Vocal results after endoscopic cordectomy have not yet been well defined. The aim of this study was to assess the vocal function of patients who had undergone CO2 laser cordectomy.

Retrospective, observational and control group study, conducted in a tertiary care medical department.

One hundred and thirty-five male patients (age range 36–83 years) underwent different types of endoscopic cordectomy. Forty age-matched, euphonic male subjects were selected as controls. Patients were classified according to the main site of the phonatory neo-glottis. Outcome measures were maximum phonation time, vocal intensity and harmonic/noise ratio. Mann–Whitney and rank Spearman tests were used for statistical analysis.

Findings indicated statistically significant differences for all parameters, comparing patients and controls (p<0.001), and a direct positive relation between type of functional compensation and outcome measures in the study patients (p<0.001).

The results indicate that functional compensation and outcome measures were related, and that no functional compensation enabled the study patients to achieve a voice quality comparable with that of controls.

The epidermal growth factor receptor (EGFR) and type 1 insulin-like growth factor receptor (type 1 IGF receptor or IGF1R) have played an important role in the growth and apoptosis of cancer. The RNA interference (RNAi) technique can suppress gene expression, but the effects of dual silencing of EGFR and type 1 IGF receptor have not been well understood.

pU6-EGFR-shRNA-1, pU6-EGFR-shRNA-2, pU6-IGF1R-shRNA-1 and pU6-IGF-1R-shRNA-2 plasimd vectors were transfected to the nasopharyngeal cancer cells. Seven groups were selected for the study. The protein and downstream protein expression were assessed by Western blot. Apoptosis was determined via flow cytometry. Meanwhile, chemosensitivity of nasopharyngeal cancer cell lines transfeced to chemotherapeutic drugs were carried out by MTT.

In dual silencing of EGFR and IGF-1R, the protein expression much more was decreased than single silencing of EGFR or IGF-1R, but the cell apoptosis much more is increased than single silencing EGFR or IGF-1R. Dual silencing of EGFR and IGF-1R enhanced chemosensitivity to anticancer drugs, compared with single silencing of EGFR or IGF-1R.

Dual silencing of EGFR and IGF-1R are capable of suppressing EGFR and IGF-1R expression of the nasopharyngeal cancer cell and can promote apoptosis and increase the cell sensitivity of anticancer drug. The dual silencing of genes RNAi technique is significantly better than a single gene.

To evaluate the benefits of chest computed tomography and X-ray as screening tools in patients with newly diagnosed head and neck squamous cell carcinoma, to determine the incidence of lung metastases or synchronous pulmonary lesions, and to evaluate factors associated with positive radiological findings.

Five-year, retrospective survey of all newly diagnosed cases of head and neck squamous cell carcinoma.

We included 102 patients (63 men and 39 women), with a mean age of 67 years (range 33–91 years). The incidence of pulmonary involvement was 17 per cent. The sensitivity and specificity of computed tomography were 100 and 89.8 per cent, respectively. For chest X-ray, the sensitivity was 35.7 per cent and the specificity 92.7 per cent. The accuracy of computed tomography was 91.5 per cent and that of chest X-ray 83.1 per cent. There was a clear correlation between higher nodal stage and larger tumour with the development of distant metastases. In patients with a positive chest computed tomography scan, 86 per cent had T3 or T4 tumours, in contrast to 38 per cent of those with a negative chest scan (p < 0.05). In addition, 71 per cent of patients with positive findings had N2 or N3 nodal disease, compared with 29 per cent of those with negative findings (p < 0.05).

There is currently no consensus on the use of chest X-ray and computer tomography for screening newly diagnosed cases of head and neck squamous cell carcinoma. We recommend routine scanning of high-staged head and neck squamous cell carcinoma. The National Institute of Health and Clinical Excellence guidelines should be reappraised.

Several studies have implied that patients' quality of life stabilises six months after undergoing total laryngectomy. However, these studies may well have overlooked persistent short term variations in patients' quality of life. The aim of this study was to assess the impact of seasonal change (i.e. summer vs winter) on the quality of life of patients following total laryngectomy.

