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Biomedical subjects

G B Brookes

Publications and source records attributed to G B Brookes.

81 records · Page 5Linked to original sources
PubMed1983

Epiglottopexy: a new surgical technique to prevent intractable aspiration.

Severe derangement of the protective function of the larynx results in intractable aspiration with secondary life-threatening pneumonia. The new surgical technique of epiglottopexy is described, which in addition to achieving protection of the laryngeal inlet, allows preservation of speech and in certain cases an adequate laryngeal airway. The advantages over current alternative treatment methods is discussed, and the results of five cases of gross laryngeal incompetence managed by epiglottopexy are presented.

Deglutition Disorders↗
PubMed1982

Chronic upper airway obstruction: value of the flow volume loop examination in assessment and management.

Chronic obstructive lesions of the upper airways such as post-traumatic strictures, bilateral vocal cord paralysis and chronic inflammatory foci are uncommon. The functional assessment of the severity and character of an obstruction is important both for diagnosis and management, and may also allow evaluation of the efficacy of medical and surgical treatment. There are limitations of simple spirometric pulmonary function tests, which are evident when assessing upper airways obstruction. The flow volume loop is a graphic recording of airflow during maximal respiration and expiration at different lung volumes, and may be affected in a characteristic way by alterations in the airway resistance. Three unusual cases of chronic upper airway obstruction are presented which illustrate the value of the flow volume loop examination in their management.

Airway Obstruction↗
PubMed1981

Nutritional status and general immune competence in patients with head and neck cancer.

Anergy to 2,4-dinitrochlorobenzene (DNCB) has been reported as a highly significant adverse prognostic immunological factor in several studies of patients with squamous cell carcinomas involving the head and neck. Patients with these tumours often present with concurrent nutritional deficiencies. This paper reports the findings of a prospective study into both the nutritional status and general immune competence of 53 such patients.Analysis of the results has demonstrated a statistically highly significant positive correlation between nutritional status and both the delayed hypersensitivity response to DNCB, and the pretreatment total lymphocyte count levels. It is suggested that nutritional deficit may be a primary adverse prognostic factor in this disease group, with immunoincompetence a secondary phenomenon, and supporting evidence is presented. The consequent probable importance of nutritional status with regard to clinical trials, and the necessity for controlled studies to determine the possible beneficial effect of nutritional support on `cure' rates, are discussed.

Aged↗
PubMed1980

'Costen's syndrome'--correlation or coincidence: a review of 45 patients with temporomandibular joint dysfunction, otalgia and other aural symptoms.

Forty-five patients with temporomandibular joint dysfunction, and otalgia together with other aural symptoms (deafness, tinnitus, pressure/blockage and vertigo) were evaluated clinically and audiometrically. The theoretical mechanisms by which aural symptoms may be produced as a result of temporomandibular joint dysfunction are outlined and discussed in the light of the patients under review. The wide diversity in the incidence of additional aural symptoms apart from otalgia reported in the literature is noted, together with the general lack of full objective audiometric assessment. In 37 patients the aural symptoms were directly attributable to other coincidental otolaryngological pathology. Details of the remaining 8 cases are presented. The other aural symptoms of 4 of these patients were also probably accounted for by other coincidental otalaryngological pathology. It may be significant that 2 of the other patients were suffering from concurrent psychiatric disorders. Thus in this series at least 9% of the patients were considered to have other aural symptoms coincidental to temporomandibular joint dysfunction. This is compatible with the relatively common occurrence of both temporomandibular joint dysfunction and aural symptoms in the general population. This study leads us to believe that there is no direct aetiological basis to link temporomandibular joint dysfunction and other aural symptoms apart from otalgia.

Adolescent↗
PubMedDate not supplied

Bilateral middle ear carcinomas associated with Waldenström's macroglobulinemia.

A case of bilateral middle ear squamous cell carcinomas with concurrent Waldenström's macroglobulinemia is described. An increased incidence of malignant tumors occurring in patients with this potentially fatal, chronic lymphoproliferative disorder is well recognized, but the association with an otological tumor has not previously been reported. The relationship between the two conditions is discussed.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Otoadmittance changes following glycerol dehydration in Meniere's disease.

Otoadmittance studies were undertaken in 76 patients with Meniere's disease and 8 control subjects undergoing glycerol dehydration. Baseline otoadmittance values were significantly higher in ears with fluctuant hydrops compared to the non-fluctuant ears (p less than 0.01), suggesting that there is a pathophysiological difference between these clinical Meniere's groups. Significant maximum conductance changes were seen in 53.4% of hydroptic ears, and were associated with subjective audiometric threshold shifts in 23.2%. Similar changes were not seen in the control ears. These findings provide further clinical evidence to support an underlying physical basis for the auditory symptoms of endolymphatic hydrops and the effects of glycerol dehydration on the inner ear. Objective otoadmittance changes appear to be a more sensitive indicator of reversible hydrops than conventional audiometry. Possible mechanisms to explain the somewhat paradoxical increase in the resistance to the flow of sound energy through the cochlea following reduction of the endolymphatic hydrops by glycerol dehydration are discussed.

Adolescent↗