• Nd:YAG laser hyaloidotomy for valsalva pre-macular haemorrhage.

      Kirwan, R P; Cahill, M T; Department of Ophthalmic Surgery, The Royal Victoria Eye and Ear Hospital,, Adelaide Road, Dublin 2, Ireland. ruaidhri.kirwan@ucd.ie (2012-02-01)
      AIM: To report a case of successful drainage of a large pre-macular haemorrhage using laser photo-disruption of the posterior hyaloid membrane. MATERIALS AND METHODS: A case report. RESULTS: A 47-year-old man presented acutely to our emergency department complaining of a 24-h history of sudden onset, painless and persistent loss of vision in his left eye. Immediately before noticing this loss of vision, he had been vomiting violently from excessive alcohol intake. The left visual acuity was counting fingers. Dilated fundoscopy of the left eye revealed a large pre-macular haemorrhage which was 14 disc diametres in size. Clotting investigations were normal. A diagnosis of valsalva retinopathy was made and the patient elected to receive a prompt neodymium-doped yttrium aluminium garnet (Nd:YAG) laser posterior hyaloidotomy as an outpatient. At 1 week follow-up, the haemorrhage had drained completely into the vitreous space revealing a healthy macula and the visual acuity had improved to 6/12 unaided. At 6-month follow-up the left visual acuity stabilised at 6/9 unaided. CONCLUSION: Nd:YAG laser posterior hyaloidotomy is a useful outpatient procedure for successful clearance of large pre-macular haemorrhages that offers patients rapid recovery of visual acuity and the avoidance of more invasive intraocular surgery.
    • A novel homozygous truncating GNAT1 mutation implicated in retinal degeneration.

      Carrigan, Matthew; Duignan, Emma; Humphries, Pete; Palfi, Arpad; Kenna, Paul F; Farrar, G Jane (2016-04)
      The GNAT1 gene encodes the α subunit of the rod transducin protein, a key element in the rod phototransduction cascade. Variants in GNAT1 have been implicated in stationary night-blindness in the past, but unlike other proteins in the same pathway, it has not previously been implicated in retinitis pigmentosa.
    • Oncogenic impact of human papilloma virus in head and neck cancer.

      Heffernan, C B; O'Neill, J P; Timon, C; The Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin, Ireland., Heffernan_colleen@hotmail.com (2012-02-01)
      There is considerable debate within the literature about the significance of human papilloma virus in head and neck squamous cell carcinoma, and its potential influence on the prevention, diagnosis, grading, treatment and prognosis of these cancers. Cigarette smoking and alcohol consumption have traditionally been cited as the main risk factors for head and neck cancers. However, human papilloma virus, normally associated with cervical and other genital carcinomas, has emerged as a possible key aetiological factor in head and neck squamous cell carcinoma, especially oropharyngeal cancers. These cancers pose a significant financial burden on health resources and are increasing in incidence. The recent introduction of vaccines targeted against human papilloma virus types 16 and 18, to prevent cervical cancer, has highlighted the need for ongoing research into the importance of human papilloma virus in head and neck squamous cell carcinoma.
    • Ophthalmic manifestations of vitamin A and D deficiency in two autistic teenagers: case reports and a review of the literature.

      Duignan, Emma; Kenna, Paul; Watson, Rosemarie; Fitzsimon, Susan; Brosnahan, Donal (Karger Publishing, 2015-01)
      We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.
    • Orbital exenteration in periorbital malignancies.

      Roche, Phoebe; Timon, Conrad; Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland. phoebe.roche@yahoo.co.uk (2012-08)
      Orbital exenteration is a disfiguring procedure most commonly performed for locally advanced or recurrent periorbital malignancies.
    • Outcome measures and scar aesthetics in minimally invasive video-assisted parathyroidectomy.

