ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00774.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Thirty‐six patients, aged 12–75 years, with dry, central tympanic membrane perforations and a negative Valsalva manouevre and/or a negative aspiration/ deflation test, were included in a randomized, double‐blind, placebo‐controlled trial on the effect of a decongestant agent (xylometazoline chloride 0.1%) and placebo (saline 0.9%) applied directly to the pharyngeal opening of the Eustachian tube. Judged by the Valsalva manouevre, tubal patency was significantly improved after application of the active drug (P<0.003). In contrast, no effect was demonstrated by the aspiration test (P=0.80) or the deflation test (P=0.51). It is concluded that a topical decongestant improves Eustachian tube function but only at unphysiologically high pr

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00775.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The aetiology of tympanosclerosis following grommet insertion remains controversial. In this study tympanosclerotic changes of the tympanic membrane in 92 ears were shown to be related to the presence of intra‐epithelial haemorrhage shortly after myringotomy with grommet insertion (P<0.01) and to the grommet beingin situon follow‐up 6 months later (P<0.025). Ears in which haemorrhage was absent and where the grommet had extruded did not develop tympanosclerosis. These findings would indicate that bleeding, if causally implicated is not the sole aetiological factor, but careful attention to surgical technique to reduce this may subsequently minimize the development of tympanosclerotic chan

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00776.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A method is described for observing the pharyngeal airway in children with proven sleep apnoea using a flexible nasendoscope during light anaesthesia. Fifteen children were referred for endoscopic evaluation and treatment. All had documented obstructive sleep apnoea. Flexible endoscopic assessment of the airway revealed the site of obstruction in all cases and allowed a rational and successful management plan.The mechanism of obstructive sleep apnoea in infants and young children is discussed and the findings at endoscopy and results of treatment are reported.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00777.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

This study aims to assess the indications for histological examination of polypoid lesions removed from the nose. To achieve this we have performed a national survey of consultant ENT surgeons and reviewed 2866 nasal polypectomy operations. The operations were performed between 1982 and 1988 in the Radcliffe Infirmary, Oxford and the Freeman Hospital, Newcastle.One hundred and fifty questionnaires were sent to randomly selected ENT consultants in the United Kingdom. One hundred and seventeen were returned completed (return rate 78%). The questionnaire asked whether or not the surgeon sent all polyps for examination and, if not, what his indications were for so doing. A retrospective review of all nasal polypectomy operations at the two hospitals was performed. The questionnaire revealed that 38% of the surgeons who replied sent all nasal polyps for examination and 62% did not. The commonest indications for requesting histology were unilateral polyps, abnormal appearance and a history of bleeding. The review of polypectomies showed that 74% of cases in Oxford were examined histologically and 33% in Newcastle. Two per cent of polyps were tumours, of which half were malignant. There were no cases in this study in which unsuspected malignancy was found. All cases of nasal tumours, benign or malignant, were diagnosed clinically either in the Outpatient clinic or in the operating theatre.The results of this survey suggest that it is unnecessary to send all nasal polyps for histological examination.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00778.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Cricopharyngeal myotomy was performed on 60 patients suffering from cervical oesophageal dysphagia. Of 37 that had a Zenker diverticulum the diverticulum was excised in 24. All patients were free of symptoms on post‐operative follow‐up at 2–10 years. In 10 patients with a cervical oesophageal web or postcricoid stenosis, the ability to eat normal food was restored. In 7 of 9 patients with neuromuscular diseases affecting swallowing and 2 of 4 patients with cricopharyngeal achalasia, food intake improved after myotomy. Apart from 4 transient palsies of the left recurrent nerve and 2 patients with aspiration pneumonia, no serious complications occurred.Cricopharyngeal myotomy can be a safe and effective method to improve the swallowing and quality of life of patients suffering from cervical oesophageal dysphagia of varied aeti

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00779.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The survival rates of 58 patients treated for squamous carcinoma of the tongue between 1972 and 1985 were evaluated. The overall 5‐year survival rate was 41.6%; for stage I it was 61.8%; stage II 59.5%; and stage III, 27.7%. No patient survived for more than 2 years when their tumour was stage IV on presentation.A composite pull‐through resection with radical neck dissection gave a 5‐year survival rate of 50.7%, which was significantly (P

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00780.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

This retrospective study comprised 176 patients with squamous cell carcinoma of the oral cavity treated at The Linkoping University Hospital over a 19‐year period. Clinical parameters, microscopic malignancy grading (according to Jakobssonet al.and Glanz and Eichhorn), DNA cytofluorometry, analysis of therapeutic modalities and statistics regarding survival and prognosis are reported. The mean age was 70 years with a male: female ratio of 1.3:1One hundred and four patients had T1 or T2 tumours and 109 an N0 neck. Cervical lymph node metastases were more frequent in patients with larger tumours (T3+T4) than in those with smaller (T1+T2) (P<0.01), in tumours with a high malignancy grading compared to those with a low (P<0.05) and in DNA non‐diploid tumours compared to diploid ones (P<0.001).The aneuploid tumours responded better to preoperative radiotherapy than did diploid (P<0.01) or polyploid (P<0.05) tumours.Eighty‐nine per cent of the recurrences occurred within 1 year of initial therapy. Secondary treatment was successful in 15 of 37 (41%) patients in whom the tumour recurred either at the primary site or in regional lymph nodes, but only in 1 of 8 (12%) with recurrences in both locations.Surgery alone or combined with radiotherapy resulted in equivalent survival rates for tumours in stages I and II. In advanced stages combined radiotherapy and surgery gave better survival figures than either modality alone (P<0.01; Kaplan‐Meier).The presence of lymph node metastases (P<0.001), tumour size (P<0.01) and tumour ploidy (P<0.005) were the only clinical and histological parameters that significantly influenced survival (Cox regression analysis).located in the aerodigestive tract. Twenty‐four patients developed a secondary primary malignancy; 21 of

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00781.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A prospective study was carried out to compare blood loss from various types of nasal surgery, to investigate how accurately this loss was estimated during surgery and to find out how soon any losses were replenished.Blood loss during surgery was estimated, and by serial blood tests actual blood loss and continuing changes in haematological parameters were recorded.It was found that blood loss was highest when a nasal polypectomy and submucous resection were performed together and over the whole range of nasal surgery studied the actual blood loss was more than double the estimate during surgery. Although the blood volume recovers soon after surgery it was found that even after 6 weeks many patients had still not made up their loss of haemoglobin.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00782.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

One hundred and thirty‐four hemilarynges were examined for the presence of the ceratocricoid muscle. This muscle arises from the cricoid cartilage, below the posterior cricoarytenoid muscle, and inserts onto the posterior aspect of the inferior horn of the thyroid cartilage. A prevalence of 6.3% was found. The anatomy, relations and innervation of the muscle are discusse

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1990.tb00783.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY