Frontalis muscle flap: a novel method for donor site closure of an interpolated paramedian forehead flap.

OBJECTIVE: We present a previously unreported technique which we have found useful for closure of the donor site created by a paramedian forehead flap, during nasal reconstruction. CASE REPORT: An 80-year-old woman was referred to the ENT department for management of a large tumour involving the left nasal dorsum. The lesion measured 2.5 x 2.5 cm, and an incisional biopsy confirmed moderately differentiated squamous cell carcinoma. Complete excision with an interpolated paramedian forehead flap reconstruction was performed. The pedicle was divided three weeks post-operatively, and the 2 x 2 cm forehead defect was closed at this time. A frontalis muscle flap and full thickness skin graft were used to close the donor site. CONCLUSION: A frontalis muscle flap is a novel method of closing large forehead defects created by a paramedian forehead flap. A frontalis muscle flap provides a healthy base for a full thickness skin graft, which allows good skin colour matching and an enhanced cosmetic result.

Patient quality of life with bone-anchored hearing aid: 10-year experience in Glasgow, Scotland.

OBJECTIVES: This study aimed to ascertain the usefulness of the bone-anchored hearing aid and its impact on the quality of life of patients fitted in Glasgow between 1996 and 2006. METHOD: The Entific Medical Systems questionnaire and the Glasgow Benefit Inventory were posted to patients in order to assess their satisfaction and quality of life changes. RESULTS: Sixty adult patients were identified, with a questionnaire response rate of 63 per cent. Thirty-two respondents (85 per cent) reported using their bone-anchored hearing aid for more than eight hours per day. Twenty-nine respondents (75 per cent) found their bone-anchored hearing aid to be generally better than their previous, conventional aid. Twenty-seven respondents (71 per cent) reported that their bone-anchored hearing aid improved their quality of life. The median total Glasgow Benefit Inventory score was +33.3. CONCLUSIONS: Bone-anchored hearing aid usage rates and satisfaction levels were high amongst patients in Glasgow. Glasgow Benefit Inventory indices were comparable to published findings from other centres. Despite this, bone-anchored hearing aid funding is still not universally available within the National Health Service in Scotland.

Laryngopyocoele: simple management of an acute airway crisis.

OBJECTIVE: We present the first reported case of ultrasound-guided aspiration of a laryngopyocoele in a patient with acute airway obstruction. CASE REPORT: A 71-year-old woman was diagnosed with a right-sided laryngocoele. Six weeks later, the patient was admitted as an emergency with a three-day history of increasing dyspnoea and stridor. Neck examination revealed a large, right-sided, soft neck mass, centred at level III, measuring approximately 10 x 5 cm. Fibre-optic laryngoscopy revealed a large, smooth, inflamed, right supraglottic mass obscuring the laryngeal inlet. The patient was taken directly to the radiology department, where ultrasound imaging confirmed a laryngopyocoele. Under ultrasound guidance, a 21-G needle was directed into the cyst and 30 ml of pus was aspirated. The dysphonia and stridor resolved immediately. Six weeks later, the patient underwent definitive surgical excision of the laryngocoele. CONCLUSION: Laryngopyocoele is a rare diagnosis. It can present as an acute airway emergency. We present the first reported case managed by ultrasound-guided aspiration, which averted the need for endotracheal intubation or tracheostomy.

Cytotoxic effects of the oncolytic herpes simplex virus HSV1716 alone and in combination with cisplatin in head and neck squamous cell carcinoma.

CONCLUSIONS: HSV1716 alone and combined with cisplatin was efficacious in destroying head and neck squamous cell carcinoma (HNSCC) cells. Combination treatment with HSV1716 and cisplatin gave additive efficacy. These results indicate that HSV1716 in combination with cisplatin could be of therapeutic value in HNSCC and warrants further investigation. OBJECTIVES: HSV1716 is a replication competent herpes simplex virus which selectively replicates and lyses actively dividing cells but not normal or terminally differentiated cells. The objective of this study was to determine the efficacy of HSV1716 alone and in combination with cisplatin in HNSCC. MATERIALS AND METHODS: Three HNSCC cell lines were studied; UM-SCC 14C, UM-SCC 22A and UM-SCC 22B. The permissivity of HSV1716 in these cell lines was determined using multicycle growth experiments. In vitro, cytotoxicity of HSV1716 and cisplatin was determined using an MTS proliferation assay. Isobologram analysis was used to determine the interaction between HSV1716 and cisplatin combination treatment. RESULTS: The three HNSCC cell lines studied were permissive for HSV1716 replication. Cytotoxicity increased in a dose-dependent fashion in all three cell lines. Cisplatin was non-toxic to the virus. Isobologram analysis showed additive cytotoxicity when HSV1716 was combined with cisplatin in all three cell lines.

Benign ectopic submandibular thyroid with a normotopic multinodular goitre.

Ectopic submandibular thyroid tissue is a rare entity and poses difficult diagnostic and management problems. The first case of ectopic submandibular thyroid with a normotopic multinodular goitre is presented

Foreign body reaction to an oil-based ointment: a cause of persistent otorrhoea following mastoid surgery.

Foreign body reactions and myospherulosis are rare complications of using oil-based ointments in otological surgery. A case of persistent otorrhoea following mastoid surgery is presented. Histology showed a foreign body reaction, with some features of myospherulosis.