Biomedical subjects

K L Howarth

Publications and source records attributed to K L Howarth.

3 recordsLinked to original sources

PubMed2004

A sinonasal primary Ewing's sarcoma.

Nasal fractures are a common complaint familiar to all otolaryngologists. Sinonasal primary Ewing's sarcomas are extremely rare. The case of a 9-year-old boy is presented whose nasal fracture and subsequent lateral nasal wall hematoma revealed an underlying Ewing's sarcoma. There are several unusual features in the history and clinical course of this patient. Following biopsies, immunohistochemistry proved essential in distinguishing a Ewing's sarcoma from other small cell tumours. It is important that a seemingly common condition can be the first presentation of a less common, more sinister pathology.

Biopsy, Fine-Needle↗

PubMed2001

Prognostic value of electrocochleography in patients with unilateral Menière's disease undergoing saccus surgery.

Although a controversial operation, saccus surgery has continued to be used in patients with severe Menière's disease in whom hearing preservation is the objective. The aim of this study was to determine if electrocochleography (ECoG) could predict the patients who would be free of vertigo, 2 and 5 years after surgery. Seventy patients with severe Menière's syndrome underwent ECoG prior to endolymphatic sac surgery. Eighty-four per cent of the patients had an abnormal electrocochleogram. The patients were interviewed 2 and 5 years after surgery. At 2 years, 4/10 (40%) patients with normal ECoG were relieved of dizziness compared to 38/51 (75%) with abnormal ECoG (P < 0.05). At 5 years, 5/8 (63%) patients with normal ECoG were relieved of dizziness compared to 30/30 (100%) with abnormal ECoG (P < 0.001). The patients with a normal ECoG do have less severe measurable hearing impairment (P < 0.05) although they are more likely (P < 0.05) to complain of constant tinnitus. Their history of dizziness is longer and their dizziness more disabling before surgery. In conclusion, patients with a normal ECoG will be less likely to benefit from saccus surgery in the first 5 years. These patients may represent a different nosological entity.

Adult↗

PubMed1999

Cochlear implantation following temporal bone fracture.

Seven cases of profound hearing impairment following either unilateral or bilateral temporal bone fracture are presented who were implanted with the Nucleus 22 channel or Ineraid devices. Six patients suffered bilateral temporal bone fractures. One patient had prior congenital unilateral profound hearing impairment. This patient suffered a unilateral temporal bone fracture. Six patients became regular users of their implants. One gained little benefit and became a non-user. Two of the regular users experienced facial nerve stimulation, which could not be programmed out. In these two cases the implant was removed and the contralateral ear successfully implanted. Implant-aided audiometry demonstrated a hearing threshold of 40-50 dB at nine months after switch-on. The reliability of computed tomography (CT) scanning in predicting cochlear patency in cases of temporal bone fracture will be discussed. The benefit of complimentary imaging with magnetic resonance (MR) is highlighted.

Adolescent↗