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Biomedical subjects

M A Siddiq

Publications and source records attributed to M A Siddiq.

16 recordsLinked to original sources
PubMed2006

Facial palsy secondary to cholesteatoma: analysis of outcome following surgery.

Facial palsy is a rare presenting feature of cholesteatoma. Prompt treatment usually results in a good outcome, but if treatment is delayed the prognosis can be difficult to predict. We retrospectively reviewed 326 consecutive patients who had undergone temporal bone surgery for cholesteatoma. Eleven patients had presented with facial palsy, of whom eight had petrous apex involvement and three had disease confined to the middle-ear cleft. All patients with middle-ear disease were operated upon within two months of presentation, and all showed some recovery in facial function. The diagnosis had been delayed in all eight cases of apical disease, with four cases having had a long-standing total weakness. One case treated after seven months' partial weakness achieved a full recovery. In three cases of long-standing partial weakness, pre-operative facial function was preserved by maintaining the facial nerve in its normal anatomical location. Facial palsy associated with cholesteatoma should be treated as early as possible. Recovery can occur even if treatment is delayed for up to seven months. After this time, recovery is increasingly unlikely, but any residual function can be maintained and further deterioration prevented.

Adult↗
PubMed2006

Early results of titanium ossiculoplasty using the Kurz titanium prosthesis--a UK perspective.

Titanium has been shown to be a highly biocompatible material and recently interest has been raised by its use as a prosthetic material in the ear. Our objective was to prospectively assess the early results of titanium partial and total ossicular replacement prostheses in chronic ear disease. Thirty-three consecutive patients (20 titanium partials and 13 total ossicular replacement prostheses) were analysed and data from pre and post-operative pure tone audiograms were collected and compared at six months over a four frequency range (0.5-4 kHz) as well as using the American Academy of Otolaryngology-Head and Neck Surgery criteria (0.5-3 kHz). Closure of the air-bone gap and improvement in air conduction at six months was also calculated. 69% of patients obtained an air-bone gap of < or = 20 dB, with titanium partial ossicular replacement prostheses (85 per cent) doing better than total ossicular replacement prostheses (46 per cent). There have been no cases of sensorineural hearing loss or extrusion. In conclusion, titanium prostheses are easy to use, allow good visibility and have shown good short-term results in our hands.

Adolescent↗
PubMed2006

Otosclerosis: a review of aetiology, management and outcomes.

Otosdcerosis is an autosomal dominant condition affecting the temporal bone. It presents predominantly with deafness in a young population. This review looks at the aetiological theories, present treatment strategies and surgical outcomes of this condition.

Adult↗
PubMed2005

Cerebellopontine angle arachnoid cysts in adult patients: what is the appropriate management?

Arachnoid cysts can occur at different intracranial sites, including the cerebellopontine angle (CPA). The incidence of arachnoid cysts is 1 per cent of all intracranial lesions. Recent advances in MRI (magnetic resonance imaging) scan techniques have led to CPA arachnoid cysts being more frequently diagnosed and with a higher degree of certainty. The need for further understanding of their natural history as well as for the development of a management rationale has been highlighted with this increased rate of diagnosis. We present a series of five adult patients with different clinical presentations attributed to CPA arachnoid cysts. These lesions have a characteristic location in the posterior-inferior aspect of the CPA below the facial and vestibulocochlear nerves. These cysts did not show change in size on repeated MRI scan and the patients' symptoms did not progress over the period of follow up. Our findings would support a conservative management approach to the majority of these cysts.

Adult↗
PubMed2004

Long-term hearing results of incus transposition.

Incus transposition is an option for reconstructing an ossicular discontinuity. We looked at the long-term outcome (average 9.2 years) in terms of hearing results in patients who had undergone incus transposition. Patients were requested to attend for a pure tone audiogram. Details of their preoperative audiograms were obtained from the patients' case notes. A postoperative air-bone gap of 20 dB or less averaged over four frequencies (0.5, 1, 2, 4 kHz) was considered to be an acceptable result. We found that 70% of patients had an air-bone gap of 20 dB or less and 54% had had cholesteatoma surgery at the time of the incus transposition. This study represents the longest follow-up of patients having undergone incus transposition from our search of the literature. Incus transposition, we feel, offers good long-term hearing results.

Adolescent↗
PubMed2004

Gastrointestinal stromal tumour of the pharynx.

This documents the case of a 55-year-old female presenting with a solitary polypoidal tumour of the pharynx. Histological examination revealed features consistent with a gastrointestinal stromal tumour. Although well described elsewhere in the gastrointestinal tract, from our literature search, this is the first reported case of such a tumour occurring in the pharynx

Female↗
PubMed2004

Current management in pharyngeal pouch surgery by UK otorhinolaryngologists.

INTRODUCTION: Many surgical techniques have been described for the treatment of pharyngeal pouches but there is no single treatment of choice. The aim of this study was to determine current practice in pharyngeal pouch surgery by UK otolaryngologists. METHODS: A postal questionnaire was sent to all UK-based consultant members of the British Association of Otolaryngologists - Head and Neck Surgeons (BAO-HNS). RESULTS: Endoscopic stapling diverticulotomy is the most commonly performed procedure, performed by 89% of surgeons, followed by excision. Of those consultants that considered there to be a treatment of choice, 83% stated endoscopic stapling as their preference. Practices differ regarding the insertion of nasogastric tubes after endoscopic procedures and the need for postoperative barium studies. The length of in-patient stay tends to be short with 80% of surgeons discharging patients by day 2. CONCLUSIONS: Endoscopic stapling diverticulotomy is now the most commonly performed procedure for the management of pharyngeal pouches by UK otolaryngologists and is now considered by many to be the treatment of choice.

Consultants↗
PubMed2003

First branchial cleft anomaly presenting as a recurrent post-auricular abscess.

Embryological anomalies of the first branchial cleft are uncommonly encountered. They usually present as cysts, swellings, or fistulas in the pre-auricular or post-auricular area or high in the neck, which may become infected. Failure to recognise these unusual cases may result in misdiagnosis, inadequate treatment, and subsequent recurrence. Further definitive surgery may thus be complicated. A case is reported of a patient who attended accident and emergency on three occasions with an infected post-auricular cyst, which was treated by incision and drainage. It was subsequently found to be a first branchial cleft anomaly.

Abscess↗
PubMed2003

Persistent otorrhoea after ventilation tube insertion: a treatment protocol.

Otorrhoea is the commonest complication of ventilation tube (grommet) insertion. In some cases it may be unresponsive to short courses of topical antibiotic/steroid drops and/or systemic antibiotics. This study investigated whether a five-day course of inpatient treatment with intravenous antibiotics, topical medication and daily microsuction was effective in treating persistent otorrhoea. Eleven subjects were included, of whom nine responded to the proposed treatment regimen. We recommend that patients with persistent otorrhoea after ventilation tube insertion should be managed according to these guidelines before considering an examination under anaesthetic or a ventilation tube removal.

Amoxicillin↗
PubMed2001

Pharyngeal pouch (Zenker's diverticulum).

Pharyngeal pouches occur most commonly in elderly patients (over 70 years) and typical symptoms include dysphagia, regurgitation, chronic cough, aspiration, and weight loss. The aetiology remains unknown but theories centre upon a structural or physiological abnormality of the cricopharyngeus. A diagnosis is easily established on barium studies. Treatment is surgical via an endoscopic or external cervical approach and should include a cricopharyngeal myotomy. Unfortunately pharyngeal pouch surgery has long been associated with significant morbidity, partly due to the surgery itself and also to the fact that the majority of patients are elderly and often have general medical problems. External approaches are associated with higher complication rates than endoscopic procedures. Recently, treatment by endoscopic stapling diverticulotomy has becoming increasingly popular as it has distinct advantages, although long term results are not yet available. The small risk of developing carcinoma within a pouch that is not excised remains a contentious issue and is an argument for long term follow up or treating the condition by external excision, particularly in younger patients.

Aged↗
PubMed2000

Metastatic endometrial carcinoma of the neck.

We report a case of metastatic endometrial carcinoma of the neck. A patient with a past medical history of squamous cell carcinoma of the larynx, breast carcinoma and endometrial carcinoma presented with a neck mass. Fine needle aspiration cytology (FNAC) showed this to be a poorly differentiated carcinoma with squamoid features and thus a potentially curative neck dissection was performed. Histology of the mass showed a clear cell endometrial carcinoma. Metastatic gynacecological malignancies to the head and neck are rare and this is the first reported case of metastatic endometrial carcinoma in the neck.

Aged↗
PubMed2000

Pharyngeal pouch surgery: a five year review.

The treatment of pharyngeal pouch varies widely. Our aim was to establish current and recent practice in pharyngeal pouch surgery in our department and set guidelines for future management. A retrospective audit over a 5-year period was performed with all data derived from patient notes. 28 procedures were performed on 24 patients with a mean age of 72 years. Over two thirds of these patients (68%) underwent an endoscopic procedure (stapling or diathermy) and the remainder underwent excision (14%), inversion (10%), cricopharyngeal myotomy (4%) or dilatation (4%). The primary diagnostic investigation performed was a barium swallow in 17 cases, but in 7 cases, referred by gastroenterologists, an oesophagogastroscopy was performed despite characteristic presenting features in all cases. The average inpatient stay was similar for endoscopic and excision procedures (5.5 and 5 days respectively), but longer for inversion procedures (9 days). This was influenced mainly by operative complications. 2 endoscopic stapling procedures were complicated by perforations and 1 patient developed hoarseness after an inversion procedure. The mean follow up time was one month at which stage all asymptomatic patients were discharged. 2 patients treated by endoscopic stapling and 1 patient treated by inversion complained of persistent symptoms and required further surgery. We conclude that endoscopic stapling was the commonest procedure used. Concerning future management, the use of nasogastric tubes after uncomplicated stapling procedures was abandoned. Also it was felt that large pouches should be treated by excision, small pouches by cricopharyngeal myotomy and the remainder by endoscopic stapling. The long-term evaluation of results was also deemed necessary.

Aged↗
PubMed1999

Erythema multiforme after application of aural Gentisone HC drops.

Erythema multiforme is an uncommon acute self-limiting condition characterized by mucocutaneous lesions of varying severity with a variable pattern of recurrence. This is a case of a four-year-old girl who developed erythema multiforme secondary to topical aural application of Gentisone HC drops (hydrocortisone acetate one per cent, gentamicin 0.3 per cent (as sulphate)) prescribed as a treatment for otorrhoea following grommet insertion. The clinical features are described and the literature reviewed. To my knowledge, this is the first reported case in the literature, of erythema multiforme secondary to a topical aminoglycoside/steroid preparation.

Anti-Bacterial Agents↗