Showing papers by "Neil Tolley published in 1994"
TL;DR: Primary infection of the larynx with Aspergillus spp.
Abstract: Primary infection of the larynx with Aspergillus spp. is rare. It is more commonly seen as part of a wider infection involving the respiratory system in an immunocompromised host. In noncompromised patients laryngeal aspergillosis may represent colonization rather than invasion requiring no systemic anti-fungal treatment. The diagnosis is important as the presenting symptoms are suggestive of malignant laryngeal disease. We present a 62-year-old man with a short history of hoarseness. Direct laryngoscopy and biopsy confirmed the diagnosis of aspergillosis. Clinical presentation, diagnosis and the important pathological characteristics of this infection are discussed.
43 citations
TL;DR: An 83-year-old man with a left tonsillar fossa lipoma is presented and clinical presentation, management and a literature review are discussed.
Abstract: Lipomas are common benign connective tissue tumours composed of adult adipose tissue. They are relatively rare in the upper aerodigestive tract, although they occur with considerable frequency in other areas, particularly in the subcutaneous tissues of the neck. Although there are several reports of this tumour occurring in the oropharynx, there is no recorded case of a lipoma of the tonsillar fossa. An 83-year-old man with a left tonsillar fossa lipoma is presented. Clinical presentation, management and a literature review are discussed.
18 citations
TL;DR: A 34-year-old female with a six-week history of hearing loss and a unilateral parotid swelling is presented with Wegener's granuloma, a systemic necrotizing vasculitis which predominantly affects the upper and lower respiratory tracts and kidneys.
Abstract: Wegener's granuloma is a systemic necrotizing vasculitis which predominantly affects the upper and lower respiratory tracts and kidneys. The nose and paranasal sinuses are often the first or main sites to be affected. Equally ear involvement is common and a recognized early manifestation of the disease. Salivary gland involvement is rare and is usually part of more widespread systemic involvement.We present a 34-year-old female with a six-week history of hearing loss and a unilateral parotid swelling. One year previously she was diagnosed as having myalgic encephalomyelitis following a long period of post-viral malaise. The case points to the difficulties encountered when Wegener's granuloma presents in an unusual and varied way. A high index of suspicion coupled with early diagnosis and treatment is essential. The patient made a good recovery.
16 citations
TL;DR: In this study of 82 patients with non-irradiated T3 glottic carcinomas managed by total laryngectomy, 45% had been clinically understaged and were pT4, suggesting vigilance against understaging is required.
Abstract: Controversy surrounds the relative merits of radiotherapy and laryngectomy for the treatment of T3 glottic carcinoma. In this study of 82 patients with non-irradiated T3 glottic carcinomas managed by total laryngectomy, 45% had been clinically understaged and were pT4. There was a significant association between subglottic extension and tracheostomy with understaging. A trend to understage anterior commissure tumours was also evident. Nodal status did not influence understaging and therefore should not determine the choice of treatment of the glottic primary. Laryngectomy is recommended for patients with subglottic extension or a tracheostomy. If radiotherapy is to be used for the remaining tumours, then vigilance against understaging is required.
9 citations