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Biomedical subjects

J van der Merwe

Publications and source records attributed to J van der Merwe.

9 recordsLinked to original sources
PubMed1999

Eagle's syndrome: lesser cornu amputation: an alternative surgical solution?

A case is reported of a 42-year-old female patient, who presented with clinical symptoms of Eagle's syndrome, radiographic evidence of marginally elongated styloid processes as well as markedly elongated lesser cornua of the hyoid. The symptoms were successfully treated by amputating the lesser cornua of the hyoid. The patient has now been asymptomatic for more than 6 years.

Adult↗
PubMed1995

Comparison of sodium nitroprusside- and esmolol-induced controlled hypotension for functional endoscopic sinus surgery.

The purpose of this study was to compare surgical conditions for functional endoscopic sinus surgery (FESS) under general anaesthesia during controlled induced hypotension, using either sodium nitroprusside (SNP) or esmolol. Twenty patients, assigned to receive either of the drugs as the primary hypotensive agent, were studied. The same surgeon, blinded to the hypotensive agent used and the haemodynamic variables, performed all the operations. The surgeon used a category scale (0-5) to assess surgical conditions--a value of 2-3 being ideal. Patients were positioned in 5 degrees reverse Trendelenburg position and the mean arterial blood pressure (MABP) was reduced in steps of 5 mmHg. The anaesthetist prompted category scale estimations by the surgeon following a change in any of the haemodynamic variables. Average category scale (ACS) values were compared between the two groups for four data groups, i.e., MABP > 65 mmHg (mild), 60-64 mmHg, 55-59 mmHg and 50-54 mmHg. Pre-treatment MABP was 79.8 +/- 10.4 mmHg in the SNP group and 76.1 +/- 6.8 mmHg in the esmolol group. At mild SNP-induced hypotension, surgical conditions were poor (ACS = 3.63 +/- 0.22; mean +/- SEM), while in the esmolol group, ideal surgical conditions (ACS = 2.94 +/- 0.34) were recorded at MABP > 65 mmHg. The combined effects of increased venous drainage due to the reverse Trendelenburg position, hypotension as well as capillary vasoconstriction due to unopposed alpha-adrenergic effect on the mucous membrane vasculature in the esmolol group (as opposed to vasodilatation in the SNP group) probably caused the superior surgical conditions.

Adrenergic beta-Antagonists↗
PubMed1994

Functional endoscopic sinus surgery--the South African experience.

Questionnaires were sent to 148 South African otorhinolaryngologists to ascertain their experience of functional endoscopic sinus surgery (FESS). The Messerklinger approach to FESS was followed by 87% of the surgeons who responded. In South Africa FESS is performed mainly under general anaesthesia. An incidence of 1.3% is reported in respect of major complications. Information obtained from the questionnaires describes training and supports further study. Registrars need more than knowledge and surgical experience; their skills must also be assessed by some form of certification.

Endoscopy↗
PubMed1987

The negative effects of mucolytics in otitis media with effusion.

Much controversy still exists in the treatment of otitis media with effusion. A double-blind randomised prospective trial during which bromhexine hydrochloride was compared with a placebo is reported. Information from 60 patients was analysed and the results reveal interesting findings on the effects of bromhexine on middle-ear clearance. The data clearly reveal that bromhexine retards resolution of the effusion. Further discussion of the literature gives insight into the controversy surrounding the treatment of middle-ear effusion. Steroids are proposed for further research and clinical trials.

Acoustic Impedance Tests↗