Laryngotracheoplasty using the Medpor implant: an animal model.

OBJECTIVE: The Medpor implant (Porex Surgical, College Park, GA) is a porous polyethylene that has been used safely in areas in the head and neck. Medpor allows the in-growth of capillaries and soft tissue and reduces the risk of infection and extrusion. This study was undertaken to evaluate the use of the Medpor implant in laryngotracheal reconstruction and to compare epithelialization of the trachea following two different methods at various intervals. METHODS: Eight beagles were divided into two groups. The first group underwent laryngotracheoplasty using the Medpor implant only, whereas the second group had the Medpor implant lined with a strap muscle flap. One animal from each group was sacrificed at 5-, 7-, 9-, and 12-month intervals. The degree of stenosis, inflammation, and epithelialization were compared. RESULTS: The Medpor implant can safely be used to reconstruct the trachea in this animal model. There is less stenosis and better epithelialization when the Medpor implant is lined with a strap muscle flap. CONCLUSION: The Medpor implant can safely be used in laryngotracheal reconstruction in beagles.

A pilot study of the relationship between Down's syndrome and hearing loss.

OBJECTIVE: Hearing loss is one of the most common disabilities in children with Down's syndrome. The objective of this study is to investigate the incidence and types of hearing loss in Down's syndrome patients. METHODS: Twenty-six subjects with Down's syndrome aged between 2 and 17 year old were evaluated during the year 1998, referred randomly by the Pediatric Department and the Down's Syndrome Centre. Screening audiological procedures were used to evaluate these patients, which include behavioral audiometry, play and pure tone audiometry, tympanometry and ABR, which is the measurement of the activity of the auditory pathway structures from the distal auditory nerve to the midbrain using clicks or tonepips. RESULTS: The study showed that 35% were found to have normal hearing compared to 4% found to have sensorineural hearing loss, while the majority of patients were found to have a conductive hearing loss (50%). CONCLUSION: Hearing evaluation of children with Down's syndrome revealed a high prevalence of conductive hearing loss. This study proposed that this might be attributed to eustachian tube dysfunction and middle ear ciliary malfunction. Further diagnostic studies need to be carried out.

Transverse sinus thrombosis and venous infarction of the brain following unilateral radical neck dissection.

Radical neck dissection is one of the commonest procedures performed in any unit dealing with head and neck surgery. Intracranial complications following this procedure are uncommon. Transverse sinus thrombosis and venous infarction of the brain following unilateral radical neck dissection have not been reported in the literature. We present a case in which this complication occurred following an uneventful radical neck dissection.

Inflammatory myofibroblastic tumour of the tonsil.

Inflammatory myofibroblastic tumours are aetiologically enigmatic, nosologically confusing and biologically unpredictable lesions. The lungs are the organs of apparent predilection. These tumours have also been documented in a number of extrapulmonary sites including the head and neck. So far only two cases of inflammatory myofibroblastic tumour of the tonsil have been reported in the English literature. We document another case, occurring in a 41-year-old man with history of cadaveric renal transplant nine years ago. A comprehensive review of the literature is also presented.