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J Laryngol Otol [journal]
- MicroRNA-519a demonstrates significant tumour suppressive activity in laryngeal squamous cells by targeting anti-carcinoma HuR gene. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Dec 3.:1-9.
Objective: This study investigated the expression and functional effects, and related molecular mechanisms, of microRNA-519a in laryngeal squamous cell carcinoma. Methods: MicroRNA-519a and HuR messenger RNA in laryngeal squamous cell carcinoma were measured using reverse transcription polymerase chain reaction. MicroRNA-519a effects on the growth of human epithelial type 2 cells were tested using an MTT assay. The influence of microRNA-519a on the expression levels of HuR and other related genes in protein was tested by Western blotting. Cell cycle analyses were performed using flow cytometry. Associations between expression levels and patients' clinical parameters were analysed with Pearson correlation analysis. Results: Expression of microRNA-519a in laryngeal squamous cell carcinoma tissues was significantly lower than in adjacent non-cancerous tissues. The expression of microRNA-519a was negatively associated with histological differentiation, tumour-node-metastasis stage, lymphatic metastasis and disease-free survival time. After increasing the level of microRNA-519a in laryngeal squamous cell carcinoma human epithelial type 2 cells, cell growth was inhibited and cell cycle was arrested in the G2/M phase. MicroRNA-519a down-regulated HuR gene expression in protein levels without affecting messenger RNA levels. Conclusion: MicroRNA-519a may function as a tumour suppressor by inhibiting HuR expression, and may serve as a therapeutic target for laryngeal squamous cell carcinoma.
- Oesophageal foreign body: an unusual presentation. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Dec 3.:1-2.
Objective: This paper describes and discusses the case of an oesophageal foreign body, in which the patient presented with primarily respiratory clinical signs. Case report: A 17-month-old child, who had ingested a watch battery, presented to emergency services on multiple occasions with upper respiratory tract symptoms. Subsequent radiographs showed the battery in the oesophagus impinging on the trachea. The battery was removed successfully under a general anaesthetic. Conclusion: Large oesophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. In such cases, anteroposterior and lateral chest films are imperative to make a correct diagnosis.
- Middle-ear involvement in type I Gaucher's disease - a unique case. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Dec 3.:1-4.
Objective: Gaucher's disease is a rare autosomal recessive lysosomal storage disease. We describe a unique case of middle-ear involvement presenting with hearing loss. Case report: A five-year-old boy with known Gaucher's disease presented with bilateral hearing impairment and conductive hearing loss on pure tone audiometry with flat tympanometry traces. Intervention: Exploratory Tympanomastoidectomy revealed inflammatory material filling the mastoid and the middle ear. Histological analysis confirmed Gaucher cell infiltrates. Conclusion: This is the first detailed report in the english language literature of Gaucher's disease affecting the middle ear and the mastoid. We discuss the disease process and suggest future management options.
- Epistaxis management at Guy's Hospital, 2009-2011: full audit cycles. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Dec 2.:1-4.
Objective: To assess management of epistaxis at a tertiary ENT referral hospital against a recently published standard of best practice. Methods: Fifty consecutive cases of acute epistaxis that required admission to Guy's Hospital in 2009 were evaluated. Epistaxis education sessions were held to introduce our algorithm of best practice in tandem with an emphasis on emergency department care. Similar retrospective reviews were carried out in both 2010 and 2011 (on groups of 50 patients). Results and conclusion: The first audit cycle demonstrated that only 8 per cent of patients underwent a suitable nasal examination in the emergency department prior to transfer, with no documented attempts at nasal cautery. Surgical intervention procedures were performed on only 40 per cent of eligible patients. The audit cycles that followed the introduction of the epistaxis algorithm demonstrated continued improvement in initial evaluation and management of epistaxis. In select patients, sphenopalatine artery ligation can provide timely, definitive management of refractory epistaxis.
- Laryngeal cancer management in a small, rural, multidisciplinary team setting: 15-year review. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Dec 2.:1-5.
Background: The Cumberland Infirmary, Carlisle, serves a largely remote, rural population of 330 000. The aim of this study was to report the treatment and survival figures for patients treated for laryngeal cancer at this centre. Methods: The study included 209 consecutive patients with squamous cell carcinoma of the larynx diagnosed between 1996 and 2010 at the Cumberland Infirmary. Results: Disease-specific survival was 100 per cent for stage one, 76 per cent for stage two, 87 per cent for stage three and 46 per cent for stage four. In total, 76 patients (36 per cent) had a laryngectomy, either as primary treatment or as a salvage procedure. Conclusion: Our tumour-specific survival rate was very high, and this success may be due in part to high rates of surgical intervention. Survival data compared favourably with other centres, despite less radical radiotherapy regimes. Laryngeal cancer can be managed effectively in a small, relatively remote, multidisciplinary team setting.
