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Biomedical subjects

I L Hutchison

Publications and source records attributed to I L Hutchison.

16 recordsLinked to original sources
PubMed2005

Observation of tumour thickness and resection margin at surgical excision of primary oral squamous cell carcinoma--assessment by ultrasound.

Tumour thickness and the status of resection margins are of prognostic significance in the treatment of oral cancer. In a single blind prospective study, 14 patients with biopsy proven oral squamous cell carcinoma had intraoral ultrasound imaging done preoperatively to measure tumour thickness, and intraoperatively to measure the deep surgical margin half way during resection. The cut surface was demonstrated on ultrasound by placing a metal, ultrasound-reflective, retractor into the surgical cut. The ultrasound measurements were compared to the subsequent histological measurements. Using the threshold of 5mm as indicator of margin clearance, there was agreement in 10 out of 14 cases between ultrasound and histology. Ultrasound detection of close surgical margins had a sensitivity of 83% and a specificity of 63%. For preoperative tumour thickness measurement, ultrasound imaging showed a high degree of correlation with histology (Pearson correlation coefficient=0.95, P<0.01). This original paper demonstrates that high resolution ultrasound imaging applied intraorally is a reliable tool in objectively assessing both the tumour thickness and the surgical margin clearance at the time of surgery.

Carcinoma, Squamous Cell↗
PubMed2001

Intracranial metastases from oral squamous cell carcinoma.

We present two cases of histologically confirmed intracerebral metastases from oral squamous cell carcinoma (SCC). This site of distant spread has not to our knowledge previously been reported. The only common feature in all these cases was the long period over which the patients had untreated primary disease (12--24 months). Both patients developed symptoms from their cerebral deposit within a short time of diagnosis and treatment of the primary disease. They died rapidly of their cerebral metastases despite extensive and effective treatment of the primary site and regional lymph nodes. We recommend that a magnetic resonance (MR) scan of the brain is considered for patients who present with long-standing untreated primary oral SCC.

Brain Neoplasms↗
PubMed2000

Tongue piercing resulting in hypotensive collapse.

Tongue piercing remains popular. A variety of complications have been reported, including life-threatening infection, airway problems and damaged teeth or mucosal surfaces. A patient who collapsed after continuous profuse bleeding following tongue piercing is presented. It is recommended that piercing practitioners be licensed and inspected. A list of written post piercing instructions for customers is included on how to deal with, or who to contact regarding potential complications including haemorrhage.

Adult↗
PubMed1999

Solitary nodal metastases presenting as branchial cysts: a diagnostic pitfall.

Two patients with metastatic squamous cell carcinoma are presented. Both were initially clinically diagnosed as branchial cysts. The importance of a full examination of the upper aerodigestive tract, and fine needle aspiration cytology is emphasised to avoid the possibility of excision as a branchial cyst, which could lead to tumour dissemination.

Adult↗
PubMed1998

The BAOMS United Kingdom survey of facial injuries part 1: aetiology and the association with alcohol consumption. British Association of Oral and Maxillofacial Surgeons.

OBJECTIVE: To determine the age and sex distribution, timing, causes, geographical location, and nature of facial injuries in the UK and to determine the association of these factors with alcohol consumption by the patient or any other involved person. DESIGN: A 12-section proforma was completed on all patients with facial injuries covering their age and sex, time and day of injury and presentation, the cause and type of injury and where it occurred, the treatment the patient received, any other injuries, and alcohol consumption by the patient and any other involved person. The total attendances for the study week and the catchment population for each A&E department were recorded. SETTING: 163 of the A&E departments in the UK served by 137 of the UK's oral and maxillofacial departments. SUBJECTS: All patients who presented with facial injuries to these 163 A&E departments in England, Scotland, Wales and Northern Ireland over the study week from 09.00 hours on Friday 12 September 1997 to 08.59 hours on Friday 19th September 1997. RESULTS: 6114 patients with facial injuries presented over the week, out of a total of 152,692 A&E attendances. The male:female ratio was 68:32. This rose to 79:21 in assault cases. The mean age of all patients was 25.3 years, of males 23.2 years, and of females 29.8 years. Forty per cent of the facial injuries were caused by falls. A large proportion of these happened to the under-5 age group in the home. Eleven per cent of all falls were associated with alcohol consumption. Twenty-four per cent of the facial injuries were caused by assault. The commonest sites for assault were the street followed by public drinking establishments. More women than men were assaulted at home. Fifty-five per cent of assaults were related to alcohol consumption. Eight per cent of assaults were with bottles or glasses. Five per cent of the facial injuries occurred in road traffic accidents (RTAs). Fifteen per cent of RTA victims had consumed alcohol. The 15-25 age group suffered the greatest number of facial injuries caused by assault and RTAs and had the highest number associated with alcohol consumption. At least 22% of all the facial injuries in all age groups were related to alcohol consumption within 4 hours of the injury. In the over 15 age groups, alcohol consumption was associated with 90% of facial injuries occurring in bars, 45% on the street, and 25% in the home. Assault, RTA and alcohol consumption conveyed an increased risk of serious facial injury. CONCLUSIONS: Campaigns should be instituted to educate young people about the link between excessive alcohol consumption, assault, road traffic accidents and serious facial injury.

Accidental Falls↗
PubMed1995

A comparative evaluation of the conventional and closed-mouth technique for inferior alveolar nerve block.

The conventional inferior alveolar nerve block is sometimes ineffective for certain clinical and anatomical reasons. As a result, alternative methods have been suggested. This double-blind study compared the effectiveness of the Akinosi technique and conventional mandibular block injection techniques in 250 patients. It was concluded that the conventional or direct technique was more effective in achieving inferior alveolar nerve anaesthesia.

Adult↗
PubMed1990

Neoplasia masquerading as periapical infection.

Seven examples of neoplasia which presented as periapical radiolucencies are described. These were all initially treated for presumed periapical infection. The atypical features that should alert dentists to the possibility of a tumour presenting in this manner are: a vital tooth with minimal caries, root resorption and an irregular radiolucent outline, tooth mobility in the absence of generalised periodontal disease, regional nerve anaesthesia, and failure to respond to good endodontic therapy. All material removed at the time of apical surgery must be examined histologically to prevent neoplasia being overlooked.

Adolescent↗
PubMed1990

The investigation of osteoradionecrosis of the mandible by 99mTc-methylene diphosphonate radionuclide bone scans.

The need for a reliable non-invasive investigation in osteoradionecrosis (ORN) of the mandible is discussed. The results of 99mTc-methylene diphosphonate bone scans using single photon emission tomography, and measuring dynamic uptake in 13 patients are presented. These suggest that sites of osteoradionecrosis may be defined by a paradoxically increased uptake of 99mTc-methylene diphosphonate.

Gamma Cameras↗
PubMed1990

The investigation of osteoradionecrosis of the mandible by near infrared spectroscopy.

The results of near infrared spectroscopy in eight patients with osteoradionecrosis of the mandible are presented. These suggest that sites of osteoradionecrosis may be marked by decreased amounts of deoxygenated haemoglobin. The advantages and potential of near infrared spectroscopy are discussed but the technique requires further refinement.

Adult↗
PubMed1989

A parotid fistula and sialocele complicating temporomandibular joint surgery.

A case of a persistent parotid fistula and sialocele following temporomandibular joint surgery is described. This rarely reported complication is postulated to result from pre-existing bucco-masseteric obstruction of parotid outflow causing raised intraductal pressure in the patient. Following unsuccessful conservative management, the patient was cured by a 5-day course of restricted oral intake and propantheline bromide.

Adult↗