The Journal of laryngology and otology
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Foregut duplication cysts are heterotrophic rests of foregut-derived epithelium which are usually found in the abdomen and thorax; rarely are they found in the head and neck. ⋯ The occurrence of a foregut duplication cyst in the head and neck region mandates vigilance with respect to the airway. Magnetic resonance imaging is a useful part of pre-operative evaluation but cannot be relied upon for definitive diagnosis. Although foregut duplication cysts are benign lesions, definitive cure ultimately requires surgical excision, and this is often the means by which a definitive diagnosis is made. The prognosis for these lesions is excellent, with no reports in the literature of recurrence following excision.
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We aimed to highlight a rare anatomical variation involving the recurrent laryngeal nerve, and to emphasise its implications for thyroid surgery. ⋯ The recurrent laryngeal nerve must be carefully dissected and totally exposed during thyroid surgery in order to best preserve its function. Moreover, the thyroid surgeon must be aware of the existence of anatomical variations, which are not as rare as one may think.
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Cancerous involvement of the pre-epiglottic space has been known for many years to be an important prognostic factor. The aim of this study was to investigate the prognostic value of pre-epiglottic space invasion, according to the degree of invasion (i.e. absence, minimal or gross), and to assess the oncological suitability for supracricoid partial laryngectomy in patients with supraglottic laryngeal carcinomas. This study included 52 patients with squamous cell carcinomas of the supraglottic and glotto-supraglottic larynx, treated with supracricoid partial laryngectomy-cricohyoidopexy, between 1992 and 2001. ⋯ The five-year overall survival and cause-specific survival were 78.8 and 82 per cent, respectively. Supracricoid partial laryngectomy with cricohyoidopexy can safely be performed in supraglottic and glotto-supraglottic carcinomas with minimal or gross invasion of the pre-epiglottic space which have no extralaryngeal spread. Nodal status is an important predictor affecting survival.
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This study aimed to elucidate the potential inner-ear effects of fotemustine, a chemotherapeutic agent which crosses the blood-brain barrier and is used in the treatment of primary and metastatic brain tumours and metastatic melanoma. ⋯ Fotemustine was administered via intraperitoneal slow infusion in a rat experimental model. Twelve ears of six survivors, from 10 rats, were evaluated at the second month. Fotemustine was determined to have a potential for ototoxicity at 3600 and 3961 Hz. Three randomly chosen rats underwent electron microscopy for morphological analysis. Morphological effects in the cochlear basal turn were observed. Oedematous intracytoplasmic spaces and perivascular areas of the stria vascularis, as well as distorted chromatin content, were detected, thereby suggesting potential ototoxic effects for this agent. Further experimental and clinical studies are required in order to determine whether the effect seen in this pilot study is reversible, and to analyse effects in humans.
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The aim of this retrospective analysis was to evaluate the diagnosis of vertigo, dizziness and imbalance in elderly patients in two tertiary neurotology clinics. ⋯ This retrospective study showed that 93.5 per cent of the elderly patients studied had been diagnosed with peripheral vertigo. The majority of patients had been classified as having benign paroxysmal positional vertigo, idiopathic vestibulopathy or migraine vestibulopathy.