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Biomedical subjects

M Oluwole

Publications and source records attributed to M Oluwole.

17 recordsLinked to original sources
PubMed2002

Bronchoscopy training: is simulated surgery effective?

Intensive surgical skills courses have become an essential part of surgical skill acquisition for surgeons in training. There is a need to monitor the value of these courses in terms of skill attainment. The aim of this study was to determine the effectiveness of skills-laboratory-based training in rigid bronchoscopy and bronchial foreign body removal. Bronchoscopies were recorded, analysed and categorized by a single observer according to time to completion and four predetermined parameters of surgical error. An overall quality score was obtained by simple summation of the number of errors and determined as acceptable or unacceptable (scoring 0 or 1 respectively). The data was analysed using a t-test for paired groups. P < 0.05 was considered to be significant. In total, 20 trainee otolaryngologists performed 80 separate bronchoscopies. The time to complete the task pre versus post training showed significant improvement; P < 0.001. The overall quality score pre training was 66 and post training 17; P < 0.001. We conclude that intensive surgical simulation-based courses appear to be an effective means of training surgical trainees in surgical skill proficiency.

Animals↗
PubMed1999

Surgical simulation: an animal tissue model for training in therapeutic and diagnostic bronchoscopy.

A series of surgical simulation exercises has been developed using an animal model to allow trainees to practise basic instrument handling and develop psychomotor skills in bronchoscopy, without risk to patients. A pig model was found to be most suitable. After suitable preparation the model can be used for diagnostic and therapeutic exercises in bronchoscopy, including lavage, biopsy and the removal of various foreign bodies. The model is a safe, inexpensive and convenient means of bronchoscopic training for otolaryngology trainees. For the trained specialist who has to remove bronchial foreign bodies infrequently, the model is a useful way of maintaining skills.

Animals↗
PubMed1999

A randomised control trial of surgical task performance in rigid bronchoscopy: foreign body extraction with optical versus non-optical forceps.

There are currently two types of forceps used for foreign body removal at rigid bronchoscopy, these can be classified as standard bronchoscopy forceps and optically guided grasping forceps. In order to evaluate them in the removal of foreign bodies from the tracheo-bronchial tree a randomised subject controlled trial was conducted. All 80 bronchoscopies were recorded and analysed by a single observer according to predetermined criteria for surgical error. The data was analysed using a t-test for paired groups. The results showed no significant differences between the two groups. We conclude that no clear advantages were found comparing the optically guided forceps with the standard bronchoscopy forceps and that further clinical evaluation will be difficult to initiate.

Animals↗
PubMed1997

The naso-oral index: a more valid measure than peak flow rate?

Using a modified respiratory spirometer, we set out to determine whether the nasal peak flow rate, or a new parameter the naso-oral 1 second index (the ratio between the nasal forced inspiratory '1 second' volume and the oral forced inspiratory '1 second' volume) correlated with anterior rhinomanometry and visual analogue scores. Ten patients undergoing nasal surgery for nasal obstruction were recruited into the study. The naso-oral 1 second index consistently correlated better than the nasal peak flow rate with anterior rhinomanometry. The naso-oral index also correlated better than nasal peak flow with visual analogue scores. Correlation was best demonstrated when assessing the benefit gained by patients from surgery. The naso-oral index is a potentially useful clinical parameter, and correlates acceptably well both with visual analogue scores and anterior rhinomanometry.

Adolescent↗
PubMed1996

Tympanic membrane perforations in children.

We have assessed children with perforations of the pars-tensa presenting to an otolaryngology clinic over a 7-year period. We found that over 70% of the perforations followed the insertion of a ventilation tube. Using a novel method of dividing the tympanic membrane into quadrants, we were able to assess the sites and grade the size of perforations. The most common site of involvement, in all perforations, was the antero-inferior quadrant. With the exception of perforations following the use of T-tubes, we found little difference between the sites, sizes and hearing levels of ventilation tube and non-ventilation tube related perforations. Larger perforations resulted in a greater degree of hearing loss.

Child, Preschool↗
PubMed1996

An animal model for training in endoscopic nasal and sinus surgery.

An animal model has been devised to allow trainees in nasal and sinus endoscopy to develop basic instrument handling and psychomotor skills, without risk to patients. The sheep's head obtained from the abattoir was modified slightly to simulate more closely the human situation. The model permits nasendoscopy, foreign body removal, septoplasty, turbinate reduction, frontal and maxillary sinoscopy, antrostomy and an epistaxis exercise. To date the tissues have been used freshly thawed, and must be used on the day of preparation.

Animals↗
PubMed1996

The management of unilateral vocal cord palsy by augmentation using autologous fat.

Augmentation of the vocal cord with Teflon paste has been one of the mainstays of treatment of a unilateral vocal cord palsy. Recently the licence for Teflon in the UK has been withdrawn, creating the need for an alternative. Over the last 2 years we have been using autologous fat harvested from the abdominal wall for this purpose. Fat is more difficult to work with than Teflon and we have developed a modified injection gun in order to facilitate the injection of the fat. The technique has been used in 14 patients with improvement of the voice in eight.

Adipose Tissue↗
PubMed1996

A comparison of computerized tomographic staging systems in chronic sinusitis.

A number of different systems exist for staging computerized tomography (CT) scans in rhinosinusitis. The aim of this study was to determine which of four selected staging systems, currently in common use facilitated the highest level of agreement. The systems studied were those by Jorgensen (1991), May and Levine (1991), Lund and Mackay (1993) and Newman (1994). Ten observers independently assessed 10 representative films. In our assessment, the Lund and Mackay system facilitated the highest level of both inter-observer and intra-observer agreement of the four systems tested. We recommend it be adopted as the standard method of measuring the extent of disease, as depicted by CT scanning for chronic. rhinosinusitis.

Chronic Disease↗
PubMed1996

Orbital floor fracture following nose blowing.

A 70-year-old woman with an upper respiratory infection sustained an orbital floor fracture after vigorous nose blowing. The injury was complicated by orbital emphysema and cellulitis. CT scanning confirmed orbital floor fracture and associated orbital soft tissue herniation into the maxillary antrum. A follow-up sinus endoscopy three months later showed a healed periosteum and mucosa, but continued orbital herniation. As the patient's symptoms had largely resolved, repair was averted. Follow-up after nine months showed no recurrence of orbital swelling. The case presented illustrates a rare complication of vigorous nose blowing, coupled with thinning of the sinus walls seen in aging.

Aged↗
PubMed1995

Development of a mucosal challenge test for leprosy using leprosin A.

There is little information about the mucosal immune response in leprosy. We have developed a nasal provocation test with leprosin A which will be used to investigate mucosal immunity to Mycobacterium leprae. Initial studies were performed with increasing doses of leprosin A (1.0 pg/ml-10 micrograms/ml) to determine the optimal safe dose of leprosin A. Anti-M. leprae IgA antibody and normal IgA concentrations were measured in the saliva of leprosy contacts and controls before and after instillation of leprosin A. Nasal leprosin A was well tolerated up to a concentration of 10 micrograms/ml without side effects. None of the six subjects who had not been exposed to leprosy had salivary IgA against whole M. leprae, whereas IgA was detected from 64 h to 140 h following instillation of leprosin A in all of the leprosy hospital workers and in 15 out of 18 healthy household contacts tested. There was no correlation between serum and salivary anti-M. leprae IgA levels before and after testing. Salivary IgA anti-lipoarabinomannan responses were seen in 12 out of 20 household contacts. Normal salivary IgA concentrations varied from 8 to 240 mg/l. The leprosin A nasal provocation test appears to be a safe method for the investigation of the role of mucosal immunity in the pathogenesis of leprosy.

Adolescent↗
PubMed1995

Methods of selection for adenoidectomy in childhood otitis media with effusion.

We have examined the implications of selecting children with otitis media with effusion (OME) for adenoidectomy using different criteria. Data were collected pre-operatively on 125 consecutive cases of OME. Ages 1-13 years, mean = 4.9 years; 68 males and 57 females. The criteria used were: (1) obstructive nasal symptoms, (with three sub-categories); (2) age: and (3) nasopharyngeal airway size. The three sub-categories of obstructive nasal symptoms were based on the clinical practices of colleagues in the UK. Thus we analysed five criterion groups in all. These were: (1) snoring; (2) snoring + mouth breathing; (3) snoring + nasal obstruction; (4) age = 4-8 years and (5) nasopharyngeal airway < 4 mm. We found that applying each criterion separately to the group of children would result in widely differing numbers of children being selected for adenoidectomy. Of the 125 children, the percentage selected by each method varied considerably, ranging from 35-70%. In addition, there was only limited overlap, (43-71%) between the composition of the groups. This helps to explain the variations in surgical rates in different centres. In the absence of any universally acceptable guidelines, therefore, the importance of individual assessment of children can not be overemphasised.

Adenoidectomy↗
PubMed1994

An audit of the early complications of turbinectomy.

An audit of the complications of turbinectomy operations carried out in our unit between 1987 and 1988 indicated an unacceptably high rate of significant haemorrhage. In view of this the surgical technique was changed in an attempt to avoid damage to the main arterial supply of the turbinate. The haemorrhage rate has fallen, but we have had one case of severe nasal crusting, a complication not seen in the earlier series. The morbidity associated with complications of turbinectomy is severe enough for the operation to be reserved for patients with severe rhinitis unresponsive to other treatments.

Adult↗
PubMedDate not supplied

Exophthalmometry in Nigerians.

Exophthalmometry was studied in 100 Nigerians to determine a baseline data of normal exophthalmometry reading, and to compare this with normal values in black and white Americans. The exophthalmometry reading was higher in females than males, more in the left than the right eyes. The mean values were 13.5 mm and 15 mm in males and females respectively. Although these values are lower than those of American blacks they are similar to those of the white Americans. We suggest anatomical reasons for these differences. No correlation was found between the height and weight and degree of exophthalmometry reading in Nigerians.

Adolescent↗
PubMedDate not supplied

Pyoderma gangrenosum: an unusual cause of periaural ulceration.

A case of pyoderma gangrenosum affecting the pinna and neck of a diabetic patient is reported. Appearances were suggestive of malignant otitis externa. A small biopsy resulted in rapid and aggressive exacerbation of the lesion. Pyoderma gangrenosum, although uncommon, should be considered as a cause of ulceration, particularly when the ulcer yields no growth on culture in a non-dependent area.

Diabetes Complications↗
PubMedDate not supplied

Congenital vallecular cyst: a cause of failure to thrive.

Congenital vallecular cysts are fairly uncommon, but can lead to death. They may present as failure to thrive. This case emphasises the value of plain radiographs of the neck. Direct laryngoscopy is mandatory to confirm diagnosis and ablate the lesion satisfactorily. Laryngomalacia should be a diagnosis of exclusion. Adequate marsupialisation is necessary to prevent recurrence.

Cysts↗