ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01093.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The problems of open radical mastoid cavities are well known. One of the ways to manage such problems is obliteration of the mastoid cavity. Most biological materials, such as muscle flap or bone chips/paste, tend to be resorbed with time, resulting in reformation of the cavity. The author reports a series of 34 mastoid obliteration operations using hydroxyapatite granules and an inferiorly based periosteal flap. The follow‐up period was between 1 and 5 years. The obliterated cavities remained small, stable and trouble‐free. Water was tolerated in the cavities allowing most patients to enjoy water sports. Only one patient had permanent discharge due to incomplete epithelialization of the obliterated cav

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01094.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Fifty patients with sleep‐related breathing disorders were tested with nocturnal polysomnography and with nasendoscopic diurnal polysomnography after diazepam administration, and various indices of breathing disorders were examined, and the results obtained in the two sleep studies compared. There were no significant differences between the two sleep studies in either the type of apnoea or the indices of breathing disorder except for the longest duration of apnoea. There was a significant difference in the duration of REM sleep between the two sleep studies, but no significant difference in the duration of each stage of non‐REM sleep. We speculate that nasendoscopic diurnal polysomnography with diazepam can be used as a substitute for nocturnal polysomnography in the clinical study of non‐REM sleep stage but it is not sufficient in evaluating REM sleep stage, in patients with sleep‐related breathing disorders without pathological obesity or abnormal respiratory f

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01095.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Thirty‐nine patients (42 ears) who have had a cultured autologous epithelial cell graft technique to a continuously discharging mastoid cavity have been evaluated to determine the continued effectiveness of this procedure. A postal questionnaire indicated a 58% improvement in both the smell and quantity of discharge, and our conclusion is that this is a very effective measure to provide extended symptomatic improvement in this troublesome conditio

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01096.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

This study evaluates the use of transient evoked otoacoustic emissions as an alternative to pure tone audiometry for the assesment of hearing after tympanostomy tube insertion. Otoacoustic emissions and pure tone audiometry were carried out in 32 patients in whom tympanostomy tubes had been inserted. Otoacoustic emissions were detected in 78% of patients, whereas pure tone audiometry testing was only possible in 59%. Of 13 children who were 3 years of age or under, otoacoustic emissions could be measured in 62%, compared to pure tone audiometry which was only possible in 8%. Otoacoustic emission testing took on average 3 min, which was less than half the time for pure tone audiometry testing which took 7 min.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01097.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Variability between observers and specificity of sinus radiographic findings are subject to discussion. The aim of this study was to assess interobserver variability, between four physicians, two otolaryngologists and two radiologists, in the evaluation of 100 maxillary sinus radiographs. Equal agreement was found within the specialities when rating radiographs as normal or abnormal (80%). Kappa values for interobserver agreement were 0.45 for otolaryngologists and 0.58 for radiologists, both representing fair to good agreement. Otolaryngologists reported more abnormalities (67 vs, 57). Agreement on specific findings (complete opacity, fluid level and mucosal swelling) was fair to good (kappa values between 0.38 and 0.83). Agreement between the four physicians was lower on all outcomes. It is concluded that interobserver variability is within acceptable limits and justifies the continued use of conventional sinus radiographs for confirmation of maxillary sinus disease.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01098.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Operations to reconstruct defects of the ossicular chain conventionally involve the creation of a link between the malleus handle or tympanic membrane and the head of the stapes. These procedures do not produce satisfactory hearing results in a significant number of patients and must be considered unphysiological. Over the last 5 years the author has been using an alternative approach for patients with defects of the long process of the incus but an intact stapes arch in which the defect is repaired with a small cortical bone graft. Because of the way in which the graft fits over the stump of the long process it is called the ‘sleeve’ technique. So far 30 operations have been carried out and 21 patients have been followed for more than 1 year. The hearing results in these patients have been compared with those for patients with the same ossicular defect who have undergone conventional reconstructions by the same surgeon. There were significantly larger hearing gains (P<0.04) and smaller postoperative air‐bone gaps (P<0.04) at 1 year in the ‘sleeve’ technique group. The technique is easy to perform and therefore appears to be the technique of choice in ears with partial erosion of the long process of

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01099.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

There is continued encouragement to increase the use of day surgery. Recent publications have suggested that day‐case tonsillectomy is a safe procedure due to the low primary haemorrhage rates (0.14–3.5%). One of the suggested benefits of day surgery is that patients want it. They prefer to recover at home after an operation. With tonsillectomy, personal experience suggested that this was not the case. A review of 117 patients having tonsillectomy was undertaken. All patients stayed in for at least one post‐operative night. No patients or parents thought that the post‐operative stay was too long (80%‘just right', 20%‘too short') and only 7% would have been happy to go home on the day of operation. ‘Safety’ does not automatically make an operation suitable for day‐case surgery. Pain, nausea, vomiting, drowsiness and anxiety about the operation and post‐operative course were all reasons given for not wanting to go home on the day of surgery. The justification for the increased use of day surgery is that it increases efficiency by reducing costs per case while maintaining the quality of care. One aspect of quality of care is patient acceptability and before day‐case tonsillectomy is acceptable to patients the factors responsible for the post‐operative morbidi

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01100.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A new test of olfactory function, the combined olfactory test, has been designed to assess odours easily recognizable by the test population. The test consists of an odour recognition test of nine odours, where an odour in a bottle is chosen from a list of four possible odours in a forced choice manner. This is followed by a threshold test using a series of three‐fold dilutions of l‐butanol. The mean of the two scores is the combined olfactory score. The test was subjected to a validation study. It was performed on 133 participants with a normal sense of smell and a normal rhinological examination and on 94 participants who said that they did not have a sense of smell. There was a highly significant difference between the combined olfactory score in the normal and ‘anosmic’ groups (P<0.001). This significant difference was the same between the two groups for the threshold and odour recognition arms of the test. There was a highly significant differece (P<0.001) between the two subgroups of ‘completely anosmic’ and ‘almost anosmic’ participants, indicating that the test could grade the degree of olfact

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01101.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The receptors and neural pathways involved in the common symptom of nasal blockage are of great interest. Studies to date suggest that the sensation of nasal patency may be related to the temperature of the nasal passages. Sixty‐two subjects were asked to assess their own nasal patency subjectively and indicate this on a visual analogue scale. The temperature of the nasal lining was continuously recorded during quiet nasal repiration using a non‐contact infrared themometer. The cooler the nasal lining, the clearer the nose felt, and the greater the drop in temperature on inspiration again the clearer the nose felt. The study supports the previously proposed hypothesis that the sensation of nasal airflow is derived from a cooling of the nasal lining on inspiration, and this is probably detected by cold thermoreceptors in the muc

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01102.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY