The effect on nasal mucosal blood flow of ice packs on the forehead and ice packs within the mouth was investigated in 16 healthy subjects. The laser Doppler flowmeter was used to record changes in blood flow to the inferior turbinate, as measured by change in the flux. Ice packs within the mouth produced a significant decrease in nasal mucosal blood flow (p less than 0.05). The average fall was 23% (SEM 5.9) compared with the control measurements. No significant change was recorded following the application of ice packs to the forehead. The results of this study question the scientific rationale behind the use of forehead ice packs in clinical practice.

We present the case of a 55-year-old man who presented with intermittent, profuse bleeding from the ear five years following radiotherapy for a nasopharyngeal carcinoma. He had developed osteoradionecrosis of the temporal bone, and the bleeding was shown to originate from an aneurysm of the internal carotid artery within his temporal bone. This has not previously been reported as a complication of radiotherapy for nasopharyngeal cancer.

Forty-one paraffin embedded specimens of primary nasopharyngeal carcinoma (NPC) were examined to investigate the expression of c-myc and ras oncogenes. Sections were stained with the monoclonal antibodies myc 1-9E10 or ras Y13-259 and binding was detected using the ABC method. The intensity of staining for each tumour was assessed as nil, moderate or intense. The results indicated that 9 (22%) had intense staining for the c-myc oncogene, 28 (68%) had moderate staining and only 4 (10%) showed no staining. For the ras oncogene, 8 (19%) had intense staining, 22 (54%) moderate staining and 11 (27%) showed no staining. The patient's clinical data indicated no correlation between the expression of either c-myc or ras p21 and age, sex, smoking, tumour stage, antibody titre to EBV, or family history. No correlation was found between ras p21 expression and survival; however, overexpression of the c-myc oncogene correlated with a poor prognosis (p < 0.05). This study is consistent with investigations demonstrating that c-myc expression correlates with poor survival in head and neck tumours.

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