In adults, otitis media with effusion causes considerable morbidity and has poorly established outcomes. A small number of nasopharyngeal carcinoma patients present with isolated ear-related symptoms. The investigation of choice for these patients is a point of debate.

A retrospective cohort study was conducted using a local database of adult patients who underwent examination under anaesthesia of the post-nasal space with grommet insertion for otitis media with effusion between January 2014 and January 2016.

Ninety-eight patients met the inclusion criteria. Follow-up duration ranged from 39 to 63 months. Complications of grommets were present in 36 out of 98 patients (36.73 per cent). The findings of examination under anaesthesia of the post-nasal space were documented as abnormal in three patients. No patient was diagnosed with nasopharyngeal carcinoma.

Grommets in adults with otitis media with effusion as the sole presenting feature carry a high complication rate, especially in those with previously inserted grommets. Examination under anaesthesia of the post-nasal space offers a low yield. A magnetic resonance imaging scan of the post-nasal space may be a more sensitive alternative.

This study aimed to evaluate acute and late toxicities in nasopharyngeal cancer (NPC) patients who were treated between split-field (SF) and extended-field (EF) step-and-shoot intensity-modulated radiotherapy (IMRT) techniques.

Between January 2011 and October 2011, 21 NPC patients with stage I-IVB (7th edition American Joint Committee on Cancer Staging) were randomly assigned to undergo radiotherapy with SF or EF step-and-shoot IMRT technique.

At a median follow-up time of 60 months (range 3–77), we reported the comparable acute and late toxicities between the two techniques. One patient (9%) in SF-IMRT arm developed grade 3 acute skin toxicity.

Both SF and EF step-and-shoot IMRT techniques for NPC patients did not produce any statistically significant differences in both acute and late toxicities. Although no difference in toxicity was observed, technical problems due to field matching management were the obstacles in utilisation of SF-IMRT in our routine practice.

Nasal stenosis is a rare but significant complication of chemoradiation treatment for nasopharyngeal carcinoma. It can cause distressing obstructive symptoms for the patient and potentially interfere with monitoring for recurrence. Quality-of-life indicators are known to be very poor in this group of patients; however, there is very little evidence in the literature as to management of this complication.

This paper presents an endoscopic day-case surgical procedure to address total posterior nasal stenosis, as conducted in three patients, which involves division of adhesions and removal of the posterior septum and posterior inferior turbinates, without the need for packing or stenting.

In this series, there was resolution of obstructive symptoms and no recurrence of stenosis during follow up (up to 20 months).

This endoscopic procedure performed to manage total nasal stenosis differs from those previously described in the literature, as post-operative stenting or packing is not required, and removal of the posterior aspect of the septum is performed routinely.

The aim of this paper is to compare neural induced changes in three-dimensional conformal radiotherapy (3D-CRT) versus intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) for nasopharyngeal cancers.

Radiotherapy plans for 10 patients with nasopharyngeal cancer stages III and IV were prospectively developed for 3D-CRT, IMRT and VMAT using Varian Eclipse planning system. The same radiation therapist carried out all planning and the same clinical dosimetric constraints were used. Normal tissue complication probabilities were calculated.

The mean planning target volume’s (PTVs) conformity index (CI) for 3D-CRT was 1·424, for IMRT 1·1, and for VMAT 1·081. The PTV homogeneity (HI) index was 0·204 for 3D-CRT, 0·124 for IMRT and 0·153 for VMAT. Normal tissue complication probabilities gave complex results for 3D-CRT, IMRT and VMAT and are analysed in detail in this paper. The mean monitor units were 95 (range 9–180) for 3D-CRT; 165 (range 52–277) for IMRT; and 331 (range 167–494) for VMAT (p<0·05).

VMAT is associated with similar dosimetric advantages as IMRT over 3D-CRT for nasopharyngeal cancer. VMAT is associated with faster delivery times and greater number of mean monitor units than IMRT. Brain radionecrosis severity and risk, in the past, have been underestimated. By improving the life expectancy of patients with nasopharyngeal cancer to ensure maintenance of the neural structures, recommended dose limits should be considered as a first degree priority (as the spinal cord, brainstem, etc.) when IMRT and VMAT plans are implemented.

The protein 14-3-3 sigma plays a role in cell cycle arrest by sequestering cyclin-dependent kinase 1 cyclin B1 complexes, as well as cyclin-dependent kinases 2 and 4, hence its definition as a cyclin-dependent kinase inhibitor. However, the nature of the interaction between these biological markers in nasopharyngeal carcinoma is unknown. This study aimed to investigate whether altered expression of these markers contributes to nasopharyngeal carcinogenesis.

The study population consisted of 30 nasopharyngeal carcinoma patients and 10 patients without nasopharyngeal carcinoma. The nasopharyngeal carcinoma cell lines TW02, TW04 and Hone-1 were also assessed. We analysed levels of messenger RNA and protein for the p16 gene and the 14-3-3 sigma, Epstein–Barr nuclear antigen 1, and cyclin-dependent kinase 2 and 4 proteins, in nasopharyngeal carcinoma tissue specimens and cell lines and in normal nasopharyngeal tissue.

Protein and messenger RNA levels for cyclin-dependent kinase 2 and Epstein–Barr nuclear antigen 1 were significantly higher in nasopharyngeal carcinoma compared with normal tissue, while levels of cyclin-dependent kinase 4 generally were not; results for 14-3-3 sigma varied. Nasopharyngeal carcinoma patients had diminished p16 gene expression, compared with normal tissue.

Levels of cyclin-dependent kinase 2 and Epstein–Barr nuclear antigen 1 were significantly higher in nasopharyngeal carcinoma than in normal tissue, while p16 gene expression was diminished. These three proteins may contribute to nasopharyngeal carcinogenesis.

The epidermal growth factor receptor (EGFR) and type 1 insulin-like growth factor receptor (type 1 IGF receptor or IGF1R) have played an important role in the growth and apoptosis of cancer. The RNA interference (RNAi) technique can suppress gene expression, but the effects of dual silencing of EGFR and type 1 IGF receptor have not been well understood.

pU6-EGFR-shRNA-1, pU6-EGFR-shRNA-2, pU6-IGF1R-shRNA-1 and pU6-IGF-1R-shRNA-2 plasimd vectors were transfected to the nasopharyngeal cancer cells. Seven groups were selected for the study. The protein and downstream protein expression were assessed by Western blot. Apoptosis was determined via flow cytometry. Meanwhile, chemosensitivity of nasopharyngeal cancer cell lines transfeced to chemotherapeutic drugs were carried out by MTT.

In dual silencing of EGFR and IGF-1R, the protein expression much more was decreased than single silencing of EGFR or IGF-1R, but the cell apoptosis much more is increased than single silencing EGFR or IGF-1R. Dual silencing of EGFR and IGF-1R enhanced chemosensitivity to anticancer drugs, compared with single silencing of EGFR or IGF-1R.

Dual silencing of EGFR and IGF-1R are capable of suppressing EGFR and IGF-1R expression of the nasopharyngeal cancer cell and can promote apoptosis and increase the cell sensitivity of anticancer drug. The dual silencing of genes RNAi technique is significantly better than a single gene.