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Biomedical subjects

M H Wickham

Publications and source records attributed to M H Wickham.

8 recordsLinked to original sources
PubMed1992

Characteristics of Groningen tracheo-oesophageal speaking valves prior to insertion and after removal for failure.

The Groningen valve was first used in Sheffield in 1986 in a patient who underwent laryngectomy for malignant disease. Since then it has been the main tracheo-oesophageal prosthesis used on our Unit for speech rehabilitation post-laryngectomy. This biflanged device inserted primarily or as a secondary procedure remains in situ until failure occurs either because of leakage or because increased effort is required to produce satisfactory phonation. This in vitro study we examined the differences between new valves prior to insertion and those removed for failure. The mean forward opening pressures were shown to be similar in the two populations but the mean forward resistances were increased in those valves which were defective (P less than 0.001). In addition the mean reverse opening pressure was found to be significantly lower in the defective valves when compared with their new counterparts (P less than 0.05).

Adult↗
PubMed1990

Emergency laryngectomy.

Emergency laryngectomy is a laryngectomy carried out for malignant obstruction of the upper airway within 24 h of admission. This combines relief of the obstruction with definitive primary cancer surgery, and is thought to reduce the risk of post-laryngectomy stomal recurrence. During a 5-year period, 13 patients with upper airway obstruction from squamous cell carcinoma were treated in two departments by emergency laryngectomy. Total laryngectomy was carried out after the diagnosis of squamous cell carcinoma of the larynx (n = 11), or piriform fossa (n = 2), had been confirmed by laryngoscopy and frozen section biopsy. The actuarial 5-year survival was 47%, and no patient in this series developed stomal recurrence. The management of the airway obstruction, and the post-laryngectomy complications, did not differ from those encountered with more conventional treatment. Our experience with this approach suggests that emergency laryngectomy is a satisfactory method of managing airway obstruction due to squamous cell carcinoma of the larynx.

Aged↗
PubMed1990

Three 'silent' mastoid abscesses.

Acute mastoiditis with abscess formation is uncommon, its incidence being modified by modern antibiotic usage for acute suppurative otitis media (ASOM). It tends to occur in young children who have no previous history of ear disease. The diagnosis is a clinical one, and treatment requires hospital admission and some form of surgical drainage procedure, in order to prevent intracranial complications, eg, meningitis and intracerebral abscess.

Abscess↗
PubMed1989

Some observations on submucous diathermy.

Submucosal diathermy (SMD) of the inferior turbinates is widely used, although its effect histologically has not been well shown. We attempted to demonstrate the acute histological changes of SMD by performing it immediately prior to inferior turbinectomy. The results found help to explain the unpredictability of producing a clinical response.

Electrocoagulation↗
PubMed1988

Nasal regurgitation as the presenting symptom of rhinolithiasis.

Rhinoliths are not common but like other rare conditions have an attraction and therefore will be familiar. This case report has been presented as a reminder that perforation of the hard palate by a rhinolith does occur occasionally, and in this instance was a pleasant surprise to all concerned.

Aged↗
PubMed1988

Use of the fibreoptic laryngoscope in pharyngeal pouch surgery.

A further new application of the fibreoptic laryngoscope as an adjunct to the excision of pharyngeal pouches is described. Its use facilitates the procedure and thus reduces the time of surgery. This is clearly advantageous, particularly as many patients with pharyngeal pouches are elderly and may be less than fully fit especially if overspill from the pouch has caused recurrent chest infections.

Aged↗