ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00470.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Informed consent is the fastest growing problem in the medical negligence debate. It was highlighted recently in the United Kingdom in the Sidaway case.Informed consent comprises the advice you would give the patient, the consequences of not taking your advice, the specific risks of the surgery or treatment you have in mind, and the risks of surgery in general. In an attempt to identify what the present practice in otolaryngology was, a postal survey was carried out of the members of the Scottish and North of England Otolaryngological Societies.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00471.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A new surgical technique is described for the repair of salivary fistulae. It has been used in three patients. The fistulae occurred after laryngectomy and had been unsuccessfully treated with local and regional flaps. The principle of the technique is to use a bipedicled jejunal patch as a free microvascular transfer. One patch is used for reconstruction of the pharynx and after excising the mucosa the skin defect is closed with the other patch. The mucosa is excised to expose the muscle and to create a recipient site for a split skin graft.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00472.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Although adenotonsillectomy is regarded as a minor procedure, it has been shown that 18% of patients may experience an operative blood loss of 10–20% of the total blood volume. The aim of this study was to determine whether calcium alginate haemostatic swabs reduce operative blood loss in adenotonsillectomy.Seventy‐two patients (ages 2–12 years) entered a prospective trial in which the operation was performed either with normal gauze swabs or calcium alginate swabs. Thirty‐six children were randomized to each group. The mean blood loss was found to be 34.9 ml (2.07% of total blood volume) and 47.8 ml (2.97% of total blood volume) respectively.Although there was no significant reduction in operative blood loss using calcium alginate, in both groups the blood loss was much smaller than that stated by the majority of previous

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00473.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Sleep screening was used to discover the incidence of sleep apnoea in 50 children undergoing routine adenotonsillectomy for recurrent upper respiratory tract infections, randomly selected from the waiting list. Preoperative assessment included a detailed parental history, physical examination, and lateral cephalometry, in order to identify factors that might alert the clinician to a diagnosis of obstructive sleep apnoea.There were 2 equal groups of snorers and non‐snorers (grade 0); 1 patient was found to have the sleep apnoea syndrome (IV), 9 patients had obstructive snoring with apnoeic episodes (III), 3 patients had snoring with a disrupted sleep pattern (II), and 12 patients snored with no disruption of sleep (I).In identifying patients with apnoea, a history of snoring was unhelpful, whereas one of breathing irregularities was found to be highly specific. Nasal obstruction correlated poorly; however, there was a significant relationship between tonsillar position and size and sleep grade (Chi‐squaredP<0.01). Stepwise regression analysis showed a large contribution to the grading was made by the size of the oropharyngeal airway measured by lateral cephalometry. The children in grade II‐IV were re‐studied 3 months post‐operatively and all reverted to grad

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00474.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The relative ease with which different ear drops pass through grommets of different designs has been investigated using a laboratory model. The viscosities of the various ear drop preparations tested have also been determined. There is a considerable variation in the volume of ear drops required to penetrate ventilation tubes. Their ease of passage is determined by the size of the tube and is probably also related to the ease with which a preparation wets the surface of the grommet. There is no relationship between ease of penetration and viscosity. The penetration of ear drops through grommets during episodes of aural discharge was studiedin vivo.Penetration into the middle ear was observed only when the drops were introduced using the displacement technique. It was more readily achieved when the grommet lumen was free of discharge.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00475.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

This cross‐over study compares the relative benefits of a standard NHS contracted hearing aid with a high‐frequency emphasis commerical aid in subjects with high‐frequency hearing loss. Disability questionnaires and free‐field speech‐in‐noise (FAAF II) tests were used to assess subjects unaided and after 6 weeks of wearing each aid. Total FAAF II test scores showed no significant difference with either aid, but analysis of frequency‐specific subscores demonstrated less use of low‐frequency information when using the high‐frequency emphasis aid. Overall questionnaire responses relating to conversation showed more benefit with the high‐frequency emphasis aid. Subjects generally preferred this aid, possibly due to less low‐tone gain than

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00476.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The present study evaluates the results of septoplasty monitored by the objective peak flow nasal patency indices and the subjective patient self‐assessment scores of nasal obstruction. Mini‐Wright peak flow meters were used. The peak flow nasal patency index was defined as the ratio between nasal and oral peak flow rates. Uni and bi‐lateral, as well as ex and in‐spiratory, indices were calculated. Both peak ex and in‐spiratory flow nasal patency indices were significantly increased 1 and 6 months post‐operatively, indicating improved nasal patency. The most marked postoperative increase of the nasal patency indices was seen for the preoperatively worst airway and the total airway. A weak significant positive correlation was found between the peak flow nasal patency indices and the patient mean self‐assessment scores of the uni and bi‐lateral nasal obstruction. The change of the peak flow nasal patency indices measured 6 months post‐operatively correlated well with the patient overall assessment of the operative changes of the total nasal patency. The method was found quick and easy to handle in monitoring the effect of functional septoplasty and is recommended as an alternative

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00477.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

This paper is intended to provide guidance to candidates sitting the Final Fellowship Examination in Otolaryngology of the Royal College of Surgeons of Edinburgh. Although some of the advice given is specific to the Fellowship in Otolaryngology of that College, much of it is of relevance to any examination.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00478.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We present a prospective controlled trial, comparing methods of analgesia for the relief of discomfort on removing nasal packing, including a general discussion on the considerations for, and methods of, nasal tamponade. On the basis that nasal packing is likely to continue to be used frequently, nitrous oxide (as Entonox) is advocated as a safe and relatively cheap means of pain relief with a statistically significant advantage over papaveretum.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00479.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY