ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00440.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

This study presents a series of malignant parotid tumours treated at the Institut Gustave‐Roussy between 1975 and 1984. The lesions represented a wide variety of histological types. Few preoperative investigations were required, management being based on histology. Effective local control requires a total parotidectomy preserving the facial nerve where possible. It should be followed by routine radiotherapy which appears to reduce the incidence of local recurrence. The rate of local recurrence also depends on the histological type. It is seen more frequently in an adenocarcinoma following a pleomorphic adenoma than in simple adenocarcinoma. Patients with inoperable disease are treated with radiotherapy alone as chemotherapy has not so far been effective. Percentage 5‐year survival for the three most common tumour types is as follows: adenocarcinoma: 49; adenoid cystic carcinoma: 83, and mucoepidermoid carcinoma:

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00441.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A personal series of 1171 patients with a laryngeal tumour seen in a 27‐year period from 1962 to 1988 is reported. Of these patients, 763 were previously untreated and had a histologically proved squamous cell carcinoma. The interaction between the host factors (age, sex and general condition) and other tumour factors, and the effect of the host factors on survival were analysed.The maximum age incidence was the same in the two sexes but performance status (general condition) declined with increasing age. There was no relation between age and site or histological grade of the tumour. However, the incidence of T3‐T4tumours increased up to the seventh decade and then declined again. Age was not a significant predictor of survival when allowance was made for patients who were untreated, or who had died of intercurrent disease or a second primary tumour.Men were more likely to have a glottic tumour: these tumours presented at an earlier stage and were likely to be well differentiated, mainly because glottic T, carcinoma is almost exclusively a male disease. When individual sites are examined the crude survival for supraglottic tumours in women is better than that in men because of a higher death rate from other diseases and other tumours in men. Sex had no other effect on survival.Good performance status was associated with lower T‐stage but not quite significantly so. It was not associated with any other tumour parameters. Performance status significantly affected survival of treated patients, probably indicating that general condition affects the patient's ability to resist his t

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00442.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A prospective study was designed to assess the relative merits of pneumatic otoscopy and tympanometry in predicting the presence of a middle ear effusion, and to determine if both tests in conjunction provided any significant advantage. In 121 patients (222 ears) pneumatic otoscopy with a Seigles speculum and tympanometry were performed prior to myringotomy. An immobile tympanic membrane on otoscopy, or a Jerger type B curve on tympanometry were considered indicative of a middle ear effusion. There was no significant difference (P>0.05) between the predictive value of pneumatic otoscopy (88%) and tympanometry (89%). When pneumatic otoscopy and tympanometry were used in conjunction, the predictive accuracy did not increase significantly. Pneumatic otoscopy and tympanometry are simple and reliable methods of predicting the presence or absence of a middle ear effusion. Their use together did not increase diagnostic accuracy.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00443.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The incidence rate of laryngeal papillomas in a Danish subpopulation (approximately 2.8 million inhabitants) was 3.84 × 10‐6per year in the period 1968–1984. For juvenile papillomas the incidence rate was 3.62 × 10‐6, compared with 3.94 × 10‐6for laryngeal papillomas of adult onset.When comparing different time periods a significantly low incidence was found in the time 1965–1968, while the incidence remained constant in 1969–1984. The low incidence rate in the early period may be real, but selectional bias may have played a part. It is in general anticipated that maternal genital HPV‐infections may serve as an HPV‐reservoir, and that juvenile laryngeal papilloma is a result of HPV transmission from the mother to the child during birth. In the period in question cervical HPV‐infections have been recorded with increasing frequency in younger women, indicating that the prevalence is rising. However, this is not reflected in the incidence of

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00444.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A questionnaire was sent to 26 successful candidates at the Royal College of Surgeons of London final fellowship examination in Otolaryngology. Twenty were returned complete. An audit of the surgical training and exam preparation of the candidates is presented. All candidates worked in teaching hospitals at the time of passing the exam and most received tuition from senior registrars. All candidates worked in the Midlands or South of the country. Fourteen of the 20 possessed another surgical fellowship. The average time spent in ENT was 29 months and in training outside ENT was 21 months.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00445.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Vertigo induced by aural suction was abolished by maintaining a constant temperature in the mastoid cavity during the procedure. This was achieved using humidified air at 38°C at the wider end of the aural speculum. The cavity temperature fell by a maximum of 0.2°C (average) in 24 patients, none of whom experienced rotatary vertigo despite prolonged suction. This contrasted with a maximum temperature drop of 8.9°C (average) in the same group of patients, 18 of whom then suffered vertigo and nystagmus, when the cavity temperature was not controlled during sucti

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00446.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The increasing detection of asymptomatic hypercalcaemic patients by biochemical screening has led to an increase in the number of patients referred for neck exploration. Familial Hypocalciuric Hypercalcaemia (FHH) has emerged as an important condition to distinguish from primary hyperparathyroidism as a cause of hypercalcaemia. Patients with FHH are usually asymptomatic, have similar biochemical findings to primary hyperparathyroidism, but fail to respond to parathyroid surgery.We have studied 15 members of a large kindred with FHH. The initial diagnosis was made in the propositus after a failed neck exploration for presumed primary hyperparathyroidism. Of the 7 affected members, 2 had recurrent acute pancreatitis and 2 had incidental malignant disease with no evidence of bony involvement.Measurement of the calcium: creatinine clearance ratio provides a good method of identifying hypercalcaemic patients who might have FHH. A ratio of less than 0.013 is an indication to screen first‐degree relatives before considering neck exploratio

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00447.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Published data on the frequency of otitis media with effusion in pre‐school children do not give a uniform view about the age‐specific rates. A cohort of 1439 2‐year‐old children in the Netherlands was followed using serial tympanometry on 9 consecutive occasions up to 4 years of age. The screening rate decreased from 87% on the first occasion to 73% on the last round.The prevalence rates in this study are high compared to results quoted in the literature. At least 80% of the children had otitis media with effusion on at least one occasion before the age of four. Distinct seasonal variation was found in the rates. It is postulated that middle ear effusion is a ‘physiological’ phenomenon at pre‐school age with some pathologic

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00448.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Thirty‐seven patients with chronic otitis externa were investigated for contact hypersensitivity to 49 agents using standardized patch testing. Positive reactions were found in 22 (58%) patients. This incidence is higher than the 40% found in the only previous similar study and is within the range of 32–72% found in patients with contact dermatitis. The average age of subjects showing sensitivity was 56.7 years compared with 34.9 years for those with negative tests. This significant age difference suggests that contact hypersensitivity is not an aetiological factor in the younger patient. There was no significant difference in the duration of otitis externa between those with positive and negative tests. This feature has not been previously examined or reported. Neomycin was the commonest sensitizing agent, sensitization occurring in 12 (32%) patie

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00449.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY