ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00976.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Recordings by combined glottography of vocal cord movements in patients with a vocal cord palsy were compared with a control group. In paralysis of the vocal cord the open quotient (OQ) is increased and the speed quotient (SQ) decreased. This system may have potential in the diagnosis and continued assessment of laryngeal abnormalities as well as providing a permanent objective record in medico‐legal case

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00977.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

In conventional underlay tympanoplasty the graft is placed medial to the malleus handle. The present study evaluates the results of a modification of this technique, in which the graft is placed lateral to the malleus handle, which has been dissected from the drum remnants. 39 ears with predominantly large or anterior pars tensa perforations were operated upon in this manner. After a median observation time of 20 months one ear was found to have a small reperforation. All ears had normal tympanomeatal angles, but 12 ears showed a small degree of laterofixation of the graft from the malleus handle. Analysis of the hearing showed good hearing improvement and no adverse effects attributable to the dissection of the ossicular chain. It is concluded that the technique is a good alternative to conventional underlay myringoplasty in ears with perforations involving the area anterior to the malleus handle.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00978.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The on‐off effect of the acoustic stapedius reflex was found in association with several kinds of ear disease: otosclerotic stapes fixation, incudostapedial dislocation and sensorineural hearing loss. One fifth (8/40) of the patient group with an on‐off effect and sensorineural hearing loss showed the typical symptoms of Ménière's syndrome. Keywordson‐off effect stapedius reflex hear

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00979.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Adeno‐tonsillectomy and tonsillectomy are frequently performed and haemorrhage remains an important post‐operative complication. A prospective study of 1090 patients undergoing surgery over a 12‐month period was undertaken investigating whether the following factors influenced postoperative haemorrhage: age and sex of patients, method of tonsillectomy, haemostasis and premedication, month of operation and experience of surgeon. A significantly higher incidence of post‐operative haemorrhage occurred in the group aged 16–25 years and significantly more males suffered post‐operative haemorrhage. This haemorrhage more frequently occurred in the warmer months of May to July. Guillotine tonsillectomy was found to be as effective as dissection and no higher incidence of post‐operative haemorrhage was recorded. Method of haemostasis, surgical experience and premedication did not influence the outcome. We conclude that the guillotine used in controlled circumstances is as safe

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00980.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We present a series of 2305 previously untreated histologically proven squamous carcinomas of the mucosal surfaces of the upper aerodigestive tract managed by one of us in a 27‐year period. 62 (2.7%) of the patients were aged 40 years or younger.The sex ratio between young and old patients was similar but, as expected, the younger patients were in better physical condition. Furthermore, 90% of young patients were treated, compared with only 78% of the older patients.Younger patients had a higher incidence of oropharyngeal tumours and lymph node metastases, but the proportion of poorly differentiated tumours, and stage T3‐T4tumours, was similar, as was the metastatic rate.The crude survival of the younger patients was 10% better than that of the older group, and adjusted (life‐table) survival was 9% better, and this better survival in younger patients was significant when differing site incidence and N‐stage were allowed for by multivariate analysis.The recurrence rate at the primary site was 19% in the younger patients and 15% in older patients, but this difference was not significant. The recurrence rate in cervical lymph nodes was similar in both age groups: 37% at 2 years in young patients and 38% in older p

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00981.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Intranasal splints have been used to maintain septal stability and prevent intranasal adhesions following septal surgery. However, their efficacy and attendant morbidity have received surprisingly little attention.Our prospective study of 100 adults was divided into patients undergoing septoplasty or submucous resection of the nasal septum alone (n= 50) and those undergoing combined septal and inferior turbinate surgery (n= 50). All patients were randomized to have paired silicon rubber splints inserted for 7 days or not at all. All noses were additionally packed with 2 pieces of Jelonet for 12–20h and examined and cleaned at 1 and 6 weeks post‐operatively. The position of the septum, patency of the airways, presence of adhesions and degree of discomfort were recorded.Statistical analysis of the 89 complete sets of results obtained indicated splints added significantly to post‐operative discomfort in both groups, with no demonstrable benefit to the pa

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00982.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Traditionally, soft cold foods have been recommended after tonsillectomy to aid comfort and haemostasis but, more recently, rougher foods have been advocated to promote physiologically normal deglutition. This trial was designed to discover whether post‐tonsillectomy dietary advice has any influence on recovery.150 patients due to undergo tonsillectomy were prospectively randomized to 1 of 3 diets: mainly rough food, mainly soft food, and no advice except to eat regularly. Food consumption, analgesia intake and pain levels were recorded daily by each patient. Tonsillar fossa slough and secondary haemorrhage were evaluated 1 and 2 weeks after surgery. Results of 137 patients were obtained.There were no significant differences between the diets regarding post‐operative pain, analgesic required, healing rates or secondary haemorrhage. Specific post‐tonsillectomy dietary advice need not be given, other than to encourage regular e

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00983.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Forty children diagnosed as having chronic purulent rhinitis unresponsive to medical and surgical management were studied. After a mean follow‐up of six years and nine months the condition resolved spontaneously in 95% of the children, usually after reaching the age of 7 year

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00984.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Improved test technique by health visitors has been shown to lead to higher accuracy in the screen of hearing aimed traditionally at prelingual sensorineural deafness. However, it gives greatly increased referrals of children having otitis media with effusion (OME) around the end of the first year of life. Two samples of children (n= 29 and 61) were tested in a children's hearing assessment clinic with properly documented testing techniques and trained personnel. The samples were each formed on a fixed population base, one before and one after screen improvements. This enabled characterization of two outcome groups within each sample (severe/persistent enough to refer to ENTvsdischarged, despite slight hearing impairment). The average audiometrie criterion for onward referral to ENT rose only very little, despite the increased assessment caseload resulting from more detections by the screen. This usefully permitted the conclusion that the number of true cases found due to the screen and assessed as lying beyond a specifiable degree of severity (average cut‐off approximately 47 dB(A) or 35 dBHTL) had increased not through lower criteria for referral to ENT, but through the improvements to the screen. The increase was from approximately 0.4% to 1.3% of the base population screened. Thus a change materially enhancing the sensitivity and positive predictive value of a screen considerably enlarges the eventual otological caseload of children with middle‐ear disease thought to justify concern at around the end of their first year. If done properly, screening is hence in practical terms about OME, not about prelingual sensorineural hearing impairment. This conclusion presses the urgency of evaluation and consensus on the otological management of the young child with

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1992.tb00985.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY