Recent Advances in Otolaryngology 8 (Recent Advances Series)

This title covers the latest developments in Otolaryngology and covers such topics as Molecular Biology of Head and Neck SCC and Image Guided Surgery. The contributors are recognized experts in their field and they provide in-depth reviews of their areas with 'key points for clinical practice'. Recent Advances in Otolaryngology 8 is recommended to all practicing and resident Otolaryngologists, and candidates preparing for the FRCS examinations. Contents 6 Contributors 8 1 MRI of cholesteatoma 10 CT IMAGING OF CHOLESTEATOMA 12 MRI OF CHOLESTEATOMA 14 MRI OF CONGENITAL CHOLESTEATOMA 16 MRI OF ACQUIRED CHOLESTEATOMA 18 MRI OF POSTOPERATIVE CHOLESTEATOMA 22 MRI OF PRIMARY BONY OBLITERATION TECHNIQUES 27 MRI PROTOCOL 27 CONCLUSIONS 27 2 Bacterial biofilm infections in otology 30 BIOFILM DEVELOPMENT 31 ATTACHMENT 31 GROWTH OF COLONIES 32 DETACHMENT AND RELEASE OF PLANKTONIC CELLS 33 SURVIVAL MECHANISMS WITHIN BIOFILMS 33 PHYSICAL BARRIERS 34 ANTIBIOTIC SEQUESTRATION AND DISRUPTION 34 ALTERED GROWTH RATE OR PERSISTER CELLS 34 EXCHANGE OF GENETIC MATERIAL 34 RELEASE OR RESEEDING 34 NOVEL MECHANISMS 34 BIOFILMS IN OTITIS MEDIA 34 BIOFILMS IN INFECTED CHOLESTEATOMA 35 BIOFILMS AND MIDDLE EAR IMPLANT INFECTIONS 36 BIOFILMS IN CHRONIC OSTEORADIONECROSIS 36 TREATMENT STRATEGIES FOR BACTERIAL BIOFILMS 37 CONCLUSIONS 38 3 Auditory midbrain implant: experimental and clinical results 42 THE INFERIOR COLLICULUS 43 AUDITORY MIDBRAIN IMPLANT 45 ELECTROPHYSIOLOGICAL FEASIBILITY 46 HISTOMORPHOLOGICAL EFFECTS 49 SURGICAL APPROACH 51 CLINICAL FINDINGS IN THE FIRST THREE PATIENTS 53 SURGICAL RESULTS 53 PSYCHOPHYSICAL RESULTS 55 SPEECH RESULTS 58 SUMMARY 60 4 Bilateral cochlear implantation 64 BINAURAL HEARING 64 SPATIAL HEARING 64 INTERAURAL LEVEL AND TIME DIFFERENCES, HEAD SHADOW EFFECT 64 LOCATION OF SOUND SOURCES, PRECEDENCE EFFECT 65 IMPROVED HEARING IN NOISE: BMLD, BILD 65 COCKTAIL PARTY PHENOMENON 65 AUDITORY PATTERN RECOGNITION, RECOGNISING THE ENVIRONMENT 65 BILATERAL COCHLEAR IMPLANTATION 66 A BRIEF HISTORY 66 IMPROVED SPEECH UNDERSTANDING IN QUIET AND IN NOISE 66 (RE-)ESTABLISHING DIRECTIONAL AND SPATIAL HEARING 66 BILATERAL COCHLEAR IMPLANTATION AFTER MENINGITIS 67 SIMULTANEOUS OR SEQUENTIAL IMPLANTATION 67 OPTIMAL TIME FOR BILATERAL IMPLANTATION 68 CONTRA-INDICATIONS FOR BILATERAL SUPPLY 68 ETHICAL, ECONOMIC AND LEGAL CONSIDERATIONS 68 BILATERAL COCHLEAR IMPLANTATION TODAY 69 CONCLUSIONS 69 5 Squamous cell carcinoma of the temporal bone: current evidence for radiotherapy alone and surgery with postoperative radiotherapy 72 AETIOLOGY 72 EPIDEMIOLOGY 74 PEAK INCIDENCE 74 CLINICAL SYMPTOMS 74 CLINICAL SIGNS 75 PATTERNS OF SPREAD 75 MANAGEMENT 75 DIAGNOSIS 75 INVESTIGATIONS 76 STAGING 77 TREATMENT 78 RADIOTHERAPY 78 SURGERY 79 RECONSTRUCTION 81 COMPLICATIONS 82 PROGNOSIS 83 PROGNOSTIC FACTORS 84 NODAL DISEASE 84 HISTOLOGY 84 HISTOLOGICAL POSITIVE MARGINS 84 DURAL AND CEREBRAL INVOLVEMENT 84 CAROTID INVASION 84 DE NOVO SURGERY VERSUS SALVAGE SURGERY 84 RADIATION-ASSOCIATED TUMOUR 85 THE FUTURE 85 6 Reflux and otitis media with effusion 88 DEFINITIONS 88 GER/GERD 88 EER/EERD 88 OTITIS MEDIA 89 OTITIS MEDIA WITH EFFUSION 89 AETIOLOGY OF GERD AND EERD 89 PREVALENCE OF GERD AND EERD 89 MECHANISM UNDERLYING GER 90 PATHOLOGICAL GER/EER 90 PHYSIOLOGICAL MECHANISMS PROTECTING THE OESOPHAGUS 90 PATHOGENESIS OF MUCOSAL INJURY 90 PATHOLOGICAL MECHANISMS CAUSING LARYNGOPHARYNGEAL REFLUX 91 RISK FACTORS FOR GERD/EERD 91 AETIOLOGY OF OME 91 FUNCTIONS OF THE EUSTACHIAN TUBE 91 PATHOGENESIS OF EFFUSION 92 ENDANGERED GROUPS OF PATIENTS 92 RISK FACTORS FOR OME DEVELOPMENT 92 CONSEQUENCES OF OME 92 LINK BETWEEN OME AND REFLUX 92 PREVALENCE OF GERD/PHARYNGEAL REFLUX IN OTOLOGICAL DISORDERS 92 SUCCESS OF ANTIREFLUX TREATMENT 93 MECHANISM OF INTERACTION BETWEEN EER AND OME 93 REFLUXATE COULD PASS THE EUSTACHIAN TUBE 93 INJURY OF MIDDLE EAR EPITHELIUM 94 CONCLUSION 94 CLINICAL FEATURES OF GERD AND EERD 94 REFLUX SYMPTOMS 94 DIFFERENCE PATTERN OF REFLUX DISEASE IN EERD AND GERD PATIENTS 95 DIAGNOSIS 95 OTITIS MEDIA WITH EFFUSION 95 EXTRA-OESOPHAGEAL REFLUX DISEASE 95 LARYNGEAL EXAMINATION 96 LARYNGOSCOPY 96 MONITORING pH 96 METHODS TO DETECT NON-ACIDIC DUODENOGASTRO-OESOPHAGEAL REFLUX 97 ENDOSCOPY 98 OTHER DIAGNOSTIC TOOLS 98 THERAPY 98 OTITIS MEDIA WITH EFFUSION 98 GERD/EERD 98 7 Proteomics and genomics of head and neck squamous cell carcinoma 104 PROTEOMICS 105 EXPRESSION PROTEOMICS 106 COMPARISON OF PROTEOMES 108 CLINICAL APPLICATION OF EXPRESSION PROFILING 110 PROGNOSIS AND TREATMENT RESPONSE 111 GENOMICS 112 DNA MICROARRAY TECHNOLOGIES 112 CLINICAL APPLICATIONS OF MICROARRAY TECHNOLOGY 113 MOLECULAR CLASSIFICATION OF HNSCC 114 TARGETED MANAGEMENT 115 CONCLUSIONS 115 8 Vaccines and immunotherapy in head and neck cancer 120 IMMUNOTHERAPY 121 OVERVIEW OF A TUMOUR VACCINE 121 HEAD AND NECK SQUAMOUS CELL CARCINOMA 122 HUMAN PAPILLOMA VIRUS 122 ROLE OF HPV IN HNSCC 123 HPV VACCINES IN HNSCC 123 DENDRITIC CELL BASED THERAPIES 124 DENDRITIC CELL THERAPIES IN HNSCC 125 EPSTEIN–BARR VIRUS 125 NASOPHARYNGEAL CARCINOMA 126 EBV AND NASOPHARYNGEAL CARCINOMA 126 NASOPHARYNGEAL CARCINOMA IMMUNOTHERAPY 126 ADOPTIVE IMMUNOTHERAPIES FOR NASOPHARYNGEAL CARCINOMA 127 CONCLUSIONS 128 ACKNOWLEDGEMENTS 128 9 Chemoradiotherapy for head and neck cancer 130 CHEMORADIOTHERAPY AND ORGAN PRESERVATION 132 CYTOTOXIC AGENTS 133 IMPROVING RADIOTHERAPY SCHEDULES 134 POSTOPERATIVE CHEMORADIATION FOR HIGH-RISK CANCERS 135 THE ROLE OF ADJUVANT LYMPH NODE DISSECTION 136 IMAGING AFTER CHEMORADIATION 136 A CHANGING ROLE FOR INDUCTION CHEMOTHERAPY 137 NOVEL AGENTS IN COMBINATION WITH RADIOTHERAPY 139 ADVANCES IN RADIOTHERAPY 139 3-D CONFORMAL RADIOTHERAPY 139 INTENSITY-MODULATED RADIOTHERAPY 140 CONCLUSIONS 141 10 Image-guided surgery in paranasal sinus and skull base surgery 146 ACCURACY 146 CT–MRI FUSION 149 INTRA-OPERATIVE UPDATING OF RADIOLOGICAL INFORMATION 151 TRACKING SYSTEMS 152 CONCLUSIONS 154 11 Questioning the prevalence of chronic rhinosinusitis 156 PROBLEMS WITH ARRIVING AT A DIAGNOSIS 157 MIDFACIAL SEGMENT PAIN 158 CONCLUSIONS 160 12 New treatments in recurrent respiratory papillomatosis 164 SURGERY 166 LASER SURGERY 167 MICRODEBRIDER 168 TRACHEOSTOMY 169 ANAESTHESIA AND PERI-OPERATIVE CARE 169 CENTRALISATION OF CARE 170 ADJUVANT THERAPIES 170 CONTROL OF GASTRO-OESOPHAGEAL REFLUX 171 CIDOFOVIR 171 INTERFERON 172 RIBAVIRIN 173 ACYCLOVIR 173 PHOTODYNAMIC THERAPY 173 INDOLE-3-CARBINOL 174 HEAT SHOCK PROTEINS (HSPS) 174 MUMPS VACCINE 174 CURRENT THERAPEUTIC STRATEGIES 174 HPV VACCINATION 175 CONCLUSIONS 175 Index 180 Contents......Page 6 Contributors......Page 8 1 MRI of cholesteatoma......Page 10 CT IMAGING OF CHOLESTEATOMA......Page 12 MRI OF CHOLESTEATOMA......Page 14 MRI OF CONGENITAL CHOLESTEATOMA......Page 16 MRI OF ACQUIRED CHOLESTEATOMA......Page 18 MRI OF POSTOPERATIVE CHOLESTEATOMA......Page 22 CONCLUSIONS......Page 27 2 Bacterial biofilm infections in otology......Page 30 ATTACHMENT......Page 31 GROWTH OF COLONIES......Page 32 SURVIVAL MECHANISMS WITHIN BIOFILMS......Page 33 BIOFILMS IN OTITIS MEDIA......Page 34 BIOFILMS IN INFECTED CHOLESTEATOMA......Page 35 BIOFILMS IN CHRONIC OSTEORADIONECROSIS......Page 36 TREATMENT STRATEGIES FOR BACTERIAL BIOFILMS......Page 37 CONCLUSIONS......Page 38 3 Auditory midbrain implant: experimental and clinical results......Page 42 THE INFERIOR COLLICULUS......Page 43 AUDITORY MIDBRAIN IMPLANT......Page 45 ELECTROPHYSIOLOGICAL FEASIBILITY......Page 46 HISTOMORPHOLOGICAL EFFECTS......Page 49 SURGICAL APPROACH......Page 51 SURGICAL RESULTS......Page 53 PSYCHOPHYSICAL RESULTS......Page 55 SPEECH RESULTS......Page 58 SUMMARY......Page 60 INTERAURAL LEVEL AND TIME DIFFERENCES, HEAD SHADOW EFFECT......Page 64 AUDITORY PATTERN RECOGNITION, RECOGNISING THE ENVIRONMENT......Page 65 (RE-)ESTABLISHING DIRECTIONAL AND SPATIAL HEARING......Page 66 SIMULTANEOUS OR SEQUENTIAL IMPLANTATION......Page 67 ETHICAL, ECONOMIC AND LEGAL CONSIDERATIONS......Page 68 CONCLUSIONS......Page 69 AETIOLOGY......Page 72 CLINICAL SYMPTOMS......Page 74 DIAGNOSIS......Page 75 INVESTIGATIONS......Page 76 STAGING......Page 77 RADIOTHERAPY......Page 78 SURGERY......Page 79 RECONSTRUCTION......Page 81 COMPLICATIONS......Page 82 PROGNOSIS......Page 83 DE NOVO SURGERY VERSUS SALVAGE SURGERY......Page 84 THE FUTURE......Page 85 EER/EERD......Page 88 PREVALENCE OF GERD AND EERD......Page 89 PATHOGENESIS OF MUCOSAL INJURY......Page 90 FUNCTIONS OF THE EUSTACHIAN TUBE......Page 91 PREVALENCE OF GERD/PHARYNGEAL REFLUX IN OTOLOGICAL DISORDERS......Page 92 REFLUXATE COULD PASS THE EUSTACHIAN TUBE......Page 93 REFLUX SYMPTOMS......Page 94 EXTRA-OESOPHAGEAL REFLUX DISEASE......Page 95 MONITORING pH......Page 96 METHODS TO DETECT NON-ACIDIC DUODENOGASTRO-OESOPHAGEAL REFLUX......Page 97 GERD/EERD......Page 98 7 Proteomics and genomics of head and neck squamous cell carcinoma......Page 104 PROTEOMICS......Page 105 EXPRESSION PROTEOMICS......Page 106 COMPARISON OF PROTEOMES......Page 108 CLINICAL APPLICATION OF EXPRESSION PROFILING......Page 110 PROGNOSIS AND TREATMENT RESPONSE......Page 111 DNA MICROARRAY TECHNOLOGIES......Page 112 CLINICAL APPLICATIONS OF MICROARRAY TECHNOLOGY......Page 113 MOLECULAR CLASSIFICATION OF HNSCC......Page 114 CONCLUSIONS......Page 115 8 Vaccines and immunotherapy in head and neck cancer......Page 120 OVERVIEW OF A TUMOUR VACCINE......Page 121 HUMAN PAPILLOMA VIRUS......Page 122 HPV VACCINES IN HNSCC......Page 123 DENDRITIC CELL BASED THERAPIES......Page 124 EPSTEIN–BARR VIRUS......Page 125 NASOPHARYNGEAL CARCINOMA IMMUNOTHERAPY......Page 126 ADOPTIVE IMMUNOTHERAPIES FOR NASOPHARYNGEAL CARCINOMA......Page 127 ACKNOWLEDGEMENTS......Page 128 9 Chemoradiotherapy for head and neck cancer......Page 130 CHEMORADIOTHERAPY AND ORGAN PRESERVATION......Page 132 CYTOTOXIC AGENTS......Page 133 IMPROVING RADIOTHERAPY SCHEDULES......Page 134 POSTOPERATIVE CHEMORADIATION FOR HIGH-RISK CANCERS......Page 135 IMAGING AFTER CHEMORADIATION......Page 136 A CHANGING ROLE FOR INDUCTION CHEMOTHERAPY......Page 137 3-D CONFORMAL RADIOTHERAPY......Page 139 INTENSITY-MODULATED RADIOTHERAPY......Page 140 CONCLUSIONS......Page 141 ACCURACY......Page 146 CT–MRI FUSION......Page 149 INTRA-OPERATIVE UPDATING OF RADIOLOGICAL INFORMATION......Page 151 TRACKING SYSTEMS......Page 152 CONCLUSIONS......Page 154 11 Questioning the prevalence of chronic rhinosinusitis......Page 156 PROBLEMS WITH ARRIVING AT A DIAGNOSIS......Page 157 MIDFACIAL SEGMENT PAIN......Page 158 CONCLUSIONS......Page 160 12 New treatments in recurrent respiratory papillomatosis......Page 164 SURGERY......Page 166 LASER SURGERY......Page 167 MICRODEBRIDER......Page 168 ANAESTHESIA AND PERI-OPERATIVE CARE......Page 169 ADJUVANT THERAPIES......Page 170 CIDOFOVIR......Page 171 INTERFERON......Page 172 PHOTODYNAMIC THERAPY......Page 173 CURRENT THERAPEUTIC STRATEGIES......Page 174 CONCLUSIONS......Page 175 Index......Page 180 "This title covers the latest developments in Otolaryngology and covers such topics as Molecular Biology of Head and Neck SCC and Image Guided Surgery. The contributors are recognised experts in their field and they provide in-depth reviews of their areas with 'key points for clinical practice'." "Recent Advances in Otolaryngology 8 is recommended to all practising and trainee Otolaryngologists, and candidates preparing for the FRCS examinations."--Jacket Recent Advances in Otolaryngology 8 is the latest volume in the successful and well-established Recent Advances series. This title covers the latest developments in otolaryngology and is recommended to all practising and trainee otolaryngologists, and candidates preparing for the FRCS examinations.