摘要:

A retrospective study of tinnitus sufferers who had commited suicide was undertaken. A questionnaire was compiled, and circulated world‐wide. Adequate information was obtained on 28 suicides. An association between suicide and left‐sided tinnitus reported previously, was not conclusively replicated. In fact, no particular tinnitus parameter, or associated audiaological symptom was over‐represented in the suicide and left‐sided tinnitus reported previously, was not conclusively replicated. In fact, no particular tinnitus parameter, or associated auidiological symptom was over‐represented in the suicide series. Demographjicallyu, tunnitus suicide victims were characterized by being male, elderly, and socially isolated. There was a high prevalence of psychiatric morbidity, in particular depressuion (70%). A suicide attempt within the year preceding suicide occured in five in

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01147.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Twenty‐four out‐patients with globus were assessed for current and past psychiatric illness with the ‘Schedule for Affective Disorders and Schizophrenia‐Lifetime Anxiety’ version. Patients then received amitriptyline or placebo in a double‐blind fashion. Treatment outcome was assessed using an inventory of throat symptoms, Beck Depression Inventory, Spielberger State Anxiety Scale, Crown‐Crisp Experiential Index and General Health Questionnaire. Nine patients met the DMS‐III criteria for psychiatric disorder in the past; six had suffered from panic disorder. Two further patients had been troubled by classic panic attacks. Nine of the 12 patients treated with amitriptyline and two of the placebo group discontinued treatment. In conclusion, clinical and psychometric associations were found between pathological anxiety and globus, and it appears that the recommendation that globus be treated ‘aggressively’ with tricyclic antidepressants is likely to lead to a high proportion of

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01148.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The use of absorbable sutures to anastomose nerves is controversial. This paper reports on a controlled trial comparing absorbable and non‐absorbable sutures for this purpose. No difference between the sutures was foun

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01149.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

It would seem logical that patients with nodal metastases low in the neck would fare less well than patients with disease high in the neck. The penultimate UICC classification suggested that neck node level was important although there was no mention of this in the most recent classification. In addition, patients with carcinomas at the various sites would be expected to have different patterns of nodal involvement.Of 3419 patients with head and neck squamous carcinoma on the Liverpool University Head and Neck Unit database, 947 had neck node metastases. The neck node levels were coded as (I)sub‐mandibular, (II) above the thyroid notch, (III) below the thyroid notch and (IV) supra‐clavicular/posterior triangle nodes. Levels II and III contained the deep jugular chain. The relationship between node level and site and sub‐site and survival were analysed with particular emphasis on multivariate methods.The 5‐year survival for the whole group was 51% and survival fell with decreasing node level (I‐IV) being 37% for sub‐mandibular nodes, 32% for deep cervical nodes and 25% for lower deep cervical nodes. The 18‐month survival for supra‐clavicular and posterior triangle nodes was 21%. The difference in survival was significant (x23= 24.42, P<0.001). Multivariate analysis confirmed that as the level of the nodes fell from the sub‐mandibular refion to the supra‐clavicular region the prognosis worsened (estimate = ‐0.3378, P = 0.0003).Level II (upper deep cervical) nodes were the most commonly involved with regards to all primary sites and formed 69% of all neck node metastases. Over three quarters of laryngeal oropharyngeal and hypopharyngeal metastases went ot this level whereas only 47% of oral cancers did. Most of the remainder of these latter lesions metastasized to level I (42%). These findings were confirmed by multiple logistic regression.When studying survival for lymph node level with regard to site all sites had a reducing prognosis with decrasing node level except for larynx.Multiple linear regression showed an association between decreasing node level and increasing N‐stage (P = 0.001) with increasing T‐stage (P = 0.0014) and as the site moved from the mouth to the larynx (P = 0.0047).The present data support the view that neck node level is important as regards prognosis for most sites in the head and neck. The data confirm the clinical view that deep cervical nodes are most frequently affected by head and neck cancer with level IV nodes being unusual and clinically tending to herald a non head and neck tumour and that level III nodes are relatively uncommon. This is surprising as one would expect at least a proportion of laryngeal carcinomas and quite a high proportion of lhypopharyngeal carcinomas to m

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01150.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Muscle obliteration of the troublesome mastoid cavity is one method of achieving a permanently dry ear, although long‐term results are often disappointing. An operation is described, which is a modification of existing techniques and utilizes a temporalis myofascial flap. This procedure has been used on 46 discharging mastoid cavities and produced encouraging results. It provides a simple, safe and reliable solution to the proble

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01151.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

The use of electrocochleography (ECochG) in the identification of endolymphatic hydrops in Menière's disease, using either trans‐tympanic or extra‐tympanic recording techniques, has become very popular. The presence of an enhanced summating potential (SP) component is considered to be a diagnostic indicator of hydrops. The response evoked by a click stimulus is widely used in this investigation. The aim of this study was to assess the value of tone‐pip stimuli for measurement of the SP component in patients with suspected Menière's disease.Extra‐tympanic ECochG was recorded from a surface electrode positioned on the postero‐inferior quadrant of the ear canal close to the tympanic annulus. Forty patients referred to the Evoked Potentials Clinic at the Queen's Medical Centre were studied. The combined summating potential and action potential waveform (SP/AP) were recorded using click and tone‐pip stimuli. The pips had tone frequencies of 1 and 4 kHz and all stimuli were presented with alternating phase at a repetition rate of 10 per second. The percentage SP (%SP), width and latency characteristics of the SP/AP waveform were calculated for each stimulus condition.There were four patients (10%) with an enhanced tone‐pip %SP when the click %SP was within normal limits. Width measurement of the tone‐pip waveform at the onset point of the response was abnormal in 13 patients (33%) when a similar measurement of the click‐evoked response was normal. There were nine of these patients identified by an abnormal width measurement at the 50% amplitude point of the SP/AP waveform. Both tone‐pip frequencies were required in order to identify all these abnormal measurements. In conclusion, the tone‐pip response provides valuable additional information to the click stimulus in support of the diagnosis o

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01152.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

In a prospective study the effects on the voice of nandrolone decanoate super‐imposed on cyclical hormonal replacement therapy (HRT) given to post‐menopausal women suffering from a severe form osteoporosis were compared with the effects of HRT alone. Comparing the experimental group with the control group, after one year of medication in the experimental group a higher percentage of patients had: a lower fundamental frequency during speech, a loss of high frequencies and an increase in voice instability and creakiness.The lowering of the frequnencies and the increase of instability can be explained by histological changes in the vocal cords and by problems in the adaptation to these histological chan

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01153.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Growth and differentiation of meatal epidermis implanted in the rat middle earP. P. C. A. VENNIX, W. KUYPERS, E. TONNAER, T. PETERS, F. RAMEKERS (Leiden, Nijmegen and Maastricht)In vitro culture of multi‐layered epithelium for the treatment of chronic otorrhoea after radical mastoidectomyH. J. ROSINGH, A. M. TOMSON, J. SCHOLMA&F. G. DIKKERS (Groningen)New development in combined surgery and radiotherapy for head and neck tumoursF. P. BAKKER, P. F. SCHOUWENBURG, L. BLANK, P. A. VOÛTE, J. B. DE BOER (Amsterdam, AMC)Thyroglossal duct carcinomaP. A. C. VAN VUUREN, A. J. M. BALM, R. T. GREGOR, E. J. TH. RUTGERS (Amsterdam, AVL)Evidence for a major role of genetic factors in the aetiology of head and neck squamous cell carcinoma: a case‐control studyM. P. COPPER, A. JOVANOVIC, J. J. P. NAUTA, B. J. M. BRAAKHUIS, N. DE VIRES, I. VAN DER WAAL, G. B. SNOW (Amsterdam, VU)A study of eye movements during and after trunk‐rotation with head fixation in controls and patients with or without whiplash injuriesH. KINGMA, J. PATIJN, J. VLES (Maastricht and Eindhoven)Long‐term effects of otitis media with effusion on language, reading and spellingA. G. M. SCHILDER, J. G. VAN MANEN, G. A. ZIELHUIS, S. A. F. PETERS, E. H. GRIEVINK, P. VAN DEN BROEK (Nijmegen)Audiological results of the ‘Bone anchored hearing aid’ (BAHA HC200 and BAHA HC220); multi‐centre resultsA. F. M. SNIK, E. A. M. MYLANUS, C. W. R. J. CREMERS, F. F. JORRITSMA, J. VERSCHUURE (Nijmegen, Eindhoven and Rotterdam)Facial nerve grafting and the transtemporaltransmastoid approachK. H. PAUW, C. J. J. AVEZAAT, R. SINGH (Rotterdam)‘Midface degloving’: a suitable alternative to lateral rhinotomyK. GRAAMANS (Utrecht)Parotid surgery in childrenC. C. LEIBBRANDT (Amersfoort)Peroneal palsyJ. P. P. M. VAN LEEUWEN (Nijmegen)An aggressive papillary middle ear tumourF. J. A. VAN DEN HOOGEN, C. W. R. J.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01154.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

MRI and CT Atlas of Correlative Imaging in OtolaryngologyVijay M. Rao, Adam E. Flanders&Barry M. Tom. Martin

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1994.tb01155.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY