Biomedical subjects
Publications and source records attributed to A Blayney.
Two patients with nasal lymphoma were seen with cutaneous lesions. Multiple biopsy specimens, immunohistochemical techniques, and gene rearrangement studies were required to establish the diagnosis.
A six-year-old girl with a rare bone dysplasia (Melnick-Needles Syndrome) presented with a five month history of severe sleep apnoea, weight loss and failure of thrive. The syndrome is associated with craniofacial abnormalities, including micrognathia. Following a multi-disciplinary assessment an elective tracheostomy was considered the most appropriate treatment. The patient developed severe respiratory distress 10 days prior to the arranged date of surgery and required an emergency tracheostomy. This resulted in a dramatic return to health. The recognition of severe sleep apnoea in patients with craniofacial abnormalities and the role of initial tracheostomy are discussed.
Congenital laryngeal clefts are rare. This paper reports on the management of 3 patients with Type 2 laryngo-tracheo-oesophageal cleft. One patient died following tracheopexy after successful cleft closure. Prognosis is related to the presence of other major anomalies, the early diagnosis of the lesion and institution of appropriate respiratory and nutritional care prior to correction of the defect. A greater awareness of the condition combined with aggressive diagnostic endoscopy should result in early diagnosis and improved survival.
Bone Anchored Hearing Aids have both cosmetic and acoustic advantages over most conventional hearing aids and hence is a popular choice today. We report the first Irish group of patients who received a BAHA over a six year period of time and evaluated outcomes of these subjects using subjective assessment. The medical records of all patients who received a BAHA at the Mater and Children's University Hospital, Dublin, were reviewed. A questionnaire had been sent to the patients to obtain long-term subjective information. Twenty three patients were identified. The commonest indication for surgery was found to be the presence of a discharging mastoid cavity, followed by congenital ear malformations. Surgical procedures were carried out as a single stage in 16 patients. Questionnaires were sent to 19 patients; sixteen patients responded in total. BAHA has a beneficial outcome to the quality of life and has significantly reduced ear discharge. The one stage technique was found to have a lower complication rate.
Throughout the years, investigators and surgeons have developed new techniques for tonsillectomy aiming to lessen the postoperative morbidity and complications of tonsillectomy. It is generally accepted that the ideal method should decrease operative time, blood loss, postoperative haemorrhage and morbidity. To compare the technique and post-operative morbidity of two different tonsillectomy methods: cold dissection and bipolar electrodissection. A prospective study including a total of 545 children (Age: 3-16 yrs) undergoing tonsillectomy at The Children's University Hospital in Dublin, Ireland, from January 2003 to December 2003. The incidence of primary, secondary haemorrhage and postoperative pain was compared between both techniques. The overall rate of haemorrhage was 3.6% (20 patients) this included primary haemorrhage in 0.3% (2 patients) and secondary haemorrhage in 3.3% (18 patents). Primary haemorrhage occurred only in the electrodissection technique. As regards to secondary haemorrhage it was higher in the electrodissection technique 2.3% (12 patients) compared to 1% (6 patients) of the cold dissection technique. Patients rated pain to be more severe in the electrodissection technique compared to the cold dissection technique. Cold dissection tonsillectomy technique is still considered to be a safe and effective method with less posoperative morbidity complications as evidenced from our study.