Biomedical subjects
Publications and source records attributed to I J Johnson.
Glossal abscesses are extremely rare, only 29 cases having been described in the last 28 years. Clinical and ultrasound examination should establish the diagnosis, and treatment should be by surgical incision and drainage. We report a case of glossal abscess presenting as a unilateral swelling of the tongue.
A case is presented of a rare congenital anomaly of the fourth branchial arch, which presented as an abscess in the anterior triangle, related to a fistula communicating with the pyriform fossa. Histopathological examination showed the fistula to be associated with thyroid tissue supporting the hypothesis that the ventral wing of the fourth pouch contributes to the thyroid gland.
Three cases of patients with acute middle ear infections complicated by a sixth nerve palsy are described. The possible causes of sixth nerve palsy in such cases are discussed. We propose that where there is a sixth nerve palsy without petrositis and without raised intracranial pressure, it can arise as a result of spreading phlebitis along the inferior petrosal sinus from the lateral sinus.
Examination of the larynx with a flexible endoscope has been a standard procedure for over 20 years. Although excellent images have been obtained there has not been a method for achieving any objective measurements and there are clearly both research and clinical applications for this. The reason for this is firstly because of the inherent distortion of the lens and secondly because of an absence of a reliable method of assessing the relative position of the endoscope within the larynx. This paper illustrates the theory of how these problems have been overcome and describes the equipment used in the clinical situation. The first clinical trial of the Vocim system is detailed, demonstrating an error of only 4%.
The appropriate degree of investigation of thyroglossal cysts is uncertain. This retrospective study analyses the pre-operative investigations and correlates this with the post-operative results. The conclusion is that only radio-isotope studies are useful, but there is a limitation regarding the age of the patient and the authors only recommend this in patients over 10 years of age.
A case of bilateral Auriculotemporal or Frey's syndrome in childhood is unique in the World literature. The clinical presentation and management is discussed. A conservative approach is advocated but other therapeutic options are considered. The literature is reviewed, only 17 cases all unilateral are known, and from the study the probable aetiology and long term follow-up is reported.
Nasal tuberculosis represents a rare manifestation of infection by Mycobacterium tuberculosis: a case is presented together with a review of the literature. The correct management is documented, especially the need to treat the patients as if there was a generalized condition, and the problems concerning drug resistance are also considered. The incidence of this disease is rising and its importance must once again be highlighted.
This was a prospective trial involving 1000 consecutive patients attending an ENT out-patient department to assess the degree of investigation and procedures undertaken in routine practice. Results demonstrate that the majority of patients (both new and old) require a procedure which would necessitate either additional staff or equipment if the consultation occurred in a General Practitioner's (GP's) surgery. The results argue against out-patient clinics taking place in a GP's surgery.
A case of primary malignant melanoma of the pharynx is presented. Mucosal melanomas of the upper respiratory tract are rare. They tend to present late and therefore the prognosis is generally poor. The initial mainstay of treatment is adequate surgical resection. Prognostic factors are less well documented than in cutaneous melanoma.
A solitary metastasis to the nose from a renal cell carcinoma is extremely rare. One such case is presented and the argument for aggressive therapy to these lesions is reviewed.
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