ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00313.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Superselective embolisation for intractable epistaxis: experiences with 19 patients Twenty‐eight patients with intractable nose‐bleeds were treated with either superselective embolization and/or surgery between 1983 and 1986. The follow‐up time ranged between 6 months and 3 years. The results for the 2 groups were similar. The success rate for embolization was 74% and that for surgery 65%. Complications however, were more frequent after embolization, (i.e. facial nerve paralysis, soft tissue necrosis). Surgery is recommended as the treatment of choice in intractable nosebleeds, until therapeutic embolization techniques have been further refined and the complication rate re

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00314.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The use of topical cocaine in nasal surgery is widely accepted. However, the value and safety of using adrenaline in addition is strongly disputed. Serial serum cocaine levels were estimated in 30 patients during routine nasal surgery with half the patients receiving preoperative nasal preparation with cocaine alone and the other half receiving a cocaine and adrenaline combination. The serum cocaine values and the incidence of toxic effects of cocaine were compared between the 2 groups. Results showed that the addition of adrenaline significantly reduced the systemic absorption of cocaine during surgery but caused no significant increase in toxic cardiovascular effects compared with the use of cocaine alone. No evidence of cocaine toxicity was seen in either group. Preparations including adrenaline were also observed to intensify local nasal vasoconstriction resulting in a better operative field. It is concluded that adrenaline can still be a valuable as well as safe addition to topical cocaine used in the nose.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00315.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Our experience with the fasciaform graft, designed specifically for the repair of subtotal or total perforations of the tympanic membrane, is presented. The technique which utilizes a total tympanic graft of formalized autologous temporalis fascia is described in detail. We have employed this method in 29 patients with total closure of the defect being achieved in 93% of cases. The fasciaform graft is therefore recommended as a successful method of repair for subtotal and total perforations of the tympanic membrane for which the conventional grafting techniques currently available are much less effective.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00316.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

In our present study we examined the pathology of the nasal mucociliary system after x‐ray irradiation in an animal model namely the rabbit. A reduced ciliary activity was observed immediately after the irradiation and did not show any recovery during our observation. No ciliary activity was seen in the nasal mucosa 8 weeks after the irradiation. Morphologically, hypersecretion of goblet cells was observed immediately after irradiation. Cytoplasmic vacuolation and nuclear pyknosis of ciliated cells started after irradiation, and sloughing of ciliated cells was observed for up to 3 weeks. Epithelial metaplasia started from 4 weeks, and no cilia were seen in the nasal mucosa and the surface of the epithelium was covered with flat squamous cells. Our present study shows that x‐ray irradiation has serious influence on the function and structure of the nasal mucociliary system and that recovery from degeneration due to x‐ray irradiation cannot be expected within several

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00317.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Human papilloma virus (HPV) and carcinomas of the head and neck Increasing evidence for a causal link between human papilloma virus and carcinomas of the cervix has emerged in recent research. This group of species‐specific, epitheliotropic viruses has also been associated with tumours of the head and neck, but the individual reports deal only with relatively small sample numbers. In the present review these reports are considered in relation to the methods employed, and it is concluded that HPV is associated with more than 50% of oral and nasal carcinomas, as well as with carcinomas of the larynx and oesophagus. The clinical relevance and strategies for future work are outline

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00318.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

T3N0M0glottic carcinoma‐a failure analysis There is at present considerable controversy regarding the appropriate management of a patient who presents with a T3N0M0glottic carcinoma. This paper presents the results for 141 patients presenting clinically with T3N0M0glottic carcinoma between 1964 and 1981 and treated with primary radiotherapy reserving surgery for residual or recurrent disease. The actuarial survival for the entire group of patients was 50.5% at 5 yr; 28% of the patients died of glottic cancer. The local relapse‐free rate achieved with radiotherapy was higher in female patients (68%) than male patients (41%)(P= 0.04); the local relapse‐free rate was higher in males 60 yr of age or older (46%) than in males 59 yr of age or younger (31%)(P= 0.02). Involvement of all three laryngeal regions and initial tracheotomy were associated with a high primary failure rate. Fifty‐nine per cent of patients alive at 5 yr retained an intact and functioning larynx. The time up until diagnosis of recurrence and the number of endoscopies required to establish recurrent or residual disease were all assessed with respect to their effects on survival and were shown to have no significant impact. Methods of improving the results of treatment for those patients with a high primary failure rate following radiotherapy are di

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00319.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

T3N0M0glottic carcinoma—a pathologic analysis of 41 patients treated surgically following radiotherapy Forty‐one patients undergoing surgery for recurrent or residual tumour following radical radiotherapy for T3N0M0glottic carcinoma had their larynges evaluated pathologically by whole organ laryngeal sectioning. All patients had been staged initially as T3N0M0glottic carcinoma and treated according to a protocol of radical radiotherapy (50–55 Gy in 4–5 weeks) with surgery reserved for radiation failure. Seventeen of the 41 patients died as a result of locoregional or distant recurrence or complications following surgery. Twenty‐four patients were either alive or dead with intercurrent disease. Pathologic staging demonstrated 58% of these tumours to be rpT4, 29% rpT3and the remainder rpT02. The incidence of major cartilage invasion, vascular or perineural invasion, and subglottic extension greater than 15 mm was more frequent in patients with locoregional recurrence than in patients without recurrence. The presence of these pathologic features had a positive predictive value of 0.78 in relation to probability of locoregional failure. In addition, there was a significant difference in the frequency of these pathologic features between patients with and without locoregional recurrence (P<0.001). The frequency of positive margins (19%) and pattern of involvement are described. The incidence of occult nodes (0%) in patients undergoing neck dissection is presented. The frequency (23%) and pattern of osteo‐chondroradionecrosis are also described. The patterns of growth and spread observed were similar to those described previously. The importance of performing wide surgical resections in patients with recurrence following radiotherapy is

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00320.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

An evaluation of topical anaesthesia for myringotomy The relative efficiency of 2 topical anaesthetic agents in controlling the pain arising from myringotomy and grommet insertion has been assessed by a prospective, single blind controlled trial. The 2 anaesthetics were 5% cocaine and a new lignocaine and prilocaine mixture named Emla. Following a standardized anaesthetic procedure the pain arising from myringotomy, aspiration of the middle ear and subsequent insertion of a grommet was recorded by the patient on a linear analogue scale. A multivariate analysis was performed to assess the factors which significantly affected the pain levels. Only the type of anaesthetic used played a major role, with Emla giving significantly better anaesthesia than cocaine.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00321.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Experience with a new topical anaesthetic in otology Producing good local anaesthesia of the external auditory meatus and tympanic membrane has always been a difficult problem facing otologists. Previously used methods are mentioned and the use of a new eutectic mixture of local anaesthetics (EM LA) for electrocochleography, myringotomy and grommet insertion in adults and older children is described. A double‐blind controlled trial involving 15 patients (30 ears) undergoing electrocochleography showed EMLA to be a very effective, safe and convenient preparation for outpatient otological us

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00322.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY