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D M East

Publications and source records attributed to D M East.

8 recordsLinked to original sources
PubMed2006

An unusual case of primary extranodal non-Hodgkin's lymphoma in the muscles of facial expression.

Primary extra-nodal non-Hodgkin's lymphoma (NHL) of the skeletal muscles is a well recognized entity although such occurrences are not very common. Presentation in the muscles of the face has only rarely been described. We present a case of primary extra-nodal NHL in a non-immunocompromised patient involving only the muscles of facial expression and not extending to the oral cavity or sinonasal tract. The patient was subsequently treated with chemotherapy and at the time of writing remained in remission. We suggest that lymphoma should be considered among the causes for malignant infiltration of the muscles of the face.

Facial Muscles↗
PubMed2004

Long-term hearing results of incus transposition.

Incus transposition is an option for reconstructing an ossicular discontinuity. We looked at the long-term outcome (average 9.2 years) in terms of hearing results in patients who had undergone incus transposition. Patients were requested to attend for a pure tone audiogram. Details of their preoperative audiograms were obtained from the patients' case notes. A postoperative air-bone gap of 20 dB or less averaged over four frequencies (0.5, 1, 2, 4 kHz) was considered to be an acceptable result. We found that 70% of patients had an air-bone gap of 20 dB or less and 54% had had cholesteatoma surgery at the time of the incus transposition. This study represents the longest follow-up of patients having undergone incus transposition from our search of the literature. Incus transposition, we feel, offers good long-term hearing results.

Adolescent↗
PubMed2002

Hearing preservation in patients with labyrinthine fistulae.

INTRODUCTION: Labyrinthine fistula is the most common complication of chronic middle ear disease with cholesteatoma. We present a series of cases of labyrinthine fistula found during the surgical procedures carried out for cholesteatoma in a district hospital setting, over 11-year period. MATERIALS AND METHODS: This is retrospective study based on case notes and author's database for the period of 1987 to 1999. During this period 382 operations were performed and 25 (6.54%) patients found to have labyrinthine fistulae. We looked at the incidence, clinical presentation, surgical technique and hearing outcomes. A standard fistula classification system has been used in order to compare the pre and post-operative hearing. RESULTS: Records were available in 22 cases, which were 12 men, and 10 women with mean age of 45.2 years at presentation. Only one-third had presented with vertigo. Lateral semicircular canal was the most affected site (95%). Fistulae classified as types: I = 8 (36.3%), II-a = 1 (4.5%), II-b = 5 (22.9%) and III = 8 (36.3%). All patients had a standard open technique mastoidectomy. In 5 ears the hearing was lost pre-operatively (1 type II-b and 4 type III fistulae), and in remaining 17 the bone conduction thresholds remained unchanged in 15 (88 per cent) ears. Two dead ears directly related to the surgery and both were of type III fistula. CONCLUSIONS: One-staged mastoid surgery can be the treatment of choice in these cases. Meticulous surgical technique with adequate sealing of the fistula helps to preserve the hearing. An appropriate classification system is an essential tool in presentation and comparison of results.

Adult↗
PubMed1999

Spindle-cell variant of intralingual lipoma--report of a case with literature review.

A true lipoma is a rare lesion in the oral cavity. A histologically distinct variant is the spindle-cell variety, which is an innocuous lesion that can simulate a myxoid liposarcoma. We report a case of intra-oral spindle-cell lipoma in a 42-year-old female and have reviewed the literature pertaining to this unusual histopathological entity. Awareness of the condition is essential for both clinicians and pathologists to avoid any misinterpretation of the benign nature of this condition.

Adult↗
PubMed1998

Atticotomy with reconstruction for limited cholesteatoma.

Several authors have confirmed that it is entirely reasonable to perform a one-stage atticotomy for attic cholesteatomas which are limited in size. Over a period of 10 years, 195 primary procedures were performed for cholesteatoma, and, out of this total, 65 were operated on by an established technique of cartilage repair. In this group of a limited atticotomy there were only two recurrences (3%) and so the technique is considered reliable and, furthermore, using the author's modification, there is no need to dissect out perichondrial flaps. It is recommended that attic cholesteatomas are operated on while they are as small as possible--no damage to the hearing occurred in 63 (96.9%) of the ears in this series--as the results of ossicular repair in ears damaged by cholesteatoma are unpredictable, especially when there is eustachian tube dysfunction.

Cholesteatoma, Middle Ear↗
PubMed1995

Assessment of a direct referral hearing aid clinic.

A direct referral hearing aid clinic (DRHAC) was set up at the Manor Hospital, Walsall, in which patient management was undertaken by an experienced senior medical technical officer in audiology and re-evaluated by an otolaryngologist. After 2 years of offering the service, we audited our experience which is presented in part one of this article. We attempted to assess the referral protocol in part two of the article. During the 2 years, general practitioners referred 458 first-time hearing aid users to the DRHAC. Of these, 91.3% were satisfactorily managed by the audiology department, although only 241 (52.6%) fitted the guidelines developed by the liaison group of the Technicians, Therapists and Scientists in Audiology (TTSA), a lower percentage than expected by the liaison group. All patients who failed to fulfil the TTSA guidelines at the DRHAC were further studied. This revealed that none of the TTSA criteria could be disregarded, but that relying on the experience of the general practitioner and audiologist is an appropriate method for excluding those patients requiring otolaryngological evaluation. It also indicated that the age of 60 years is a suitable limit for patient referrals.

Adult↗