An unusual case of primary extranodal non-Hodgkin's lymphoma in the muscles of facial expression

Understanding the aetiology and resolution of chronic otitis media from animal and human studies

Inflammation of the middle ear, known clinically as chronic otitis media, presents in different forms, such as chronic otitis media with effusion (COME; glue ear) and chronic suppurative otitis media (CSOM). These are highly prevalent diseases, especially in childhood, and lead to significant morbidity worldwide. However, much remains unclear about this disease, including its aetiology, initiation and perpetuation, and the relative roles of mucosal and leukocyte biology, pathogens, and Eustachian tube function. Chronic otitis media is commonly modelled in mice but most existing models only partially mimic human disease and many are syndromic. Nevertheless, these models have provided insights into potential disease mechanisms, and have implicated altered immune signalling, mucociliary function and Eustachian tube function as potential predisposing mechanisms. Clinical studies of chronic otitis media have yet to implicate a particular molecular pathway or mechanism, and current human genetic studies are underpowered. We also do not fully understand how existing interventions, such as tympanic membrane repair, work, nor how chronic otitis media spontaneously resolves. This Clinical Puzzle article describes our current knowledge of chronic otitis media and the existing research models for this condition. It also identifies unanswered questions about its pathogenesis and treatment, with the goal of advancing our understanding of this disease to aid the development of novel therapeutic interventions.

Summary: Chronic middle ear inflammation is a common disease. Animal models, and in particular mouse models, have been used to elucidate some potential mechanisms, including dysfunction in immune signalling, mucociliary function or Eustachian tube function.

[Non-Hodgkin lymphoma of maxillofacial soft tissue: a report of two cases and review of the literature]

The extranodal non-Hodgkin lymphomas of maxillofacial soft tissues are rare. We report two cases of maxillofacial soft tissue non-Hodgkin lymphoma treated with chemotherapy followed by localized radiotherapy with complete remission after 3 and 6 months. We study the clinical, radiological and histopathological features as well as the treatment and the prognosis of extranodal non-Hodgkin lymphomas maxillofacial muscles.

Primary extranodal non-Hodgkin's lymphoma involving masseter and buccinator muscles

Extranodal lymphoma of the head and neck comprises a heterogeneous group of tumours with different histological types, modes of presentation and prognosis. Lymphomatous involvement of skeletal muscles and particularly muscles of mastication and facial expression is extremely rare, but primary muscle lymphoma should be considered in the differential diagnosis of muscle masses. This article highlights clinical, radiological and histopathological findings of primary extranodal non-Hodgkin's lymphoma involving masseter and buccinator muscles in an immunocompetent patient.

Does copying clinical or sharing correspondence to patients result in better care?

BACKGROUND

Communication between healthcare professionals and patients is suboptimal and the measures to improve patient satisfaction such as sharing correspondence have been reported in different settings.

METHODS

A review of published literature was undertaken to specifically examine patient satisfaction and the professional healthcare provider experience across a range of specialities and settings.

RESULTS

Patients generally report high rates of satisfaction when receiving copies of correspondence although both patient and professional experience within general psychiatry indicates that further consideration may be required before routinely adopting the practice of copying letters in this discipline.

CONCLUSIONS

Dictating letters in the presence of patients can improve patient satisfaction accuracy and modalities such as the use of audio or video recordings may be useful in more specialised settings.