Metastatic tumours in the maxillary sinus. A report of two cases and a review of the literature

We present two further cases of metastasis in the antrum. A review of the literature reveals renal carcinoma as the commonest primary tumour. When an adenocarcinoma of the antrum is diagnosed, an intravenous pyelogram should be performed to exclude a renal primary. This investigation, if negative, should be repeated during follow-up. The possibility of a bronchial tumour should be investigated in patients with an anaplastic tumour in the antrum.

Inverted papilloma of the nose. Some aspects of aetiology

A study of 43 cases of inverted papilloma of the nose has been made. These cases, arising from a moderately well-defined geographical area, were seen between 1955 and 1980. A detailed clinical and histological review was made in each case. No correlation has been found between any of the variable histological features and the potential of a particular papilloma to recur. The overall incidence of transformation to carcinoma is low, even after multiple recurrences. The findings suggests that there may be an extrinsic factor contributing to the causation of these tumours.

Spontaneously regressing nodular fasciitis of the neck

Nodular fasciitis, a rare but definite clinico-pathological entity, has been described as a tumourous nodule which occurs predominantly in the subcutaneous fat and fascia, but may also rarely involve the deep fascia and contiguous muscle. It has been called subcutaneous fibromatosis, pseudosarcomatous fasciitis, proliferative fasciitis, infiltrative fasciitis, etc. Konwaler and his associates were the first to describe this condition in the name of 'pseudosarcomatous fasciitis' in 1955. Stout (1961) thinks that this term is most appropriate because the lesion simulates the appearance of sarcoma histologically, although it is not malignant, and because it usually shows some inflammatory stigmata. The term 'nodular fasciitis' was first used by Shuman (1961) and since then has been used by most authors, and therefore is used here. This paper describes a case of nodular fasciitis of the neck, unusual for its size and site, which spontaneously regressed; and it also reviews the cases described in the English Literature. We feel it is important to bring to the attention of otolaryngologists the existence of this pseudosarcomatous soft-tissue lesion (which may present in the neck), in order that it and malignant lesions may be properly differentiated and treated.

An electrocochleographic study of the effects of lignocaine on patients with tinnitus

Twenty patients complaining of tinnitus were investigated by extra tympanic electrocochleography (ECochG). Baseline ECochG recordings were carried out, followed by sequential recording after injections first of saline, as a control, and then after lignocaine in the dosage 1.5 mg/kg body weight. Significant improvement in the tinnitus was seen in 13 patients after lignocaine compared with only 3 patients after saline. A statistically significant reduction in the amplitude of the action potential was seen after the lignocaine injection. Our results confirm the views of Melding et al. that the effect of lignocaine is on the neuronal activity of the auditory pathway.

Malignant neoplasms of the nose and paranasal sinuses. A survey of cases treated in a regional centre

A review of 250 patients with malignant disease of the nose and paranasal sinuses treated over a 20 year period is presented. Treatment could be divided broadly into three groups consisting of subradical surgery plus radiotherapy; a drainage procedure plus radiotherapy and radiotherapy alone. Three and 5 year survival rates are presented for each mode of treatment for tumours originating in four anatomical sites. In tumours of the maxillary antrum the 5 year survival was significantly higher in patients who underwent a partial maxillectomy or palatal fenestration before radiotherapy. In the other anatomical sites the survival rates were not significantly different. Although this is an uncontrolled retrospective review, it does add further data to that already published on this uncommon but difficult management problem.