Otorhinolaryngology

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Axillary nodal metastasis at primary presentation of an oropharyngeal primary carcinoma : a case report and review of the literature
(BioMed Central, 2009-08) Mckenzie, Bruce J.; Loock, James W.
Introduction: Axillary nodal metastasis is very rare in head and neck squamous cell carcinoma. The few cases reported in the literature all involve patients who have previously undergone either neck dissection alone, or neck dissection and radiotherapy to the neck, and subsequently develop delayed recurrences of disease, with axillary nodal involvement. Case presentation: We present the case of a 62-year-old man of Cape Malay ethnicity, who presented with an oropharyngeal squamous cell carcinoma, and cervical and axillary nodal metastasis at primary presentation. Conclusion: Whilst previous reports in the literature suggest routine examination of the axilla is advisable in patients with previously treated neck cancer and recurrence of head and neck cancer, we propose that the axilla should be routinely examined in new cases, particularly when there is involvement of the level 5 nodes.
Bipolar diathermy for the outpatient control of posterior epistaxis
(Health and Medical Publishing Group (HMPG), 2008) McKenzie, B. J.; Loock, J. W.
[No abstract available]
Ear-invading arthropods : a South African survey
(Health & Medical Publishing Group, 2006) Kroukamp, G.; Londt, J. G. H.
[No abstract available]
The effect of fequency tolerance on audiometer accuracy
(Health & Medical Publishing Group, 1977) Guelke, R. W.; Floyd, J. D.; Van Zyl, F. J.
Investigations into the methods used to calibrate audiometers reveal that the 6000 Hz frequency is particularly liable to yield inconsistent results when calibrated in the usual way. It is shown that the TDH39 telephone receiver which is usually calibrated on a 9A coupler in accordance with the International Standards Organization recommendation R389 will depend to a considerable extent on the precise frequency used and may differ by as much as 7 db when the frequency is varied but still retained within the specified tolerance limits. A new telephone receiver, the TDH50, is much less sensitive to frequency variation. It is shown that this receiver should be calibrated with the same threshold figures as the TDH39.
Evaluation of topical 5% povidone iodine solution in chronic suppurative otitis media: a case series
(Stellenbosch : Stellenbosch University, 2023-03) Boggenpoel, Ashton; Adam, Shaun; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Otorhinolaryngology.
ENGLISH ABSTRACT: Introduction: Chronic otitis media (COM) is a major public health concern in developing and developed countries. Early detection and appropriate management of these cases are critical for minimising the complications associated with this disease. The gold standard treatment is quinolone eardrops with or without steroids. However, quinolone ear drops are expensive, not readily available in developing countries. Antiseptics provide broad-spectrum antibacterial and antifungal effects, are cost-effective, and reduce the likelihood of organisms developing resistance. Povidone (polyvinyl pyrrolidone)-iodine (PVP-I) has been widely utilised for numerous clinical applications on skin and mucosa for the past 30 years with no significant local or systemic side effects and is cost-effective. 5 Gram-positive and gram-negative bacteria, anaerobes, spores, mycobacteria, fungi, viruses, and protozoans are all susceptible to its broad antibacterial range.6 Aim: This case series aims to assess the efficacy of topically applied 5% povidone-iodine (PVP-I) in the treatment of active COM. This was measured as the resolution of active COM ears. Methods: The study design is a prospective case-controlled series. All subjects presenting to the otorhinolaryngology department with discharging ears and who met the inclusion criteria, were entered into the study. A total of 51 (39 subjects) ears were allocated to receive 5% PVPI. Six drops were administered twice daily to the affected ears. Subjects were followed up at four weeks after the initial consultation. During their review visit, an evaluation by microscopic examination was performed. Ears were graded as actively discharging (wet) deemed as failure or inactive (dry) deemed successful. This formed the main outcome measure. Outcomes: In this case series bidaily administration of 5% PVP-I solution led to a clinical improvement in 89.47% of ears, whereas 10.53 % of ears had treatment failure. This outcome was comparable to other studies using 5% PVP-I. Previous studies had more frequent consultations and aural toilets, while participants in this case only had two consultations and two aural toilets, yielding the same outcome. Conclusion: This study demonstrates that 5% PVP-I solution is an inexpensive and effective treatment for active COM. 5%PVI-I solution serves as an excellent alternative in resource limited settings where quinolone ear drops are not widely available. In the South African context, in particular the public health care system, this may translate to reduced healthcare costs and an equally effective treatment option when quinolone eardrops are not readily available.
