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Biomedical subjects

J A Carruth

Publications and source records attributed to J A Carruth.

At least 19 recordsLinked to original sources
PubMed1995

Laryngeal papillomatosis with subsequent development of papillomata in the paranasal sinuses--is it seeding by intubation?

Concern has been expressed regarding the seeding of viral DNA, in laryngeal papillomatosis, to other sites in the respiratory tract during treatment. Controversy exists regarding the concept of seeding by the laser plume. However, instrumentation and anaesthetic intubation are also strongly implicated in seeding DNA to the proximal respiratory tract. No cases of recurrent laryngeal papillomatosis and subsequent papilloma in the paranasal sinuses have been reported.

Adult↗
PubMed1992

Necrotizing fasciitis of the face without significant trauma.

Necrotizing fasciitis is a rare but well recognized clinical entity which most often occurs on the trunk, perineum or legs following surgery or trauma. The condition is much less common in the head and neck and it is particularly uncommon in the midface/periorbital region. In almost all the cases occurring in the neck the condition follows obvious dental or oropharyngeal sepsis and in all the cases of the scalp there is a history of previous surgery or trauma. However, necrotizing fasciitis of the midface/periorbital region may lack any obvious traumatic aetiology or may follow relatively minor trauma. The diagnosis in these cases may not be suspected and treatment may be delayed with fatal consequences. Treatment by wide excision of all affected skin can lead to disastrous cosmetic consequences in facial disease and it is suggested that disease control can be achieved by raising wide based skin flaps with excision of the underlying necrotic tissue. The flaps are then returned onto normal muscle with much improved cosmetic results. This paper discusses the diagnosis and treatment of patients with necrotizing fasciitis of the face which has arisen without significant trauma.

Adult↗
PubMed1992

Orbital infection secondary to sinusitis in children: diagnosis and management.

A series of 18 children with orbital infection secondary to sinusitis is described. The presenting symptoms were headache and periorbital swelling but it was found to be impossible to determine the stage of the orbital infection on clinical grounds. CT scanning can accurately identify the presence of a sub-periosteal abscess but both axial and coronal sections may be needed to diagnose abscesses in the superomedial portion of the orbit. Cellulitis may be managed by antibiotic treatment alone, but if an abscess is present it should be drained immediately with a formal ethmoidectomy to decompress the orbit if there is any evidence of reduced visual acuity.

Abscess↗
PubMed1990

Management of the parotid pleomorphic adenoma, the problem of exposing tumour tissue at operation. The logical pursuit of treatment policies.

The objective of treatment of a parotid pleomorphic adenoma is to remove all tumour cells with minimal short- and long-term morbidity and minimal recurrence rates. If an enucleation is carried out, the facial nerve may be put at risk and tumour fragments will inevitably be left in the wound. Most surgeons suggest that after enucleation, radiotherapy must be given to reduce the recurrence rate to an acceptable level. If during a formal superficial parotidectomy the tumour capsule is visualised, the objective of removing the tumour with an intact cuff of normal tissue has failed and the operation has in effect become an enucleation. This paper defines the problem and discusses its management.

Adenoma, Pleomorphic↗
PubMed1989

Photodynamic therapy in the treatment of malignant tumours of the skin and head and neck.

Photodynamic therapy utilizes a tumour-localizing photosensitive substance which, when activated by light of an appropriate wavelength, releases cytotoxic substances causing destruction of the malignant tumour with preservation of surrounding normal tissues. In this technique the only drug/light combination which has been regularly used to date is that of haematoporphyrin derivative and red light at a wavelength of 630 nm usually produced by a dye or gold vapour laser. A pilot/feasibility study was set up in Southampton in 1983, with ethical permission, to treat tumours of the skin and head and neck which had failed all other treatment modalities or for which there was no practical alternative therapy. Thirty-eight patients were treated in this study and all tumours showed a response; significant palliation was achieved in a number of patients. Basal cell carcinomas and the multiple lesions of Bowen's disease were found to be particularly suitable for this form of therapy and prolonged local control was achieved in a number of patients.

