Pub Date : 2001-08-01DOI: 10.1046/J.1365-2273.2001.00471.X
G. Browning
{"title":"Watchful waiting in childhood otitis media with effusion.","authors":"G. Browning","doi":"10.1046/J.1365-2273.2001.00471.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00471.X","url":null,"abstract":"","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"11 1","pages":"263-4"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88639297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00448.X
R. Clarke, J. Fenton
{"title":"Otolaryngology and the new undergraduate medical curriculum.","authors":"R. Clarke, J. Fenton","doi":"10.1046/J.1365-2273.2001.00448.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00448.X","url":null,"abstract":"","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"188 1","pages":"73-5"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85628885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00434.X
R. V. Lloyd Faulconbridge, R. Tranter, V. Moffat, E. Green
Drooling can be a difficult problem for a child to endure, both physically and socially, especially if they are also having to cope with physical disabilities. Chailey Heritage Clinical Services and associated School look after a large number of severely physically disabled children and adolescents. This paper reviews the management strategy of the multidisciplinary oral-motor clinic at Chailey Heritage Clinical Services, and reviews the results of children treated between 1990 and 1996. The management ranges from oral-motor skills training through palatal training appliances to surgery. Seventy-eight children, ranging from 3 to 17 years, were treated and there were complete records for 73. Eighteen per cent responded to oral skills training alone. Thirty per cent of children had good results with a palatal training appliance and did not need any further intervention. Forty-seven per cent of patients underwent some form of surgery to control their drooling. Only 8% of children were treated with medication.
{"title":"Review of management of drooling problems in neurologically impaired children: a review of methods and results over 6 years at Chailey Heritage Clinical Services.","authors":"R. V. Lloyd Faulconbridge, R. Tranter, V. Moffat, E. Green","doi":"10.1046/J.1365-2273.2001.00434.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00434.X","url":null,"abstract":"Drooling can be a difficult problem for a child to endure, both physically and socially, especially if they are also having to cope with physical disabilities. Chailey Heritage Clinical Services and associated School look after a large number of severely physically disabled children and adolescents. This paper reviews the management strategy of the multidisciplinary oral-motor clinic at Chailey Heritage Clinical Services, and reviews the results of children treated between 1990 and 1996. The management ranges from oral-motor skills training through palatal training appliances to surgery. Seventy-eight children, ranging from 3 to 17 years, were treated and there were complete records for 73. Eighteen per cent responded to oral skills training alone. Thirty per cent of children had good results with a palatal training appliance and did not need any further intervention. Forty-seven per cent of patients underwent some form of surgery to control their drooling. Only 8% of children were treated with medication.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"27 1","pages":"76-81"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84058644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00449.X
A. McDermott, S. Dutt, J. Watkinson
Nasopharyngeal carcinoma is a disease with a remarkable racial and geographical distribution. In most parts of the world it is a rare condition and in only a handful of places does this low risk profile alter. These include the Southern Chinese, Eskimos and other Arctic natives, inhabitants of South-East Asia and also the populations of North Africa and Kuwait.
{"title":"The aetiology of nasopharyngeal carcinoma.","authors":"A. McDermott, S. Dutt, J. Watkinson","doi":"10.1046/J.1365-2273.2001.00449.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00449.X","url":null,"abstract":"Nasopharyngeal carcinoma is a disease with a remarkable racial and geographical distribution. In most parts of the world it is a rare condition and in only a handful of places does this low risk profile alter. These include the Southern Chinese, Eskimos and other Arctic natives, inhabitants of South-East Asia and also the populations of North Africa and Kuwait.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"50 1","pages":"82-92"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78313745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00436.X
S. Eerenstein, P. Schouwenburg, L. van der Velden, M. D. De Boer
The VoiceMaster indwelling voice prosthesis was designed and developed for use in laryngectomized patients. The VoiceMaster pre-production model (0-series), tested during 1997 and 1998, proved to be a safe and valid concept. After the refining of a few technical details the currently available VoiceMaster device was introduced in June 1998. The preliminary results obtained with the device were encouraging and led to a multicentre study. The average device life span varies between the participating clinics, ranging up to 4.8 months. As there still are devices in situ, the average life span is still increasing. Factors such as stoma size and fistula position influence the insertion of the device and should be considered before VoiceMaster insertion. The general experience with the VoiceMaster prosthesis has proven it to be a worthwhile new device in prosthetic voice rehabilitation in laryngectomized patients.
{"title":"First results of the VoiceMaster prosthesis in three centres in the Netherlands.","authors":"S. Eerenstein, P. Schouwenburg, L. van der Velden, M. D. De Boer","doi":"10.1046/J.1365-2273.2001.00436.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00436.X","url":null,"abstract":"The VoiceMaster indwelling voice prosthesis was designed and developed for use in laryngectomized patients. The VoiceMaster pre-production model (0-series), tested during 1997 and 1998, proved to be a safe and valid concept. After the refining of a few technical details the currently available VoiceMaster device was introduced in June 1998. The preliminary results obtained with the device were encouraging and led to a multicentre study. The average device life span varies between the participating clinics, ranging up to 4.8 months. As there still are devices in situ, the average life span is still increasing. Factors such as stoma size and fistula position influence the insertion of the device and should be considered before VoiceMaster insertion. The general experience with the VoiceMaster prosthesis has proven it to be a worthwhile new device in prosthetic voice rehabilitation in laryngectomized patients.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"63 1","pages":"99-103"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89271333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00433.X
A. Chidambaram, A. Nigam, A. Cardozo
In the UK patients who undergo common ear, nose and throat (ENT) operations, and are employed, are advised to take 2 weeks sick leave before returning to their employment. A retrospective postal questionnaire survey (of adult patients who had undergone four common specific ENT operations) was conducted, to validate whether this preoperative advice given, was appropriate, and to attempt to assess the patient factors, which influenced the amount of postoperative absence from work. Among 218 questionnaires sent, 156 (71.6%) responses were returned and 132 (60.6%) were used. Analysis of the data for absence from work, showed that 58.3% had taken 2 weeks. The majority of patients (70.5%) stated that 2 weeks absence following their surgery was appropriate, whereas 5.3% reported that the period was excessive and 24.2% felt that it was inadequate. Postoperative pain (30.3%), infection (30.3%), bleeding (7.6%) and other causes (15.2%) were reported as the reasons for the delay to return to work. Nearly 31% of men and 55% of women had taken > 2 weeks of sick leave. In conclusion, the current practice of advising employed adults to take 2 weeks time off work following routine ENT surgery is appropriate. However, nearly 42% had taken > 2 weeks to return to their employment. Patients who underwent tonsillectomy and laser palatoplasty in general, required more time to recuperate prior to returning to work, when compared to those who had undergone septoplasty and functional endoscopic sinus surgery (FESS). Postoperative pain and infection were reported to be the main reasons for the delay in returning to work. Men, and self-employed patients returned to work earlier than women and other employed groups.
{"title":"Anticipated absence from work ('sick leave') following routine ENT surgery: are we giving the correct advice? A postal questionnaire survey.","authors":"A. Chidambaram, A. Nigam, A. Cardozo","doi":"10.1046/J.1365-2273.2001.00433.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00433.X","url":null,"abstract":"In the UK patients who undergo common ear, nose and throat (ENT) operations, and are employed, are advised to take 2 weeks sick leave before returning to their employment. A retrospective postal questionnaire survey (of adult patients who had undergone four common specific ENT operations) was conducted, to validate whether this preoperative advice given, was appropriate, and to attempt to assess the patient factors, which influenced the amount of postoperative absence from work. Among 218 questionnaires sent, 156 (71.6%) responses were returned and 132 (60.6%) were used. Analysis of the data for absence from work, showed that 58.3% had taken <or= 2 weeks and 41.7% had taken > 2 weeks. The majority of patients (70.5%) stated that 2 weeks absence following their surgery was appropriate, whereas 5.3% reported that the period was excessive and 24.2% felt that it was inadequate. Postoperative pain (30.3%), infection (30.3%), bleeding (7.6%) and other causes (15.2%) were reported as the reasons for the delay to return to work. Nearly 31% of men and 55% of women had taken > 2 weeks of sick leave. In conclusion, the current practice of advising employed adults to take 2 weeks time off work following routine ENT surgery is appropriate. However, nearly 42% had taken > 2 weeks to return to their employment. Patients who underwent tonsillectomy and laser palatoplasty in general, required more time to recuperate prior to returning to work, when compared to those who had undergone septoplasty and functional endoscopic sinus surgery (FESS). Postoperative pain and infection were reported to be the main reasons for the delay in returning to work. Men, and self-employed patients returned to work earlier than women and other employed groups.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"13 1","pages":"104-8"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78853273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00440.X
A. Webb, J. Eveson
This was a retrospective study of 126 primary pleomorphic adenomas to correlate capsular characteristics with tumour histopathology in relation to current surgical debate (parotidectomy versus local excision). Capsular thickness was measured by micrometry and tumours classified into subtypes (1-4). Evidence of fine needle aspiration damage (needle tracks, infarction) was sought. Minimal changes were seen in eight tumours. Tumour growth features (bosselations, enveloping) were present in 57% and 33%, respectively, also microinvasion (42%) and tumour 'buds' (12%). Parotid lesions possessed thicker capsules than submandibular tumours. There was little correlation between capsular thickness and cellular structure. The significant exception was large (> 25 mm) hypocellular parotid tumours which had thinner capsules and could be vulnerable to operative rupture. In 110 standard operations (parotidectomy, submandibular gland excision), capsular exposure was evident in 81%. Field irrigation is recommended to lessen the risk of tumour seeding. This study reaffirms many elements of capsular weakness and suggests that parotidectomy is the operation of choice.
{"title":"Pleomorphic adenomas of the major salivary glands: a study of the capsular form in relation to surgical management.","authors":"A. Webb, J. Eveson","doi":"10.1046/J.1365-2273.2001.00440.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00440.X","url":null,"abstract":"This was a retrospective study of 126 primary pleomorphic adenomas to correlate capsular characteristics with tumour histopathology in relation to current surgical debate (parotidectomy versus local excision). Capsular thickness was measured by micrometry and tumours classified into subtypes (1-4). Evidence of fine needle aspiration damage (needle tracks, infarction) was sought. Minimal changes were seen in eight tumours. Tumour growth features (bosselations, enveloping) were present in 57% and 33%, respectively, also microinvasion (42%) and tumour 'buds' (12%). Parotid lesions possessed thicker capsules than submandibular tumours. There was little correlation between capsular thickness and cellular structure. The significant exception was large (> 25 mm) hypocellular parotid tumours which had thinner capsules and could be vulnerable to operative rupture. In 110 standard operations (parotidectomy, submandibular gland excision), capsular exposure was evident in 81%. Field irrigation is recommended to lessen the risk of tumour seeding. This study reaffirms many elements of capsular weakness and suggests that parotidectomy is the operation of choice.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"2 1","pages":"134-42"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87804902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00443.X
A. Robson
{"title":"The management of the neck in squamous head and neck cancer.","authors":"A. Robson","doi":"10.1046/J.1365-2273.2001.00443.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00443.X","url":null,"abstract":"","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 1","pages":"157-61"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73442296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00442.X
H. Pau, Andrew Carney, G. Murty
Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder affecting blood vessels of the skin, mucous membrane and viscera. The otorhinolaryngologist is the commonest clinician involved in management as epistaxis occurs in 93% of the patients. As marked advances have recently been made regarding the pathogenesis and management of the condition, the otorhinolaryngological perspective is reviewed.
{"title":"Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): otorhinolaryngological manifestations.","authors":"H. Pau, Andrew Carney, G. Murty","doi":"10.1046/J.1365-2273.2001.00442.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00442.X","url":null,"abstract":"Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder affecting blood vessels of the skin, mucous membrane and viscera. The otorhinolaryngologist is the commonest clinician involved in management as epistaxis occurs in 93% of the patients. As marked advances have recently been made regarding the pathogenesis and management of the condition, the otorhinolaryngological perspective is reviewed.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"17 1","pages":"93-8"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85983124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-04-01DOI: 10.1046/J.1365-2273.2001.00441.X
A. Yuen, K. Lam, J. Choy, W. Ho, W. Wei
Bcl-2 expression was studied by immunohistochemistry on laryngectomy specimens from 176 patients. Of the 176 tumours, 11% had positive bcl-2 staining. Bcl-2 expression was significantly correlated with tumour grade: 5% of well-differentiated tumours, 12% of moderately-differentiated tumours and 23% of poorly-differentiated tumours had positive expression of bcl-2. Nodal metastases were also found to be significantly related to bcl-2 expression: 36% of nodal metastases for negative bcl-2 expression compared with 70% for positive expression. The risk of nodal metastases increased significantly with the presence of bcl-2 expression, moderate or poor differentiation and supraglottic involvement. The risk of nodal metastases increased significantly with the presence of increasing numbers of risk factors: 11% without risk factor, 21% with one risk factor, 49% with two risk factors and 77% with three risk factors. Bcl-2 expression in laryngeal carcinoma is significantly correlated with tumour grade and nodal metastases. It has added prognostic value for nodal metastases together with tumour grade and site of tumour involvement.
{"title":"The clinicopathological significance of bcl-2 expression in the surgical treatment of laryngeal carcinoma.","authors":"A. Yuen, K. Lam, J. Choy, W. Ho, W. Wei","doi":"10.1046/J.1365-2273.2001.00441.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00441.X","url":null,"abstract":"Bcl-2 expression was studied by immunohistochemistry on laryngectomy specimens from 176 patients. Of the 176 tumours, 11% had positive bcl-2 staining. Bcl-2 expression was significantly correlated with tumour grade: 5% of well-differentiated tumours, 12% of moderately-differentiated tumours and 23% of poorly-differentiated tumours had positive expression of bcl-2. Nodal metastases were also found to be significantly related to bcl-2 expression: 36% of nodal metastases for negative bcl-2 expression compared with 70% for positive expression. The risk of nodal metastases increased significantly with the presence of bcl-2 expression, moderate or poor differentiation and supraglottic involvement. The risk of nodal metastases increased significantly with the presence of increasing numbers of risk factors: 11% without risk factor, 21% with one risk factor, 49% with two risk factors and 77% with three risk factors. Bcl-2 expression in laryngeal carcinoma is significantly correlated with tumour grade and nodal metastases. It has added prognostic value for nodal metastases together with tumour grade and site of tumour involvement.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"139 1 1","pages":"129-33"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91100269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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