      Casserly, Paula; Kirby, Rachel; Timon, Conrad; Department of Otolaryngology-Head and Neck Surgery, Royal Victoria Eye and Ear, Hospital, Dublin, Ireland. paulacasserly@hotmail.com (2012-02-01)
      OBJECTIVES: To compare the scar outcome of video-assisted parathyroidectomy (VAP) with traditional bilateral cervical exploration (BCE) using previously validated scar assessment scales, and to examine the feasibility of introducing VAP into a general otolaryngology-head and neck practice. DESIGN: A retrospective review of medical records from a prospectively obtained database of patients and long-term follow-up of scar analysis. PATIENTS: The records of 60 patients undergoing parathyroidectomy were reviewed: 29 patients underwent VAP and 31 patients underwent an open procedure with BCE. The groups were matched for age and sex. A total of 46 patients were followed up to assess scar outcome. MAIN OUTCOME MEASURES: The primary outcome was a comparison of patient and observer scar satisfaction between VAP and traditional BCE using validated scar assessment tools: the Patient Scar Assessment Scale and the Manchester Scar Scale. The secondary outcomes were to retrospectively evaluate our results with VAP and to assess the suitability of introducing this technique into a general otolaryngology-head and neck practice. RESULTS: The average scar length in the VAP group was 1.7 cm, and the average scar length in the BCE group was 4.3 cm. The patients in the BCE group scored higher than the patients in the VAP group on the Manchester Scar Scale (P < .01) and on the Patient and Observer Scar Scales (P = .02), indicating a worse scar outcome. The mean operative time in the VAP group was 41 minutes compared with 115 minutes in the open procedure BCE group. There was no difference between the 2 groups in terms of postoperative complications. CONCLUSIONS: Video-assisted parathyroidectomy is a safe and feasible procedure in the setting of a general otolaryngology-head and neck practice, with outcomes and complication rates that are comparable to those of traditional bilateral neck exploration. Both patient and observer analysis demonstrated that VAP was associated with a more favorable scar outcome when compared with BCE.
    • Patients' quality of life post thyroidectomy.

      Cashman, E C; Bresnihan, M; Timon, C; Royal Victoria Eye & Ear Hospital, Adelaide rd, Dublin 2, Ireland. emmacashman@gmail.com (2011)
      This study was designed to evaluate health related quality of life post thyroidectomy for hyperthyroidism with respect to clinical benefit and patient satisfaction. This is one of the first such studies in the literature evaluating quality of life post thyroidectomy for hyperthyroidism.
    • Proteomics in uveal melanoma.

      Ramasamy, Pathma; Murphy, Conor C; Clynes, Martin; Horgan, Noel; Moriarty, Paul; Tiernan, Damien; Beatty, Stephen; Kennedy, Susan; Meleady, Paula; Royal College of Surgeons Ireland, Stephen's Green, Dublin 2, Ireland; National Institute for Cellular Biotechnology, Dublin City University, Collins Avenue, Glasnevin, Dublin 9, Ireland. Electronic address: Pathma.Ramasamy@dcu.ie. (2014-01)
      Uveal melanoma is the most common primary intraocular malignancy in adults, with an incidence of 5-7 per million per year. It is associated with the development of metastasis in about 50% of cases, and 40% of patients with uveal melanoma die of metastatic disease despite successful treatment of the primary tumour. The survival rates at 5, 10 and 15 years are 65%, 50% and 45% respectively. Unlike progress made in many other areas of cancer, uveal melanoma is still poorly understood and survival rates have remained similar over the past 25 years. Recently, advances made in molecular genetics have improved our understanding of this disease and stratification of patients into low risk and high risk for developing metastasis. However, only a limited number of studies have been performed using proteomic methods. This review will give an overview of various proteomic technologies currently employed in life sciences research, and discuss proteomic studies of uveal melanoma.
    • A rare angiosarcoma: retiform haemangioendothelioma.

      O'Duffy, F; Timon, C; Toner, M; Department of Otorhinolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. fergaloduffy@hotmail.com (2012-02)
      We report the case of a rare angiosarcoma, retiform haemangioendothelioma, in an 18-year-old young man, which presented as a recurrent ulcerating lesion of the left pinna.
    • Royal Victoria Eye and Ear Hospital annual report and accounts,1996: celebrating 100 years.

      Royal Victoria Eye and Ear Hospital (Royal Victoria Eye and Ear Hosital, 1997)
      The Dublin Eye and Ear Hospital Act, 1897 came in to force on 15th July 1897. The Act provided for the amalgamation of the National Eye and Ear Hospital in Molesworth Street (founded in 1814) and St Mark's Ophthalmic Hospital in Lincoln Place founded in 1844 by Sir William R. Wilde) and established this Hospital. We are therefore celebrating this year the completion of one hundred year of service by the Hospital to the citizens of Dublin and indeed to people from all parts of Ireland.
    • Selective fine needle aspiration of parotid masses. FNA should be performed in all patients older than 60 years.

