PubMed Health⌕ Search

Biomedical subjects

C I Timon

Publications and source records attributed to C I Timon.

At least 37 records · Page 2Linked to original sources
PubMed1994

Recurrent laryngeal nerve palsy secondary to benign thyroid disease.

A recurrent nerve palsy occurring in the presence of a goitre is considered to be caused by thyroid malignancy until proven otherwise. Three cases are described in which benign thyroid disease resulted in recurrent laryngeal nerve paralysis. Recent haemorrhage was implicated histologically as the possible aetiology in all three cases. The importance of identifying and preserving the recurrent laryngeal nerve in the surgical management is highlighted.

Aged↗
PubMed1994

The role of total laryngectomy in the management of intraluminal upper airway invasion by well-differentiated thyroid carcinoma.

Intraluminal invasion of the upper airway by well differentiated thyroid carcinoma is very uncommon, and the management can be problematic. Many conservative, reconstructive-type surgical procedures have been advocated to maintain normal laryngeal function. Although voice preservation is desirable, it may not always be in the patient's best interest and radical surgery, including total laryngectomy, may be necessary. We describe three cases in which total laryngectomy was performed, and review the indicators for this procedure in the treatment of this difficult to manage condition.

Aged↗
PubMed1993

Bacteriology of tonsil and adenoid and sampling techniques of adenoidal bacteriology.

The value of pernasal swabs and direct adenoid swabs in chronic adenoid and adenotonsillar disease was assessed in 175 patients. Prior to adenoidectomy (53 patients) or adenotonsillectomy (122 patients), pernasal and direct adenoid swabs were taken. Adenoid currettings and tonsil tissue were cultured. Haemophilus influenzae was the bacterium most frequently isolated from adenoid currettings and from the centre (core) of the resected tonsil. There was a close relationship between the bacteriology of the pernasal swab and the adenoid tissue and tonsil core in 72 and 71% of patients, respectively. There was an identical profile of pathogens in 52 and 49%, respectively. We suggest that in children with adenoiditis or adenotonsillitis and hypertrophy of the adenoid, a pernasal swab should be used in preference to a throat swab in selecting appropriate antimicrobial therapy. Penicillin and ampicillin are not appropriate blind therapy in chronic adenoid and adenotonsillar infections because of the prevalence of beta-lactamase-producing aerobes (40%) in adenoid and tonsil core in these conditions.

Adenoidectomy↗
PubMed1993

Hyoid bone tumour mass presenting with cervical nodal metastasis.

This paper presents a quite unique case report of a patient presenting with the combination of cervical metastatic lymphadenopathy and a hyoid bone tumour mass. The differential diagnosis and treatment is discussed, with emphasis on the importance of immunohistochemistry and electron microscopy in the management of such a case.

Bone Neoplasms↗
PubMed1993

Effect of pre-operative antibiotic treatment on the bacterial content of the tonsil.

The impact of 7 days pre-tonsillectomy antibiotics on the aerobic bacterial content of the tonsil was studied in 70 consecutive patients. One group received no antibiotic, one group received pre-operative amoxycillin and the final group, pre-operative cefaclor. The qualitative bacteriology was similar in the three groups Haemophilus influenzae was the predominant isolate present in the centre ('core') of the resected tonsil. Similar numbers of beta-lactamase producers including H. influenzae and Straphylococcus aureus were found in all three groups. Quantitative bacteriology of the tonsil core demonstrated that there was a significant reduction in core tonsil pathogens associated with antibiotic therapy. The most statistically significant difference was between the untreated control group and the cefaclor treated group. We conclude that in patients with established recurrent acute tonsillitis, oral antibiotics penetrate the diseased tonsil and influence the predominant core aerobic microflora.

Adolescent↗
PubMed1992

Hyoid bone involvement by squamous cell carcinoma: clinical and pathological features.

The incidence of hyoid bone involvement by neoplasia is undetermined, despite its importance in hyoid-preserving surgery. Eleven (1.46%) of 755 whole-organ laryngeal specimens examined demonstrated hyoid bone infiltration. These included 6 cases originating from the larynx, 3 from the vallecula, and 1 case each from the pyriform fossa and tongue base. Clinically, vallecular involvement was helpful in determining hyoid invasion; however, computed tomography (CT) was disappointing. The greater cornu was the sole site of invasion in six cases. Ten of 11 cases were secondary to direct tumor spread. All carcinomas were advanced, with variable differentiation. Vascular and neural invasion was a prominent feature. Hyoid bone invasion is rare, and associated with a poor prognosis. Hyoid bone preservation is feasible in a majority of patients.

Aged↗
PubMed1992

Chondrosarcoma of the larynx: a histo-radiologic analysis.

Chondrosarcoma of the larynx is a rare malignant cartilaginous neoplasm. To date, the serial sectioned laryngeal specimens of this disease have not been correlated with the pre-operative computed tomographic findings. A retrospective analysis of 833 serially sectioned laryngeal specimens found chondrosarcoma in six cases (0.72%), of which four cases had a pre-surgical computed tomography (CT). Radiologic axial sections were compared with microscopic sections in the same plane. Whole organ sections showed the tumor to have an expansile growth pattern, showing little impulse to infiltrate adjacent cartilage. CT scanning successfully predicted the diagnosis of a cartilage neoplasm prior to surgery, and accurately reflected the site and extent of laryngeal involvement. We conclude that CT is a reliable method of evaluating chondrosarcoma of the larynx, thereby predicting the feasibility of partial laryngeal resection.

Aged↗
PubMed1991

Fine-needle aspiration in recurrent tonsillitis.

The incidence of tonsillitis that is unresponsive to penicillin therapy is leading to concern. This phenomenon has been linked to a change in the core tonsil bacteria, in particular beta-lactamase production. To date, the only way to identify the presence of these resistant microbes is at tonsillectomy. In this prospective study, we performed fine-needle tonsil aspiration in 34 patients (mean age, 7.6 years) before tonsillectomy. The bacteriologic nature of the aspirate was compared with that obtained from culturing the tonsillar surface (in situ) and core of the resected tonsils. The bacteriologic findings of the aspirate corresponded closely with those of the tonsil core (qualitative and quantitative comparison), while the superficial swab was of limited value in predicting the core bacteria. Based on this study, tonsil fine-needle aspiration may have a place in the treatment of recurrent tonsillitis.

Adolescent↗
PubMed1991

Infection of Waldeyer's ring: value of pernasal retropharyngeal swabs.

The value of pernasal retropharyngeal swabs in chronic adenoid and tonsillar disease was assessed in a prospective study involving 52 patients. Prior to adenoidectomy (34 patients) or adenotonsillectomy (17 patients), pernasal and tonsillar swabs were taken and the culture compared to the bacteriology profile obtained in the adenoid and tonsil tissue following surgery. The pernasal swab correctly identified 76% of pathogens isolated in the adenoid tissue. In addition, pernasal swabs forecast the presence of pathogens in 64% of core tonsil specimens, compared to an accuracy of 38% when superficial tonsil swabs were compared to the microbes in the deep tonsil. H. influenzae was the predominant organism isolated in all cultures. Our results clearly demonstrate that pernasal swabs give a representative picture of the adenoid bacterial content. Pernasal swabs are also superior to superficial tonsil swabs in indicating the deep tonsillar organisms.

Adenoidectomy↗
PubMed1991

Head and neck cancer localization with indium labelled carcinoembryonic antigen: a pilot project.

Antibodies reacting with cancer cells are playing an increasing role in cancer detection. Most antibodies under study are directed at onco-fetal proteins, principally carcino-embryonic antigen (CEA). In terms of imaging, most work has concentrated on the abdominal and pelvic regions. Although the majority of primary head and neck cancers are amiable to clinical identification, detection of regional metastases and recurrences following radiotherapy can be difficult. Antibody to CEA was radiolabelled with Indium-111 and used to identify proven head and neck tumors by external imaging. In seven patients with squamous cell tumors, five of five primary sites and two of three secondary sites were imaged satisfactory. Comparison with conventional scanning showed good correlation. There were no false positive scans, no consistent relationship between serum or tissue CEA levels and the success of imaging was evident. The success of this pilot study should encourage the search for more tumor-specific antigens, and further studies of external scintigraphic techniques in the localization of head and neck cancers.

Aged↗
PubMed1991

Surgical treatment of hypopharyngeal tumours.

A review of 51 patients who underwent total pharyngolaryngectomy between 1972 and 1989 was undertaken and factors influencing hospital mortality and long-term survival were examined. All patients had advanced hypopharyngeal or cervical oesophageal cancer, and alimentary continuity was restored with either subcutaneous colon (39 patients) or stomach (12 patients). The overall hospital mortality rate was 25% (13 patients). Mortality was mainly caused by cardiac problems or sepsis. The 1-year survival rate was 36% and two of 26 patients (8%) survived more than 5 years. Survival was better when gastric transposition was used for reconstruction (P = 0.01). Other significant factors affecting survival were operative year, presence of metastatic cervical lymphadenopathy and microscopic pharyngeal penetration. It is concluded that surgical ablation is a viable option for advanced hypopharyngeal and cervical oesophageal neoplasia, with stomach interposition the preferred method of reconstruction. Although the prognosis is poor, satisfactory short-term palliation can be achieved.

