Biomedical subjects

J D Blanshard

Publications and source records attributed to J D Blanshard.

6 recordsLinked to original sources

PubMed1993

Conservative treatment of otitis media with effusion by autoinflation of the middle ear.

A total of 85 children on the waiting list for grommet insertion aged between 3 and 10 years with bilateral chronic otitis media with effusion (OME) were assigned at random to an observation or treatment group. Those in the treatment group were given the Otovent device to use three times a day for the duration of the study and both groups were then seen at monthly intervals for 3 months for pneumatic otoscopy and tympanometry. Statistically significant improvement was seen in those using the treatment with a compliance of more than 70%. This was detected on the outcome measures of tympanometry and pneumatic otoscopy after 1, 2 and 3 months. No side effects were demonstrated. We conclude that autoinflation is an effective short-term treatment for children with OME when used regularly under supervision.

Age Factors↗

PubMed1992

Granulomatous cutaneous T-cell lymphoma of the neck.

A case of cutaneous T-cell lymphoma is presented in which the diagnosis was obscured by a concomitant granulomatous infiltrate. A working diagnosis of tuberculosis delayed appropriate treatment for several months over which time rapid progression of the disease was seen. Inclusion of overlying skin in the repeat biopsies yielded the histological information to establish the correct diagnosis and there was rapid regression on completion of a course of radiotherapy.

Aged↗

PubMed1992

A conservative approach to the management of otitis media with effusion in cleft palate children.

Otitis media with effusion (OME) is almost universal in children born with a cleft palate. Early placement of a ventilation tube to alleviate hearing problems is common. A retrospective study has been carried out to assess whether the practice of tube placement only for definite clinical indications is successful in terms of subsequent hearing levels and speech and language development. This was assessed by a case note review, analysis of speech therapy data and by means of a special follow-up clinic. There was no difference in speech development between those treated with tube insertion for OME and those untreated. Audiological thresholds were worse in the treated group. A similar number in each group required regular speech therapy. More abnormal otological findings were present at follow up in those who had tubes inserted, some of these were directly attributable to the presence of tubes. A conservative management of OME in cleft palate children, with tube insertion for only definite clinical indications, is an appropriate management, and will lead to fewer otological complications of tube insertion.

Adolescent↗

PubMed1990

A long term view of myringoplasty in children.

Fifty-nine type 1 tympanoplasties in children under 14 years of age were assessed by recall to a special follow-up clinic up to 15 years post-operatively. Overall 78 per cent of tympanic membranes were found to be intact with a late failure of grafts noted in 6 per cent of cases. An improvement in the audiological threshold was found in 51 per cent, 24 per cent were unchanged, the remaining 25 per cent suffered a deterioration which was seen both immediately post-operatively and thereafter until reviewed in the special clinic. The age at operation, size of the perforation, grade of surgeon carrying out the operation and prior adenoidectomy had no statistically significant influence on the success rate or the audiological outcome. Revision procedures achieved similar graft take rates to the initial procedures but fared worse audiologically. We conclude that in the majority the operation was successful but hearing gain was not as good as expected and subject to late deterioration. A long term follow-up is important to detect this and other complications.

Adolescent↗

PubMed1989

Ossifying lipoma.

Lipomata are the most common benign tumour of the head and neck. They may undergo a variety of changes, one of which is ossification which, although rarely seen, has a characteristic radiographic appearance. We present a case of a retropharyngeal lipoma which demonstrates ossification and discuss the features which differentiate this from an osseous lipoma. Current theories on the aetiology of lipomata and their ossification are reviewed.

Adult↗

PubMed1989

Aspergillosis of the nose and paranasal sinuses.

Fulminant aspergillosis was diagnosed on nasal biopsy in a 49 year old man who had features of an aspergilloma. Further postmortem examination of this area was performed and the results were contrasted with the histological features of other Aspergillus infections. The nasal biopsy specimen and postmortem examination showed infiltrating Aspergillus hyphae with tissue necrosis and little inflammatory response. The hyphae were easily seen with routine stains. This contrasts with the findings in invasive aspergillosis where there is fibrosis and a granulomatous response to the Aspergillus hyphae. The hyphae are seen in giant cells using fungal stains. In the saprophytic infections aspergilloma and allergic Aspergillus sinusitis there is no tissue invasion or destruction. Aspergillus infections of the nose and paranasal sinuses often require biopsy for accurate diagnosis. As treatment varies pathologists need to be able to distinguish the different patterns of infection.

Aspergillosis↗