The management of aural polyps.
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Acute Disease↗
Biomedical subjects
H L Tay
Publications and source records attributed to H L Tay.
Nasal mucociliary clearance and salmeterol.
In vitro studies have suggested that beta 2-adrenergic agents increase the ciliary beat frequency in human respiratory epithelium. We carried out a randomized, double-blind placebo-controlled trial to investigate the effects of a topical spray, salmeterol, on nasal mucociliary clearance using the saccharin test. Thirty-three healthy adults were recruited. There was a 21% reduction of nasal mucociliary transport time of saccharin with salmeterol compared to placebo (P = 0.0001). There was no effect of age, sex, order of treatment, interval between spray and saccharin test, or history of seasonal allergic rhinitis on the improvement in clearance times.
Administration, Topical↗
Surgical bone wax causing epistaxis.
A case of recurrent epistaxis caused by bone wax in the nasal cavity is reported. This is the first reported case of a nasal complication due to surgical bone wax.
Aged↗
Post-tonsillectomy pain with selective diathermy haemostasis.
A prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the selective diathermy technique as opposed to the ligation technique. One hundred and five patients had one tonsillar fossa haemostasis secured by unipolar diathermy and the opposite side by ligation technique. There was significantly less pharyngeal pain on the diathermy side in the first post-operative day. However, there was no significant difference between the two sides, both in pharyngeal discomfort and otalgia for the rest of the post-operative period. There was no difference in the incidence of haemorrhage between the two techniques.
Adolescent↗
The mobility of the malleus and incus with varying middle ear pressures.
The mobility of the malleus and incus was studied in two fresh human temporal bones. Various pressure gradients were applied across the intact tympanic membrane and the movement of the ossicles examined, firstly with the incus in situ and secondly, with the incus removed. The displacement of the long process of the incus was less than 100 microns at the extremes of pressure gradient. However, this mobility increased by over twofold when the posterior incudal ligament was divided. With removal of the incus, the mobility of the umbo with pressure changes was further increased and can be as much as half a millimetre. In all cases the maximal rate of ossicular excursion was noted with pressure gradients of less than 100 daPa (mmH2O) across the tympanic membrane.
Ear Ossicles↗
Post-operative morbidity in electrodissection tonsillectomy.
A prospective randomized study was carried out to assess the post-tonsillectomy morbidity of the electrodissection technique as opposed to the blunt dissection and ligation technique. One hundred and four patients, each serving as his or her own control, were randomized to have either the right or left tonsil removed by electrodissection. There was significantly less pharyngeal pain on the electrodissection side in the first post-operative day in adult patients. This, however, was transient as there was increased pharyngeal discomfort and otalgia, both in severity and duration, on the electrodissection side by the end of first week. There was no difference in the incidence of haemorrhage between the two techniques.
Adolescent↗
Heterotopic pleomorphic adenoma in the neck.
Cervical heterotopic salivary tissues are rare and are predominantly found in the anterior triangle of the neck especially at the anterior border of the sternocleidomastoid muscle. We report a case of pleomorphic adenoma arising in the left posterior triangle of the neck.
Adenoma, Pleomorphic↗
Tympanic membrane atelectasis in childhood otitis media with effusion.
A prospective study on the dynamics of tympanic membrane atelectasis during the treatment for glue ear was performed in a sample of 115 ears of 83 children aged between one and 11 years. The progression in the degree of pars tensa atelectasis was analysed in relation to six potentially relevant factors. Multivariate analysis showed that the factor with the most predictive value on the progression of the pars tensa retraction was the grade of atelectasis at initial detection (p < 0.0001). The use of grommets did not have any significant influence on the outcome grade of atelectasis. There was an association between previous grommet insertion and localized retractions in the inferior segment of the pars tensa (p < 0.0001). However, localized retractions in the postero-superior quadrant were not associated with previous grommet insertion (p < 0.02). Although the hearing thresholds of atelectatic ears were significantly worse than normal ears especially at 4 kHz (p < 0.006), the difference was less than 5 dB.
Child↗
Diabetes mellitus and hearing loss.
A prospective hearing survey was performed in a sample of 102 diabetic patients. The hearing data were compared with the hearing thresholds of three control population groups. A significant difference was found in the average hearing thresholds between the diabetic patients and all of the three control populations. Diabetic patients have worse hearing threshold levels especially at low and mid frequencies (P < 0.001). There was also a correlation between the duration of diabetes and hearing loss. No significant correlation was found between the different stages of diabetic retinopathy and the degree of hearing loss.
Adult↗
Findings at initial surgery for childhood otitis media with effusion and subsequent outcome.
The outcome of initial surgical treatment in children with otitis media with effusion (OME) was analysed in a prospective study involving 225 new patients. The presence or absence of effusion in each ear and type of effusion present were recorded at surgery. The outcome measure studied was resolution or recurrence of middle ear effusions necessitating further surgical intervention. The outcome was significantly more favourable in children with unilateral effusions at surgery as opposed to bilateral effusions (P > 0.03) but was unrelated to the type of effusion (serous or mucoid). Patients with unilateral effusions at surgery appear to have a fluctuating form of OME in which effusions are present in either or both ears at different times.
Acoustic Impedance Tests↗
Ethmoidal sarcoidosis.
Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Nasal sarcoidosis commonly affects the mucosa of the septum and the inferior turbinates. These patients may present with nasal discharge, crusting, obstruction, epistaxis or anosmia. We present an unusual case of nasal sarcoidosis involving the ethmoid sinus causing recurrent eyelid swelling and discuss its management.
Adult↗
The assessment of hearing results following surgery for otitis media with effusion using the Glasgow Benefit Plot.
The hearing data from a sample of 73 children undergoing surgical treatment for chronic otitis media with effusion (OME) were analysed using a modification of the Glasgow Benefit Plot. All the patients had bilateral middle ear effusions confirmed at surgery. Using 20 dB average hearing level as the 'cutoff' point between normal and abnormal hearing, 65 (89 per cent) patients had binaural normal hearing, five (7 per cent) had monaural normal hearing and three (4 per cent) had bilateral hearing loss after surgery. However, 70 patients (96 per cent) were found to benefit from surgery. The cases with persistent hearing loss were re-examined to determine the cause of failure.
Child↗
Predictive factors for the resolution of childhood otitis media with effusion following initial surgical treatment.
A prospective study of outcome after treatment for glue ear was performed in a sample of 143 children aged between 1 and 11 years. The resolution or recurrence of effusion following initial surgery was analysed in relation to six potentially relevant factors. Multivariate analysis showed that resolution of effusion was statistically more frequent in ears found to have a dry tap at surgery, children with a history of atopy, those who underwent adenoidectomy and it was related to the age of the child at operation. Older children had a better prognosis. Univariate analysis suggested that girls have a significantly better outcome than boys, but this was not confirmed in multivariate analysis. The results suggest that there should be a longer period of observation in atopic individuals and older children. Furthermore, the study showed that ears with dry taps should not be treated with ventilation tubes.
Adenoidectomy↗
Glossopharyngeal schwannoma presenting as gagging dysphagia.
A case of cervical glossopharyngeal schwannoma presenting with gagging dysphagia is presented. Treatment was by total excision of the schwannoma following which the patient made a good recovery. To our knowledge, this is the first report of gagging dysphagia associated with a glossopharyngeal schwannoma.
Adult↗
Salivary terminal duct carcinoma.
We report two cases of terminal duct carcinoma of the minor salivary glands. The histological features, biological behaviour, treatment and the long-term management are described.
Adenocarcinoma↗
A hearing survey in patients awaiting cataract operation.
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Aged↗