ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00840.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Four present‐day surgical techniques are reviewed to assess their respective merits in surgery for cholesteatoma. The oldest method with an open cavity in ears with mastoid extension of cholesteatoma if combined with partial obliteration is still suitable for less experienced surgeons. Transcanal atticotympanotomy is suitable for limited epitympanic and tympanic cholesteatomas as long as it provides a direct view of the operative field. In similar ears, canal wall up surgery is employed if, additionally, mastoidectomy is needed because of chronic inflammation. Canal wall down surgery with full cavity obliteration with a musculoperiosteal flap, bone chips and bone pate should be the method of choice for all cholesteatomas extending beyond the facial nerve canal. The canal skin is kept as an intact tube and provides quick healing. Open cavities should be revised using similar obliteration techniques but, because of the lack of an intact canal skin tube, making use of a large modified Körner skin fl

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00841.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Inferior turbinectomy, often combined with septal surgery, is frequently performed in the surgical treatment of nasal obstruction. A patient with post‐operative greater palatine anaesthesia occurring after this procedure prompted a study of the anatomy of the greater palatine nerve in the region of the inferior turbinate. Sixty‐four lateral nasal walls were examined in cadavers. A dehiscence rate of 22% was noted, and in an additional 55% there was only a minimal bony covering to the nerve. Dehiscences occurred exclusively in the inferior meatus, anterior to the posterior bony end of the inferior turbinate. The narrow antero‐posterior extent of the dehiscence, the hard dense lateral nasal wall bone and the lateral position of the nerve in the canal help to protect the nerve from surgical trauma during turbinate su

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00842.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The incidence, origin, structure and composition of middle ear corpuscles (MEC) were studied by dissection microscopy, by special stains and immunocytochemistry of histological sections and by transmission electron microscopy. MEC are formed within fibrous bands derived from transparent fibrous sheets which appear mainly in the mastoid antrum in the middle‐aged and elderly. MEC are covered by a layer of epithelial cells with a normal basal lamina, and are largely composed of concentric layers of collagen which display alternating positive and negative birefringence.Pulmonary and prostatic corpora amylacea show a similar light microscopical structure and age relationship, but contain amyloid. It is suggested that MEC and the other bodies may be organized foci of epithelial basement membrane expansion perhaps derived from anin vivocounterpart of the ‘domes’ seenin vitroin some monolayer epithelial cul

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00843.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Conductive deafness is a common feature of the Treacher Collins syndrome. The bilateral, essentially symmetrical hypoplastic deformities of middle and external ears, are characteristic. Improved imaging of the deformities using high resolution computed tomography (HRCT) has accompanied a present reluctance to explore surgically these middle ears because of poor results and the increasing success of bone anchored hearing aids. We describe the results of HRCT in 13 patients with Treacher Collins syndrome. An unpneumatized mastoid and a greatly reduced attico‐antral region are almost constant findings, but a proportion of patients have a patent external auditory meatus, and, only in these is exploratory surgery feasible. Correction of ossicular deformities may be possible. Patients with atresia of the external auditory meatus are not suitable for exploration and need bone anchored hearing aids. Imaging for these children should be limited with regard to radiation dose and sedatio

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00844.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A histological and bacteriological study of 129 pairs of tonsils from patients with recurrent acute tonsillitis showedactinomycesto be present in 29.5%. The organism, however, was also present in 40% of tonsils from 10 patients with no history of tonsillar disease. In neither of these groups was there any specific evidence of tissue reaction toactinomycesnor was there a male preponderance as in clinical actionomycosis. The presence ofactinomycesin the tonsil was not favoured by the concurrence of β‐lactamase producing bacteria.These data indicate thatactinomycesdoes not have a causal role in recurent acute tonsillit

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00845.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Acoustic rhinometry was performed in 35 normal nose‐breathing children between 3 and 6 years. The average cross‐sectional areas at the nasal valve, at the anterior end of the turbinates, and in the nasopharynx were 0.34±0.06 cm2, 0.35±0.08 cm2and 1.37±0.48 cm2respectively. The average minimal cross‐sectional area was 0.29±0.06 cm2. The minimal cross‐sectional area was located at the nasal valve in 14 and at the anterior end of nasal tubinates in 21 of the 35 children.As would be expected, the cross‐sectional areas at different sites of the nasal cavity increased with increasing age of the children. But, whereas the minimal cross‐sectional area increased by 0.024 cm2per year, the nasopharyngeal cross‐sectional area increased by 0.20 cm2per year. No significant differences were found between boys and girls. Measurements of the posterior nasal and nasopharyngeal cross‐sectional areas were unreliable, whenever the minimal cross‐sectional area was less than 0.2 cm2. Furthermore, assessment of the nasopharynx may be difficult because of involuntary movemen

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00846.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This paper reports the results of a study to determine whether pulsed electromagnetic stimulation, applied over the mastoid bone, caused an improvement in the level of tinnitus in long‐standing tinnitus sufferers. Fifty‐eight patients from the Liverpool Tinnitus Association volunteered to take part in a double‐blind placebo controlled trial. Active and placebo devices were randomly allocated to these patients on their first visit. At the end of one week of treatment, each patient noted whether their tinnitus had completely disappeared, was improved, unchanged or made worse by the treatment. Forty‐five per cent of the patients who completed the trial were improved by the active device, but only 9% by placebo (P= 0.0013, Mann‐Whitney test). We suggest that electromagnetic stimulation may be an effective treatment in some tinnitus

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00847.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Adenotonsillectomy is traditionally performed as an in‐patient procedure. Although day‐case adenotonsillectomy is practised in some units in the USA, Canada, Finland and Israel, it is rarely practised in the UK. This study looks at a cohort of 100 consecutive children admitted for adenotonsillectomy and follows their progress after discharge. It also assesses parental attitudes to day‐case surgery. The results highlight parental anxiety associated with day‐case adenotonsillectomy. Only 28% of parents would have liked the procedure to be carried out on a day‐case basis with 46% of parents considering a single night stay to be too short. More support must be given to parents in the UK if day‐case adenotonsillectomy is to become an acceptabl

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00848.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The effects of topical beclomethasone dipropionate on changes in nasal resistance and secretion induced by topical histamine were studied in eight patients with perennial rhinitis.Patients were studied at enrolment, after 3 weeks of beclomethasone (100 μg spray to each nasal cavity twice daily), and after 3 weeks of placebo (saline) treatment administered in a double‐blind cross‐over trial. Nasal airflow resistance (Rnaw) and total protein, albumin, lysozyme and glycoconjugate secretion in nasal lavage fluids were measured after topical application of histamine to the nasal mucosa.Resistance measurements and secretory parameters were similar for the initial study and after placebo treatment. In those studies, histamine (1 and 10 mg) increased both nasal resistance and secretion of total protein, albumin and glycoconjugates. After beclomethasone treatment the rise in respiratory resistance in response to histamine was significantly attenuated (ΔRnaw, + 11.57 cm H2O/1/s with placebo, +5.80 with beclomethasone,P<0.05). Beclomethasone had no effect on histamine‐induced secretion.Because nasal resistance is determined mainly by vascular processes, beclomethasone treatment appears to have a prominent action on the vascular bed to reduce mediator‐induced vasodilatation in perennial

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00849.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY