ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02063.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A questionnaire concerning various aspects of secretory otitis media was completed by a random sample of Consultant Otolaryngologists in the United Kingdom. The replies to questions associated with the use of ventilation tubes are presented. The results suggest a wide disparity associated with their use and these findings arc discussed with reference to current research.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02064.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Adult epiglottitis is a different disease from that seen in paediatric patients both in the clinical picture and management. This paper presents 6 cases of adult epiglottitis which resulted in 2 deaths despite 3 patients having airway intervention. After reviewing some of the larger published series of adult epiglottitis in an attempt to find a consensus on management, a number of recommendations can be made: (1) indirect laryngoscopy is an essential diagnostic step which is safe in the adult and is more reliable than a lateral neck radiograph; (2) bacteriology specimens play no part in acute management and antibiotics must be given empirically; (3) adrenaline may be of value in avoiding airway intervention; (4) airway intervention must be a clinical decision and the conditions for its successful outcome made as favourable as possible by realizing that all patients can rapidly develop life threatening respiratory obstruction. An ‘intensive care’ level of clinical monitoring and early involvement of experienced ENT and anaesthetic staff is recommen

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02065.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A wide variety of surgical and pharmacological methods have been described in an attempt to reduce pain after tonsillectomy, with conflicting results. Opiates are still widely used, despite unwanted side‐effects. Recently the non‐steroidal anti‐inflammatory drugs have been shown to be effective against a variety of post‐operative pains. Diclofenac is effective in both children and adults in the relief of pain after tonsillectomy when administered rectally, but absorption is variable, and suppositories are not widely accepted in the UK.The present double‐blind study compared a single intramuscular dose of diclofenac with papaveretum in adults undergoing tonsillectomy. Post‐operatively, the patients who received diclofenac had less pain and started drinking significantly sooner than the control group. There were no undesirable side‐effects.Intramuscular diclofenac is superior to papaveretum in the relief of pain in adults undergoing

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02066.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Recent advances in surgical technique and instrumentation have ensured that success rates for microvascular free transfer can now exceed 90%. This paper reviews a prospective study of 77 free flaps performed at the Royal Marsden Hospital under the care of one surgeon (NMB) over a 2‐year period. 76 patients who underwent 77 free flaps were studied. 68 patients had malignant tumours and 8 had benign lesions. The flap success rate was 95% and the mortality rate 0%. The major complication rate was 20% and the most common complication was a salivary fistula (12%).Microvascular free transfer to the head and neck is not associated with increased morbidity and mortality. It offers single stage, reliable, effective reconstruction using a wide variety of donor sites and tissue

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02067.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The course of chronic otitis media with effusion (OME) was studied in 117 children (207 ears). Diagnosis was based on otoscopy and a flat (type B) tympanogram. This was compared with the presence or absence of middle ear effusion at myringotomy carried out 0–3, 3–6, 6–9 and more than 9 months after diagnosis. There was a highly significant reduction in the number of effusions diagnosed at myringotomy in those patients who had waited longer for operation. The effects of previous ventilation tube insertion, adenoidectomy, medical treatment between diagnosis and operation, month of diagnosis and month of admission on the results were examined. Tympanosclerosis and atelectasis occurred in 7.3 and 6.3% of ears respectively and in most cases were associated with previous grommet inse

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02068.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The outcome of 75 patients with severe dysplasia or carcinomain situof the larynx has been reviewed. The patients were divided into three groups according to treatment; Group A (16 patients) had received irradiation, Group B (24 patients) had developed invasive carcinoma less than 1 year after the diagnosis of carcinomain situand Group C (41 patients) had been observed for more than 1 year, receiving no treatment other than repeat biopsies. Of the latter group, 46% developed invasive carcinoma of the vocal cords, with a mean observation time of 51 months. Mean age at the onset of the disease was 66 years in patients where the epithelium returned macroscopically to normal during observation compared to 59 years in patients who developed carcinoma (P<0.05). This may indicate that subgroups of carcinomain situexist with different biological behaviour. No extra benefit was seen for the patients who received irradiation for carcinomain situ, and close follow‐up with, eventually, stripping of the epithelium is therefore advocated. Both altered anatomical site during observation and an increase in area of the lesion should be regarded as a warning signa

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02069.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A prospective study was undertaken to investigate an apparent correlation between ankylosing spondylitis (AS) and the incidence of otological conditions. 42 consecutive patients attending the ankylosing spondylitis clinic were examined otoscopically and had audiometric assessment. 19% of the patients (8/42) had active or inactive chronic otitis media. The prevalence of chronic otitis media in this group was significantly greater (P<0.01) than a stratified sample of the general population from the Medical Research Council Institute of Hearing Research National Study of Hearing, controlled for age, sex and socio‐economic group, where the expected incidence was 5%. A hypothetical explanation for the association is given and the need for HLA studies into chronic otitis media is discusse

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02070.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A postal questionnaire of all Consultant Otolaryngologists in the British Isles, and of General Practitioners within the local family practitioner committee area, was designed to compare the current practice in the management of discharge from the ear following grommet insertion.76% of the Otolaryngologists and 52% of the General Practitioners completed the questionnaire. Between the two groups, statistically significant differences were apparent in the management of this common complication of grommet surgery. A higher proportion of Consultants took a bacteriology swab of the ear as part of their treatment, which was significantly more frequently treated by antibiotic ear drops. Within the Consultant group, significant regional variations in choice of drugs and therefore the cost of treatment were apparent. The General Practitioners more commonly prescribed oral antibiotics.This common complication of grommet surgery is managed differently by General Practitioners and Otolaryngologists without a firm rational basis. Treatment based on current knowledge is discussed. Further evaluation of the efficacy of different treatment regimens by controlled prospective trials is required.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02071.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A double‐blind trial of Takeda's treatment of tinnitus by placing rare‐earth magnets close to the tympanic membrane was carried out on 50 patients. The trial failed to show significant benefit from this line of ther

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02072.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY