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Biomedical subjects

M R Laing

Publications and source records attributed to M R Laing.

14 recordsLinked to original sources
PubMed1998

Dissection tonsillectomy: pattern of post-operative pain, medication and resumption of normal activity.

A prospective study of 99 adults undergoing tonsillectomy was carried out to determine the pattern of post-operative pain, intake of medication and timing of return to work and normal swallowing. The differences in the pain scores, as measured by a visual analogue scale, between every third consecutive day following post-operative day four were found to be highly significant (p < 0.001). Sixty-six patients (66.6 per cent) required medication in the form of analgesics and/or antibiotics after the first post-operative day. Sixty-four out of a total of 82 patients (78.2 per cent) returned to work within 14 days of surgery. Ninety-six patients (97 per cent) reported normal swallowing within 14 days of surgery. These results suggest that the majority of adult patients undergoing tonsillectomy can be appropriately advised pre-operatively regarding the probable pattern and duration of post-operative pain and the timescales they can expect to return to work and normal swallowing.

Adolescent↗
PubMed1998

Admission and discharge policy for paediatric adenoidectomy and tonsillectomy--a rural perspective.

Adenoidectomy and tonsillectomy are amongst the most common surgical procedures carried out in children. We undertook a prospective audit in the Highlands of Scotland to document the views of general practitioners, parents, nursing staff and anaesthetists on admission and discharge policy. Of responses from 149 general practitioners, 119 (80 per cent) were in favour of change to same day admission and 22 (15 per cent) were not in favour. For change to same day discharge for adenoidectomy, 55 (37 per cent) were in favour and 81 (54 per cent) were not in favour. For change to next day discharge for tonsillectomy, the figures were 51 (34 per cent) and 89 (60 per cent) respectively. Responses from 14 trained paediatric nurses comprised 13 not in favour of same day admission, six in favour and seven not in favour of same day discharge for adenoidectomy and all 14 not in favour of same day discharge for tonsillectomy. All eight Consultant anaesthetists approached were happy with a change in policy to same day admission for children who were otherwise fit and well. Thirty-seven parents (70 per cent) preferred previous day admission and 14 (29 per cent) were happy with same day admission for their children. On the basis of these results, day-case adenoidectomy or tonsillectomy is not being considered in this area. Moves have been made, however, toward a policy of same day admission and next day discharge.

Adenoidectomy↗
PubMed1997

Fine needle aspiration cytology of head and neck lesions: an early experience.

Fine needle aspiration cytology (FNAC) was performed on 91 patients with lesions of salivary glands and cervical lymph nodes. The results were compared with histopathology in 58 patients who subsequently underwent surgery. Of a total of 105 aspirates, a definitive cytodiagnosis was possible in 88 (83.8%). An overall sensitivity of 77.7% and specificity of 93.3% were obtained when the cytological results were correlated with histopathology in 48 cases. The figures for salivary glands were 40.0 and 88.9%, and for cervical lymph nodes were 92.3 and 100.0% respectively. The incorrect diagnosis of some aspirates did not adversely affect the subsequent management of these cases. Fine needle aspiration cytology has a role in the diagnosis and management of a variety of head and neck lesions, although it should be used, along with other investigations, not as a substitute but as an adjunct to sound clinical judgement. The limitations of the procedure, including occasional errors of cytodiagnosis, should be borne in mind. The use of this technique by otolaryngologists has been limited, and we advocate that it becomes a more integral part of the diagnostic work-up in head and neck practice.

Adolescent↗
PubMed1995

Surgery for pharyngeal pouch: audit of management with short- and long-term follow-up.

A review was undertaken of 103 patients with pharyngeal pouch presenting over a 10-year period. Management was conservative in 35 patients and 68 patients were treated using external diverticulectomy and cricopharyngeus myotomy. The fistula rate was 8.9% and median hospital stay was 7 days. The results of this large series are compared to other reported series, and a long-term follow-up showing clinical outcome is reported.

Follow-Up Studies↗
PubMed1994

Macroglossia.

Explore the source record for details and available documents.

Child↗
PubMed1991

Adult tonsillectomy.

