Clinico-pathological correlation of T3 glottic carcinomas

Controversy surrounds the relative merits of radiotherapy and laryngectomy for the treatment of T3 glottic carcinoma. In this study of 82 patients with non-irradiated T3 glottic carcinomas managed by total laryngectomy, 45% had been clinically understaged and were pT4. There was a significant association between subglottic extension and tracheostomy with understaging. A trend to understage anterior commissure tumours was also evident. Nodal status did not influence understaging and therefore should not determine the choice of treatment of the glottic primary. Laryngectomy is recommended for patients with subglottic extension or a tracheostomy. If radiotherapy is to be used for the remaining tumours, then vigilance against understaging is required.

Quinsy tonsillectomy or interval tonsillectomy--a prospective randomised trial

Fifty-one patients with peritonsillar abscesses were randomised to undergo either quinsy tonsillectomy (QT) or interval tonsillectomy (IT), and the two groups were compared. The QT group lost fewer (10.3 v. 17.9) working days and less blood during the operation (158.6 ml v. 205.7 ml); haemostasis was easier and the operation was technically simpler in this group. There was no significant difference in length of hospital stay and neither group had intra- or postoperative complications. Only 64% of the IT group returned for tonsillectomy. In this study QT had distinct advantages over drainage and IT in the management of peritonsillar abscesses.

Ascariasis and acute otitis media

Ascaris lumbricoides has rarely been implicated in the causation of middle ear disease. An infant who developed acute suppurative otitis media while on antibiotics for an upper respiratory tract infection and who extruded an ascaris worm from the ear is presented. The otitis media subsequently resolved. Our understanding of the pathophysiology of ascariasis in the eustachian tube and middle ear is discussed.

A destructive false aneurysm of the maxillary sinus

A false aneurysm of the internal maxillary artery presented with clinical and radiological features suggestive of a malignant tumour of the maxillary sinus. This case illustrates a complication of antral lavage and an unusual clinical, radiological and pathological entity.