The implications of early detection and pre-school habilitation of the hearing-impaired child : with special reference to the Provincial Paedo-audiological Centre, Tygerberg Hospital
(Health and Medical Publishing Group -- HMPG, 1981-11) Du Toit, C. J.
The basic handicap of deafness, viz. the lack of natural communication skills, can be overcome by early detection of the defect and pre-school habilitation. In congenital deafness this dramatically improves the outlook for these children as regards the acquisition of normal speech, education in normal schools and emotional, social and economic integration into society. Planning for this is the responsibility of the Department of Health and Social Welfare and the provincial hospital administrations.
The negative effects of mucolytics in otitis media with effusion
(Health & Medical Publishing Group, 1987) Van der Merwe, J.; Wagenfeld, D. J. H.
Much controversy still exists in the treatment of otitis media with effusion. A double-blind randomised prospective trial during which bromhexine hydrochloride was compared with a placebo is reported. Information from 60 patients was analysed and the results reveal interesting findings on the effects of bromhexine on middle-ear clearance. The data clearly reveal that bromhexine retards resolution of the effusion. Further discussion of the literature gives insight into the controversy surrounding the treatment of middle-ear effusion. Steroids are proposed for further research and clinical trials.
Patient-related benefits for adults with cochlear implantation : a multicultural longitudinal observational study
(S. Karger AG, Basel, 2017-07-19) Lenarz, Thomas; Muller, Lida; Czerniejewska-Wolska, Hanna; Varela, Hector Valles; Dotu, Cesar Orus; Durko, Marcin; Irujo, Alicia Huarte; Piszczatowski, Bartosz; Zadrożniak, Marek; Irwin, Colin; Graham, Petra L.; Wyss, Josie
ENGLISH ABSTRACT: To assess subjectively perceived, real-world benefits longitudinally for unilateral cochlear implant (CI) recipients in a multinational population treated routinely. To identify possible predictors of self-reported benefits. Design: This was a prospective, multicenter, repeated-measures study. Self-assessment of performance at preimplantation and postimplantation at 1, 2, and 3 years using standardized, validated, local language versions of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), and the Health Utilities Index Mark 3 (HUI3) was performed. Outcomes were analyzed using a longitudinal mixed-effects model incorporating country effect. Patient demographics were explored for associations with change over time. Subjects: Two hundred ninety-one routinely treated, unilateral CI recipients, aged 13-81 years, from 9 clinics across 4 countries. Results: Highly significant improvements were observed for all outcome measures (p < 0.0001). Postimplantation, mean outcome scores remained stable beyond 1 year, with notable individual variability. A significant association for one or more outcomes with preimplantation contralateral hearing aid use, telephone use, age at implantation, implantation side, preimplantation comorbidities, dizziness, and tinnitus was observed (p < 0.004). Conclusions: Longitudinal benefits of CI treatment can be measured using clinically standardized self-assessment tools to provide a holistic view of patient-related benefits in routine clinical practice for aggregated data from multinational populations. Self-reported outcomes can provide medical-based evidence regarding CI treatment to support decision-making by health service providers.
Rinoliet (neussteen) geassosieer met chroniese otorree : 'n gevalbespreking
(Health & Medical Publishing Group, 1986) Hoffmann, A. J.; Wagenfeld, D. J. H.
A rare case of a 12-year-old girl with a nasopharyngeal rhinolith causing chronic unilateral otorrhoea is presented. The role of posterior rhinoscopy as an integral part of a routine otological examination is highlighted.
The simple bread tag – a menace to society?
