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Biomedical subjects

G S Kenyon

Publications and source records attributed to G S Kenyon.

At least 19 recordsLinked to original sources
PubMed2006

The maturation of balance in children.

BACKGROUND: Balance function is known to change with age during infancy and childhood. However, the relative contributions of the three primary inputs to position sense are not fully understood. METHODS: In this paper we report the computerised dynamic posturography findings in a group of 60 healthy children from the age of five to 17. RESULTS: The results confirm that there is a progressive improvement in balance function with age. The EquiTest system that was used gave indications of the relative contributions of the three principal contributors to overall balance function and showed that somatosensory function was intact throughout the age range tested and that there are significant increases in vestibular function with age and visual contribution with height. The technique used was found to be reliable and repeatable in this paediatric sample. CONCLUSIONS: It is hoped that a better understanding of the normal age related development of balance will be helpful in dealing with children presenting with disequilibrium and vertigo.

Adolescent↗
PubMed2002

Columelloplasty: a new suture technique to correct caudal septal cartilage dislocation.

Deviation of the nasal septum is a common finding in patients with nasal obstruction and, when such deviation is severe, a septoplasty or submucous resection with or without turbinate reduction is commonly recommended for the relief of the patient's symptoms. In cases where there is anterior subluxation of the septum, the caudal margin frequently presents on one or either side of the midline at the external nares. We report a simple suture technique which, when subluxation is not severe, will correct this caudal displacement. The technique can either be used as an adjunct to conventional septoplasty or it can be undertaken as an isolated procedure in patients having routine rhinoplasty.

Humans↗
PubMed2001

Treatment of external nasal valve (alar rim) collapse with an alar strut.

Alar (external valve) collapse may be iatrogenic or can occur as a consequence of ageing or trauma. We have utilized an autogenous cartilage graft inserted as an underlay graft to the alar rim to treat 17 patients who have presented with nasal obstruction due to alar collapse. We report the short- and medium-term functional results and the cosmetic sequelae of our approach and conclude that this procedure offers an improvement in nasal airway performance in patients with external valve collapse without producing serious adverse cosmetic sequelae.

Adult↗
PubMed2001

The effect of decreasing mAs on image quality and patient dose in sinus CT.

The aim of this study was to determine the effect of reducing mAs on the diagnostic quality of images and the radiation dose to the orbits in patients undergoing sinus CT. We studied 40 consecutive patients undergoing paranasal sinus CT for inflammatory disease prior to functional endoscopic sinus surgery (FESS). Four groups of 10 patients were scanned at 200 mAs, 150 mAs, 100 mAs and 50 mAs, respectively. Orbital radiation dose was measured using thermoluminescent dosemeters. Images were reviewed independently by two observers who were unaware of the mAs setting used. Image quality was evaluated using a semi-quantitative scoring system for six anatomical structures. The osteomeatal complex, uncinate process, infundibulum, frontal recess, middle turbinate and optic nerve were assessed as: clearly demonstrated (2 points); demonstrated but not clearly visualized (1 point); or not seen (0 points). No significant difference was shown between any of the four groups in terms of image quality according to the scoring system used in this study. Mean radiation dose to the orbit was reduced by 77%, from 13.5 mGy at 200 mAs to 3.1 mGy at 50 mAs (p<0.05). CT of the sinuses can be performed in patients prior to FESS at greatly reduced mAs without loss of diagnostic quality of the images. This is important in reducing the radiation dose to the lens.

Analysis of Variance↗
PubMed2001

Assessing the reproducibility of nasal spirometry parameters in the measurement of nasal patency.

The reproducibility of nasal spirometry was assessed in ten subjects at two visits. Topical nasal decongestion was applied to minimise mucosal variation. Eleven parameters of flow volume were measured. Data analysis using Spearman's rank correlation coefficients revealed peak inspiratory flow rate (PIFR) followed by forced expiratory volume in first one second (FEV1) to be the most reproducible measures, yielding significance values of < 0.05. For all other spirometric parameters significance was not reached. Analysis revealed that using a naso-pulmonary index (a ratio of nasal to pulmonary flow) was detrimental to reproducibility. We conclude that future nasal spirometric studies should use PIFR and FEV1 as their derived variables of flow-volume loops in the assessment of nasal patency, and the naso-pulmonary index is of no value.

Forced Expiratory Volume↗
PubMed2000

The nasal valves: changes in anatomy and physiology in normal subjects.

There is confusion in the literature concerning the physiology and pathology of the nasal valve, and some debate as to whether there is one valve or two. In an attempt to clarify these uncertainties we have measured nasal function by assessing nasal minimum cross-sectional area, inspiratory resistance and peak inspiratory flow under baseline conditions and after the application of a topical vasoconstrictor. These measurements were then repeated following the application of external and internal nasal splints. Whatever test was employed the results showed that vasoconstriction tended to be the most potent stimulus which changed nasal function producing significant expansion of the minimum cross-sectional area, a decrease in inspiratory resistance and an increase in peak inspiratory flow. External splints also increased the minimal cross sectional area but they had no effect on inspiratory resistance or on the tendency of the vestibular rim to collapse at high inspiratory flow rates. The tendency for lower lateral cartilage collapse was, however, prevented by internal splintage using alar dilators. The results of this study suggest that there is an internal valve at the nasal isthmus where the principal alterations in airway patency follow changes in mucosal congestion, and a mobile external valve where airflow is limited by the tendency of the alar cartilages to collapse. These should be considered as separate entities with differing pathophysiology and these differences should be taken into account when treating patients with airway obstruction due to pathology at these sites.