- Voluntary contraction of the tensor tympani muscle and its audiometric effects. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Dec 2.:1-3.
Background: The tensor tympani muscle is the largest muscle within the middle ear. Its voluntary contraction is a very unusual event. Only a few papers have documented its audiometric effects. Objective: To report an unusual case of voluntary tensor tympani muscle contraction and describe its audiometric effects. Case report: A 27-year-old man, who presented complaining of voluntarily evoked bilateral tinnitus, was found to be able to voluntarily contract the tensor tympani muscle in both ears simultaneously. Audiograms were performed under conditions of rest and maximal contraction of the tensor tympani muscle. The most remarkable effects were conductive hearing loss at lower frequencies and an increase in middle-ear impedance. Conclusion: The importance of the tensor tympani muscle in middle-ear physiology remains unclear. It has been related to the attenuation of sounds produced during the mastication process. Voluntary control over the tensor tympani muscle is an extremely rare event. However, an understanding of the potential audiometric effects of its contraction could aid the diagnosis of hearing disorders.
- Role of subtotal tonsillectomy ('tonsillotomy') in children with sleep disordered breathing. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Nov 26.:1-5.
Introduction: Sleep disordered breathing in children causes disturbance in behaviour and also in cardiorespiratory and neurocognitive function. Subtotal tonsillectomy ('tonsillotomy') has been performed to treat sleep disordered breathing, with outcomes comparable to established therapies such as total tonsillectomy or adenoidectomy. This review critically assesses the role of subtotal tonsillectomy in a paediatric setting. Method: The Medline database (1966 to October 2012) was electronically searched using key terms including subtotal or intracapsular tonsillectomy, tonsillotomy, tonsillectomy, paediatrics, and sleep disordered breathing. Results: Eighteen papers were identified and reviewed. Subtotal tonsillectomy would appear to have an efficacy equal to that of total tonsillectomy for the treatment of sleep disordered breathing, and has significant benefits in reducing post-operative pain and analgesia use. Subtotal tonsillectomy patients appear to have less frequent post-operative haemorrhage compared with total tonsillectomy patients. Conclusion: In children, subtotal tonsillectomy is associated with fewer post-operative complications whilst having a comparable effect in improving sleep disordered breathing, compared with total tonsillectomy.
- Endoscopic transsphenoidal drainage of an aggressive petrous apex cholesterol granuloma: unusual complications and lessons learnt. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Nov 26.:1-5.
Objectives: This case report describes the endoscopic transsphenoidal management of a cholesterol granuloma situated in a technically challenging part of the petrous apex, and the associated peri- and post-operative complications that arose. The literature on diagnosis and management of petrous apex cholesterol granulomas is reviewed. Method and results: Surgical intervention was attempted on three occasions, each time via an endoscopic, transsphenoidal approach with image guidance. The procedure was abandoned on the first occasion as there was a significant risk to the carotid artery; only a small drainage ostium was created because of the proximity of the carotid artery. The second attempt, complicated by copious bleeding from the clival venous plexus, was arrested prematurely. Successful drainage was achieved at the third attempt, but recovery was complicated by tension pneumocephalus. Conclusion: The transnasal route is less invasive than a lateral labyrinthine or cochlear approach, and spares cochlear and vestibular function. However, this approach is not without risk. It is important to consider the natural anatomical variance of vasculature when planning surgical intervention for a lesion situated in a technically challenging part of the petrous apex. Additional magnetic resonance venography is recommended to circumnavigate the venous plexus, thereby avoiding an unexpected breach.
- Olfaction, pheromones and life. [JOURNAL ARTICLE]
- J Laryngol Otol 2013 Nov 26.:1-4.
Background: From an evolutionary standpoint, olfaction is one of the oldest senses, and one that affects all aspects of life. This review discusses the influence of olfaction and pheromones on life. Methods: A literature search was conducted using MEDLINE (1966-2012), Embase (1988-2012), The Cochrane Library (1993-2013) and Ovid (1966-2012). Results: Olfaction plays an important role in life, from infancy through to adulthood and declining health in old age. Culture, memories and emotions, which add to life's complexity and overall enjoyment, are also influenced by olfaction. Conclusion: Olfaction has a chronological influence on life, affecting all aspects from the cradle to the grave; it plays a role in the quality of life as a key ingredient of human evolution, survival and enjoyment.
- Focus on the external auditory canal. [Journal Article]
- J Laryngol Otol 2013 Nov; 127(11):1045.