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Biomedical subjects

G A Morrison

Publications and source records attributed to G A Morrison.

At least 37 records · Page 2Linked to original sources
PubMed1990

Long-term results of revision endolymphatic sac surgery.

The results of revision endolymphatic sac surgery on 30 patients with unilateral Menière's disease are presented. Good control is achieved in 73.3 per cent of cases at six months, falling to 56.7 per cent at one year and only 33.3 per cent by four years. The long-term results are disappointing but are more favourable if the initial surgery was successful, if the hearing remains fluctuant and improves on glycerol dehydration prior to the revision procedure and also if the sac is intubated. The current place of endolymphatic sac surgery is discussed and revision surgery only recommended for carefully selected cases.

Adolescent↗
PubMed1990

Identification of hypoxaemia in children having tonsillectomy and adenoidectomy.

A series of children having tonsillectomy and adenoidectomy was investigated for hypoxaemia during sleep and to assess the value of signs and symptoms as predictors of hypoxaemia. Forty-four children were studied the night before surgery. Oxygen saturation (SaO2) was measured whilst the child was awake using a pulse oximeter and when the child was asleep oxygen saturation. ECG and chest impedance were continuously monitored and recorded. In addition, 20 control children having urological surgery were studied in the same way. All the measures of hypoxaemia (awake SaO2, baseline asleep SaO2, number of hypoxaemic episodes) differed significantly between patients and controls (P less than 0.01). When significant hypoxaemia was defined as a baseline sleeping SaO2 below 90% or one dip in SaO2 of at least 10% below the baseline per hour 15 children were found to have abnormal studies. These children could not be identified from history or clinical examination but using the criteria of mouth breathing, audible respiration at rest and an awake SaO2 of less than 96%, 14 of the 15 children were accurately identified (93% sensitivity, 86% specificity). Thus a combination of the physical signs of mouth breathing and measurement of oxygen saturation whilst awake may provide a useful clinic screening test for children suspected of suffering from sleep apnoea.

Adenoidectomy↗
PubMed1989

Pulsatile tinnitus and dural arteriovenous malformation.

An unusual case of a patient presenting with left sided pulsatile tinnitus is presented. This was later shown to be due to a dural arteriovenous malformation involving the lateral venous sinus. The diagnosis was suspected by the presence of a bruit over the mastoid process and confirmed by a CT scan and angiography. Management involved pre-operative embolisation and neurosurgical excision. The differential diagnosis of pulsatile tinnitus and the management of a dural arterio venous malformation is discussed.

Angiography, Digital Subtraction↗
PubMed1989

Cochlear dialysis for Menière's disease. An update.

The early results of hyperosmolar perfusion of the scala tympani for advanced Meniere's disease were reported in 1987. Thirty patients were treated in this way between March 1981 and March 1986; follow-up is now 2 to 7 years. The rationale of cochlear dialysis is to reduce the endolymphatic hydrops of the pars inferior by filing the scala tympani with a sterile solution of mannitol in 5% dextrose that has an osmolality of 350 m.osm per liter, which compares with a scala media osmolality of circa 300 m.osm per liter. The technique is a qualitative and quantitative extension of the "salt in the round window niche" used as far back as 1972 by Arslan.

Adult↗
PubMed1988

Relapsing malignant otitis externa successfully treated with ciprofloxacin.

Two cases are presented, both patients with advanced relapsing malignant otitis externa. The antibiotic ciprofloxacin has strong anti-pseudomonal activity. It was given orally for six months to both patients, following administration of the traditional parenteral antibiotic courses, and in each case the disease has been extinguished. We therefore recommend that the management of patients shown to have malignant otitis externa should include strict diabetic control, regular local aural toilet, gentamicin ear drops and a six week course of parenteral antipseudomonal antibiotic agents (usually gentamicin and azlocillin) together with metronidazole to cover any anaerobic element in the infection. This regimen should be followed by a six month course of oral ciprofloxacin (750 mg b.d.). Indium scans should be used to monitor recovery. We believe that this regimen can significantly reduce the morbidity and mortality of patients suffering from malignant otitis externa with cranial nerve involvement.

Aged↗