ABSTRACT
Reports indicate that the incidence of multiple primary tumours in head and neck cancers is high. However, most of these tumours are either metachronous primary or secondary tumours of the same histopathological type. The development of a synchronous primary squamous cell skin cancer of the nose and an in-situ vocal cord carcinoma is something unusual. We present the case of a patient with a primary neoplasm along the lateral side of the nose up to the bone of the pyramid, including the skin of the inner side of the nose and an infiltration of the inferior nasal concha on the right side, together with a small synchronous primary lesion of the left vocal cord. To the best of our knowledge the case described is the first in the English medical literature and we discuss the complete management of synchronous head and neck malignancies, emphasising the importance of panendoscopy in the prevention of pitfalls in diagnosis and the therapeutic procedure.
Subject(s)
Carcinoma in Situ/diagnosis , Laryngeal Neoplasms/diagnosis , Neoplasms, Multiple Primary/diagnosis , Nose Neoplasms/diagnosis , Skin Neoplasms/diagnosis , Vocal Cords , Carcinoma in Situ/pathology , Carcinoma in Situ/radiotherapy , Carcinoma in Situ/surgery , Combined Modality Therapy , Endoscopy , Humans , Laryngeal Neoplasms/pathology , Laryngeal Neoplasms/radiotherapy , Laryngeal Neoplasms/surgery , Laryngoscopy , Male , Middle Aged , Neoplasm Staging , Neoplasms, Multiple Primary/pathology , Neoplasms, Multiple Primary/radiotherapy , Neoplasms, Multiple Primary/surgery , Nose Neoplasms/pathology , Nose Neoplasms/radiotherapy , Nose Neoplasms/surgery , Radiotherapy, Adjuvant , Skin Neoplasms/pathology , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgery , Vocal Cords/pathology , Vocal Cords/surgeryABSTRACT
OBJECTIVES: The aim of this study was to examine extended high-frequency (EHF) hearing in patients with acoustic trauma. DESIGN: A prospective, case-control study in a group of soldiers with acoustic trauma caused by shooting practice during basic training. SETTING: Tertiary referral centre. PARTICIPANTS: A total of 39 young soldiers hospitalized for hearing loss and tinnitus following exposure to weapon impulse noise were studied. Conventional audiometry in the frequency range 0.25-8 kHz and EHF audiometry in the frequency range 9-20 kHz were performed, both on admittance and before discharge. Thirty healthy recruits of similar age and sex were used as controls. MAIN OUTCOME MEASURES: Pure-tone threshold changes documented by conventional and EHF audiometry. RESULTS: The most significant differences in pure-tone thresholds on initial testing were found in the frequency range 0.25-11.2 kHz, and especially in the 4-8 kHz region. Reduction in thresholds across most frequencies was observed after treatment, although recovery was partial in most cases. CONCLUSIONS: The EHF audiometry adds no significant additional information to conventional pure-tone audiometry in assessing and monitoring noise-induced hearing loss.