A prospective, cross-sectional study of recurrence-free laryngectomy patients was performed, using the European Organization for Research and Treatment of Cancer (version three) QLQ-C30 questionnaires (EORTC QLQ-C30), during January 2004 (i.e. winter), August 2004 (summer) and January 2005 (winter).

Thirty-six patients were entered into the study. The response rate was 70.3 per cent. Patient's time elapsed since surgery varied from six months to 12 years. In all questionnaire domains, responses seemed remarkably consistent over time.

No statistically significant differences were found between summer and winter scores in all the domains analysed by the EORTC QLQ-C30.

Carotid body tumours are rare lesions which are familial in 10 per cent of cases. In this paper, we demonstrate the clinical applicability of predictive genetic testing for familial carotid body tumours.

We report a case manifesting with multiple carotid body tumours, in which subsequent genetic testing demonstrated a germline mutation which could be traced across generations. We review the diagnosis and management of carotid body tumours in the familial setting, together with the strategies presently available to screen individuals from susceptible families.

The recent advent of a predictive genetic test for familial carotid body tumours offers a novel means of pre-selecting those at risk, so as to minimise screening costs and patient morbidity. Early diagnosis of lesions is essential to allow early intervention, reducing surgical morbidity and progression to malignancy.

To draw attention to the possibility of an aberrant internal carotid artery behind an intact tympanic membrane presenting as a middle-ear mass.

A 48-year-old female patient presented with a hearing impairment in her right ear that had started 10 years ago. Otoscopic examination revealed a retro-tympanic mass. A high resolution computed tomography scan of the temporal bone was performed that showed protrusion of the internal carotid artery into the middle ear. Magnetic resonance angiography provided excellent visualisation of the internal carotid artery. Finally, a diagnosis of an aberrant internal carotid artery was made and the patient was evaluated with a conservative approach.

All retro-tympanic masses should ideally be visualised with a computed tomography scan of the temporal bone before any middle-ear surgery, such as tympanotomy and biopsy, and it is essential for every otologist who undertakes myringotomy and middle-ear surgery to know about this rare entity.

To describe a unique presentation of a predominantly extracranial glomus faciale tumour. To discuss the role of imaging in the differential diagnosis and evaluation of a hypervascular parotid mass. To review the previous literature concerning the glomus faciale tumour.

A 54-year-old woman presented with a six-month history of facial weakness, pain and a parotid mass. Ultrasound revealed a hypervascular parotid mass and pre-operative core biopsy suggested a paraganglioma. Computed tomography defined its deep extent and demonstrated involvement of the petrous temporal bone along the descending portion of the facial nerve canal with a pattern of permeative lucency. A tumour was surgically removed which arose from the facial nerve from the second genu to the proximal divisions within the parotid gland and histology confirmed a paraganglioma.

A facial nerve glomus faciale tumour should be considered in the differential diagnosis of a hypervascular parotid mass and may present in a predominantly extracranial location. Computed tomography will prove helpful in such a case in order to limit the differential diagnosis and to define the extent of skull base involvement.

We report a case of Masson's pseudotumour or intravascular papillary endothelial hyperplasia presenting in the ethmoid sinus.

We present a diagnostically challenging case of Masson's pseudotumour of the ethmoid sinus presenting with persistent epistaxis and a review of the available literature.

Intravascular papillary endothelial hyperplasia is a benign, reactive lesion first described by the French pathologist Pierre Masson in 1923. It can lead to diagnostic uncertainty due to its close resemblance clinically, radiologically and histopathologically to angiosarcoma.

Oral involvement is a common manifestation of acquired immunodeficiency syndrome related Kaposi's sarcoma, and it occurs in approximately one-third of afflicted patients.

We report an unusual case of Kaposi's sarcoma of the hard palate which invaded the underlying maxillary bone.