      Kieran, S M; McKusker, M; Keogh, I; Timon, C; Department of Otolaryngology, Head and Neck Surgery, Royal Victoria Eye and Ear, Hospital, Dublin, Ireland. skieran@rcsi.ie (2012-02-01)
      OBJECTIVES: The exact role of fine needle aspiration in the pre-operative assessment of patients presenting with parotid masses is controversial. Some surgeons propose that fine needle aspiration be performed only selectively in those patients with likely malignant disease, whilst others recommend it for all patients presenting with such a mass. Intuitively, one would expect older patients to be more likely to suffer from primary malignant parotid tumours and secondary deposits of malignant skin tumours. Therefore, we hypothesised that older patients with a parotid mass should undergo fine needle aspiration regardless of their medical history. DESIGN: We retrospectively reviewed 197 consecutive parotidectomies to test this hypothesis. RESULTS: One hundred and twenty-one patients (61.4 per cent) were diagnosed with benign disease, whilst 76 (38.6 per cent) were diagnosed with malignant disease. Eighty-three per cent of patients aged 60 years or younger had benign disease, as opposed to 35.6 per cent of patients aged more than 60 years. Malignant disease occurred more commonly in patients older than 60 years (odds ratio 8.962, 95 per cent confidence interval 4.607-17.434). CONCLUSION: In patients with a parotid mass, fine needle aspiration should be performed on all those aged 60 years or older.
    • Systematic review and meta-analysis of wound drains after thyroid surgery.

      Woods, R S R; Woods, J F C; Duignan, E S; Timon, C; Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. (2014-04)
      Drainage after routine thyroid and parathyroid surgery remains controversial. However, there is increasing evidence from a number of randomized clinical trials (RCTs) suggesting no benefit from the use of drains.
    • "Tarantula keratitis": a case report.

      McAnena, L; Murphy, C; O'Connor, J; Royal Victoria Eye and Ear Hospital (RVEEH), Adelaide Road, Dublin 2, Ireland. lmcanena@yahoo.co.uk (2013-09)
      A case of an 11-year-old boy presenting with a two-week history of a red, irritated right eye after handling a Chilean Rose Tarantula at an exotic pet exhibition. Examination revealed innumerable microscopic hairs embedded at all levels of the cornea. He was commenced on steroid drops with subjective and objective improvement at follow up.
    • Temporomandibular joint osteochondromatosis: an unusual cause of preauricular swelling.

      Phelan, Eimear; Griffin, John; Timon, Conn; Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin,, Ireland. (2012-02-01)
      We report an unusual and rare cause of preauricular swelling and review the most recent literature concerning synovial osteochondromatosis of the temporomandibular joint. We report the clinical and radiologic findings of a case of synovial osteochondromatosis of the temporomandibular joint that presented as preauricular swelling in a female patient. This disease typically affects large joints; fewer than 100 cases reported in the literature affect the temporomandibular joint. This case illustrates that disorders of the temporomandibular joint should also be included in the differential diagnosis of patients who present with a preauricular mass.
    • Tinnitus as an unusual presentation of Schneiderian papillomatosis.

      Ali, R B; Amin, M; Hone, S; Department of Otolaryngology and Head and Neck Surgery, Royal Victoria Eye and, Ear Hospital, Dublin, Ireland. rohana.oconnell@gmail.com (2012-02-01)
      INTRODUCTION: Primary Schneiderian papillomatosis of the middle ear and mastoid cavity is extremely rare. It is frequently associated with intermittent unilateral otorrhoea and mass in the middle ear and mastoid cavity. METHODS: Case presentation, symptoms, diagnostic criteria, management and literature review are discussed. CONCLUSION: Schneiderian papillomatosis is an important differential diagnosis of mass in the middle ear and mastoid cavity, and tinnitus as a presenting symptom has not been reported before. Primary radical treatment is essential in preventing tumour recurrence.
    • Triple manifestation of extramedullary plasmacytoma in the upper airway: an unusual clinical entity.

      Morariu, I; Burns, P; Roche, P; Hone, S; Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin,, Ireland. iulianam2002@yahoo.com (2012-02-01)
      OBJECTIVE: We report an extremely rare case of extramedullary plasmacytoma. METHOD: Case report and review of the English-literature concerning extramedullary plasmacytoma and multiple myeloma. RESULT: We present an unusual case of multiple extramedullary plasmacytomas, which, over a protracted course of 30 years, presented on different occasions at three separate sites in the head and neck. The patient was managed surgically on all occasions, and was disease-free at the time of writing. CONCLUSION: Following review of the literature, we believe this to be the only case with this extremely unusual presentation. This case is noteworthy, not only because of the rarity of extramedullary plasmacytoma, but also because it highlights a number of important clinical issues. The diagnosis and management of extramedullary plasmacytoma require close cooperation between multiple disciplines.
    • Update on immunosuppressive therapy for corneal transplantation.

      O'Doherty, Maeve; Murphy, Conor C; Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland. (2012-02-01)