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Biomedical subjects

A R Grace

Publications and source records attributed to A R Grace.

9 recordsLinked to original sources
PubMed1996

Monitoring of intra-operative visual evoked potentials during functional endoscopic sinus surgery (FESS) under general anaesthesia.

Functional endoscopic sinus surgery (FESS) is an effective treatment for inflammatory sinus disease. The potential for major complications during FESS is high particularly under general anaesthesia. The most serious of these is injury to the eye leading to blindness. We looked at the feasibility of monitoring flash visual evoked potentials (VEP) simultaneously from both eyes during FESS. Five patients were included in this preliminary study. A haptic contact lens connected by fibreoptic cable to a photostimulator was placed on the eyes and stimulus of comparable intensity to a conventional strobe was delivered. We found that an increase in P100 latency to be an indicator of optic nerve compression. However, for this to be useful the diastolic blood pressure should not fall below 50 mmHg, the oxygen saturation should be maintained at 98 per cent and bleeding should be minimized during surgery. The changes in the amplitude of P100 was not found to be useful. While there is no substitute for learning endoscopic surgery by cadaveric dissection and supervised training we believe that in selected cases VEP monitoring can be employed with profit.

Anesthesia, General↗
PubMed1994

Use of the Carden anaesthetic tube for surgery around a tracheostome.

This short communication describes the use of the Carden anaesthetic tube during surgery in and around a tracheostome. The technique, which greatly facilitates access to the operating field, is described along with it's indications and contraindications. We would like to recommend extending the use of the Carden tube to operations around a tracheostome, thereby maximizing surgical access.

Anastomosis, Surgical↗
PubMed1993

Superficial siderosis of the central nervous system--diagnosis by magnetic resonance imaging.

Superficial siderosis of the central nervous system is a rare disorder characterized by the deposition of haemosiderin in the leptomeninges, cranial nerves and spinal cord. The clinical features include sensorineural deafness, ataxia and pyramidal tract signs. We describe two cases demonstrating the characteristic findings on magnetic resonance imaging of widespread peripheral low signal on T2-weighted images.

Adult↗
PubMed1990

Dysequilibrium and otitis media with effusion: what is the association?

An association between non-suppurative otitis media (NSOM) and symptoms of dysequilibrium has been observed but not previously quantified in children (Gates, 1980; Busis, 1983; Blayney and Coleman, 1984). This study compared the incidence of balance related problems in 154 children with surgically proven glue ear and 51 children with normal ear function. Symptoms ranging from true vertigo to mild ataxia were discovered in 22 per cent of the children with NSOM but in none of those within the control group (p less than 0.001). Periods of dysequilibrium were associated with episodes of otalgia in 64 per cent of the children but were not increased in those with unilateral compared to those with bilateral effusions. Complete resolution of symptoms occurred in 85 per cent of children following the insertion of grommets. A history of balance disturbance should be actively sought in all children with otitis media with effusion, and when present, provides a strong indication for early operative intervention.

Child↗
PubMed1988

Nasal lipoma.

Explore the source record for details and available documents.

Humans↗
PubMed1988

A screening protocol used for the detection of acoustic neuromas: a clinical evaluation.

Screening for acoustic neuromas in large numbers of patients in whom the possibility exists should effectively select out the small proportion who have a tumour, prior to more definitive but costly radiological scanning techniques. A suitable screening protocol has been suggested using a combination of caloric testing, tomography of the internal auditory meati and evoked response audiometry. The protocol was applied retrospectively from the records of 64 patients with proven acoustic neuromas and found to predict correctly the presence of a tumour in 97% of cases. It is concluded that this combination of investigations constitutes an effective method of screening patients in whom an acoustic neuroma confined to the 8th nerve is suspected. The great importance of early diagnosis is that the operative mortality and morbidity is much less when the tumour removed is small.

Audiometry, Evoked Response↗