ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00800.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00801.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In many centres carcinoma of the oral cavity, if relatively early, is treated by irradiation. The present study includes 186 patients treated in this manner.The primary recurrence rate for previously untreated patients was 34% and was not significantly affected by host or tumour factors. The 5‐year survival for the 144 previously untreated patients was 65%, and salvage surgery offered a 35% chance of cure. Survival was reduced in patients aged 60 years and over (p<0.02).The recurrence rate in cervical lymph nodes following radiotherapy was 38% and was more likely to occur for primary sites in the tongue and floor of mouth (p<0.01).The five‐year survival rate after nodal recurrences was 31% and was predicted only by the presence of extracapsular rupture (P<0.01).One‐third of patients had died of causes other than the primary tumour at 5 years and one‐third had died of the original tumour. The rest of the patients are alive and well, only 7% having had a major resection.We feel that the present policy has optimum cure rate whilst saving most patients from major

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00802.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

To determine the relationship between subjective sensation of nasal patency and objective measurement of nasal inspiratory peak flow rate, a longitudinal study was conducted using healthy volunteers. Five healthy medical practitioners, one woman and 4 men, aged 24–34 years, made daily subjective estimations of their sensation of nasal patency on a 10cm visual analogue scale. This was followed immediately by measurements of nasal inspiratory peak flow rate using a Youlten meter, repeated on at least 25 days per subject. Correlation coefficient and regression lines for subjective nasal patency on nasal inspiratory peak flow rate were calculated. One hundred and sixty nine sets of observations were made, range 25–44 per subject. Each subject showed strong evidence (P<0.01) of positive correlation between subjective nasal patency score and nasal inspiratory peak flow rate. There was strong evidence (P<0.001) that different regression lines are needed for different subjects, but no evidence that the lines are not parallel. Subjective sensation of nasal patency is strongly correlated with objective nasal patency, as measured by peak inspiratory flow rate. This relationship varies between individuals. Measurement of nasal inspiratory peak flow rate may be a valuable objective test of nasal patency, and is quick and simple to perf

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00803.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

CT imaging of the temporal bone is highly predictive of the presence of cholesteatoma but its value in the routine management of cholesteatoma has not been assessed. We aimed to establish the indications for CT imaging in CSOM by a prospective study of patients suspected of having cholesteatoma. The patients were assessed clinically and a management plan chosen; this was later adjusted, if indicated, on the basis of radiological findings. Surgical findings were recorded and correlation with CT appearances evaluated. Twenty patients completed the study. CT altered the management plan in 10 and was considered helpful in a further 6. We recommend its routine use in children, medically unfit patients, only or better hearing ears, patients in whom the tympanic membrane cannot be adequately visualized, patients who have had previous mastoid surgery whose operative records are available and patients with intratemporal or intracranial complications of disease.

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00804.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Topical steroids are known to be effective in allergic inflammatory airway disease. However, progress in the treatment of these diseases has also called for the use of unadulterated drugs, without lubricants and preservatives. Rhinocort® Turbuhaler®, a multi‐dose inhaler containing budesonide as a pure powder, is a newly developed device without any carrier gas, preservatives or lubricants. The efficacy and tolerance of this product were evaluated in 60 patients with birch pollen rhinitis. After a run‐in period of 1 week the patients received once daily for 4 weeks either budesonide pure powder (400 μg) or placebo in a double‐blind randomized fashion. Assessment of efficacy was made by comparing scores for different nasal and eye symptoms. The additional use of antihistamine tablets was assessed. In 22 of the patients nasal peak inspiratory flow rate was measured before and after 1 week of treatment. Budesonide was significantly more effective than placebo in controlling the nasal symptoms (P‐values ranging from 0.011–0.045). The use of antihistamine tablets was significantly lower in the budesonide group (P= 0.012). The nasal inspiratory flow rate was increased after 1 week of treatment in the budesonide treated group of patients as compared with placebo (P= 0.007). No differences were observed between the groups with regard to eye symptoms or adverse effects. The results show that budesonide delivered from a dry powder inhaler is an effective and well tolerated treatment of seasonal aller

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00805.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Malignant melanoma affecting the nasal cavity and paranasal sinuses is a rare condition with a poor prognosis. The Head and Neck Oncology Clinic at the University Hospital Nottingham has treated 16 patients in an 8‐year‐period. Twelve patients were treated with primary radical surgery and salvage radiotherapy was used for 7 patients with local recurrence. This resulted in tumour shrinkage in 4 patients. Eight patients treated surgically, have died of systemic spread. Four are currently alive, although 2 have local dise

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00806.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Presence of tumour at the resection margin following primary surgical treatment for squamous cell carcinoma of the head and neck is thought to adversely affect prognosis. To confirm this we performed a review of 478 patients treated by primary surgery for squamous cell carcinoma of the head and neck and sub‐divided them into those exhibiting postive margins and those with negative margins following resection.Uni‐variate and multi‐variate statistical methods were used to analyse survival figures and a variety of parameters associated with the presence of positive resection margins. We found 5‐year survival was decreased if resection margins were found to be positive (P<0.025). The presence of positive resection margins was also significantly associated with time to tumour recurrence (P<0.001) and survival with nodal recurrence (P<0.001). Other factors which were significantly associated with survival using Cox's multi‐variate analysis were site of tumour (P<0.005), nodal extracapsular rupture (P<0.05) and pathological T‐stage (P<0.05).Uni‐variate analysis revealed no significant associations betweent the presence of positive margins and the patient's age, sex, tumour site, degree of tumour differentiation, and nodal status, though using multiple logistic regression, the general condition of the patient (P<0.01) and the tumour siteP<0.05) were significantly related.The results support the concept that every effort should be made to obtain negative resection margins when undertaking primary ablative surgery for squamous cell carcinoma of the

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00807.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Ligation of the maxillary artery is a logical and effective method for the arrest of severe uncontrollable posterior epistaxis. The failure rates for arrest of haemorrhage are given in the literature as 10–13%. In our centre, over the last 9 years, 23 patients have undergone maxillary artery ligation to control epistaxis without a failure. Bilateral maxillary artery ligation was carried out whenever the maxillary artery of the bleeding side was found to be of small diameter. To investigate whether there is an asymmetry in the size of the maxillary arteries we performed 13 cadaveric dissections. In 6 of the cadavers one maxillary artery was significantly larger than the other. This fact has hitherto not been observed by otolaryngologists or anatomists. Failure to arrest haemorrhage may have resulted from ligation of the non‐dominant maxillary artery with consequent opening of cross‐anastamoses from the dominant

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00808.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The otological characteristics of a birth cohort of 7.5–8‐year‐old Dutch children are reported. Questionnaire information was available for 1004 children, while otomicroscopic, tympanometric and pure‐tone audiometric data were available for 946 children. Twenty‐nine per cent of the children had been treated surgically for various ENT diseases. Fifty‐five per cent of the children had normal tympanic membranes, 19% mild abnormalities, and 26% moderate to severe abnormalities. At this age the prevalence of bilateral otitis media with effusion (OME), as shown by a type B tympanogram was 2.5%, while that of unilateral OME was 7%. A pure‐tone average hearing level of ≥ 15 dB in the better‐hearing ear was found in 4% of the children. The presence of OME was associated with a mean hearing loss of 20 dB. This study shows that structural and functional middle‐ear abnormalities are highly prevalent in Du

ISSN:0307-7772    

DOI:10.1111/j.1365-2273.1993.tb00809.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY