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Biomedical subjects

M A Thorp

Publications and source records attributed to M A Thorp.

16 recordsLinked to original sources

Extreme microglossia.

The congenital anomaly of extreme microglossia is uncommon and fewer than 50 cases have been described. The microglossia has often occurred in association with limb abnormalities and, therefore, these cases have been grouped together as the hypoglossia-hypodactylia syndrome within the oromandibular-limb hypogenesis syndromes. We present five cases seen at our referral centre. Surprisingly for this number none had limb anomalies but all had marked micrognathia-Gorlin-Hall classification type 5-two requiring tracheostomy for upper airway obstruction. All required tube feeding for between 4 and 17 months. Long term follow-up is not yet available.

Airway Obstruction↗

The AAO-HNS Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière's disease: have they been applied in the published literature of the last decade?

To assess how effectively the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium (AAO-HNS CHE) guidelines for the diagnosis and evaluation of therapy in Meniere's disease have been applied in the last 11 years of published literature. This was a MedLine-based review. Some 79.7% of papers attempted to use the AAO-HNS CHE guidelines. However, only 50% of these publications managed to use the AAO-HNS CHE criteria in the diagnosis and evaluation of therapy correctly. In order to advance our understanding of this condition, improved application of the AAO-HNS CHE guidelines by authors and editors alike is required in the reporting of results of the therapy of Meniere's disease.

Evaluation Studies as Topic↗

Inverted papilloma: a review of 53 cases.

OBJECTIVE: To assess the surgical management of patients with inverted nasal papilloma over a 14-year period. STUDY DESIGN: Retrospective study. SETTING: Tertiary health care center. RESULTS: Fifty-three patients (38 males, 15 females) with an average age of 49.8 years were treated. Overall recurrence rate was 28% and a malignant association of 9% was shown. Recurrence rates varied from 27% in patients with more extensive disease involvement treated by lateral rhinotomy and medial maxillectomy, to 30% in patients with less extensive disease treated conservatively. Of the 5 patients with associated malignancy, 3 (6% of all patients) are likely to have undergone malignant transformation. CONCLUSION: Aggressive initial management remains the therapeutic aim in this condition.

Adult↗

Partial labyrinthectomy approach for brainstem vascular lesions.

Conventional wisdom has typically dictated that the bony labyrinth is an inviolate structure. This notion, however, was successfully challenged following the introduction of the partial labyrinthectomy approach, which was primarily used for the surgical management of cerebellopontine and petrous apex meningiomas. In this article, we discuss an extension of the technique of partial labyrinthectomy in a series of patients that has been used for the treatment of brainstem vascular lesions. We believe that this technique provides superior exposure to the brain stem when compared with conventional retrosigmoid and retrolabyrinthine approaches while reducing the inherent morbidity seen in transotic or petrosectomy approaches.

Adult↗

Does evidence-based medicine exist in the treatment of Menière's disease? A critical review of the last decade of publications.

Debate surrounding the need for evidence-based research in all fields of otolaryngology has recently emerged. A review of English language articles dealing with the treatment of Menière's disease published from 1989 to 1999 was performed. The papers were classified according to article type (observational studies, non-clinical studies, controlled trials, randomised controlled trials) and according to the grade of evidence that was offered. A total of 128 publications were reviewed, of which only three were randomised controlled trials and a further three were well-designed controlled studies without randomization. The majority of papers were non-experimental clinical descriptive studies or case series. Data from this review would suggest that more comprehensive evidence-based studies are required in order to settle areas of confusion surrounding treatment of this relapsing condition

Clinical Trials as Topic↗

Determination of the lowest dilution of aluminium acetate solution able to inhibit in vitro growth of organisms commonly found in chronic suppurative otitis media.

Burow's solution has been found to inhibit the in vitro growth of most commonly occurring bacteria found in the discharging ear. These organisms were inoculated onto appropriate agar plates that contained serial dilutions of aluminium acetate. Results show that the lowest dilution able to inhibit the growth of these organisms lies between a 1:80 and a 1:160 dilution of Burow's solution.

Acetates↗

Burow's solution in the treatment of active mucosal chronic suppurative otitis media: determining an effective dilution.

Burow's solution (13 per cent aluminium acetate) has been found to inhibit in vitro the growth of most commonly occurring bacteria found in the discharging ear. An in vitro study has shown that the minimum inhibitory concentration of Burow's solution for these organisms lies between a 1:80 and a 1:160 dilution. This paper reports on a clinical trial that incorporated 67 discharging ears to establish the most effective strength of aluminium acetate solution. There was no statistical difference in the effectiveness of full strength Burow's solution compared to 3.25 per cent aluminium acetate solution (a quarter strength Burow's solution). Response rates of 80.8 per cent and 75 per cent respectively following a two-week treatment period were achieved using these two solutions. A 1.3 per cent aluminium acetate solution (1/10 strength Burow's solution) was found to be markedly inferior. Bacteriological and audiological profiles were recorded for each patient.

Acetates↗

Tonsillectomy and tonsillitis in Cape Town--age and sex of patients.

OBJECTIVES: To assess the sex and age of patients undergoing tonsillectomy in the Cape Town metropolitan area. METHODOLOGY: A retrospective audit was conducted from 1991 to 1995 comparing the sex and age of patients undergoing tonsillectomy with patients admitted to hospital for acute tonsillitis and the general population. RESULTS: A total of 7,250 tonsillectomies were performed for recurrent tonsillitis, and 111 adult patients were admitted with acute tonsillitis. When the data for the adult tonsillectomy patients were isolated, the female/male ratio was 3.22:1, which is highly significant when compared with the data for the general population (Cornfield's 95% confidence limit: 2.82, 3.68) and for patients with acute tonsillitis (Cornfield's 95% confidence limit: 1.14, 2.65). CONCLUSION: Recurrent tonsillitis requiring tonsillectomy occurs more commonly in female than male patients.

Adolescent↗

Complicated acute sinusitis and the computed tomography anatomy of the ostiomeatal unit in childhood.

The ostiomeatal unit is postulated to be a critical area in the pathogenesis of sinus disease and accurate assessment of this anatomical area has made possible by the coronal computed tomography (CT) scan. Data from the CT scans of 24 patients with complications of acute sinusitis were retrospectively reviewed and compared with a set of normative data of the infundibular length, and width and the uncinate angle in 196 scans of healthy children. In the patients with complicated sinusitis the infundibular length was found to be less and the infundibular width greater than the normative data. No difference in the mean uncinate angle of the two groups was shown. One, therefore, has to assume that the pathological process at the ostiomeatal unit is more likely to be mucosal than bony.

Acute Disease↗

Parathyroid and thyroid function five years after treatment of laryngeal and hypopharyngeal carcinoma.

The proximity of the thyroid and parathyroid glands to the larynx and hypopharynx puts them at risk from treatment of squamous cell carcinoma (SCC) of this region. Consequently parathyroid and thyroid function was evaluated in patients surviving at least 5 years following treatment of primary SCC of the larynx or hypopharynx. Twenty-eight patients, initially treated from 1990 to 1992, were assessed and divided into four groups according to treatment received. Hypoparathyroidism (partial and hypocalcaemic) occurred in 88% and hypothyroidism (clinical and subclinical) in 50% in Group 1 (radiotherapy only) Group 2 (salvage laryngectomy for failed radiotherapy) had 66% hypoparathyroid and 33% hypothyroid. Group 3 (surgery + radiotherapy combined) had 89% hypoparathyroid and 89% hypothyroid. Group 4 (surgery only) had 63% hypoparathyroid and 63% hypothyroid. Significant endocrine hypofunction therefore occurs following the treatment of laryngopharyngeal carcinoma, more so with radiotherapy and combined therapy than with surgery alone.

Carcinoma, Squamous Cell↗

The antibacterial activity of acetic acid and Burow's solution as topical otological preparations.

At present there are no topical otological preparations on the World Health Organisation's essential drug list, largely due to the ototoxic potential of preparations containing aminoglycoside antibiotics. Acetic acid and Burow's solution have long been used in the treatment of the discharging ear. The aim of this study was to ascertain the antibacterial activity of these two preparations against the most commonly occurring bacteria isolated from discharging ears in our department. Twenty fresh isolates of each of the following organisms--Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis and Streptococcus pyogenes--were plated onto blood agar and tested against one per cent, two per cent and three per cent acetic acid and Burow's solution (13 per cent aluminium acetate). The activity of each agent was ascertained by the size of the zone of inhibition of bacterial growth. Burow's solution showed significantly larger average zones of inhibition than acetic acid (p < 0.001). The two per cent and three per cent acetic acid as well as the Burow's solution were active against all the organisms tested.

Acetates↗

Hypoparathyroidism after the treatment of laryngopharyngeal carcinoma.

Thirty patients with squamous cell carcinoma of the laryngopharynx were treated with surgery (total laryngectomy and hemithyroidectomy) and radiotherapy. Group 1 (n = 7) patients had surgery only; Group 2 (n = 7) had radiotherapy followed by salvage surgery while Group 3 (n = 16) had surgery followed by radiotherapy. Parathyroid hormone and calcium levels were measured pre- and post-operatively and post-radiotherapy. In Group 1 no patients were hypoparathyroid. In Group 2, 29 per cent of patients preoperatively and 57 per cent post-operatively, were hypoparathyroid. In Group 3, no patients were hypoparathyroid pre-operatively, while 25 per cent were hypoparathyroid post-operatively and post-radiotherapy. Parathyroid hormone and calcium levels were averaged and compared within and between each group. There was no significant difference within each group, when comparing levels post-operatively and post-radiotherapy from those of pre-operatively. There was no significant difference in levels between each of Groups 1, 2 or 3 (p > 0.05).

Aged↗