The patient underwent excisional biopsy and was subsequently treated with localised radiation and systemic chemotherapy including liposomal doxorubicin.

The presentation, differential diagnosis, radiographic appearance and management of this serious complication are discussed. Our case highlights the need for a multidisciplinary approach, consisting of ENT, oncology and infectious disease consultation, to ensure appropriate management of maxillofacial, intraosseous, acquired immunodeficiency syndrome related Kaposi's sarcoma.

Extraskeletal Ewing's sarcoma is a rare tumour of mesenchymal origin, which is histologically similar to primary osseous Ewing's sarcoma. The majority of cases have been reported in the lower limb and paravertebral region, with a few cases reported in the neck.

We report a patient with extraskeletal Ewing's sarcoma presenting with a right-sided neck mass, vocal fold palsy and T1 nerve root involvement. The detection of characteristic features on computed tomography and magnetic resonance imaging scans, in conjunction with histological analysis, was required to make the diagnosis.

Radiological imaging demonstrated that the tumour was infiltrating through the neural exit foramina of the lower cervical nerve roots, with encasement of the vertebral artery. The patient was managed with combination chemotherapy for systemic control and irradiation for local control.

Extraskeletal Ewing's sarcoma has a propensity to occur in a paravertebral location, being found rarely in the cervical region, and has a predilection to infiltrate through neural exit formina. Computed tomography and magnetic resonance imaging are helpful in the diagnosis of this rare tumour.

We report a rare case of chronic facial pain following sclerotherapy for intraparotid haemolymphangioma, thereby highlighting an important clinical consideration when advising this treatment option as an alternative to surgery in the head and neck.

Case report, with a review of relevant literature.

Sclerotherapy of lymphangiomata is well reported in the literature. Unusually, our young patient with an intraparotid haemolymphangioma experienced severe, chronic pain following intralesional injection of sodium tetradecyl sulphate, which required management by a specialist pain service. We discuss the technique of sclerotherapy for such lesions, and also discuss the potential side effects of two agents commonly used in our centre: OK 432 and sodium tetradecyl sulphate.

Non-surgical treatments of lymphangiomata and venous vascular malformations are not without complication. Both patient and clinician should be aware of this, and of the other potential side effects of sclerotherapy, prior to its use in the head and neck.

A case of solitary extracranial cysticercosis of the parotid gland is reported. A discussion concerning the clinical features, imaging modalities, diagnostic methods and management of cysticercosis, along with a review of relevant literature is also presented.

A young female patient presented with features resembling acute parotitis. Solitary cysticercosis of the parotid gland was diagnosed, based on fine needle aspiration cytology and radiological investigations. Medical therapy was effective, consequently surgery was deferred.

This is the first report of solitary extracranial cysticercosis of the parotid gland. A high index of suspicion for such parasitic infestations is essential even in non-endemic areas due to the ease of worldwide travel.

We present a rare case of laryngeal mucosal neuroma, and its management, in a patient with multiple endocrine neoplasia type 2 B.

We present a case report and a review of the world literature concerning laryngeal mucosal neuroma and its association with multiple endocrine neoplasia type 2 B.

An 11-year-old girl was diagnosed with multiple endocrine neoplasia type 2 B on the basis of clinical presentation and genetic testing. Several years later, whilst undergoing general anaesthesia for routine dental treatment, the anaesthetic team were concerned by masses on the patient's vocal folds, which they felt could compromise her airway. The ENT team were informed of the situation and an urgent microlaryngoscopy was performed. Biopsies taken at the time were reported as showing benign mucosal neuromas. A few months later, the patient presented with acute stridor, and flexible nasal endoscopy revealed recurrence. This episode settled without surgery.

Multiple endocrine neoplasia syndromes are inherited autosomal cancer syndromes. Laryngeal mucosal neuroma can manifest as potentially airway compromising lesions in patients with multiple endocrine neoplasia type 2 B. Although apparently rare, we feel this case highlights the need for vigilance and prompt recognition of this treatable condition.