Adult↗
PubMed1990

Changes in tonsillar bacteriology of recurrent acute tonsillitis: 1980 vs. 1989.

Recurrent acute tonsillitis is a common problem. Despite this, there still remain many controversies regarding aetiology and correct management. The tonsillar microflora of 33 children with recurrent acute tonsillitis studied in 1980 and 58 patients studied in 1989 is presented. A comparison of the microbiology in the two periods studied a decade apart suggests that the pathogenic profile is changing. Haemophilus influenzae increased from 39 to 62% in the deep tonsillar tissue in the decade. There was a concomitant increase in incidence of Staphylococcus aureus from 6 to 40% of cases. In the same interval, mixed microflora increased from 18 to 52%. Anaerobic organisms were isolated in insignificant numbers. Unique to this study, 44% of H. influenzae isolates in 1989 were beta lactamase producers, increasing from only 2% in 1980. All of the S. aureus were beta lactamase producers. In the majority, the throat swabs grew only organisms commensal to the upper respiratory tract however, the deep tonsillar tissue excised at tonsillectomy carried significant growths of pathogenic organisms confirming the inadequacy of the superficial tonsillar swab as an indicator of treatment.

Acute Disease↗
PubMed1990

Ingrowing toenails: improving treatment.

Sixty-six patients with ingrowing toenails were randomly assigned to one of two treatment groups and followed up for 16 to 30 months after surgery. In group A 39 nail edges in 32 patients were treated by excision of the nail edge and chemical ablation of germinal matrix edge with 70% aqueous phenol. There were 34 patients in group B, in whom 46 nail edges and germinal matrix edges were surgically excised. In group A recurring symptoms developed in four (10%) nail edges, necessitating further surgery, and asymptomatic spicules developed in seven (18%) nail edges. Two (4%) nails in group B required reoperation and spicules developed in 10 (22%). Both procedures were performed as outpatient surgery, relieved pain and infection, and were acceptable to patients. At an average 2-year follow-up, both procedures yielded comparable results that were superior to those of simple avulsion.

Adult↗
PubMed1990

Management of tonsillitis by the general practitioner.

Seventy-eight of 107 general practitioners completed a questionnaire to assess the management of recurrent acute tonsillitis by the primary care physician. Penicillin was the antibiotic of choice in acute tonsillitis, used by 74 (95%) respondents. Of these, 45% recommended ampicillin/amoxycillin. In the case of penicillin allergy, 67 (86%) chose erythromycin. For the treatment of tonsillitis unresponsive to initial therapy, a wide variety of agents were quoted; the most common being erythromycin (27 cases, 35%) and co-trimoxazole (16 cases, 20%). There were 17 separate indications for surgical referral given, the most common being recurrent tonsillitis (68 cases, 87%). Two or more reasons for surgical referral were stated by 55 (71%) GPs. These findings are discussed with particular reference to recent reports of penicillinase producing bacteria in association with recurrent acute tonsillitis.

Erythromycin↗
PubMed1989

Ethmoidal mucocoeles in children.

Children presenting with ethmoidal mucocoeles are rare. Five children are presented with such findings, and the diagnosis, treatment and possible aetiology discussed. C.T. scanning was found to be the investigation of choice, while plain sinus X-rays correlated poorly with the presence of disease. Exenteration through an external approach was found to be satisfactory. In two cases drainage obstruction due to congenital abnormality was thought to be the underlying cause, while in four cases there was a strong history of atopy, indicating allergy as a possible reason for mucocoele formation.

Adolescent↗
PubMed1989

Hypopharyngeal involvement by thyroid cancer.

Direct upper airway infiltration by thyroid neoplasia is a rare occurrence, a unique case of papillary thyroid neoplasia presenting as a pyriform fossa mass is described and the management of these problem patients is discussed, emphasising the controversy between radical and conservative surgery. The possibility that the thyroid tumour resulted from previous radioactive iodine prescribed for thyrotoxicosis is also considered.

Adenocarcinoma↗
PubMed1989

Treatment of combined subglottic and critically low tracheal stenoses secondary to burn inhalation injury.

We report a case of combined severe subglottic and lower tracheobronchial stenoses after an inhalation burn injury. The patient was successfully treated by the insertion of a bifurcated silicone rubber stent. The proximal limb of the silicone tube was used to stent the subglottic stenosis after it had been resected, a treatment option not previously reported. It is speculated that the diffuse airway damage resulted from a combination of thermal injury, mechanical trauma and infection. The relatively late symptomatic presentation of the lower tracheal stricture is stressed and the treatment options discussed.

Burns, Inhalation↗