(Health and Medical Publishing Group, 2015) Karro, Ryan; Goussard, Pierre; Loock, James; Gie, Robert
ENGLISH ABSTRACT: Foreign bodies (FBs) are potentially life-threatening when inhaled by a child, depending on where they lodge. Symptoms can range from acute upper airway obstruction to mild, vague respiratory complaints. Between 80% and 90% of inhaled FBs occlude the bronchi, while the larynx is a less common site. The commonest inhaled paediatric FBs are organic, e.g. seeds or nuts. Plastic FBs are less common and more difficult to diagnose. They are generally radiolucent on lateral neck radiographs and are often clear and thin. We report three cases of an unusual plastic laryngeal FB, the bread tag. Plastic bread tags were first reported in the medical literature as an ingested gastrointestinal FB in 1975. Since then, over 20 cases of gastrointestinal complications have been described. We report what is to our knowledge the first paediatric case of an inhaled bread tag, and also the first case series, briefly discuss the symptoms and options for removal of laryngeal FBs, and highlight the dangers of the apparently harmless bread tag. Images of the bread tags in situ and after their removal are included.
Subjective pulsatile tinnitus cured by carotid endarterectomy
(Health & Medical Publishing Group, 1989-05) Louwrens, H. D.; Botha, J.; Van der Merwe, D. M.
A 70-year-old woman with unilateral pulsatile tinnitus was relieved of the complaint after carotid endarterectomy. Internal carotid artery stenosis presenting with pulsatile tinnitus is rare. Endarterectomy can relieve symptoms if the correct diagnosis is made.
Timpanoplastiekoperasies in septiese gevalle : 'n nuwe tegniek
(HMPG, 1981-08) Wagenfeld, D. J. H.
The very high incidence of postoperative sepsis in tympanoplasty operations on ears with infected cholesteatoma prompted the development of a new technique to improve the control of local infection. An irrigation tube is placed into the mastoid antrum at the time of operation, through which the ear is irrigated in the postoperative period with an antibiotic solution. In 25 tympanomastoidectomy operations, only 6 patients developed postoperative sepsis, 5 of which were due to faulty administration of the antibiotic. In 13 tympanoplasty operations, 6 patients had an unsuccessful outcome. Four of these were due to poor patient selection. Systemic antibiotics are given immediately preoperatively, and continued in the postoperative period until the course has been completed.
Treatment of laryngeal lipoid proteinosis using CO2 laser
(Health and Medical Publishing Group (HMPG), 2007-02) Kroukamp, Gary; Lehmann, Karen
Lipoid proteinosis (Urbach-Wiethe disease, hyalinosis cutis et mucosae) is an autosomal-recessive condition with variable penetrance. It is characterised by distinctive skin and mucous membrane lesions, particularly on the eyelids, on the extensor surface of large joints and in the mouth. Laryngeal involvement is typical and causes hoarseness due to lesions on and around the vocal cords and occurs in 75% of patients with the condition. Patients are normally hoarse from infancy, and a chronic and benign course is usual.
Treatment of otitis externa with miconazole nitrate : a comparative study involving 85 cases
(Health & Medical Publishing Group, 1983) Bak, J. P.; Wagenfeld, D. J. H.
The hazards of neomycin in local preparations have recently been re-emphasized. Eighty-five patients with otitis externa were treated with one of two preparations between August 1980 and April 1982 - 54 were treated with a cream containing miconazole nitrate and hydrocortisone (Daktacort; Janssen) and 31 with a preparation containing neomycin (Kenacomb; Squibb); sixty eight per cent of the patients were cured within 1 week with both preparations. Most treatment failures were due to a resistant Pseudomonas aeruginosa. The miconazole cream proved as effective as the preparation containing neomycin in the first-line treatment of otitis externa. A gentamicin-containing steroid ointment was effective against the Pseudomonas infection.
X linked deafness in a South African kindred
(Health & Medical Publishing Group, 1974) Thorpe, P.; Sellars, S.; Beighton, P.
The X linked deafness of Nance is present in a South African kindred. Recognition of the familial pattern of the disorder, together with the characteristic clinical and audiometric features, permits diagnostic precision, thereby facilitating accurate genetic counseling and rational management. Linkage studies indicated that the loci for the Xg blood group and the deafness gene are unlikely to be very close to each other.

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