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Biomedical subjects

L P Gray

Publications and source records attributed to L P Gray.

17 recordsLinked to original sources
PubMed1985

Septal manipulation in the neonate: method and results.

The septal configuration at birth may be straight (type A) which occurs in 42% cases, bent to one side (type B), or deformed to both sides (type C). There is a close correlation of these types, immediately with nasal obstruction and feeding problems and later with the development of dental abnormalities and respiratory infections of the throat and ear. These symptoms occur most in type B cases and least in type A cases. A total of 284 babies was assessed at birth and then when aged about 5 years. A total of 105 babies, who had minimal trouble and were used as controls and not manipulated, were compared with 179 who had troublesome symptoms and were manipulated. Manipulation greatly reduced the incidence of these problems at a statistically significant level. The physiological reason why type B causes more ear disease than types A or C is described. This involves the normally occurring Bernouilli's phenomenon in the nose. The external nasal deformity which causes minimal physiological changes, and occurs in 4% of births, can be successfully straightened by manipulation.

Deafness↗
PubMed1983

The development and significance of septal and dental deformity from birth to eight years.

The septa of a series of 145 babies at birth was assessed into 3 types: type A--in the midline, type B--unilateral bending or kinking at the vomerine junction, type C--deformed to both sides. These were reassessed aged 5-6 years with the primary dentition present, and 90 cases reassessed aged about 8 years. In some there was a change to types B and C, but none changed to type A. Of 15 cases of external deformity of the nose at birth, 10 (66%) had irregularity of the columella. The children had dental examination and plaster casts made, an ear, nose and throat examination, and were photographed. The chances (which were statistically significant) of developing dental abnormalities and malocclusion, palatal asymmetry, upper respiratory tract infections and ear disease were found to be mostly in type B cases, less in type C cases and least in type A cases. Thus ear troubles were found in 45% type B, 25% type C and only 10% of type A cases. The palatal height was not related to any septal deformity.

Australia↗
PubMed1983

The relationship of the 'inferior constrictor swallow' and 'globus hystericus' or the hypopharyngeal syndrome.

The term 'Globus Hystericus' is considered to be a very bad term for such a common condition and it is recommended that it be replaced by the 'Hypopharyngeal Syndrome'. The normal modified swallow initiated from the lingual tonsil--epiglottis area, called the Inferior Constrictor Swallow, can cause all the symptoms. The epiglottis does not bend. There are two groups of symptoms: the first due to sensation from local irritation of the lingual tonsil; and the second due to vicious circles causing increased muscle tension and strain swallowing. If there is pain or dysphagia or impairment in swallowing, then it is not the Hypopharyngeal Syndrome. The key-note of treatment is the logical explanation of these symptoms and that the vicious circles must be broken.

Adolescent↗
PubMed1983

Unilateral tonsillectomy--indications and results.

Seventy-six cases of unilateral tonsillectomy performed over the last 20 years are reported. The average age was 3.75 years. Fifty per cent had adenoidectomy. A review of their case notes and of 54 questionnaires returned by parents, asking their opinion of the change in symptoms before operation and two years after operation, showed that they could be allotted into three groups: Group 1 35 cases (65 per cent) had dramatic improvement in the symptoms of allergy, colds, otitis, sore throats, eating, meat eating and sleep. Group 2 of nine cases (17 per cent) had considerable improvement in most symptoms. Group 3 of 10 cases (18 per cent) had minimal improvement. Post-tonsillectomy hypertrophy of the remaining tonsil occurred within two to four years in nine cases, necessitating removal. Four (11 per cent) in Group 1, (22 per cent) in Group 2, and three (30 per cent) in Group 3. The three secondary tonsillectomies in Group 3 gave good results in two cases. In five cases the other tonsil was removed six to 15 years later. This series of cases has demonstrated that a tremendous decrease in incidence of throat and upper respiratory tract infection in young children, apparently prone to infection can occur in over 80 per cent of cases following unilateral tonsillectomy, in spite of the continued presence of the remaining large tonsil.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoidectomy↗
PubMed1983

The relationship between the 'superior constrictor swallow', clicking of the ears and ear disease.

A normal modified type of swallow is described, the function of which is to open the pharyngotympanic tube. It is associated with clicking of the ears. The tensor veli palatini, the levator palatini and the superior constrictor muscles appear to be the muscles involved, as it can occur without swallowing or movement of the tongue, or speaking. This modified swallow has been called the 'superior constrictor swallow', and it is demonstrated by productions of typical frames from a cine film. Sniffing, yawning and normal swallowing can occur with or without opening of the pharyngotympanic tubes, but this normal modified swallow (SCS) must be initiated to produce opening of the tubes. The change in middle-ear pressures with clicking is well shown with tympanometry. Modified swallow, largely involving the inferior constrictor muscle, may also occur.

Deglutition↗
PubMed1982

The development of septal and dental deformity from birth.

The findings on the development of dental, facial and septal conditions from birth to about 6 years of age include the following: 1) Septal configuration can be readily tested at birth, and if deformity is present, then deformity will still be present at age 6 years. 2) The internal septal configuration can be categorized into three types: type A: The septum is in the midline. type B: There is unilateral bending or kinking of the septum at the vomerine junction. type C: The septum is deformed to both sides in an S configuration. 3) Height of the palate does not predispose to septal deformity. 4) Dental abnormalities of rotation, compression or crowding of the teeth, asymmetry of width and height of the palate, and shift of the mandibular arch from the midline occur most frequently in cases of type B (88%), much less in type C and least in type A. 5) At birth one can predict that type B babies will have considerably more likelihood of developing occlusal abnormalities than type A babies. 6) The dental abnormalities in many of these subjects are of sufficient degree to expect that malocclusion will undoubtedly develop. Thus the same etiological factors producing septal abnormalities at birth must be considered to be factors producing many malocclusions.

Child↗
PubMed1980

Relationship of septal deformity to snuffly noses, poor feeding, sticky eyes and blocked naso-lacrimal ducts.

Septal deformity is part of a facial deformity and is considered to be due to a combination of irregular developmental growth of the palatal folds, and external pressure on the maxilla, during pregnancy or parturition. The incidence and types of septal deformity in 2380 Caucasian births are compared with those of 2112 adult skulls of different ethnic groups. The close association of septal deformity with snuffliness, disturbed feeding and sticky eyes, and the relief of symptoms by manipulation of the palate and septum is described. Puffy eyes are due to severe birth pressures and may lead to moist, then sticky, then infected eyes. This occurs 2 to 3 days after birth and is to be distinguished from the severe eye infections in the first 24 h from contamination at birth. A high incidence of septal deformity occurs in sticky eyes and a close association with the type of deformity and the side of the infection has been found. The presence of septal deformity and the close correlation with the affected side has been found in every case (100%) of continued epiphora requiring probing and syringing of the naso-lacrimal ducts (NLDs). Manipulation of the palate and septum, often with medial dislocation of the anterior end of the inferior turbinates, has been of considerable help in the treatment of continued epiphora. Some aetiological factors in NLD obstruction are described.

Eye Diseases↗
PubMed1977

Prevention and treatment of septal deformity in infancy and childhood.

There are two basic types of septal deformity, namely anterior nasal deformity and combined septal deformity, which may occur independently or both together. They are considered to be acquired from different types of pressures on the foetus during pregnancy or parturition. The incidence of anterior nasal deformity was found to be 4% in cases of spontaneous vaginal delivery, but 13% in cases of increased pressure as persistent occipitoposterior. The combined septal deformity is part of a facial deformity, and is best tested by using simple nasal testing struts. The incidence of straight septa varied with the degree of pressure with an average of 42%. In adult surveys a little over 20% are straight. Methods of manipulation are described using special infant forceps. Indications for manipulation are: Stuffy nose, feeding problems and sticky eyes. The procedure and results of rapid maxillary expansion are presented.

Age Factors↗
PubMed1975

Results of 310 cases of rapid maxillary expansion selected for medical reasons.

1. Rapid Maxillary Expansion is a comparatively simple, conservative method of treating impaired nasal respiration. 2. It can be used from 4 years to 25 or 30 years of age, but the younger the patient the better the long term results. 3. The medical indications are a combination of poor nasal airway, septal deformity, recurrent ear or nasal infection, allergic rhinitis and asthma, and prior to septoplasty. 4. The dental indications are mainly unilateral or bilateral cross bite, class III (prognathoid) malocclusion, maxillary compression, and cleft palate. 5. The dental contra-indications are normal occlusion in the permanent dentition and to a lesser degree severe class II occlusion and micromandible. 6. In selected cases, it produces a change of over 80 percent from mouth to nose breathing. In this series of 310 consecutive cases 87 percent were greatly improved, 9 percent had a fair result and 4 percent a poor result. 7. It also gives considerable improvement in colds and respiratory infection, nasal allergy and many cases of asthma. The improvement in health and confidence and concentration in over 30 percent of cases is particularly pleasing. 8. The rationale of Rapid Maxillary Expansion can be explained by the maxillary moulding theory of production of septal and facial deformities.

Adolescent↗
PubMedDate not supplied

Deviated nasal septum. Incidence and etiology.

Septal deformity is of two kinds, which may occur independently, or together: 1) anterior cartilage deformity of the quadrilateral septal cartilage, caused by direct trauma or pressure at any age; and 2) combined septal deformity involving all the septal components, caused by compression across the maxilla from pressures occurring during pregnancy or parturition. This is part of a facial deformity. The incidence of septal deformity was investigated in 2,380 Caucasian infants at birth, 2,112 adult skulls of five ethnic groups (European, Indian [Asian], Chinese, African and Australian Aborignal), 918 mammals (266 higher and lower apes, 457 other placental mammals and 185 marsupials). The method of nasal testing of infants by passage of special testing struts (6 by 2 mm) is described. Forty-two percent of septa of infants were straight, 27% deviated and 31% kinked. A similar pattern was found in adult skulls, namely 21% straight, 37% deviated and 42% kinked. Anterior cartilage deformity occurred in about 4% of births. The maxillary molding theory of transmitted pressures during pregnancy or partitution, causing septal deformity, is described. The findings show that varying degrees of septal deformity occur at a constant rate at birth and in the adult. These may vary slightly for each ethnic type. Birth molding pressures are a major cause of dental malocclusion. The shape and strength of the skull and the erect posture appear to be major factors, for septal deformity did not occur in the lower animals, but occurred in 37% of the higher apes and also in a skull of a hominid 1,750,000 years old. This concept enables easy recognition at birth, and the carrying out of a rational method of treatment by manipulation and rapid maxillary expansion.

Adult↗