Blunt trauma to the parotid gland.

Trauma involving the parotid gland is rare and is usually caused by penetrating injuries or fractures of the facial skeleton. A unique case is presented of rupture of the parotid gland after a minor external force in a 14 year old boy. The radiological findings are presented, which pointed to diffuse rupture of the gland parenchyma with an intact duct system. A conservative management policy using antibiotics and anticholinergics was effective, with complete resolution of symptoms. A literature review of more serious parotid injuries supported the conservative management policy.

Occipital meningocele and Mondini deformity of the cochlea.

We present two cases of a previously unreported association between occipital meningocele and Mondini deformity of the cochlea. The probability of the association is supported by the intimate relationship between the development of these structures; the existence of dysembryoplastic factors that can cause both abnormalities; and the universal existence of cochlear abnormalities in anencephalic foetuses. The importance of considering the association is emphasized, in terms of early identification and referral of children with hearing loss, and avoidance of duplication of investigations.

Pseudopolyp of the right laryngeal ventricle following atraumatic intubation: a diagnostic dilemma.

The traumatic effects of tracheal intubation are well recognized. Whilst these usually follow prolonged intubation, acute lesions have been described, usually following a traumatic intubation technique. We present a case of acute, localized swelling of the right laryngeal ventricle which followed an entirely atraumatic intubation by an experienced paediatric anaesthetist. The lesion was not present at the time of intubation, but developed subsequently during the surgical procedure. Although previously observed at our institution, such lesions have not been described in the literature. The potential for a diagnostic pitfall, by mistaking the lesion for a laryngeal cyst or nodule, is discussed.

Management of neck lumps--a triage model.

We report our experience in the out-patient triage of 100 patients presenting with a lump in the neck. The out-patient visit consisted of a general history and examination, assessment of the upper air and food passages and, where indicated, ultrasound and core needle biopsy of the lump. Other investigations were performed as appropriate. One hundred neck lump patients were seen in a 9 month period. Ninety-six of these lumps were diagnosed on an out-patient basis, only four requiring admission for formal excision biopsy. Among the diagnoses were eleven lymphomas, nine parotid neoplasms, nine lymph node metastases, five thyroglossal cysts, and four branchial cysts. Almost half the patients seen had either a reactive lymphadenopathy, or no abnormality. The establishment of a tissue diagnosis on an out-patient basis allowed appropriate referrals to be made and management plans to be formulated. The theoretical risk of seeding of malignant cells in the needle tract is acknowledged and discussed.

Intracordal cyst in a neonate.

Vocal cord cysts are rare, and typically present with symptoms of dysphonia in older children and adults. There is often a background of voice abuse. We present the first recorded and photographed case of an intracordal cyst presenting in a neonate. The patient presented with symptoms of episodic stridor, respiratory distress, and feeding difficulties, which resolved rapidly after simple incision of the cyst. Theories for the aetiology of intracordal cysts are discussed. The authors believe that this case lends support to the theory that intracordal cysts are congenital in origin.

Self-induced vertigo.

Benign paroxysmal positional vertigo is the most commonly recognized form of self-induced vertigo. This paper describes other means by which patients have been able to induce vertigo to the extent that at times it has been incapacitating. Hypotheses for the production of these phenomena are suggested in a number of the cases. Some of the features cannot be explained on the basis of our present knowledge of the vestibular system.

Revision of a vertical tracheotomy scar using the W-plasty technique.

Repair of a vertical tracheotomy scar using a W-plasty technique is discussed, and an illustrative case is presented. The indications and technique of the W-plasty repair are reviewed. The advantages over the classical running Z-plasty in this type of scar repair are outlined.

[Metastatic cancer of the endocardium].

16 cases of metastatic cancer in the endocardium collected from 2,050 autopsy cases in Baptist Medical Center, Missouri, USA from 1961 to 1983 are reported. There were 484 malignant tumors and 68 metastatic cancers in the heart, in which 16 involved the endocardium comprising 0.8% of the total autopsies during the same period, 3.3% of the malignant tumors and 23.5% of the metastatic cancer in the heart. Primary sites of these 16 cases are as follows: malignant melanoma 6 cases, lung cancer 2, thyroid carcinoma 2, rectal cancer 2, breast, liver, kidney and skin 1 case each. Metastatic cancer in the endocardium is rare. Diagnosis is commonly made by occurrent findings during autopsy. The primary lesions, metastatic sites and pathological and clinical features are discussed.

Autorregulacion de la secrecion sebacea. Donde esta localizado el factor inhibidor? / Autoregulation of the sebaceous secretion. Where is the inhibitor factor placed?

Se ha estudiado el indice de secrecion sebacea en 6 voluntarios, sometidos a dos lavados de cabeza integrales diarios, comenzando la recoleccion a distintos tiempos del ultimo lavado y haciendo dos determinaciones seguidas. A medida que aumenta el periodo de latencia entre el lavado y el comienzo del test, la secrecion sebacea se reduce en forma exponencial independentemente de la cantidad de sebo que se encuentre en la superficie. Este hecho sugiere que si existe un factor que autorregule la secrecion sebacea es poco posible que se halle en el sebo acumulado en superficie cutanea

Autorregulacion de la secrecion sebacea. Donde esta localizado el factor inhibidor? / Autoregulation of the sebaceous secretion. Where is the inhibitor factor placed?

Se ha estudiado el indice de secrecion sebacea en 6 voluntarios, sometidos a dos lavados de cabeza integrales diarios, comenzando la recoleccion a distintos tiempos del ultimo lavado y haciendo dos determinaciones seguidas. A medida que aumenta el periodo de latencia entre el lavado y el comienzo del test, la secrecion sebacea se reduce en forma exponencial independentemente de la cantidad de sebo que se encuentre en la superficie. Este hecho sugiere que si existe un factor que autorregule la secrecion sebacea es poco posible que se halle en el sebo acumulado en superficie cutanea