The Laryngoscope
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We here present a clinical study of 37 patients with Meniere's syndrome. Meniere's syndrome can occur subsequent to and in some cases simultaneously with chronic otitis media. ⋯ Endolymphatic hydrops is described in pathological cases of labyrinthitis and in 11 human temporal bone cases where there is evidence of chronic otitis media in the absence of visible labyrinthitis. A discussion of pathogenic factors includes considerations of quantity of endolymph due to hypodevelopment of the endolymphatic duct and sac related to mastoid hypocellularity and otomastoiditis in childhood and to other endolymphatic malabsorptions and also considerations of endolymph quality which can influence endolymph production as well as absorption.
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The clinical course of five patients with varying degrees of laryngeal trauma are presented to illustrate the predictive value of computed tomography (CT) in the management of laryngeal trauma. Computed tomography visualizes well the laryngeal skeleton, soft tissues and airway in the injured larynx. Cost effectiveness of CT scanning is an important consideration, and the authors have chosen their case examples to restrict this examination to selected patients.
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Eighty-five cases of cancer of the tongue treated with total glossectomy are presented; 82 had a squamous carcinoma. The majority had a large primary with no disease in the neck. Thus only 6 patients required concurrent therapeutic radical neck dissection. ⋯ Local recurrence rate was 42% for predominantly posterior lesions and 27% for anterior lesions. The speech, though not quite articulate, was fairly understandable. Thus, in cases of total glossectomy preservation of larynx is worthwhile and justifiable except when involved with disease, when the risk of even minor degrees of aspiration is high (elderly, frail individuals) and with associated extensive pharyngeal resection hampering the swallowing machanism.
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Cavernous sinus thrombosis is a serious life threatening condition which usually results from midfacial skin infections. Preantibiotic era mortality rates of 80% have improved markedly because of an early awareness of the condition and prompt initiation of parenteral antibiotics. Sphenoid sinusitis is an uncommon associated cause of cavernous sinus infection and is itself a rare and elusive clinical problem. A case of sphenoid sinusitis and concurrent cavernous sinus thrombophlebitis is presented to highlight the clinical diagnostic considerations with special emphasis on bilateral eye signs as indicators of the impending thrombophlebitic process.