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Biomedical subjects

A J Prichard

Publications and source records attributed to A J Prichard.

17 recordsLinked to original sources
PubMed1998

Adenocarcinoma of the larynx--a distant metastasis from a rectal primary.

Laryngeal metastases from remote primary tumours are uncommon. They derive mostly from melanomas or renal cell carcinomas. The generally rare laryngeal adenocarcinomas can only be classified as metastatic tumours in the presence of a distant primary of the same histology. Only five cases of a laryngeal secondary originating from adenocarcinoma of the large bowel have been reported in the world literature. A further case is presented which to our knowledge is the first to arise from the rectum, a site which suggests haematogenous tumour spread. This paper emphasizes the need for the search of synchronous metastatic disease and discusses the therapeutic options on the grounds of current management of singular colorectal secondaries.

Adenocarcinoma↗
PubMed1997

Complications of palatoplasty for snoring or sleep apnoea.

A questionnaire was sent to consultant Otolaryngologists (483) throughout the UK to identify any mortality associated with uvulopalatoplasty and other forms of palatoplasties for snoring and/or obstructive sleep apnoea. The response rate was 76.8 per cent (371). Six intra- and post-operative deaths were reported and four were known to have obstructive sleep apnoea. Life-threatening morbidity occurred in at least seven patients (three known apnoeic), two required immediate tracheostomy and two were managed in the intensive care unit. This suggests that the apnoeic patients undergoing palatoplasties experienced significant mortality and morbidity. Pre-operative sleep study should be performed in all snoring patients to identify the apnoeic subgroup. Continuous positive airway pressure, management of excessive obesity, elective tracheostomy and other strategies should be first considered before palatoplasties in these patients.

Humans↗
PubMed1997

Comparing the outcome of two surgical treatments for snoring using a patient-orientated measure of benefit.

Many different surgical techniques are currently used to treat simple snoring and their outcomes are difficult to compare. We used the Glasgow Benefit Inventory (GBI) to examine the outcome of two different surgical procedures. Thirty patients had been treated by uvulopalatopharyngoplasty (UPPP) and fifty-six by laser palatoplasty. The GBI scores showed close agreement with other subjective outcome measures. The two groups gave similar scores at 15 months postoperatively, and there was no deterioration in score with time. The GBI could be used to evaluate new surgical techniques for snoring, and could be useful in research and audit in this field.

Adult↗
PubMed1995

Comparison of methods for assessing snoring.

Objective measurements of several sound level indices were made on 32 subjects referred because of snoring and who subsequently underwent uvulopalatopharyngoplasty (UPPP). The measurements were repeated approximately 6 months post-UPPP. The indices were compared with the subjective assessment of snoring by both the subject and his/her bed partner. Correlations between objective and subjective assessments were generally weak and were strongest when the supine posture only was considered. The index which correlated best with subjective assessment was the level which 1% of the sound level samples exceeded.

Abdomen↗
PubMed1995

Objective measurement of the results of uvulopalatopharyngoplasty.

Thirty-two patients undergoing uvulopalatopharyngoplasty (UPPP) for snoring have been studied prospectively using objective measurement of snoring levels. A significant reduction was found, especially in the supine posture. The quantitative reduction was small and correlations between subjective and objective changes in snoring volume were weak.

Adult↗
PubMed1994

Uvulopalatopharyngoplasty: The Leicester experience.

Twenty-nine patients undergoing uvulopalatopharyngoplasty (UPPP) for snoring are presented. Ninety per cent expressed an overall improvement in their symptoms: 21 per cent had complete abolition of snoring. Post-operative complications included nasal regurgitation of food/fluids and hyponasal speech development.

Adult↗
PubMed1994

The use of sound recording and oxygen saturation in screening snorers for obstructive sleep apnoea.

It is desirable to screen snoring patients for obstructive sleep apnoea (OSA) prior to surgical treatment. We postulated that the addition of a sound profile would increase the value of overnight oxygen saturation (SaO2) as a screening method. Thirty-nine polysomnographic studies including sound level measured by calibrated meter were performed on snorers being considered for uvulopalato-pharyngoplasty (UPPP). Polysomnography showed an apnoea/hypopnoea index (AHI) > or = 15 per hour of sleep in seven subjects. Two experienced observers independently, without knowledge of other data, classified paper records of SaO2 alone and SaO2 plus sound level obtained during polysomnography as OSA 'unlikely', 'equivocal' or 'definite'. The addition of sound to SaO2 reduced the number of equivocal results from 14 to six and increased the number classified as 'definite' or 'unlikely'. The sensitivity of oximetry +/- sound increased as the threshold AHI used in the definition of OSA increased; addition of sound improved recognition of mild OSA without impairing specificity.

Adult↗
PubMed1994

Surgical voice restoration: the Sunderland experience.

Surgical voice restoration following tracheo-oesophageal puncture is a well established procedure and the principal means of speech rehabilitation following laryngectomy and more recently laryngopharyngectomy. A valve prosthesis was used in 65 patients, 50 of whom underwent insertion at the time of surgery. Of the 65, 49 were men, 16 women and 15 have since died; the median length of follow-up of valves in situ has been 24.7 months (range 2-46 months). Of the 50 living patients 80% were using the valve at last examination. Complications arose in 52% but were generally minor and easily overcome.

Adult↗
PubMed1992

Long-term results of Goode's tympanostomy tubes in children.

The results of a retrospective study of the complications of middle ear ventilation by Goode's T-tubes in children are presented. 248 T-tubes were inserted into 119 patients. 16.9% progressed to spontaneous extrusion with a mean period of ventilation approaching 20 months. 54.9% of patients experienced otorrhoea which was found to be significantly more common in those ears with a mucoid effusion at the time of T-tube insertion. 21.1% of ears developed a persistent perforation where spontaneous extrusion had occurred or the T-tubes had been removed. Perforation also occurred more frequently in those with otorrhoea.

Child↗
PubMed1992

Higher surgical training in Otolaryngology.

The views of the membership of the Association of Otolaryngologists in Training (all current UK Senior Registrars and Consultants in their first year of post) were sought on topical aspects of Higher Surgical Training. 80 members (72.3%) participated. The main points to emerge were that the intercollegiate exam is unpopular. 66% feel it is neither well suited to the developing career structure nor a good assessor of trainees, 80% of Senior Registrars for whom the exam is voluntary say they will not sit it, 66% have doubts about the confidentiality of the Specialist Advisory Committee (SAC) interview and 73% felt the need for a separate faculty for Otolaryngology at the Royal College of Surgeons.

Education, Medical, Continuing↗
PubMed1992

Complications of superficial parotidectomy versus extracapsular lumpectomy in the treatment of benign parotid lesions.

A total of 46 patients with benign parotid gland tumours have been operated upon between 1979 and 1989 in the Department of Otolaryngology at Leicester Royal Infirmary. Thirty-one were pleomorphic adenomas, six Warthin's tumours and nine miscellaneous tumours or tumour-like lesions. Extracapsular lumpectomy without facial nerve preparation was used in 31 cases (67%) and superficial parotidectomy in 15 cases (33%). One case of permanent partial facial palsy and one recurrence occurred in patients who underwent superficial parotidectomy. Frey's syndrome occurred in 40% of patients undergoing superficial parotidectomy. No permanent palsy, recurrence or Frey's syndrome occurred after extracapsular lumpectomy. These results suggest that extracapsular lumpectomy may reduce the morbidity rate in carefully selected patients.

Adenolymphoma↗
PubMed1990

Episodic intermittent claudication associated with a Baker's cyst.

Baker first described synovial cysts in the leg in connection with diseases of the knee joint. Whilst the majority are asymptomatic, some present as a localised swelling behind the knee, and others either compress the popliteal vein or rupture and can be misdiagnosed as deep vein thrombosis; transmitted pulsation through the cyst can suggest the presence of a popliteal aneurysm. This paper documents a case of intermittent claudication of the lower limb secondary to compression of the popliteal artery by a Baker's cyst.

Constriction, Pathologic↗
PubMed1990

Tumefactive fibroinflammatory lesions of the head and neck.

The term 'tumefactive fibroinflammatory lesion' has been used to describe a fibrosclerosing disorder which has a locally destructive nature but is characterized by a benign histological appearance. We report five patients, over a five year period, with such a lesion. The clinical behaviour and surgical findings suggest the lesion to be an invasive malignancy. However, the histological appearance of an admixture of chronic inflammatory cells and fibrosis is consistent with a benign condition. We recommend surgical excision of the lesion as the mainstay of treatment; other studies report the use of steroids and radiotherapy.

Adult↗
PubMed1990

Imbalance and chronic secretory otitis media in children: effect of myringotomy and insertion of ventilation tubes on body sway.

We studied balance in 34 children with chronic secretory otitis media and compared them with 34 age- and sex-matched control children between the ages of 3 and 5 years. In addition to history and examination, objective measurements were obtained by use of a fixed force plate body sway platform in both the control group and the group with chronic secretory otitis media. We took measurements in both groups at an interval of 4 months to ensure that any improvement in body sway could not be attributed to normal maturation. Eight parameters of body sway were compared, including three new parameters not described elsewhere (mean squared velocity, the number of intersections, and velocity moment). Our study showed that balance is significantly worse in children with chronic secretory otitis media compared to a control group. Furthermore, the increased body sway of children with chronic secretory otitis media was returned to the normal range by myringotomy and insertion of ventilation tubes.

Child, Preschool↗
PubMedDate not supplied

Throat swabs in chronic tonsillitis: a time-honoured practice best forgotten.

We have estimated that in 1995 more than 2 million pounds was spent by the National Health Service on throat swabs used to investigate chronic tonsillitis in the UK. This study was devised to assess the value of this investigation. The surface microflora, obtained using a throat swab, was compared with the microflora of the deep tonsil in 30 cases of chronic tonsillitis. None of the throat swabs grew pathogenic organisms, while in 16 cases, heavy growths of recognised pathogens were grown from the tonsillar tissue. This paper demonstrates that throat swabs have little value in the management of chronic tonsillitis, and if the investigation was omitted in this condition, a substantial saving could be made.

Adolescent↗