Adult↗
PubMed1988

Photodynamic therapy and the treatment of head and neck cancer.

An account is given of how Photodynamic Therapy (PDT) may be used in the diagnosis and treatment of cancer of the head and neck. The role and mode of action of the tumour sensitising agent, Haematoporphyrin derivative (HPD), are shown and the current use of lasers as suitable light sources will be discussed. Individual cases are used to illustrate the current state of this form of treatment and an indication of future developments is provided.

Adult↗
PubMed1988

The role of the carbon dioxide laser in treatment of carcinoma of the tongue.

This paper presents 35 patients with carcinoma of the tongue who have been treated in Southampton using the Carbon Dioxide laser. The treatment programme for each individual patient was determined by radiotherapists and surgeons in a combined head and neck/oncology clinic. T1 carcinomas were treated by primary laser excision biopsy whereas larger tumours were treated first by conventional radiotherapy unless there was a significant contraindication to this treatment modality. Of 10 patients with T1 lesions nine are alive and well and disease free, but one patient died of other causes with no sign of recurrence. The minimum follow-up period has been two years. Of 25 patients with T2 and T3 lesions treated either before or after radiotherapy, nine are alive and disease-free, eleven died of disease and five patients died of other causes with no evidence of recurrence.

Carbon Dioxide↗
PubMed1988

Photodynamic therapy: a better treatment for widespread Bowen's disease.

We report here the use of photodynamic therapy to treat two patients with multiple lesions of Bowen's disease. A total of over 500 lesions were treated, less than 10% requiring two treatments, and at follow-up 6 months later no lesions remained in either patient. The only important side-effect of treatment was a marked photosensitivity reaction. We consider photodynamic therapy an efficient treatment for Bowen's disease; multiple lesions can be treated in a short treatment session, without local anaesthesia, and healing occurs within 2 weeks.

Aged↗
PubMed1987

Lasers in ENT.

Explore the source record for details and available documents.

Humans↗
PubMed1986

Photodynamic therapy: the state of the art.

Photodynamic therapy is a new and exciting treatment modality for many forms of localised malignant disease. A considerable amount of laboratory and clinical research has been carried out using the tumour sensitiser haematoporphyrin derivative activated by red light at a wavelength of 630 n commonly produced by either an argon/dye laser or a pulsed gold vapour laser. It appears certain that continuing research will produce better tumour sensitisers activated by different wavelengths of light, but it will be several years before any new drug/light combination is ready for clinical trials. This paper presents an overview of the current situation and a summary of some of the exciting results that are being obtained in clinical trials throughout the world.

Clinical Trials as Topic↗
PubMed1986

The treatment of laryngeal stenosis using the CO2 laser.

Conventional open treatment for laryngeal stenosis involves major surgery. Seventeen patients with various pathologies, who needed tracheostomy to relieve their laryngeal stenosis, have been assessed following endoscopic treatment with the CO2 laser. Following an initial direct laryngoscopy, 3 of the patients were considered to be unsuitable for laser treatment. The remaining 14 patients had the stenosed area excised until it was felt that the airway was sufficiently patent to allow closure of the tracheostomy. Eight of the patients were successfully decannulated. The CO2 laser may be used endoscopically to treat certain patients with laryngeal stenosis, who would otherwise require open operation or a permanent tracheostomy.

Adolescent↗
PubMed1985

Preliminary report of a pilot study of photoradiation therapy for the treatment of superficial malignancies of the skin, head and neck.

Within the past few years photoradiation therapy has emerged as a promising new treatment for many forms of localized malignant disease and a number of clinical trials are now in progress. The pilot study described in this paper is the first clinical trial of photoradiation therapy to be carried out in Great Britain. Although it is not possible to draw significant conclusions from the results obtained, it has been shown that all the tumours responded to treatment and in four patients who had tumours which were suitable for photoradiation therapy, complete tumour regression was obtained. Further trials are in progress and others are planned in a number of centres.

Adult↗