Routine nasopharyngeal biopsy in adult secretory otitis media.

This study was to determine whether routine examination under anaesthesia and nasopharyngeal biopsy in adults presenting with deafness due to secretory otitis media (SOM) is necessary for detection of nasopharyngeal malignancy. Two patient groups were studied. The first comprised 72 adults with SOM. Of these patients, 3 had nasopharyngeal tumours, 2 of whom also had cervical lymphadenopathy. The prevalence of malignancy in patients with SOM but no other suspicious signs was 1/72 (1.4%). The second group comprised 66 patients receiving treatment for nasopharyngeal neoplasms. In this group, 8 patients had SOM at presentation, 7 of whom had other features suspicious of malignancy. SOM as the sole presenting feature of nasopharyngeal malignancy was 1/66 (1.5%). EUA and biopsy of the nasopharynx is a cost effective investigation which continues to be indicated in adults presenting with deafness due to SOM.

Clinical or rhinometric assessment of the nasal airway--which is better?

Multiple regression analysis was used to examine the relationship between clinical and rhinometric assessment of the nasal airway and the subjective nasal airway. Clinical examination and rhinometry correlated poorly with the subjective overall nasal airway. Analysis of the data obtained on the differences between the right and the left nasal cavities showed that adding rhinometry did not improve on clinical examination in predicting the patient's subjective sensation of nasal airway.

Clinical and rhinometric assessment of the nasal airway--do they measure the same entity?

Multiple regression analysis was used to investigate the relationship between clinical examination of the nasal airway, precisely defined using 16 simple and 9 derived parameters, and active anterior rhinometry. Clinical examination and rhinometry were found to correlate poorly and must be regarded as measuring 2 distinct though related entities.

The nasal cycle and clinical examination of the nose.

A recent study from this department demonstrated the importance of interobserver variation in examination of the nasal airways. Part of this variation may have been due to the mucosal changes of the nasal cycle. We investigated this suggestion and assessed the correlation between anterior rhinometry, a patient questionnaire and 4 different methods of recording the findings of clinical examination. Applying the Kappa statistic we found there was no significant reduction in interobserver variation despite eliminating nasal cycle influence.

Observer variation in clinical examination of the nasal airway.

There has been no standardization of clinical assessment of the nasal airway between different clinical trials. In order to evaluate the reproducibility of tests in use in current clinical practice, a pre-trial inter-observer assessment of the nasal airway tests was made and an intra- and inter-observer assessment was made in 25 patients. Differing degrees of correlation were demonstrated, using the Kappa statistic. Suggestions are made to enable improved standardization of clinical examination of the nasal airways for clinical trials.

Submucosal diathermy of the inferior turbinate and the congested nose.

Surgical correction of the congested nose is frequently attempted. In the absence of a septal deformity, engorgement of the inferior turbinate is usually held to be the culprit, and various procedures have been advocated to counter this problem. Submucosal diathermy to the inferior turbinates is widely practised, but relatively little has been published about it. 204 patients who underwent submucosal diathermy of the inferior turbinates between 1977 and 1983 have been studied. 60 patients have been followed up by questionnaire, for periods ranging from 1 to 5 years since surgery. Surgery was of benefit in up to 72% of cases. Surgical technique and the problems of patient selection and assessment are discussed.

Metastatic carcinoma of the external auditory meatus secondary to carcinoma of the rectum. A case report.

A case of metastatic carcinoma of the external auditory meatus secondary to a primary adenocarcinoma of the rectum is presented, together with histological evidence of the association of these tumours.