Investigating the learning curve in endoscopic compared to microscopic myringotomy and ventilation tube insertion.

Objective: Rate of learning is often cited as a deterrent in the use of endoscopic ear surgery. This study investigated the learning curves of novice surgeons performing simulated ear surgery using either an endoscope or a microscope.

Methods: A prospective multi-site clinical research study was conducted.

Age, smoking and nasal ciliary beat frequency.

The nasal ciliary beat frequency of 120 individuals in a British urban population was determined from nasal brushings. These individuals formed part of a previous study which looked at nasal and middle ear ciliary beat frequency in 60 patients with middle ear disease and compared it to nasal ciliary beat frequency in 60 matched controls. The present study intended to investigate any changes in nasal ciliary beat frequency with age.

Increase in epithelial mast cell numbers in the nasal mucosa of patients with perennial allergic rhinitis.

The aim of the study was to compare the numbers and distribution of mast cells in the nasal mucosa of perennial allergic rhinitis (PAR) patients and controls, as demonstrated by different staining methods for light microscopy. Biopsies of inferior turbinate mucosa were taken from 10 patients with PAR and 10 patients undergoing septoplasty or septorhinoplasty (control group). Sections for light microscopy were stained with azure A.

Mucociliary function in patients with nasal polyps.

Patients with nasal polyposis complain of nasal blockage and rhinorrhoea, which may be due to impaired mucociliary clearance. The saccharine clearance time and ciliary beat frequency of samples of ciliated epithelium from patients with nasal polyps was measured. We also studied the effect of fluid from the oedematous stroma of nasal polyps and of histamine and prostaglandin (PG) D2, E2 and F2 alpha on the cilia from normal individuals.

Multiple rice body formation in chronic subacromial/subdeltoid bursitis: MR appearances.

Multiple rice body formation is an unusual complication of chronic bursitis. Clinically and macroscopically, it can resemble synovial osteochondromatosis. Radiographic and MR appearances, however, may allow an accurate pre-operative diagnosis.

Papillary carcinoma arising in a thyroglossal duct cyst: a case report and literature review.

Papillary carcinoma arising in a thyroglossal duct cyst is a rare finding. Less than 100 cases have been reported in the English literature. In most cases the diagnosis is only established after excision of a clinically benign thyroglossal duct cyst.

Nasal and middle ear ciliary beat frequency in chronic suppurative otitis media.

The middle ear mucociliary system has been shown to have an important function in the clearance of effusions. Little is known, however, about its role in chronic suppurative otitis media (CSOM). The ciliary beat frequencies of middle ear mucosal biopsies and nasal brushings of 27 patients with CSOM were analysed using a computerized photometric technique.

The effect of temperature on nasal ciliary beat frequency.

Using a photometric method of measuring ciliary beat frequency, the effect of temperature on ciliary activity was investigated. A linear increase in ciliary beat frequency between 19 degrees and 32 degrees C was found. Between 32 degrees and 40 degrees a plateau was reached in which temperature did not significantly affect frequency and above 40 degrees C the frequency began to decline.

Smoking and middle ear ciliary beat frequency in otitis media with effusion.

The middle ear mucociliary system has been shown to play an important role in clearing middle ear effusions. There is conflicting epidemiological evidence, however, as to whether exposure to tobacco smoke plays a significant role in persistence of middle ear effusion in patients with otherwise normal mucociliary function. Samples of middle ear mucosa from 33 patients with persistent otitis media with effusion (OME) were taken at myringotomy, together with corresponding nasal brushings.

Surface morphology of middle ear epithelium in chronic ear disease.

The ultrastructural details of normal middle ear mucosa have been reported in detail in the literature. This study was aimed at investigating the superficial structure of middle ear epithelium with the scanning electron microscope in patients with persistent otitis media with effusion (OME) and chronic suppurative otitis media (CSOM), especially in the light of the authors' recent findings regarding decreased ciliary beat frequency (CBF) in patients exposed to tobacco smoke. Mucosal biopsies were taken from the anterior mesotympanum in four patients with OME and another four patients with CSOM.

Simultaneous bilateral pleomorphic adenomas of the parotid glands with unilateral tyrosine rich crystalloids.

A case of simultaneous, bilateral pleomorphic adenoma of the parotid glands following irradiation to the head and neck for childhood Hodgkin's disease is presented. The tumour on the side given the highest radiation exposure contained so-called tyrosine rich crystalloids (TRCs). Simultaneous salivary gland neoplasms are rare; TRCs are also an unusual finding.

Primary malignant melanoma of the pharynx.

A case of primary malignant melanoma of the pharynx is presented. Mucosal melanomas of the upper respiratory tract are rare. They tend to present late and therefore the prognosis is generally poor.

P53 overexpression and Epstein-Barr virus infection in undifferentiated and squamous cell nasopharyngeal carcinomas.

We have analysed 22 nasopharyngeal carcinomas (NPCs) for expression of the small nuclear Epstein-Barr virus (EBV)-encoded RNAs (EBERs) and for immunohistologically detectable overexpression of p53. In situ hybridization demonstrated expression of the EBERs in 13 undifferentiated NPCs while nine squamous cell NPCs were EBER-negative. These results therefore confirm our previous DNA-DNA in situ hybridization studies and demonstrate that in the nasopharynx EBV is exclusively associated with undifferentiated but not with squamous cell carcinomas.

Computerized measurement of ciliary beat frequency.

We describe how ciliary beat frequency (CBF) of human respiratory epithelium in vitro can be robustly and quickly measured. The proven photometric technique has been improved by using a microcomputer to calculate and display the results. The software, which runs on an IBM-compatible PC, was developed using Borland Turbo Pascal and employs a fast Fourier transform routine to derive the CBF.

Ciliary ultrastructure in nasal brushings.

Normal ciliary ultrastructure is thought to be necessary for effective function. There has been little or no attempt to quantify ultrastructural abnormalities in nasal disease and assess their significance. In this study we measured nasal ciliary function and examined ciliary ultrastructure in nasal brushings from 35 patients with perennial nasal symptoms refractory to treatment.

Ciliary beat frequency of nasal and middle ear mucosa in children with otitis media with effusion.

Impaired mucociliary function of respiratory tract mucosa is associated with secretory otitis media in some well recognized syndromes. Ciliary activity per se may now be assessed directly by determination of ciliary beat frequency by a photoelectric technique. 49 children with otitis media with effusion undergoing surgical treatment were studied.

Factors affecting ciliary function in vitro: a preliminary study.

Nasal ciliary function forms an important defence mechanism within the upper respiratory tract which has largely been ignored in recent years. The effects of various drugs used extensively in the treatment of diseases of the nose have not been fully established. Furthermore, the physiological control of ciliary activity is unclear.

An animal investigation into the effects of tympanostomy on middle ear mucociliary function and cilia.

The effect of tympanostomy on guinea-pig middle ear mucosa with particular reference to mucociliary function and cilia was investigated. 13 guinea-pigs were used; 5 acted as the control group with no surgical intervention whilst the other 8 had perforations made in one tympanic membrane. 6 weeks later an attempt was made to measure mucociliary function in all the ears, but this was unsuccessful.

Nasal mucociliary function: comparison of saccharin clearance with ciliary beat frequency.

Mucociliary clearance as measured by saccharin clearance time is in part dependent on the physiological characteristics of mucus and is partly dependent on ciliary function. This study compared the relationship between saccharin clearance time and ciliary beat frequency in 44 patients attending a rhinology clinic. Whilst saccharin clearance time may be used as a screening test for ciliary function there was no clear linear relationship between mucociliary clearance and ciliary beat frequency.

Mast cell numbers in the mucosa of the inferior turbinate in patients with perennial allergic rhinitis: a light microscopic study.

The number of mast cells in the inferior turbinate from patients with perennial allergy due to house dust mite were compared with ten normal controls. Ten random high powered fields were counted in the epithelium and the submucosa in samples which had been divided into two and fixed either in aqueous formalin or Carnoy's fixative. The sections from each block were stained with either Azure A or Chloroacetate esterase technique.

Growth of preschool coloured children in Cape Town.

The growth of a random sample of coloured children in Cape Town was studied from birth until 5 years. At birth they were relatively light and short for gestational age. Size at birth correlated with social class.

Fanconi's anaemia and post-cricoid carcinoma.

A case of post-cricoid carcinoma, occurring in a patient with Fanconi's anaemia is presented. The case illustrates the rare association of the two diseases. The problems with the management of such a case are discussed.

Flat condylomata of the penis presenting as patchy balanoposthitis.

Fifty patients presenting with either primary or recurrent patchy balanoposthitis which became aceto-white after the application of 5% acetic acid underwent biopsy. Microbiological screening, including Grocott staining of the biopsy material for fungal hyphae was performed. Forty nine biopsies showed marked koilocytosis suggestive of human papilloma virus (HPV) infection, and of these, only three showed fungal hyphae.