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Volume 130 - December 2016

Contents

Page 14 of 48

Book Reviews

Clinical Records

  • Migration of an ingested fish bone into the paraglottic space

  • U C Megwalu
  • Published online by Cambridge University Press:
    08 August 2016, pp. 973-974
  • Background:

    Ingested foreign bodies are common emergencies encountered in otolaryngology practice. The vast majority can be managed with endoscopic removal. Migration of foreign bodies into the paraglottic space is a rare event that often necessitates using a more invasive procedure for removal.

    Case report:

    A 68-year-old man presented with sore throat and odynophagia 4 days after ingesting a fish bone.

    Results:

    A computed tomography scan revealed a 2.5 cm linear foreign body embedded in the larynx within the right paraglottic space. The patient underwent endoscopic examination and transcervical exploration of the paraglottic space via a posterolateral approach, with successful removal of the foreign body on the second attempt.

    Conclusion:

    This is the first case report of an ingested paraglottic space foreign body managed by transcervical exploration using a posterolateral approach to the paraglottic space.

  • Acute unilateral sensorineural hearing loss associated with anabolic steroids and polycythaemia: case report

  • T Tikka, N Mistry, A Janjua
  • Published online by Cambridge University Press:
    14 December 2015, pp. 309-313
  • Background:

    Unilateral sudden sensorineural hearing loss due to an infarct in the vertebrobasilar system has been widely reported. Most patients have a background of traditional coronary risk factors related to these cerebrovascular episodes.

    Case report:

    A 32-year-old male, a regular user of anabolic steroids, presented to the emergency department with unilateral sensorineural hearing loss and symptoms suggestive of an infarct of the anterior inferior cerebellar artery but in the absence of risk factors for ischaemic stroke.

    Results:

    Magnetic resonance imaging confirmed the presence of infarction in the region supplied by the anterior inferior cerebellar artery. Polycythaemia was found on haematological analysis, which we believe was secondary to the use of anabolic steroids. The patient was commenced on aspirin as per the stroke management protocol. There was resolution of neurological symptomatology six weeks after the episode, but no improvement in hearing.

    Conclusion:

    To our knowledge, this is the first case report of unilateral sensorineural hearing loss secondary to the use of anabolic steroids causing polycythaemia. This cause should be considered in the differential diagnosis of patients presenting with sensorineural hearing loss, especially in young males, when no other risk factors can be identified.

Main Articles

  • Laryngeal biopsies: are we doing more, and why? A decade of results

  • S Lim, P Sau, L Cooper, A McPhaden, K MacKenzie
  • Published online by Cambridge University Press:
    08 December 2015, pp. 100-103
  • Background:

    Over the last decade, we have observed an escalating trend in the number of laryngeal biopsies performed, despite the incidence of laryngeal cancer remaining constant. This study aimed to quantify the rate of laryngeal biopsies and record the indications.

    Method:

    A retrospective analysis of laryngeal biopsies performed in North Glasgow, Scotland, UK, between 2001 and 2010, was conducted.

    Results:

    From 2001 to 2010, 3902 laryngeal biopsies were carried out in North Glasgow. Histopathological results indicated the following diagnoses: squamous cell carcinoma, in 889 cases (23 per cent); dysplasia, in 986 cases (25 per cent); ‘no tumour’, in 913 cases (23 per cent); and benign pathology, in the remaining 1084 cases (28 per cent). There has been a significant increase in the number of biopsies performed after 2004, with the incidence of squamous cell carcinoma and benign disease remaining relatively static.

    Conclusion:

    It is hypothesised that organ preservation strategies, endoscopic resection in early stage laryngeal cancer and chemoradiotherapy in advanced head and neck cancer are responsible for the increase in laryngeal biopsies.

Book Reviews

Letters to the Editors

ID: 615.2

Abstracts

Clinical Records

  • Active middle-ear implant fixation in an unusual place: clinical and audiological outcomes

  • J F Polanski, A D Soares, Z M Dos Santos, O L Mendonça Cruz
  • Published online by Cambridge University Press:
    17 February 2016, pp. 404-407
  • Objective:

    The Vibrant Soundbridge is an active middle-ear implant for hearing rehabilitation that is usually placed in the long process of the incus or round window. This study reports on the unusual implant attachment to the short process of the incus in a patient with ear malformation, and describes their audiological and clinical outcomes.

