bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison between short-term and long-term post-operative evaluation of sleep apnoea after uvulopalatopharyngoplasty
Authors: Lu Shao-Jung , Chang Shyue-Yih , Shiao Guang-Ming 
Published: November 2007

AbstractFor a long time uvulopalatopharyngoplasty (UPPP) has been used to treat the obstructive sleep apnoea syndrome (OSAS). The diverse surgical effects, the inadequate understanding of operation effect consistency, the possibility of disease progression, and the few reported papers for long-term evaluation after UPPP aroused our interest in designing this study. Fifteen OSAS patients who had undergone UPPP with pre-operative, initial post-operative and long-term post-operative polysomnographic studies were included in this study. Long-term post-operative polysomnography was undertaken more than five years after surgery. The polysomnographic evaluations included respiratory disturbance index (RD I), duration of saturation SaO2 <85 per cent (DOS), and the lowest O2 saturation (LOS). Amongst them, 10 patients with initial post-operative RDI reduction > 50 per cent were considered responders. In these responders, the long-term follow-up results of all three parameters showed improvement compared to the preoperative data. In a comparison between the initial and long-term post-operative sleep study results, LOS and DOS showed no significant difference. However, the long-term post-operative RDI result became significantly worse. More than 80 per cent of all cases had subjective symptomatic improvement in the long-term post-operative evaluation. The subjective improvement after operation is not adequately correlated to the polysomnographic result. We suggest that long-term follow-up for patients after UPPP is necessary.
Treatment of Robin sequence with nasal CPAP
Authors: Deegan Paul C. , McGlone Brian , McNicholas Walter T. 
Published: November 2007

AbstractA 12-year-old schoolgirl presented with severe obstructive sleep apnoea due to the Robin sequence. The sleep apnoea, together with the associated findings of daytime sleepiness, nocturia, right heart strain and growth retardation, were successfully reversed by nasal CPAP therapy. This therapy allows postponement of a decision concerning corrective surgery until after full growth has occurred.
Verbal auditory agnosia with focal EEG abnormality: an unusual case of a child presenting to an ENT surgeon with “deafness”
Authors: Kale Uday , El-Naggar Mohamed , Hawthorne Maurice 
Published: November 2007

AbstractVerbal auditory agnosia implies the failure to recognize sounds in a patient who is nevertheless not deaf. We present a child referred to the ENT outpatients for suspected hearing loss investigation. At one point she had grommets inserted on the basis of a flat tympanogram but with no effect. All hearing tests, including electrocochleography and distraction tests, revealed normal hearing thresholds. At the age of three years and three months, and on direct questioning of the parents, we discovered that the child responded remarkably well to music. Paediatric neurologists made the diagnosis of verbal auditory agnosia. The condition is very similar to another acquired language disorder called Landau-Kleffner syndrome. It is unusual for such a case to present primarily to an ENT surgeon.
Valve section of the eustachian tube
Authors: Su Chih-Ying 
Published: November 2007

AbstractResearch on the eustachian tube (ET) and related paratubal structures was carried out by serial section of the temporal bone-ET specimens. In the cadaveric studies, the mid-cartilaginous section of the ET presented a curved slit-like lumen. It is believed that this section functions principally as a valve mechanism and acts like an active sphincter of the ET. This report illustrates the dynamic movement of the valve section in a living ET which can be observed by using a superfine fibreoptic videomicroendoscope. Disorders of the open-close mechanism of the valve section in a diseased ET due to different aetiologies are also discussed. This study indicated that transtympanic ET microendoscopy had considerable potential for exploring fascinating new aspects of the physiology, pathophysiology and anatomy dynamics of the ET.
Non-tuberculous mycobacterial infections presenting as salivary gland masses in children: investigation and conservative management
Authors: Cox H. J. , Brightwell A. P. , Riordan T. 
Published: November 2007

AbstractNon-tuberculous mycobacterial (NTM) infections in children commonly present as cervicofacial masses. The importance of early diagnosis is in the exclusion of infection requiring treatment, particularly tuberculosis and the rare case of malignancy. Five children with NTM presenting with salivary gland masses illustrate the value of skin testing with new tuberculins and the place of fine-needle aspiration cytology in the investigation of these infections.Four children who were skin tested reacted specifically to one of the new tuberculins, two indicating infection withMycobacterium malmoense, confirmed by culture, the others responding to tuberculins fromM. scrofulaceumandM. avium-intracellulare, neither having a positive culture. The one case not skin tested producedM. avium-intracellulareon culture.All five patients were managed conservatively. The place for conservative management when the facial nerve is at risk and extensive skin excision is indicated are discussed.
Audit of the treatment of tonsillar and peritonsillar sepsis in an ear, nose and throat unit
Authors: MacDougall G. , Denholm S. W. 
Published: November 2007

AbstractWe became aware that a range of antibiotics were being used in our unit to treat patients suffering from tonsillitis or peritonsillar abscess (quinsy). There appeared to be no rationale to determine which antibiotics were used, and we felt that we were possibly using expensive antibiotics when cheaper equally effective ones were available. An audit project was therefore devised to establish the current practice in the ENT Unit at the City Hospital at Edinburgh. Following a six-month prospective pilot study, a protocol for the treatment of tonsillar and peritonsillar sepsis was drawn up and subsequent practice and outcome was then audited, thus completing the audit cycle. As a result substantial savings in the cost of prescribed antibiotics have been made without compromising patient care.
An unusual cause of cochlear implant failure
Authors: Thomas D. M. , Abramovich S. , Rakkar-Thomas S. 
Published: November 2007

AbstractWe present a cochlear implant failure previously unidentified and unreported. Following successful implantation and activation of a Cochlear Mini 22 system, a distressing barrage of crackling noises was heard by the patient despite repeated programming with threshold and comfort level adjustment. The implant soon became nonfunctional and integrity testing showed deficient electrical responses and abnormal surface measured wave forms. Investigation of the explant, following reimplantation with an identical system, showed a defective trim capacitor, an electric component of the internal circuit in the stimulator. Paired Student's t-test showed a marginally significant increase (p = 0.047) in effective threshold level and a highly significant decrease (p = 0.0002) in maximum comfort level for the second implant compared to the first implant.
An unusual complication following inferior turbinectomy
Authors: Ravikumar A. , Griffiths T. D. , Flood L. M. , McNeela B. J. 
Published: November 2007

AbstractNeurological complications following turbinate surgery are relatively rare. We present here an unusual complication of unilateral partial oculomotor and trigeminal nerve palsy after bilateral inferior turbinectomies. The probable aetiological mechanism is discussed.
Dilemmas in auditory assessment of developmentally retarded children using behavioural observation audiometry and brain stem evoked response audiometry
Authors: Rupa V. 
Published: November 2007

AbstractThe records of 94 consecutive developmentally retarded children with speech retardation and suspected hearing loss who underwent auditory assessment by both conventional behavioural observation audiometry (BOA) and brain stem evoked response audiometry (BERA) were analysed. In 54 children (57.4 percent) there was good agreement between the results of both techniques leading to a clearcut diagnosis. In 22 children a diagnosis was possible only by the results of BERA as the results of BOA were inconclusive. Of the remaining 18 children, two groups could be identified whose results posed a dilemma. Group 1 (n = 7) consisted of children whose BOA test results differed considerably from their BERA results. Group 2 (n = 11) consisted of children in whom there was no discernible response by BERA while the response by BOA was either inconsistent (n = 5) or not elicitable (n = 6). The specific strategies to be adopted for hearing assessment in these situations are discussed.
The influence of race on the position of the jugular bulb
Authors: Low W. K. , Fenton J. E. , Fagan P. A. , Gibson W. P. R. 
Published: November 2007

AbstractThe position of the jugular bulb (JB) is of great clinical significance to the otologist. A high and laterally situated jugular bulb may pose difficulties when dealing with the middle ear while a high and medially sited jugular bulb can create problems in neuro-otological surgery. This paper aims to study possible racial differences in the position of the jugular bulb.Fine-cut computed tomogram (CT) scans of temporal bones (in the axial plane) of 34 Caucasians and 34 Chinese were studied. The position of the jugular bulb was determined with reference to the midpoint of the lumen at the inferior limit of the cochlea (mpC).Of the 60 Caucasian and 58 Chinese temporal bones with identifiable jugular bulbs, 33 jugular bulbs of the Caucasian (55 percent) and 34 jugular bulbs of the Chinese (58.6 percent) were at the same height or higher than the mpC (p= 0.2; chi-squared test). The midpoint of the jugular bulb was 8.67 ± 1.73 and 8.61 ± 2.49 mm posterior to the mpC for the Caucasian and Chinese respectively (p= 0.2;t-test). However, the midpoint of the jugular bulb of eight Caucasian (24.2 percent) and 22 Chinese (64.7 percent) were medial to the mpC (p<0.001; chi-squared test).Race does not influence the height of the jugular bulb nor its position in the sagittal plane but can influence whether a high jugular bulb is medially or laterally situated.
Day-case septal surgery under general anaesthesia and local anaesthesia with sedation
Authors: Srinivasan V. , Arasaratnam R. B. S. , Jankelowitz G. A. 
Published: November 2007

AbstractSeptal surgery (submucous resection and septoplasty) has been performed as a day-case procedure routinely under general anaesthesia and local anaesthesia with sedation at the Ipswich Hospitalsince 1992. The outcome of the day-case septal surgery over a period of 18 months has been audited. A total of 95 cases were operated on of which 48 were under general anaesthesia (GA) and 47 under local anaesthesia (LA) with sedation using midazolam intravenously. The bleeding rate and overnight admission rate were 10.5 and 11.4 percent respectively. The bleeding rate was the same in both GA and LA groups. The combination of local anaesthesia and sedation has been foundto be safe, effective and acceptable to patients. It is concluded that septal surgery is suitable as a day procedure and that local anaesthesia combined with sedation has a definite place ifcarried out properly.
A prospective randomized study to assess the efficacy of post-operative nasal medication after endonasal surgery
Authors: Spraggs Paul D. R. , Macnamara Marcelle , Joseph Theo 
Published: November 2007

AbstractPost-operative nasal medications are commonly used following routine septal or turbinate surgery but their efficacy in removing blood clots, improving the sensation of a patent airway and promoting healing are unknown. This prospective randomized trial of patients undergoing septal and/or turbinate surgery assessed the efficacy of three commonly used nasal medicines, 0.5 per cent ephedrine hydrochloride nasal drops, betamethasone sodium phosphate (Betnosol®) nose drops and alkaline nasal douches, in producing the sensation of a patent airway in the 14 days following surgery. Ninety-seven patients were randomized into the three treatment groups and a control group who received no nasal medication. Patients assessed their nasal patency by means of a visual analogue scale (VAS) and any complications of treatment were recorded. Statistical analysis of the 76 complete sets of results using the Mann-Whitney U-test showed that there was a significant difference in the distribution of all of the treatments for each of the time intervals (p<0.05). Glass rank biserial correlation coefficients were all small (rg<0.085) but the most significant differences were between ephedrine and the control group at two hours, two, seven and 10 days (0.02, 0.054, 0.057, 0.085 respectively), alkaline nasal douches being most significant at four and 14 days (0.06 and 0.0722 respectively).
Spindle cell carcinoma of the parotid gland
Authors: Ishibashi Toshio , Hojo Hiroshi 
Published: November 2007

AbstractSpindle cell carcinomas of the salivary gland are extremely rare, with only a few cases having been previously reported. We present a 55-year-old man with a rapidly enlarging mass in the left parotid gland. Despite radical surgery, the tumour recurred, and led to death 11 months later. Histopathologically, the tumour was composed of two components, a squamous cell carcinoma component and a spindle cell sarcomatoid component. A diagnosis of primary spindle cell carcinoma of the parotid gland was made. Immunohistochemical studies revealed keratin positivity and vimentin negativity in the squamous cell carcinoma component: the spindle cell sarcomatoid component was positive for vimentin and negative for keratin, but showed focal positivity for epithelial membrane antigen. The origin of the sarcomatoid component and the differential diagnosis from malignant mixed tumours are discussed.
Raised ABR threshold after suction aspiration of glue from the middle ear: three case studies
Authors: Mason J. D. T. , Mason S. M. , Gibbin K. P. 
Published: November 2007

AbstractBetween 1991 and 1993, 13 children (25 hearing ears) underwent recordings of the auditory brain stem response (ABR) under a general anaesthetic. The anaesthetic technique was similar for each child. Fourteen of these ears had fluid aspirated after myringotomy with insertion of grommets prior to the auditory brain stem response investigation. On subsequent hearing assessment six of these 14 ears (43 per cent) showed clear evidence of a threshold shift of 15 dB or greater. Eleven ears had either dry myringotomies or did not have a myringotomy prior to ABR and none of these showed evidence of a temporary threshold shift. Using Fisher's Exact probability test this difference is significant (p = 0.034). We feel it is important to report these observations so that unexpected high ABR thresholds following aspiration of glue are interpreted with caution.
Audiological findings in a Phase I protocol investigating the effect of WR 2721, high-dose cisplatin and radiation therapy in patients with locally advanced cervical carcinoma
Authors: Rubin John S. , Wadler Scott , Baitler Jonathan J. , Haynes Hilda , Rozenblet Alla , McGill Frances , Goldberg Gary , Runowicz Carolyn 
Published: November 2007

AbstractWR 2721 (ethiofos) protects against the toxic effects of the heavy metal compound cisplatin. which is used in the treatment of solid tumours. In a Phase I protocol designed to determine the maximum dose of WR 2721 which could be tolerated when administered in combination with cisplatin and radiation therapy to patients with cervical carcinoma. 11 patients were evaluated by audiologic testing before and after cisplatin WR 2721 administration in an attempt to identify the degree of ototoxicity. Forty-five per cent were noted to have significant hearing threshold changes. predominantly in the high frequencies. There were no significant changes in the speech frequencies in this series. This contrasts with the greater degrees of ototoxicity observed in controls treated in the same way who received cisplatin without WR 2721 protection.
Non-cholesteatomatous suppurative otitis media: facial nerve palsy in an immunocompromised patient
Authors: Hartley C. , Saeed S. R. , Lyons T. J. 
Published: November 2007

AbstractA 47-year-old man developed a complete facial nerve palsy secondary to non-cholesteatomatous suppurative otitis media. At operation, this was seen to be due to destruction of the nerve from halfway along the horizontal segment to a point just distal to the second genu. The history of recent renal transplantation and subsequent immunosuppression was judged to be significant in the pathogenesis of the palsy.
Deep lobe parotid lipoma: a case report
Authors: Weiner Graeme M. , Pahor A. L. 
Published: November 2007

AbstractWe present a patient with a lipoma of the deep lobe of the parotid gland. Despite the common occurrence of this tumour in other regions of the body, we believe that this is only the second report in the literature of a lipoma in this location. We believe that these tumours are easily dealt with by simple enucleation, and that superficial parotidectomy should be reserved for tumours deep to the facial nerve.
Fine-needle aspiration cytology of submandibular gland lesions
Authors: Atula Timo , Grénman Reidar , Laippala Pekka , Klemi Pekka-Juhani 
Published: November 2007

AbstractThe usefulness of fine-needle aspiration cytology (FNAC) in the diagnosis and treatment of submandibular gland lesions is not well known. The 210 FNACs taken from submandibular gland lesions at Turku University Central Hospital between 1984 and 1991 were reviewed. Of these FNACs, 78 samples from primary lesions were confirmed histologically. Within this subset 10 FNACs were taken from benign neoplasms, all of which were correctly classified (sensitivity 100 per cent; specificity 88 percent). Only four of the 14 FNACs from malignant lesions were cytologically considered malignant (sensitivity 29 per cent). On the other hand, four FNACs raised a false suspicion of malignancy (specificity 6 per cent). Out of 54 FNACs from non-neoplastic lesions 43 were correct (sensitivity 80 per cent; specificity 63 per cent). There were 104 patients (123 FNACs), who had not been operated on: the follow-up of these patients shows that in this subset of FNACs there were no false malignant but probably one false benign finding (1 per cent). We conclude that FNAC can offer valuable information about the type of the submandibular gland lesion, but the decision of operative and other treatment should not be based solely on the result of FNAC.
The modified Valsalva manoeuvre to improve visualization of the hypopharynx during flexible nasopharyngoscopy
Authors: Spraggs Paul D.R. , Harries Meredydd Lloyd 
Published: November 2007

