ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00759.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

In a study of 3466 claimants for noise‐induced occupational hearing loss tinnitus was reported by half of the patients. Its characteristics in this select group were different from tinnitus seen in other groups. Specifically, tinnitus prevalence seemed to be independent of age, state of hearing and duration of noise exposure if greater than 10 years. The reasons for these differences are unclear, though the possibility of financial motivation by some claimants is raised. Further work in this area is urgently required to achieve standardization and objectivity. Being a subjective complaint these aims will be difficult to accomplish. However not until then can a fair handicap scale be developed for workers who develop this disquieting symptom as a result of their occupatio

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00760.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Producing deliberate damage to the facial nerve in the middle ear is an established method of treating idiopathic hemifacial spasm. However, no previous electrophysiological studies have investigated the effect of this operation on facial nerve function. Eleven patients undergoing transtympanic facial nerve needling were investigated with electromyography. Following operation reduction in the abnormal discharges and synkinesis typical of hemifacial spasm was seen in the majority of patients. The success of this type of operation, although temporary in some patients, together with other neurophysiological studies conflicts with the hypothesis that this disorder is duetoephaptic transmission caused by vascular compression of the facial nerve in the cerebello‐pontine angl

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00761.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Seventeen stab wounds to the cervical region presenting over a 3 year period are described. Clinical assessment, appropriate investigations and surgical management are discussed. Examination of the oral cavity for the presence of blood or displacement of the lateral oropharyngeal wall by an expanding haematoma, assessment of air bubbling from a wound, particularly on coughing, chest and lower cranial nerve examination are all required. Blind probing or attempted clamping of a bleeding vessel in a neck wound is not recommended. The use of urgent angiography in stab wounds high in the neck behind and above the angle of the mandible is recommended. Primary repair is optimal for all laryngotracheal, pharyngo‐oesophageal and significant neurological injurie

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00762.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00763.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The aim of this study was to assess whether patients with open mastoid cavities should be advised to avoid water contaminating the ear in order to avoid aural discharge. A detailed history and clinical examination was performed on 53 patients with a unilateral modified radical mastoid cavity of more than 5 years duration. The results showed that it is possible to identify reliably the well‐designed trouble‐free cavity by the features of its skin lining and the ability to visualize the entire cavity through a size 4 Siegle speculum. A patient with this form of cavity very rarely develops aural discharge following water exposure and need not protect the ear during washing but should do so when swimming because of caloric effe

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00764.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

In this retrospective study of 130 ears over a 5‐year period, the effect of intubation with the Goode T‐tube was evaluated. The tubes improved the hearing in 86% of ears with a conductive loss secondary to a middle ear effusion to an average 5 dB air‐bone gap. They improved the early stage retracted tympanic membrane but had no effect on the established postero‐superior retraction pocket. They were successful in treating barotrauma. The main complication with their use was otorrhoea which occurred in 28% of ears, and persistent perforation occurring in 6% of the ears. Seventy‐seven per cent of tubes were in place after 36 months. Extrusion was significantly related to infection in the ear, and also to the presence of glue on insertion but there was no correlation between the number of previous grommets or the age of the patient. The Goode T‐tube is advocated for use in middle ear effusion refractory to conventional grommet insertion or that due to

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00765.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Forty‐seven patients with acute mastoiditis were treated in our hospital over a 2 and a half year period. Seven patients were symptomatic for a short period only. The other 40 gave a history of chronic ear disease, 22 of them with cholesteatoma. Post auricular swelling is an important sign of acute mastoiditis but was found in only 64% of the patients. Forty‐five percent of our patients were found to have infection spread beyond the mastoid. Meningitis was the most common complication (13 patients). Most of the patients who presented without post auricular swelling were diagnosed as a result of having one or more complications. We believe that in cases of intracranial pathology or septic fever associated with ear disease, the diagnosis of mastoiditis is most likely. Early operation combined with appropriate antibiotic treatment can prevent further complications and fatal outc

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00766.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Patients with adult onset otitis media with effusion are generally subjected to an examination and biopsy of the nasopharynx under a general anaesthetic to exclude a neoplasm of the post‐nasal space. The likelihood in Caucasian countries of a tumour being detected has not been clearly denned. The clinical features of the 55 patients with nasopharyngeal malignancy presenting to the Glasgow hospitals since 1970 have been analysed, and the incidence of malignancy in all adults presenting with middle ear effusions has been assessed in order to define the association of the 2 conditions. The study confirmed that while an effusion is commonly associated with a nasopharyngeal tumour (33%), in only 2% was it the sole clinical manifestation at the initial consultation. In addition, adults with effusions, but without other symptoms and signs suggestive of a tumour, are unlikely to harbour a tumour, the incidence in this review being 0.4%. Therefore, an examination and biopsy of the nasopharynx under general anaesthesia is likely to give a very low yield of additional information in cases of isolated middle ear effusions in adults, and the cost effectiveness of the procedure should be questione

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00767.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Thirty‐two consecutive patients undergoing middle ear surgery using local anaesthesia were assessed on the adequacy of anaesthesia for their surgery, both by the patients themselves, and by the surgeon. A method of local anaesthesia is described which includes the possibility of inducing an iatrogenic transient homolateral facial weakness in order to simplify the technique of administration of anaesthesia. Both the surgeon and the patients were happy with the quality of the anaesthesia, and no adverse effects occurred either as a consequence of the local anaesthesia itself, or of the transient facial weaknes

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1988.tb00768.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY