bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of radiological investigations in pre-endoscopic assessment of children with stridor
Authors: Tostevin P. M. J. , de Bruyn R. , Hosni A. , Evans J. N. G. 
Published: November 2007

AbstractThe differential diagnosis of stridor in an infant depends on a careful history and examination, followed by radiological and endoscopic investigations. Currently a chest, lateral neck and antero-posterior, high kilovolt (Cincinnatti) view radiographs in association with a diagnostic barium swallow are performed prior to the definitive diagnostic procedure of microlaryngobronchoscopy.Our impression was that some of the routinely ordered radiological investigations were of limited value in the differential diagnosis. We undertook a retrospective audit study to determine the value of radiological investigations in the pre-endoscopic assessment of infants with stridor. The radiological and endoscopic information of 100 infants presenting over the three-year period 1991–1993 at Great Ormond Street Hospital, London (a tertiary referral centre) was collected.It was found that only five out of 65 barium swallow investigations performed had consistent positive findings at diagnostic microlaryngobronchoscopy. The lateral neck and Cincinnatti views identified many of the more gross pathologies of the larynx and trachea e.g. the space occupying lesions, which occur infrequently. The more common diseases e.g. laryngomalacia or subglottic stenosis are rarely identified radiologically.Our results confirmed that radiology had a limited screening role and that in a child presenting with stridor the initial radiological assessment should be a chest radiograph with further imaging and a barium swallow only if an abnormality is found at microlaryngobronchoscopy.
Plasma cell granuloma of the supraglottic larynx
Authors: Zbären Peter , Läng Hubert , Beer Karl , Becker Minerva 
Published: November 2007

AbstractThe occurrence of plasma cell granuloma of the larynx appears to be unusual. Review of the literature revealed only two previously reported cases. We present an additional case of plasma cell granuloma of the larynx. The diagnosis was made by histological and immunohistochemical examinations. The tumour was successfully treated by radiation therapy.
Unusual inflamed thyroglossal cyst
Authors: Zidar Nina , Gale Nina , Podboj Jernej 
Published: November 2007

AbstractThe authors report a case of an unusual inflammatory reaction in a thyroglossal cyst. It consisted of broad papillary intraluminal projections covered by histiocytes and occasional multinucleate giant cells. This benign process should not be confused with a true papillary neoplasm, a rare complication of a thyroglossal cyst.
Endoscopic anatomy of the sphenoid sinus and sella turcica
Authors: Sethi Dharambir S. , Stanley Ralph E. , Pillay Prem Kumar 
Published: November 2007

AbstractAn endoscopic study of the sphenoid sinus was carried out, on 30 cadavers, to understand the important anatomical relationships of the sphenoid sinus, and the sella turcica. The aim was to study the endoscopic anatomy and the variants, and to determine if endoscopic instrumentation and techniques, could play a beneficial role in endoscopic management of sellar lesions.The results of this study are discussed, with particular reference to the important surgical anatomical features of the sphenoid sinus. A surgical technique for the endoscopic transsphenoid approach to the sella turcica was developed.Anatomical variants can be identified endoscopically, and endoscopic techniques have the advantages of improved visualization, magnification, angled vision, and a panoramic perspective of the intrasphenoid anatomy, compared to currently employed methods of pituitary/sellar surgery, using the operating microscope/.
A combined approach excision of branchial fistula
Authors: De P. R. , Mikhail T. 
Published: November 2007

AbstractSecond branchial cleft and pouch anomalies are by far the commonest of the branchial anomalies. In most cases, however, there is a unilateral cleft sinus. A complete fistula with external and internal openings is rare. We present a case with a complete branchial fistula in which the tract was followed from the neck to the tonsillar fossa using a combined approach.
Schwannoma of the external auditory canal
Authors: Harcourt J. P. , Tungekar M. F. 
Published: November 2007

AbstractSolitary schwannomas are relatively rare. There has been only one previously reported case, in the English literature, of a schwannoma arising in the external auditory canal. We present a case which was managed by local excision and was unassociated with cochlear or retrocochlear pathology.
Localization of active otosclerotic foci by tympano-cochlear scintigraphy (TCS) using correlative imaging
Authors: Ross Uwe H. , Reinhard M. J. , A. Berlis 
Published: November 2007

AbstractHigh-resolution, tympano-cochlear scintigraphy (TCS) is a useful tool for visualizing changes in labyrinthine bone metabolism in active otosclerosisin vivo. But until now, the activity patterns have mostly been rather imprecisely ascribed to the labyrinthine structures; more exactly by means of high- resolution CT (HR-CT). Experimental studies on TCS using a human temporal bone model revealed that correlative imaging of X-ray photographs and the scintigrams or superimposition with masks of the temporal bone drawn from the X-rays can facilitate the localization of small foci of about 0.5–1 mm.Clinical applications of the visualization technique, combining functional with structural images, confirmed the benefit of this method, improving the accuracy in detection and localization of focal activity enrichment of the petrous bone in cases of active otosclerosis by means of TCS.
Flexible endoscopic tracheo-oesophageal puncture under local anaesthetic
Authors: Hong Ga Sze , John A. B. , Theobald David , Soo Khee Chee 
Published: November 2007

AbstractBlom—Singer valve prosthesis is an increasingly popular technique for voice rehabilitation in alaryngeal patients. Although primary voice puncture is being practised, the creation of the tracheo-oesophageal fistula is performed in the majority of patients as a secondary procedure.We describe a technique of secondary tracheo-oesophageal puncture using the flexible endoscope which can be performed under local anaesthetic and sedation. The technique overcomes the difficulty of passing a rigid oesophagoscope or forceps to the level of the tracheostome in a scarred and irradiated neck. The new technique also obviates the need for general anaesthesia.We have successfully used the technique in three patients.
Osteogenic sarcoma of sphenoid bone: an extended lateral skull base approach
Authors: Hazarika P. , Nayak D. R. , Sahota J. S. , Rao D. , Kapadia R. D. 
Published: November 2007

AbstractOsteogenic sarcoma involving the sphenoid bone is an extremely rare condition. The rarity of the disease and the close proximity of the sphenoid bone to the various important intracranial structures poses a real challenge in diagnosis and surgical management of these lesions. An extended lateral craniofacial resection by a multidisciplinary approach was carried out in one such case to attempt en bloc resection. This case is presented and also a review of the relevant literature.
Right vocal fold paralysis as a result of central venous catheterization
Authors: Martin-Hirsch D. P. , Newbegin C. J. R. 
Published: November 2007

AbstractInvasive peri- and post-operative monitoring is being increasingly utilized, and a corresponding increase of concomitant complications are becoming apparent.Two cases of complete right vocal fold paralysis are reported as a possible complication of right central venous catheterization. The underlying aetiology of this complication is presumed to be either direct trauma at the time of introduction of the central venous catheter, or by thrombosis and fibrosis around the recurrent laryngeal or vagus nerve. It is suggested that multiple attempts at cannulation and leaving the central line in situ for long periods increases the risk of this complication.When the integrity of the left recurrent laryngeal nerve or vagus is jeopardized or must be sacrificed during surgery, it is suggested that ipsilateral central lines are inserted to minimize the risk of bilateral vocal fold paralysis.Cases of vocal fold paralysis secondary to central line insertion should be followed expectantly and surgical intervention only be considered after 12 months review.
Acute sjögren-like syndrome as the first manifestation of a generalized cmv infection in a patient with aids
Authors: Van Vooren J. P. , Farber C. M. , Daelemans P. , Delforge M. L. , Liesnard C. 
Published: November 2007

AbstractWe report the first case of generalized cytomegalovirus (CMV) disease in an AIDS patient who presented with an acute Sjogren-like syndrome and was diagnosed by parotid gland biopsy. All symptoms disappeared after a few days of intravenous ganciclovir therapy.
Measurement of small tissue volumes using Holden's apparatus
Authors: Mason J. D. T. , Hehar S. S. , Holden M. , Jones N. S. 
Published: November 2007

AbstractA reproducible method for the estimation of volumes of small tissue samples was needed to allow comparison of the biological activity of tissue explants and to relate symptom improvement to procedures such as adenoidectomy or polypectomy. Holdens apparatus, which utilizes fluid displacement between two chambers, was compared to displacement in a 20 ml syringe. Two observers made four readings each on 20 tissue samples (range 0.37 to 4.70 ml) using both methods for comparison.A two-way analysis of variance for replicated data gave an F ratio of 0.6885 (df 19; p>0.8) for Holden's apparatus, and an F ratio of 1.4307 (df 19; p>0.1) for the 20 ml syringe. The standard error of the mean for repeated readings on the same sample by an observer was 0.001 ml for Holden's apparatus and 0.014 ml for the syringe method. For accurate estimation of small tissue volumes within 0.01 ml we recommend Holden's apparatus.
Removal of superglue from the external ear using acetone: case report and literature review
Authors: Abadir Wedad F. , Nakhla Venice , Chong Philomina 
Published: November 2007

AbstractThe ability of superglue preparations (cyanoacrylate) to bond instantly to skin as well as inanimate objects presents a special problem when instilled into the external ear canal. We present two cases of patients who had it successfully removed under the microscope with the help of acetone BP to debond it from the skin, without any damage to the meatus or the tympanic membrane. The third patient had the superglue removed without the help of acetone but sustained damage to the tympanic membrane. A literature review of similar cases is included.
Survival times of Provox™ valves
Authors: de Carpentier J. P. , Ryder W. D. J. , Saeed S. R. , Woolford T. J. 
Published: November 2007

AbstractThis study was performed to assess the survival times of the Provox™ valve in the Manchester area. Thirty-nine patients from four hospitals, representing 81 valve failures, were studied. The effects of the timing of the tracheo-oesophageal puncture, previous radiotherapy, and the presence and timing of cricopharyngeal myotomy on valve life were analysed. Regression analysis using an extension of the Cox model to allow strata showed that the lifetime of the first valve only is adversely affected by previous radiotherapy. The other covariates do not have a statistically significant effect on valve survival. The median valve survival is 4.5 months, (range one to 12 months). A small percentage of valve users with particularly frequent valve failures may require additional support and prolonged anti-fungal therapy.
Should nasopharyngeal biopsy be mandatory in adult unilateral glue ear?
Authors: Lee W. C. , Weiner G. M. , Campbell J. B. 
Published: November 2007

AbstractUnilateral secretory otitis media is a recognized presenting feature of nasopharyngeal neoplasia. In the two cases presented, biopsy from the nasopharynx revealed an unsuspected underlying adenocarcinoma. The need to biopsy the normal looking post-nasal space is highlighted.
Laser-assisted uvulopalatoplasty: an assessment of a technique
Authors: Wareing Michael , Mitchell David 
Published: November 2007

AbstractThe Kamami technique of laser-assisted uvulopalatoplasty has recently been introduced into British practice as an office-based multistage procedure for the treatment of snoring and, in certain cases, for obstructive sleep apnoea. We have treated 50 patients with simple snoring, with a minimum follow-up of six months. Six-month telephone interview follow-up has assessed partner and patient satisfaction, as well as willingness to undergo the procedure again. We have found the procedure easy to perform with no serious intra-operative complications. Thirty-four (68 per cent) of patients' partners have been definitely satisfied with the results of treatment, with 11 (22 per cent) definitely unsatisfied. However, only 25 of these 34 satisfied patients (76 per cent) would be prepared to undergo the treatment again with postoperative pain and discomfort cited as the reason in those who would not. The failure rate doubled between one and six months post-operatively. There have been no serious complications but a 40 per cent minor side-effect rate is noted. These results are discussed in the context of previously reported results, with consideration of future strategies to improve outcome.
DNA indices of primary and recurrent squamous cell carcinomas of the tongue and tonsil using image cytometry
Authors: Sarker S. K. , Tierney P. , Patel K. S. , Fisher C. , Coleman D. V. 
Published: November 2007

AbstractPloidy status of squamous cell carcinomas of the head and neck (SCCHN) from primary and recurrent tonsillar and tongue lesions has not been compared using image cytometry. We have measured and compared the DNA indices in 41 cases. There were 29 tongue SCCHN, 20/29 were primary and 9/29 were recurrent. Mean DNA index (DI) was 1.19 (range 0.70–1.81) and 1.28 (range 0.79–1.94) respectively. There were 12 tonsillar cases, 10/12 primary and two out of 12 recurrent. Mean DI was 0.84 (range 0.57–1.09) and 1.00 (range 0.98–1.02) respectively. Mean DNA indices of both primary carcinomas were lower than the mean DNA indices of the recurrent carcinomas. This difference between the two groups may be a reflection of their tumour biology. However, since our study is small no definite conclusions can be made at this stage. We aim in the future to evaluate the prognostic role of DNA indices of patients with paired primary and recurrent SCCHN. This may be of clinical value and improve the treatment modalities available to this group.
Predictive value of flow cytometric analysis in DNA contents in patients with locally advanced head and neck carcinoma
Authors: Wong Gene , Stidley Christine , Dressler Lynn , Castillo Michael , Crooks Lida , Bartow Susan 
Published: November 2007

AbstractA restrospective study was performed on 61 eligible patients with stage III and IV (AJC/UICC Staging System) squamous carcinomas of the head and neck region who were treated with definitive radiotherapy with, or without, surgery. DNA contents were measured by flow cytometric analysis of archival paraffin blocks and were correlated with clinicopathological findings, tumour response and patient survival. Comparison of variables including treatment modality was performed for identification of significant prognostic factors. There were 28 diploid, 27 aneuploid tumours and the remaining six were questionable. All patients were followed-up for at least two years or until death.Aneuploid tumours had a significantly higher S-phase fraction (percentage S-phase) (p<0.001). Neither ploidy nor percentage S-phase were found to have predictive value in tumour response or patient survival within the power of a sample size of 61. Twenty of the 27 (74 per cent) aneuploid tumours had a complete response (CR) whereas 19 out of 28 (68 per cent) diploid tumours achieved CR. Five-year survival by the Kaplan-Meier method was 33 per cent for both aneuploid and diploid tumours. However, nodal stage (N stage) was found to have significant predictive value in both tumour response and patient survival. The complete response for stage N0 patients was 96 per cent, N1 patients 61 per cent, N2 patients 60 per cent and 43 per cent for N3 patients (p<0.002). Similarly, the five year survival for the N0 and N3 groups of patients was 53 per cent and 29 per cent respectively (p<0.05).
A double-blind comparative study of ofloxacin otic drops versus neomycin-polymyxin B-hydrocortisone otic drops in the medical treatment of chronic suppurative otitis media
Authors: Tong Michael C. F. , Woo John K. S. , Andrew van Hasselt C. 
Published: November 2007

AbstractActive chronic suppurative otitis media poses a management problem when patients are being considered for surgical treatment. Topical antibiotics have demonstrated varying degrees of success in the management of discharging ears. The introduction of quinolones has revived interest in these topical agents. This double-blind study compares two antibiotics, namely ofloxacin and neomycin-polymyxin B, with similar in vitro sensitivities to Gram positive and Gram negative organisms. Fifty-two patients were selected randomly and the results show that ofloxacin eardrops have marginal benefits in symptomatic improvement (89 per cent versus 79 per cent, p = 0.27) and bacterial eradication (81 per cent versus 75 per cent, p = 0.81) in active chronic suppurative otitis media. Significantly fewer patients (seven per cent versus 29 per cent, p = 0.04) in the ofloxacin group had active disease at the end of the two-week treatment. We recommend the use of ofloxacin eardrops in managing active chronic suppurative otitis media since it has high clinical efficacy, contains no steroid component and has no demonstrated risk of ototoxicity.
Speech assessment of patients using three types of indwelling tracheo-oesophageal voice prostheses
Authors: Heaton J. M. , Sanderson D. , Dunsmore I. R. , Parker A. J. 
Published: November 2007

AbstractA multidisciplinary prospective study compared speech acceptability between three types of indwelling tracheo-oesophageal voice prostheses. Twenty male laryngectomees took part over five years, using 42 prostheses. Speech was assessed on a discrete scale by trained and untrained personnel. The majority scored in the mid-range for each assessor. The kappa coefficient was used to test similarity between assessors, and for all pairings agreement was significant (p<0.05). The speech and language therapist tended to give higher scores and the patient lower. A relationship was found between patients' ages categorized by decade and the surgeon's score alone. This relationship held for Groningen high resistance and Provox prostheses individually too (p<0.05). The untrained assessed similarly to the professionals – humans are all voice listeners. The analysis suggests surgeons find tracheo-oesophageal speech in older patients better than in younger ones; or make more allowances for the elderly. There was a trend for Provox prostheses to produce the best scores.
Value of lymph node biopsy in the diagnosis of acquired toxoplasmosis
Authors: Tuzuner Nukhet , Doǧusoy Gülen , Demirkesen Cuyan , Ozkana Ferda , Altas Kemal 
Published: November 2007