    Methods:

    Case report and literature review.

    Results:

    Audiological evaluation with the Vibrant Soundbridge implant showed a pure tone average of 31 dB. The speech test, at 65 dB HL, revealed correct recognition of 92 per cent of disyllabic words. The Glasgow Hearing Aid Benefit Profile showed high levels of satisfaction, hearing aid use and benefit.

    Conclusion:

    Fixation of the Vibrant Soundbridge implant on the short process of the incus is a feasible option, with good clinical and audiological outcomes. Coupling the floating mass transducer to the short process of the incus is a good surgical option, especially when the long process and the oval or round window are inaccessible.

  • Simultaneous cochlear implantation and labyrinthectomy for advanced Ménière's disease

  • R L Heywood, M D Atlas
  • Published online by Cambridge University Press:
    17 December 2015, pp. 204-206
  • Background:

    Patients with Ménière's disease can develop unaidable sensorineural hearing loss. Cochlear implantation has recently been utilised in this group with favourable results. A more challenging group are those with intractable vertigo, and they have traditionally posed a significant management dilemma.

    Case report:

    Two female patients with unaidable hearing and recurrent incapacitating vertigo attacks despite conservative management underwent simultaneous labyrinthectomy and cochlear implantation. There was complete resolution of vertigo in both patients. Speech perception in quiet conditions and the ability to hear in background noise improved considerably.

    Conclusion:

    Surgical labyrinthectomy is effective for the elimination of vertigo in Ménière's disease patients. The major disadvantage in the past was loss of residual hearing. Cochlear implantation is now an option in these patients. The benefits of simultaneous labyrinthectomy with cochlear implantation include the prevention of implantation of a fibrosed or ossified cochlea, a decrease in the duration of deafness, and a single operative procedure.

Book Reviews

Back Cover (IBC, OBC) and matter

  • JLO volume 130 issue 9 Cover and Back matter

  • Published online by Cambridge University Press:
    19 September 2016, pp. b1-b2
    • Article
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Guidelines

  • Oral cavity and lip cancer: United Kingdom National Multidisciplinary Guidelines

  • C Kerawala, T Roques, J-P Jeannon, B Bisase
  • Published online by Cambridge University Press:
    12 May 2016, pp. S83-S89
    • Article
      • You have access
      • Open access
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  • This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessment and management of patients with cancer of the oral cavity and the lip.

    Recommendations

    • Surgery remains the mainstay of management for oral cavity tumours. (R)

    • Tumour resection should be performed with a clinical clearance of 1 cm vital structures permitting. (R)

    • Elective neck treatment should be offered for all oral cavity tumours. (R)

    • Adjuvant radiochemotherapy in the presence of advanced neck disease or positive margins improves control rates. (R)

    • Early stage lip cancer can be treated equally well by surgery or radiation therapy. (R)

ID: 615.3

Abstracts

Short Communication

  • Smartphone speech-to-text applications for communication with profoundly deaf patients

  • F C Lyall, P J Clamp, D Hajioff
  • Published online by Cambridge University Press:
    27 November 2015, pp. 104-106
  • Objective:

    Visual communication aids, such as handwriting or typing, are often used to communicate with deaf patients in the clinic. This study aimed to establish the feasibility of communicating through smartphone speech recognition software compared with writing or typing.

    Method:

    Thirty doctors and medical students were timed writing, typing and dictating a standard set of six sentences appropriate for a post-operative consultation, and the results were assessed for accuracy and legibility.

    Results:

    The mean time for smartphone dictation (17.8 seconds, 95 per cent confidence interval = 17.0–18.7) was significantly faster than writing (59.2 seconds, 95 per cent confidence interval = 56.6–61.7) or typing (44 seconds, 95 per cent confidence interval = 41.0–47.1) (p < 0.001). Speech recognition was slightly less accurate, but accuracy increased with time spent dictating.

    Conclusion:

    Smartphone dictation is a feasible alternative to typing and handwriting. Slow speech may improve accuracy. Early clinical experience has been promising.

Letters to the Editors

Book Reviews

Letters to the Editors

Front Cover (OFC, IFC) and matter

  • JLO volume 130 issue 5 Cover and Front matter

  • Published online by Cambridge University Press:
    20 April 2016, pp. f1-f4
    • Article
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Book Reviews

Page 14 of 48