ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02086.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Nasal obstruction influences respiration during sleep and nasal packs may cause obstructive sleep apnoea. In order to investigate this, the perioperative oxygen saturation was monitored for 3 nights with continuous pulse oximetry in 12 patients, who had bilateral nasal packs after septoplasty. A significant increase in the number of nocturnal episodes of hypoxia and a significant prolongation of the mean duration of the individual hypoxic periods were demonstrated during the first and the second post‐operative nights. The clinical significance of these results is as yet unknown, but the use of partial nasal packing in septoplasty is advocated. Further investigations of nocturnal oxygen desaturation and design of nasal packs, securing the post‐operative nasal airway, are nee

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02087.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Thirty‐four patients with bilateral vocal cord abductor paralysis were treated surgically during the period from 1960 to 1979. The main cause of paralysis was thyroid surgery (85%). Woodman's external laterofixation was performed in 31 patients, 1 had laterofixation by laryngofissure and 2 had endoscopic arytenoidectomy. In Woodman's procedure the body of the arytenoid cartilage was removed in 10 cases and mobilized from the cricoarytenoid joint in 21 cases. Thirteen of the 34 patients needed further surgery. Including previously performed procedures in 6 patients, altogether 68 operations were performed and 17 patients (50%) were operated on more than once. The immediate failure rate of laterofixation was 22% but the need for reoperation increased with time and the total failure rate of the method was 44%. Endoscopic arytenoidectomy was successful in 1 of 2 cases as a primary operation and in 3 of 3 cases as secondary operation. Follow‐up time ranged from 2 months to 29 years 8 months (mean 15 years 10 mont

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02088.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

52 patients with laryngeal carcinoma were studied before and after laryngectomy with regard to what factors might influence the development of oesophageal speech. The investigations consisted of oesophageal manometry, a follow‐up interview and a review of surgical approaches and radiotherapy. 43% of the patients achieved socially acceptable oesophageal speech, 22% were able to speak single words, and 35% had no oesophageal speech at all. 61% had post‐operative dysphagia. Age was the only factor which significantly correlated to intelligible speech. The intraoesophageal pressure during oesophageal phonation exceeded in all cases the low PO‐HPZ pressure after operation. The extension of surgery and radiation field, severity of dysphagia, alcohol and smoking habits, and mental condition did not differ between the 3 groups of oesophageal speech. It was concluded that the rather complicated process of acquiring oesophageal speech is much more dependent on learning ability which decreases with age than on various kinds of motor dysfunction after larynge

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02089.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Previous reports of an association between HLA tissue type and Wegener's granulomatosis are contradictory. By using for the first time a highly sensitive restriction fragment‐length polymorphism (RFLP) analysis in addition to standard microcytotoxicity assays, the largest series yet investigated (41 patients) was tissue typed. No association was found between any specific HLA antigen and Wegener's granulomatosis. Although the condition appears to be immunologically mediated, this study indicates that the HLA antigens do not have a major rol

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02090.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

This study assesses the prevalence of psychological disturbance among a consecutive series of 120 neuro‐otology outpatients, using a structured interview conducted by a clinical psychologist. 42% of all patients were found to be in need of, and were offered, psychological help (27% of those with hearing loss, 45% of those with tinnitus and 64% of those with dizziness). 86% of those offered psychological help accepted it. Current psychological distress was associated with the number of symptoms complained of and past psychiatric history. Patients completed the General Health Questionnaire which was found to have a sensitivity rate of 82% and a specificity rate of 87% in this setting. Physicians were also asked to rate patients' psychological state; close agreement was found between these ratings and those of a psychologist. The contribution of psychological assessment of neuro‐otology patients is discus

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02091.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

This prospective study examined the influence of aspirating middle ear effusions, immediately prior to ventilation tube insertion, upon the subsequent development of otorrhoea and tympanosclerosis. 50 children were studied and aspiration of effusions did not influence the incidence of purulent otorrhoea or ventilation tube obstruction within 1 month of surgery. The development of tympanosclerosis did not correlate with effusion aspiration, but in those ears which had an effusion aspirated there was a relation between operative bleeding and the development of tympanosclerosis.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02092.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

We present 70 patients with tumours of the posterior pharyngeal wall, considering tumours of the posterior hypopharyngeal and posterior oropharyngeal wall as one unit.Almost half (45%) of the patients were in poor general condition at the time of presentation, and 60% had Stage III or IV tumours. One‐third of the patients were untreated, and surgery was mainly reserved for patients with Stage I and II tumours. The larynx could be preserved in two‐thirds of those undergoing surgery. The best current method of repair of the posterior pharyngeal wall after partial pharyngectomy appears to be a revascularized radial forearm flap.The median survival for patients with Stage I tumours was 236 weeks, but for patients with Stages II‐IV tumours was only 33 weeks. There was no significant difference between the survival for II–IV stage groups, but there was between Group I and the rest.We identify 2 defects in the UICC classification system: lack of definition of the lateral limit of the posterior pharyngeal wall, and a gross discrepancy between size and T staging of tumours arising primarily from the posterior wall of the hypo

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02093.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

expression of EGFR was determined immunohistochemically in two groups of patients with glottic carcinoma, one that recurred after a full course of radiotherapy and one that did not. Using a 4‐graded scale (‐, +,++,+++) 80% (12/15) of the recurrent carcinomas had a staining intensity and proportion of stained cells of ++ or more. The same figure for non‐recurrent carcinomas was 39% (7/18). The difference is statistically significant (chi‐squared with Yates' correction,P&<5). The results indicate that an increased expression of EGFR may influence the rate of recurrence of glottic squamous cell carcinoma after radio

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02094.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Forty‐nine patients underwent 158 procedures (including 19 revisions) for complete facial palsy. The variety of causes of facial palsy are enumerated, with the various procedures used to rehabilitate the face. Some improvement is invariably achieved. It is concluded that a readiness to intervene with a wide choice of procedures as early as realistically possible offers the best outcome in function and cosmetic appearanc

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1991.tb02095.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY