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Olfactory dysfunction represents one of the most frequent symptoms of coronavirus disease 2019, affecting about 70 per cent of patients. However, the pathogenesis of the olfactory dysfunction in coronavirus disease 2019 has not yet been elucidated.
Case report
This report presents the radiological and histopathological findings of a patient who presented with anosmia persisting for more than three months after infection with severe acute respiratory syndrome coronavirus-2.
Conclusion
The biopsy demonstrated significant disruption of the olfactory epithelium. This shifts the focus away from invasion of the olfactory bulb and encourages further studies of treatments targeted at the surface epithelium.
Advances in immunohistochemistry have spearheaded major developments in our understanding and classification of sinonasal tumours. In the last decade, several new distinct histopathological entities of sinonasal cancer have been characterised.
Objectives
This review aims to provide a clinical update of the major emerging subtypes for the ENT surgeon and an overview of the management strategies available for this heterogeneous group of pathologies.
Conclusion
Although rare, knowledge of sinonasal neoplasm subtypes has implications for prognosis, treatment strategies and the development of novel therapeutic targets.
Lipoid proteinosis is a rare autosomal recessive disorder caused by mutations in the extracellular matrix protein 1 gene. It is characterised by deposition of hyaline material in the skin and mucous membranes. This paper describes the management of two cases with laryngopharyngeal disease.
Methods
Two patients with a biopsy diagnosis of lipoid proteinosis were identified from the surgical pathology archive covering the period 2004–2016. Their notes were reviewed.
Results
An adult male and an adult female were identified. Both had dysphonia and laryngopharyngeal lesions. The patients underwent interval laser microlaryngoscopy to debulk disease but minimise mucosal injury and scarring, using a ‘pepper pot’ technique. Both had adequate symptom control.
Conclusion
Lipoid proteinosis is a rare genetic condition, which typically presents in infancy with dysphonia and subsequent skin involvement. Two cases are presented to demonstrate that laryngotracheal symptoms can be controlled with interval laser debulking and the ‘pepper pot’ technique without causing stenosis.
Delays in head and neck cancer treatment lead to increased mortality, more extensive treatment and patient anxiety. We aim to treat all patients with cancer within 62 days of receipt of a referral. An analysis was conducted of those patients whose treatment had been delayed in order to identify factors associated with treatment delay.
Methods:
In this retrospective case–control study, 50 patients whose treatment was delayed were identified and compared with 50 patients whose treatment was not delayed. Individual factors assessed included patient age, co-morbidity, tumour location and stage, the treatment agreed, the hospitals to which the patients were referred, and the clinicians they saw.
Results:
There was a significant association between referral to a non-head and neck cancer centre, or review by a non-head and neck multidisciplinary team member, and treatment delay.
Conclusion:
In the context of centralisation of head and neck cancer services, it is important to consider delays that may be associated with a ‘hub and spoke’ model of service provision.