Biomedical subjects
Publications and source records attributed to B M Lyons.
Disorders of voice are a common problem in general practice. An understanding of the complex mechanism of voice production enables us to appreciate how many systemic disorders can affect voice. This article details the pathophysiology of voice production and how to assess the patient with hoarseness. Contemporary management of vocal disorders is described with reference to some newer surgical and investigative techniques.
Radical surgery for sinonasal neoplasms in combination with radiation therapy has vastly improved the outlook for these tumors. Magnetic resonance imaging (MRI) combined with high resolution computerized tomography (CT) scanning and recognition of symptoms suggestive of extensive disease has allowed more accurate determination of surgical margins. Long-term follow-up is still needed to define the limits of radical surgery necessary to treat very extensive tumors.
We have reviewed 21 cases with the clinical diagnosis of Post Traumatic Syringomyelia (P.T.S.). Fifteen of these cases had proven syrinx formation on Contrast Computed Tomography (C.C.T.) and the other 6 had obviously abnormal cords. A much earlier onset of P.T.C.M. was found in complete spinal injuries than in incomplete ones. We have discussed the technique of contrast computed tomography used at this hospital, its value in the diagnosis of this condition and its ability to define actual spinal cord structure. Most cases (91%) benefitted from surgery and several had marked sensory improvement, which previously has been described as unusual. Syringo-cisternal shunting, a new technique for the drainage of cervical and upper thoracic syrinxes is described. A theory is proposed to explain why, in some patients with classical presentations of P.T.S., no syrinx was found on C.C.T., although abnormal cords were found in all cases. It is felt that these abnormal areas of spinal cord are responsible for the presenting symptomatology and may be precursors of syrinxes.
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