries in the nose in male children of Caucasian origin. The importance of early diagnosis, treatment and the long-term morbidity of such a foreign body in the nose are discussed.
Highly invasive papillary thyroid carcinoma
Authors: Hefer Tsila , Joachims Henry Z. , Eitan Arie , Golz Avishay , Brown Jacob
Published: November 2007

Papillary carcinoma is the most common malignant tumour of the thyroid gland, accounting for at least two-thirds of newly diagnosed carcinomas. This tumour may be occasionally multicentric in origin. It frequently spreads to regional lymph nodes in the neck and mediastinum, but uncommonly metastasizes outside these regions. Local invasion of this tumour to the upper airway or digestive tract structures is infrequent. However, when that occurs, it is a source of significant morbidityand mortality.

In the last two years four patients suffering from invasive papillary carcinoma to the aerodigestive tract were treated in our department. A short case history of one of them is presented and current trends in management of the disease are reviewed.
Expression of the cell–cell adhesion molecule E-cadherin in tongue carcinoma cell lines
Authors: Kinsella A. R. , Bowie G. L. , Fields J. K. , Jones A. S.
Published: November 2007

A reduction in cell adhesiveness and cell invasion are essential steps in tumour progression. In the present study six tongue carcinoma cell lines were compared with regard to their invasive potential in two invitroinvasion assay systems and for their patterns of expression of the cell–cell adhesion molecule E-cadherin. The three cell lines negative for E-cadherin expression were invasive in both assays. One cell line with strong E-cadherin expression was strongly invasive and one weakly invasive. One cell line with reduced E-cadherin expression was weakly invasive. There was no significant pattern to these findings (x2= 0.375;p= 0.54). This supports previous studies from this group that suggest that E-cadherin is only one of the presumably many molecules involved in tumour progression in squamous cell carcinoma of the tongue.
Topical antiseptic mouthwash in oncological surgery of the oral cavity and oropharynx
Authors: Redleaf Miriam I. , Bauer Carol A.
Published: November 2007

A multivariant analysis of the value of the use of a pre-operative topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in 106 consecutive patients undergoing head and neck surgery involving the oral cavity or oropharynx was carried out at the University of Iowa, Department of Otolaryngology-Head and Neck Surgery. An oral presentation employing povidone–iodine solution was used for 43 patients. The remaining 63 patients studied received no oral presentation. Unfavourable wound outcome was not associated with age, sex, presence and condition of teeth, or serious pre-existing medical illnesses. A significant correlation was found between post-operative wound breakdown and type of closure, stage of disease, and previous operation or radiotherapy. The use of an oral preparation correlated significantly with favourable wound outcome independent of all other variables (p<0.01).

Our data support the use of a topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in surgery of the oral cavity and oropharynx.
Kimura's disease: case report and brief review of the literature
Authors: Nyrop Mette
Published: November 2007

Kimura's disease is a chronic inflammatory disease which often presents as a tumour-like swelling in the head and neck region with or without lymphadenopathy. Most cases have been described predominantly in Chinese and Japanese people. The lesion is benign, but it may easily be mistaken for a malignant tumour. Kimura's disease has been confused with angiolymphoid hyperplasia with eosinophilia (ALHE), from which it probably should be distinguished as a separate entity. The diagnosis may be suggested by a fine needle aspirate, but is established by a biopsy. The treatment of choice is surgical removal.

A case of Kimura's disease in a Caucasian male of 12 years' duration is presented together with a brief review of the literature.