One hundred consecutive adult patients having tonsillectomy were carefully analysed with regard to preoperative history, operative findings and pathology. Follow-up was made at 1 and 3-year intervals, with particular reference to the patient's view of the outcome. Results of operation were compared with the clinical course of 100 age and sex-matched controls who had been on the waiting list for tonsillectomy for 2 or more years. These results are presented and a case is made for tonsillectomy in young adults as a valid and cost-effective procedure.

Adult↗
PubMed1990

Tracheal stenosis in infants and young children.

Eight cases of intra-thoracic tracheal stenosis presenting to the ENT department at the Hospital for Sick Children, Great Ormond Street, over the past 10 years are reported. The varied aetiology and presentation of these cases is discussed and the frequency of associated cardio-pulmonary anomalies emphasized. Difficulties in diagnosis and investigation are outlined, in addition to an overview of current management. While the overall outlook for many of these children remains poor there is reason to believe that a balance of conservative management and surgical reconstruction in selected cases will result in improved survival figures.

Child, Preschool↗
PubMed1990

Non-Hodgkins lymphoma of the head and neck: experience in the Grampian area.

The records of 44 cases of non-Hodgkins lymphoma (NHL) presenting to the ear, nose and throat department in the Grampian area from 1980-1988 were examined in relation to site of occurrence, histology, age at presentation, clinical stage, treatment and survival. The median age was 67 years and there was a preponderance of high grade histology, especially in disease affecting the tonsil. Most deaths occurred in the first year; patients with high grade disease and those in stages three and four had a significantly poorer survival during the first year. The site of disease had no influence on survival.

Adolescent↗
PubMed1990

Analgesia and removal of nasal packing.

We present a prospective controlled trial, comparing methods of analgesia for the relief of discomfort on removing nasal packing, including a general discussion on the considerations for, and methods of, nasal tamponade. On the basis that nasal packing is likely to continue to be used frequently, nitrous oxide (as Entonox) is advocated as a safe and relatively cheap means of pain relief with a statistically significant advantage over papaveretum.

Adult↗
PubMed1988

Intraparotid anatomy of the facial nerve and retromandibular vein.

Fifty-four cadaver dissections of the parotid gland and the extracranial course of the facial nerve were made. In 52 out of 54 specimens dissected (96.3 per cent) the retromandibular vein was present and of significant calibre (greater than 2 mm). In all specimens the main facial nerve trunk or its major divisions were in direct contact with the retromandibular vein at the level of its entry into the parotid gland. This finding is discussed in the context of new developments in body scanning techniques and put forward as a potential adjuvant in the clinical management of lumps in the parotid region.

Facial Nerve↗
PubMed1988

Ectopic thyroid malignancy in the midline of the neck (a case report and literature review).

A 71-year-old female presented with a midline neck mass. The clinical impression was that of a thyroglossal cyst but preoperative assessment suggested a solid lesion, possibly malignant. The mass was removed surgically using the Sistrunk technique and shown pathologically to be a mixed papillary-follicular carcinoma of the thyroid with no cystic elements. Clinically and radiologically the thyroid was normal and thyroidectomy was not performed. This management is discussed along with a brief review of the relevant literature on the pathology and treatment of similar lesions.

Adenocarcinoma↗
PubMed1985

Treatment of acute abscesses by incision, curettage and primary suture without antibiotics: a controlled clinical trial.

One hundred and thirty-seven consecutive acute superficial abscesses were randomly allocated to incision, curettage and primary suture without parenteral antibiotics (64 cases) or to conventional treatment with incision, drainage and dressings (73 cases). Wound healing was faster; 7.0 days: 25.1 days (P less than 0.01, Wilcoxon's rank sum test), the number of hospital visits was smaller; 3.8 visits: 11.1 visits (P less than 0.01) and the time off work was shorter; 4.0 days: 14.1 days (P less than 0.01) in the group treated by primary closure compared with those managed conventionally. In this study no complications attributable to the withholding of antibiotics occurred. Incision and primary closure of abscesses is safe and more economic than conventional drainage. Routine antibiotic cover is not necessary.

Abscess↗