ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01015.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The pharmacological treatment of Meniere's diseaseThe management of Menière's disease often provides a formidable clinical challenge largely because its precise aetiology is unknown. There is no known ‘cure’ once the condition is established, but drugs may be helpful in treating both the acute attacks of vertigo, and in more long‐term management, particularly in the earlier fluctuant stage. These remedies are largely symptomatic and there are few if any properly controlled studies of their efficacy. Suppressant drugs may act centraly at neurotransmitter sites, or peripherally on the labyrinth. Conventional diuretics and osmotically acting agents have been given to reduce the endolymph fluid volume Histamine anlogues directly reduce inner ear fluid pressure mainly by increasing the cochlear blood flow. and are probably the treatment of choice. Otovestibulotoxic drugs given systemically to cause chemical labyrinthine ablation are frequently effective in abolishing attacks of vertigo but often resulted in disabling oscillopsia and ataxia. There is now evidence that local administration by intratympanic injection may well be more efficacious resulting in selective partial end organ ablation. To date innovative immune modigying regimes have not proved h

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01016.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Recurrent epistaxis and nasal septal deviation in young adultsEpistaxis is common in young adults but the aetiology is unknown in many cases. To investigate the possibility that septal deviations are associated with epistaxis, 54 servicement with recurrent epistaxis were compared with 46 controls. The epistaxis group were significantly more likely to have a history of nasal trauma (P=0.008) and radiologically‐proven nasal fracture (P=0.002); on clinical examination, they were more likely to have a deviated septum (P<0.00001), maxillary spur (P=0.00004) and nasal obstruction (P=0.011); they were also more likely to have radiological evidence of a deviated septum (P=0.020). Those patients able to locate their epistaxis to one side tended to do so to the side of their septal deviation. This study supports the hypothesis that septal deviation is associated with epistaxi

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01017.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Treatment of facial synkinesis and facial asymmetry with botulinum toxin type A following facial nerve palsyFacial synkinesis and asymmetry commonly impair the outcome of facial nerve palsy. Botulinum toxin type A is a neurotoxin which prevents acetylcholine release at the neuromuscular endplate, paralysing skeletal muscle. This paper examines its use in 24 patients with synkinesis and asymmetry affecting the eye and mouth. Sixty‐eight of 72 treatments produced improved cosmesis. Dose‐related complications occurred in 26 treatments but were generally mild and transient. The total dosages of toxin used were analysed. The higher dose group compared with the lower dose group had no significant advantage in overall cosmetic improvement but the complication rate was significantly higher in the higher dose group (20/39) compared with the lower dose group (6/33) (X26.675,P>0.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01018.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The role of ultrasound in screening patients referred for sialography: a possible protocolIn a prospective study, ultrasound examination of the salivary glands was performed in 31 consecutive patients referred for sialography. Good correlation between ultrasound and digital sialography was observed in 26 patients with only one false negative ultrasound in a patient with significant sialectasis. We recommend initial ultrasound examination in patients with symptoms suggesting an inflammatory lesion in the salivary glands. If this is normal or reveals a solid mass, sialography is not indicated. If ultrasound examination demonstrates the presence of calculi, duct dilatation, cystic elements or an enlarged gland, digital sialography should be performed to identify lesions in the main duct such as strictures or obstructing calculi.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01019.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Small cavity mastoidectomy ‐ 5 year reviewIt has been recognized that the traditional method of open mastoid surgery often produces a larger mastoid cavity than necessary. Small cavity mastoidectomy is advocated to reduce the size of the mastoid cavity by exteriorizing the cholesteatoma from the epitympanum backwards. When this operation is performed in a sclerotic mastoid bone, the resulting cavity is very small. The 5 year review of 39 ears with small cavity mastoidectomy is presented. Not only were the mastoid cavities small, they remained stable and trouble‐free. It also enabled the patients to enjoy swimming and minimizing wax accumulation within the cavities. The hearing results after 5 years were comparable to that of the closed technique. Formation of cholesterol granuloma behind the concho‐meatal flap was an uncommon complic

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01020.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The ENT manifestations of HIV infection in childrenThis study identified the ENT symptoms of 66 HIV infected children over an 8 year period (1986‐1993) at Great Ormond Street Hospital for Children. The incidence, nature and age of onset of ENT symptoms were investigated; 91% of the children had ENT symptoms, the most common being cervical lymphadenopathy, oro‐oesophageal candidiasis and otitis media. The HIV infected children suffered from the common ENT diseases of childhood. They also presented with specific conditions such as diffuse parotid swelling. Therefore, their clinical features differed from HIV infected adults as well as non‐infected children. An increasing incidence of paediatric HIV infection was demonstrated by the study. Most were due to vertical transmission. ENT surgeons are likely to see more HIV infected children in future, either with the usual ENT diseases of childhood (to which they seem more susceptible) or with HIV‐specific conditions. Although the diagnosis of HIV may be known, the ENT condition could be the initial presentation suggestive of immunodef

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01021.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Extended supraglottic laryngectomy for primary base of tongue carcinomasA retrospective review of 56 patients with a primary base of tongue carcinoma was undertaken to determine the value of supraglottic laryngectomy. All the patients had a supraglottic laryngectomy and a total of 77 neck dissections. Forty‐three (76.8%) patients received post‐operative radiotherapy. The incidence of local recurrence was 23.2%, neck relapse being seen in 16.1% of patients. The 3 year survival was 47%. The overall survival of the whole series and by stage was not improved by combined therapy compared with surgery al

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01022.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Occupational laryngitis with immediate allergic or immediate type specific chemical hypersensitivityReports of allergic laryngitis are sparse. In some reports allergy has been mentioned as an aetiological factor, but the diagnosis has not been confirmed with provocation tests. This paper reports on 20 patients in order to show that laryngitis can be caused by organic substances and chemicals with mechanisms of immediate allergy or immediate type specific hypersensitivity. The agents in the former group consisted of flours, obeche, plants and acid anhydrides, whereas these in the latter group included chemicals like formaldehyde, acrylate compounds, and chemicals used in hairdressing. All the cases were confirmed with provocation tests in which the patients displayed a change in vocal cord status. Thirteen patients had positive skin‐prick test results with suspected causative agents. Eleven of these 13 patients had an elevated level of specific lgE‐antibodies to the same age

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01023.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Malignant tumours of the cervical oesophagusForty‐seven patients with malignancy of the cervical oesophagus are described and compared with a group of 647 patients with hypopharyngeal malignancy. There was a higher proportion of non‐squamous malignancy in cervical oesophageal cancer compared with hypopharyngeal cancer. Cervical oesophageal malignancy tended to present earlier with significantly lower T stage and neck node metastases were relatively unusual at presentation. Patients with cervical oesophageal malignancy were frequently incurable at the time they are first seen and 21 had palliative treatment only, 26 patients had curative treatment, 12 underwent radical radiotherapy and 14 had surgery. Cervical oesophageal malignancy had a significantly worse prognosis than hypopharyngeal malignancy with an 18% 3 year survival compared with a 33% 3 year survival (χ21=7.1089, P<0.01). Those patients with oesophageal malignancy who were treated fared considerably better than the whole group with 30% being alive at 3 years (χ21=10.5185, P<

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1996.tb01024.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY