ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00819.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Thirty normal incudes were examined using scanning electron microscopy (SEM) to assess the pattern and degree of bony remodelling. The body and short process appeared stable throughout life. By contrast, the lenticular and long processes demonstrated marked osteoclastic activity with a tendency to undergo progressive erosion with advancing age.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00820.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Objective nasal airflow resistance, as measured by the rhinomanometer, and the subjective sensation of nasal patency are usually regarded as showing poor correlation. However, previous population studies comparing nasal resistance and subjective nasal airflow sensation have failed to takee into account the great individual variation in resting nasal resistance. To investigate the potential relationship between the two parameters, 20 healthy volunteers underwent histamine nasal challenge tests. Nasal resistance prior to the intra‐nasal administration of histamine (‘resting’ nasal resistance, NRR) was compared with nasal resistance when the subject reported a subjective sensation of nasal blockage (‘obstructed’ nasal resistance, NR0) and the two were found to be significantly correlated using the Spearman rank correlation method (rs= 0.648, P = 0.002). Linear regression analysis using the method of least squares demonstrated an association between the two variables (P = 0.029), conforming to the formula NR0= 1.26NR + 0.478, (resistance units kPa.s.1−1). Subjective and objective measurements of nasal patency may be much more closely related than has previously be

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00821.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The selection of children with otitis media with effusion for adenoidectomy has been criticized on a number of grounds. In spite of the widespread popularity of the procedure there are few objective guidelines to help the otolaryngologist make a decision which is therfore usually subjective. We present a scientifically derived model using a Generalized Linear Interactive Modelling (GLIM) technique from a population of 122 children who underwent either adenoidectomy or no pharyngeal surgery. The outcome parameter studied was otoscopic clearance in an unoperated ear 1 year after treatment. This was related principally to the operation type (P<0.001) and to the age at which the operation was performed (P<0.005). Using a probability of clearance threshold of 50% the model was tested on a prospective population of 166 children and outcome was correctly predicted in over 72%.This model enables the surgeon to determine the probability of clearance of effusion following adenoidectomy in an individual child. At a probability threshold of 50% adenoidectomy would be offered to children with bilateral otitis media with effusion aged between 4.33 and 8.00 years. Over the age of 8 years the probability of clearance occurence spontaneously increases beyond 50%. By careful selection of the probability of clearance thresholds it was possible to produce otoscopic resolution in over 80% of those selected undergo adenoidectomy.The model also enables the otolaryngologist to determine the proportion of children with established disease that require adenoidectomy at his own chosen probability thresholds which will ensure that a more effective resource allocation is achieved.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00822.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Freeze‐thawed co‐axially aligned skeletal muscle autografts provide new concept in peripheral nerve repair, and are being investigated in the repair of mixed motor/sensory nerves. These grafts provide an orientated matrix of large basement membrane tubes through which regenerating axons can migrate and reinnervate the distal nerve.Using the buccal branch of the rat facial nerve as a model, we compared five freeze‐thawed muscle autografts with five interposed nerve autografts. Some 300 days after grafting, the morphology of the distal nerve was evaluated.When the two groups were assessed morphometrically, it was found that nerve grafts showed a small but significant improvement over muscle grafts in respect of indices of the fibre matur

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00823.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The deleterious effects of parental smoking on the upper respiratory tracts of children are becoming increasingly recognized. This study examines the effect of parental smoking on the frequency of tonsillitis and incidence of tonsillectomy in children. A group of children being admitted for tonsillectomy and a control group of children from an orthoptic clinic were studied.Details recorded about the children included a history of tonsillectomy and the number of courses of antibiotics taken for sore throats in the previous 12 months. Parents were questioned about their smoking habits. A marked and statistically significant association has been found between the incidence of tonsillectomy in children and parental smoking in the home environment. There was a higher frequency of attacks of tonsillitis requiring antibiotic treatment in those children whose parents smoked. This effect may be mediated by altered oropharyngeal flora, mucociliary dysfunction, increased cross infection or a combination of these. If parents are encouraged to stop smoking there will be a reduction in tobacco smoke levels in the home environment and this should lead to a fall in both the incidence of tonsillitis and the need for tonsillectomy in their children.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00824.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The objective measurement of alaryngeal speech is desirable so that results between different centres can be compared. We examined several phonatory parameters of alaryngeal speech with the Visi‐pitch and correlated these with the subjective assessment of voice quality. Amplitude, percentage voiced and perturbation correlated extremely well with the subjective assessment of voice qualit

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00825.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Over the past 11 years, 25 primary and 29 secondary tracheo‐oesophageal punctures have been performed in 51 laryngectomees. Pre‐operative assessment is required for the secondary procedure. Both primary and secondary procedures require intensive speech therapy after fitting of the prosthesis. Fifty‐four per cent of the primary and 37% of the secondary patients attained long‐term speech, the latter figure rising to 58% with newer valves and increasing experience. Failures were commonly due to psychological or prosthesis‐related problems. Complications were relatively minor, none being life threatening. Seventy per cent of the long‐term users were self caring. Adequate rehabilitation counselling and support is necessary to ensure long‐term use of t

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00826.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A total of 85 children on the waiting list for grommet insertion aged between 3 and 10 years with bilateral chronic otitis media with effusion (OME) were assigned at random to an observation or treatment group. Those in the treatment group were given the Otovent® device to use three times a day for the duration of the study and both groups were then seen at monthly intervals for 3 months for pneumatic otoscopy and tympanometry. Statistically significant improvement was seen in those using the treatment with a compliance of more than 70%. This was detected on the outcome measures of tympanometry and pneumatic otoscopy after 1, 2 and 3 months. No side effects were demonstrated.We conclude that autoinflation is an effective short‐term treatment for children with OME when used regularly under supervisi

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00827.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The stoma following laryngectomy may be placed either within the incision or separately. To determine if this variation had a bearing on its ultimate size, measurements of the stoma size were carried out in 61 patients who underwent laryngectomy by one of these methods. It was found that the stoma was nearly twice the size in patients in whom the stoma had been sited within the main wound and that there was a minimal need for the use of a tube or stoma button post‐operatively in these patient

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00828.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY