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Biomedical subjects

G K Banfield

Publications and source records attributed to G K Banfield.

9 recordsLinked to original sources
PubMed2000

Day case rhinoplasty.

Rhinoplasty is considered by many to be an inpatient surgical procedure. This may be because the operation is thought to be traumatic with a risk of epistaxis and periorbital haematoma. Since 1992 rhinoplasty surgery at St George's hospital has been routinely performed on a planned day case basis. The hospital records of 97 patients were examined of which 17 patients (18%) underwent planned admission and 12 (12%) unplanned admission. No patients were re-admitted to hospital after discharge. With the advances in day case surgical practice within the UK we consider that the practice of day case rhinoplasty is likely to have its place. Such surgery should ideally be performed in a dedicated day case unit and provision for admission overnight should be available.

Adult↗
PubMed2000

A national survey of disinfection techniques for flexible nasendoscopes in UK ENT out-patient departments.

Flexible fibre-optic nasendoscopes have become a ubiquitous ENT out-patient tool for the inspection of the nasopharynx, larynx and hypopharynx. Disinfection of the instrument between patient use is important to prevent potential spread of infection but the methods used vary considerably. We designed a questionnaire which was piloted and then sent to 115 UK ENT out-patient departments to establish current UK practice. Most units (67 per cent) use a chemical soak system but the type of chemical disinfectant, the method of delivery and the duration of soak varied considerably. A few hospitals use a disposable plastic sheath system and others simply wipe the instrument with an alcohol swab in between patient use. The protocols for disinfection after high risk patients e.g. human immunodeficiency virus (HIV), hepatitis B varied from hospital to hospital. The results demonstrate a lack of standard practice that is wasteful of financial resources and may expose patients to unnecessary risk. There is a need for an authoritative ENT body to publish national guidelines as may be found in other specialties and other countries.

Disinfection↗
PubMed2000

Does vestibular habituation still have a place in the treatment of benign paroxysmal positional vertigo?

Particle repositioning procedures such as the Epley manoeuvre have become popular in the management of benign paroxysmal positional vertigo (BPPV) at the expense of more traditional therapies such as vestibular habituation. We prospectively analysed the response of consecutive patients presenting with BPPV to treatment with vestibular habituation exercises using a symptom score sheet before and after treatment. This same patient group was then followed up, on average three years, eight months after discharge, to determine their long-term response to treatment. The results of the study demonstrated an excellent short-term response rate to treatment but a high level of recurrence after discharge. Most patients who experienced further symptoms following discharge were however self-reliant and were able to return to their habituation exercises without the need for further medical input. The aim in the management of these patients must be to provide long-term self reliance as well as short-term cure and it may be that this has not yet been well demonstrated with the Epley manoeuvre. It must also be remembered that particle repositioning manoeuvres cannot be used in all patients for example those who suffer with cervical or thoracic spine pathology and that some will fail to respond at all. We believe that vestibular habituation retains a useful role in the treatment of BPPV.

Adult↗
PubMed1999

Partial resection of the middle turbinate at functional endoscopic sinus surgery.

The middle turbinate is often carefully preserved at Functional Endoscopic Sinus Surgery (FESS). However there is no clear understanding of its importance and its presence may prevent good access to the middle meatus to the detriment of the surgical result. In addition its bulk may cause symptoms of nasal obstruction and prevent paranasal sinus drainage. Adhesions and stenosis have been reported at the middle meatus following its preservation. We undertook a prospective study of 50 consecutive patients all of whom underwent resection of the anterior half of the middle turbinate at the time of Functional Endoscopic Sinus Surgery. The patients were asked to complete a symptom score sheet before and ten weeks after surgery. The parameters considered were nasal obstruction, nasal congestion, discharge, facial pain and headache. Non parametric analysis of the results indicated a significant improvement in all patient symptom scores and no postoperative complications were noted. We conclude that partial resection of the middle turbinate is a useful modification of accepted endoscopic sinus surgery techniques.

Acute Disease↗
PubMed1995

Penetrating laryngeal injury: two case reports from Bosnia.

Penetrating injury to the larynx is uncommon. We present two cases resulting from the recent Bosnian conflict. It is possible to achieve good laryngeal function by appropriate conservative management once the airway is secured. Progress should be monitored by repeated endoscopic examination and imaging techniques.

Adult↗
PubMed1995

Intrapetrous carotid artery aneurysm presenting as epistaxis and otalgia.

Aneurysm of the intrapetrous carotid artery is an extremely rare and potentially serious occurrence that presents diagnostic and therapeutic difficulties. Such aneurysms may follow trauma, atherosclerosis, mastoid surgery or most commonly can represent a developmental abnormality. We present the case of an 18-year-old female with a short history of recurrent left-sided otalgia and epistaxis who underwent successful endovascular balloon entrapment of a left intrapetrous carotid aneurysm.

Adolescent↗
PubMed1995

Rhabdomyosarcoma arising in teratoma of the testis.

Rhabdomyosarcoma arising in teratoma of the testis is an exceptionally rare occurrence. The rhabdomyosarcomatous element infers a less favourable prognosis and standard treatment regimes well recognised for the treatment of teratoma of the testis may not be effective.

Adult↗
PubMed1995

Long-term sequelae of Palmar-Plantar erythrodysaesthesia syndrome secondary to 5-fluorouracil therapy.

Palmar-Plantar erythrodyasesthesia syndrome has been reported as a temporary complication of 5-fluorouracil therapy consisting of a debilitating erythema and tenderness of the skin of hands and feet. The syndrome has previously been observed to respond rapidly to either temporary cessation of chemotherapy or pyridoxine with little residual disability. We report a case which was characterized by persistent morbidity necessitating prolonged discontinuation of treatment.

Erythema↗