Adult↗
PubMed1999

Adverse effects of nasal continuous positive airway pressure therapy in sleep apnoea syndrome.

Nasal continuous positive airway pressure (nCPAP) is now the treatment of choice for patients with sleep apnoea syndrome. Side-effects and adverse reactions have been described in isolated reports with this device. We have, therefore, systematically studied the side-effects of nCPAP therapy in 300 consecutive patients referred to the London Chest Hospital Ventilatory Support Unit. Ninety-six per cent of patients complained of at least one side-effect resulting from the therapy, with 45 per cent complaining of a side-effect specific to the nasal mask. There was no correlation between the side-effects and level of pressure used during nCPAP. The rate of compliance remained high in spite of the side-effects, with a daily use of 7.8 hours (SD 8.05) and with 83 per cent of the patients using the device every night. Although nCPAP treatment remains acceptable to most patients there exists a high incidence of adverse effects.

Adult↗
PubMed1997

A running nose.

Explore the source record for details and available documents.

Adult↗
PubMed1997

Diathermy tonsillectomy: comparisons of morbidity following bipolar and monopolar microdissection needle excision.

Tonsillectomy is frequently associated with a considerable post-operative morbidity. In some cases reactionary or secondary haemorrhage occurs and all patients suffer a degree of post-operative pain. The use of bipolar diathermy excision has become popular because it reduces intra-operative blood loss, but all diathermy inevitably produces a degree of damage to adjacent normal soft tissues. In turn this inadvertent injury must act to increase the post-operative pain. Monopolar dissection using a fine tungsten diathermy needle (the Colorado needle) allows sharp dissection at low power levels and in previous studies has been shown to produce a reduction in collateral tissue damage. In this prospective study the morbidity associated with tonsillectomy using this needle was compared to that following a standard bipolar dissection. Using the monopolar needle produced no enhanced risk of reactionary or secondary haemorrhage while causing significantly less post-operative pain and a reduction in eschar. We believe that excision using this needle preserves the advantages associated with bipolar dissection while reducing local soft tissue damage.

Adolescent↗
PubMed1997

An unique tumour of the geniohyoid muscle: an intramuscular haemangioma.

We present the first case report in the English literature of an intramuscular haemangioma of the geniohyoid muscle. This occurred in a 24-year-old female and the diagnosis was not made prior to resection. Haemangiomas are uncommon tumours of the head and neck and intramuscular haemangiomas account for fewer than one per cent of the total. Diagnosis of the vascular nature of the tumour is often missed. Recurrence is common and usually due to incomplete excision. A review of the literature and a case report of these locally destructive lesions is presented.

Adult↗
PubMed1996

Cervical necrotising fasciitis with pharyngeal perforation: treatment and reconstruction.

We present a case of life-threatening necrotising fasciitis of the neck with acute pharyngeal perforation following a parapharyngeal abscess caused by tonsillitis. The joint occurrence of cervical necrotising fasciitis and acute pharyngeal perforation has not been previously reported. A new way of reconstructing the pharyngeal defect using an islanded submental perforator flap is presented.

Acute Disease↗
PubMed1996

Use of photodynamic therapy for the treatment of squamous cell carcinoma of the soft palate.

A 53-year-old white woman presented with a 5-month history of throat pain. The soft palate was biopsied and histological examination confirmed the diagnosis of infiltrating squamous cell carcinoma. She refused surgery and radiotherapy and was therefore offered photodynamic therapy which she accepted. She was treated with 20 J/cm2 at 100 m W/cm2 over a 3 cm area. She was discharged three days later having made an uncomplicated recovery, though substantial analgesia was required. Healing was complete after 2 months, with no loss of palatal function and at most recent follow-up (16 months) there was no sign of residual disease and she remained well.

Carcinoma, Squamous Cell↗
PubMed1996

Day-stay myringoplasty.

Grafting of the tympanic membrane (myringoplasty) has traditionally been performed as an in-patient procedure in the UK. We have performed day-stay myringoplasty on 21 consecutive patients (15 adults and six children) under general anaesthesia using an underlay temporalis fascia graft. In 18 cases there was complete healing of the tympanic membrane and in three cases the patients developed perforations at four weeks. This success rate is consistent with previously reported studies. All patients were discharged on the day of admission with no major complications. We have compared the results with a group of patients having the same operation as an in-patient and have concluded that day-stay myringoplasty under general anaesthesia is as safe and effective as in-patient surgery for the majority of patients.

Adolescent↗
PubMed1996

Day-stay tonsillectomy: is hospital stay reduced at the expense of increased community care?

There is concern about the burden day-stay surgery created upon community services. We have followed 128 children and 38 adults undergoing day-stay tonsillectomy and a similar cohort of adults and children undergoing tonsillectomy as inpatients and looked at the demands made on general practice and casualty services over the 2 weeks after discharge. Twelve adults (18%) and four children (3%) required overnight admission after day-stay surgery. Within the first 2 weeks, 27 adults (48.2%) and 62 children (50%) visited their GP and 13 adults (23.2%) and six children (4.8%) visited the casualty department. There was no statistically significant difference for either adults or children when comparing the day-stay and inpatient cohorts. Adult day-stay tonsillectomy is associated with a high admission rate. Both adult and paediatric tonsillectomy lead to considerable demand for general practice and casualty services, but this demand is high regardless of whether the day-stay or inpatient route is chosen.

Adolescent↗