AbstractA simple, safe and effective procedure of improving the diagnostic accuracy of nasopharyngoscopy is described. It is most useful for the exposure of the hypopharynx, especially in the elderly patient.
Cisplatin in children: hearing loss correlates with iris and skin pigmentation
Authors: Todd N. Wendell , Alvarado Carlos S. , Brewer Debra B. 
Published: November 2007

AbstractPigmentation is reported to affect cisplatin-induced ototoxicity in adult humans. The hearing loss is worse in people with brown irises, than in those with blue irises. We assessed the hypothesis that cisplatintreated children with dark irises suffer more deterioration in auditory thresholds than do those with less pigmentation. For the 19 children whose data met the requirements of this observational retrospective study, we found a weak correlation (Spearman's r = 0.50; p>0.05) of high frequency hearing loss (at 4000 Hz) and pigmentation. Blue or hazel-eyed children averaged 2.9 dB worsening at 4000 Hz, in contrast to 14.2 dB worsening for brown or black-eyed children.Pigmentation may account for some of the individual susceptibility to cisplatin ototoxicity. We suggest that iris colour be included in future reports of cisplatin-related hearing loss
Is a community-based mastoid microsuction service feasible: the audit of a pilot project
Authors: Lewis Charles , Resouly Adel 
Published: November 2007

AbstractPatients who have had a mastoidectomy form a considerable long-term follow-up commitment to their local ENT Department. A community-based mastoid aural toilet pilot project run by a GP is described using an operating microscope and suction apparatus in his surgery. To obtain the necessary information about community treatment, an audit was performed of all mastoidectomy patients from a large general practice in Portsmouth: 57 mastoidectomy patients were reviewed. During the project it was possible to transfer to the community microsuction project the long-term care of most of their mastoidectomy patients who were attending the hospital ENT outpatient clinic.
Atlanto-axial subluxation (Grisel's syndrome) following otolaryngological diseases and procedures
Authors: Samuel D. , Thomas D. M. , Tierney P. A. , Patel K. S. 
Published: November 2007

AbstractGrisel's syndrome is a rare condition of uncertain aetiology characterized by atlanto-axial subluxation following an infection in the head and neck region. The condition most frequently affects children and characteristically presents in the post-operative period with cervical pain and torticollis. We describe three cases and discuss the aetiology and pathogenesis. A high index of suspicion may lead to early diagnosis in its natural history thereby preventing potentially serious complications.
VIIIth cranial nerve involvement in sarcoidosis
Authors: O'Reilly B. J. , Burrows E. H. 
Published: November 2007

AbstractHearing loss and vertigo are uncommon but well-recognized complications of neurosarcoidosis. Until recently the site of the lesion has been debatable and the efficacy of steroids commonly prescribed for this type of hearing loss has been said to be doubtful. A case is presented of sarcoidosis-induced hearing loss in which bilateral VIIIth nerve lesions were demonstrable by MRI with gadolinium enhancement. Treatment with high- dose steroids and azathioprine produced a symptomatic improvement and virtual resolution of the lesions.
Comparison of the proteins of middle ear effusion with human mast cell proteins
Authors: Rakover Yoseph , Shneyour Amir , Rosen Gabriel , Lensky Yaacov 
Published: November 2007

AbstractIn order to clarify the role of mast cells in the aetiology of secretory otitis media (SOM), we compared the protein components of middle ear effusion (MEE) with human mast cells using acrylamide gradient gel electrophoresis and electrofocusing methods. This first direct comparison between the proteins of MEE and human mast cells has been made possible by a method developed in our laboratory for cultivation of human mast cells in tissue culture.On electrophoresis, we found that out of 12 bands of MEE proteins that were different from the serum, seven (58 per cent) had a similar electrophoretic migration rate (Rx) to mast cells. On electrofocusing, three of the four bands of MEE had a similar Rxto the mast cells. We have shown that proteins of mast cells and MEE had similar Rxs. Therefore, our study supports previous studies which suggests that mast cells play an important role in the aetiology of SOM.