AbstractToxoplasmic lymphadenitis generally involves a solitary lymph node in the head and neck regions, without systemic symptoms. In order to determine the frequency of toxoplasmic lymphadenitis, we reviewed the histological sections of 731 consecutive patients with reactive lymph node hyperplasia. Amongst 731 patients, 112 had histological features supporting a diagnosis of toxoplasmic lymphadenitis (15.3 per cent). In 80 of these patients (71 per cent), either Indirect Haemaglutination test (IHA), in 37 cases, or the Enzyme-Linked Immunosorbent Assay (ELISA) for detecting toxoplasmic IgG or IgM antibodies, in 43 cases, were performed. In 76 out of 80 patients (95 per cent), histological features correlated well with serological studies. The IHA test was positive in 30 patients with a titre of 1/64 or higher. The IgG-ELISA test was positive in 11 whereas the IgM-ELISA test was positive in 28 patients. These results provide further evidence of the distinctive nature of the histological changes in toxoplasmic lymphadenitis, which should enable the clinician to make a confident diagnosis of acute acquired toxoplasmosis.
An improvement in hearing sensitivity following hearing-aid fitting in a child with an apparent sensorineural hearing impairment
Authors: Munro K. J. , Cafarelli Dees D. 
Published: November 2007

AbstractThis case describes an apparent improvement in hearing sensitivity in a young girl over a period of 12 months, after she was fitted with binaural hearing-aids. Discrepancies between objective and subjective test results are highlighted. Even if the underlying reason for the conflicting test results was due to poor listening skills or test error, this child behaved like a hearing-impaired child and her performance improved after hearing-aid use. The case also illustrates the application of earphone testing from six months of age. The importance of closely monitoring all children who are fitted with hearing-aids is highlighted.
Post-tonsillectomy pain with selective diathermy haemostasis
Authors: Tay H. L. 
Published: November 2007

AbstractA prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the selective diathermy technique as opposed to the ligation technique. One hundred and five patients had one tonsillar fossa haemostasis secured by unipolar diathermy and the opposite side by ligation technique. There was significantly less pharyngeal pain on the diathermy side in the first post-operative day. However, there was no significant difference between the two sides, both in pharyngeal discomfort and otalgia for the rest of the post-operative period. There was no difference in the incidence of haemorrhage between the two techniques.
Meatoplasty in Marfan syndrome
Authors: Fenton J. E. , Fagan P. A. 
Published: November 2007

AbstractMarfan syndrome (MS) is a rare connective tissue disorder, uncommon in otological practice. Ear surgery in MS has not been previously reported. An identical complication of meatoplasty developed in two patients with MS after modified radical mastoidectomy and meatoplasty for chronic otitis media. Both cases presented postoperatively with an external auditory canal narrowing when the walls of the initial meatoplasty in both cases collapsed. It is proposed that this occurred because of the inherent structural abnormality of the cartilage in Marfan syndrome. A simple technique of revision meatoplasty is described that resulted in successful management of these cases.
Parapharyngeal vagal neurilemmoma extending to the jugular foramen
Authors: Yumoto Eiji , Nakamura Koshiro , Mori Toshihiro , Yanagihara Naoaki 
Published: November 2007

AbstractA large vagal neurilemmoma in a 33-year-old man is reported. He complained of slowly progressive palsy of the tongue on the left side. Weakness of soft palate movement was also noted. Magnetic resonance imaging (MRI) revealed a tumour in the left parapharyngeal space with partial extension to the posterior cranial fossa through the jugular foramen. Carotid angiography revealed avascularity of the tumour and anterior shift of the left internal carotid artery. The venous phase showed no blood flow in the internal jugular vein. The tumour was successfully extirpated via a transmandibular transpterygoid approach. Although vagus nerve dysfunction was not observed pre-operatively, the tumour was identified as a neurilemmoma arising from the vagus nerve. The surgical approach should be selected according to the lesion in individual patients. Since neurilemmoma is benign in nature, minimal post-operative sequelae should be expected.