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Biomedical subjects

N D Padgham

Publications and source records attributed to N D Padgham.

12 recordsLinked to original sources
PubMed2006

A comparative study of patient satisfaction with day case and in-patient major ear surgery.

INTRODUCTION: Major ear surgery can be safely performed on a day case basis (i.e. six hour stay). This study aimed to ascertain whether patients had the same level of satisfaction and speed of recovery following major ear surgery when it was performed as a day case compared with performance as an in-patient procedure. METHOD: A cross-sectional survey, by postal questionnaire, of patient satisfaction with day case and in-patient major ear surgery was carried out with 158 patients. Comparisons were made between the responses of the two groups. RESULTS: The response rate was 71 per cent. Patients returned to work significantly sooner following day surgery (p < 0.025) but felt their operation to be of significantly more benefit following in-patient surgery (p < 0.05). CONCLUSIONS: Patient satisfaction following day case major ear surgery is as good as that following in-patient surgery. This has supported the expansion of this service in our unit.

Adolescent↗
PubMed2003

The Canterbury technique for canalplasty via an endaural approach in the surgical management of chronic refractory otitis externa.

We describe an endaural technique for soft tissue and bony meatoplasty and canalplasty in the surgical management of chronic otitis externa unresponsive to medical treatment and out-patient microsuction. Following analysis of the surgical outcome via a retrospective review of patient records, we would recommend this surgical treatment in this patient group.

Adolescent↗
PubMed1998

Osteologic classification of the sphenopalatine foramen.

Textbook descriptions and illustrations of the opening of the sphenopalatine foramen (SPF) into the nasal cavity place it above and behind the posterior end of the middle turbinate (i.e., within the superior meatus). Although true for some skulls, this is not the situation for the majority and may be of importance, because the major blood supply to the nasal cavity enters via this route. Having studied 238 lateral nasal walls, the authors propose a classification of the osteology of the sphenopalatine foramen. In class I (35%) the opening of the SPF is purely into the superior meatus with a notch or foramen in the middle turbinate/ethmoidal crest of the palatine bone. In class II (56%) the SPF spans the ethmoidal crest (i.e., opens into both the superior and middle meati). In class III (9%) there are two separate openings into the superior and middle meati. These findings may explain the route of the artery to the inferior turbinate and indicate the need for care in dealing with the posterior end of the middle turbinate. They may also suggest a potential site for dealing with "difficult" epistaxis via an intranasal route.

Cadaver↗
PubMed1994

Maxillary sinusitis in children with otitis media with effusion.

Sinus radiographs have been carried out on 240 new cases of childhood otitis media with effusion (OME). When the films were suggestive of infection, maxillary sinus washouts were carried out as part of the surgical treatment. Abnormal X-rays were obtained in 28 per cent of the study group, but only 16 cases (seven per cent) of sinus infection were confirmed on antral lavage. In those with positive washouts, there was an apparent relationship between the findings in the maxillary sinuses and middle ears of the same side in some of the cases. There was also evidence of improvement of the middle ear disease when the sinus infection was successfully treated. It does not appear that sinus infection is an important cause of OME, though it may be relevant in a small number of cases.

Child, Preschool↗
PubMed1993

One aid or two?--more visits please!

A prospective trial of hearing aid provision was undertaken to define factors which might be used to allow hearing aids to be fitted optimally. Patients referred for the provision of a hearing aid were studied prospectively at each of five visits when they were questioned by means of a proforma. Fifty-six patients completed the trial and gave adequate responses for analysis. No audiometric or symptomatic criteria were found to be of use in predicting the final choice of hearing aid combination. It may be that initial sequential monaural aiding leads to a higher uptake of binaural aids in the long term. Patients valued multiple visits to the clinic and sequential trials of monaural aiding, the majority felt that binaural aids should be tried.

Adult↗
PubMed1993

Haemorrhagic nasal nodules.

Haemorrhagic nodules have been mentioned previously as a significant cause of epistaxis in adults. We have taken photographs and obtained biopsies to characterize them. They consist of an aneurysmal dilatation of an unusually sited muscular artery with evidence of hypertensive changes in the wall, and thrombus and haemorrhage into the adjacent connective tissue.

Aged↗
PubMed1991

Management of childhood cholesteatoma.

We report a retrospective study of 54 children with 57 involved ears who underwent surgery for cholesteatoma before their sixteenth birthdays. The majority of these underwent open cavity operations (modified radical mastoidectomy, radical mastoidectomy or atticotomy). The incidence of residual disease was only 6 per cent and overall 70 per cent of ears have been free of chronic discharge. The post-operative hearing thresholds were disappointingly low, though overall no worse than those recorded before surgery. The mean post-operative hearing level for the group was 39 dB and the mean air-bone gap was 29 dB. Open cavity surgery is the method of choice for childhood cholesteatoma, mainly because of the low incidence of residual disease.

Adolescent↗
PubMed1991

Surgical anatomy of the singular nerve.

The course of the posterior ampullary (singular) nerve has been studied in 30 preserved human temporal bones. In 17 dissections (57%), the nerve was readily accessible in the floor of the round window niche without undue risk to the round window membrane or the ampulla of the posterior semicircular canal. In 5 bones (16%), the nerve was closely related to the round window membrane and could not have been approached without significant risk of damage to the membrane. In 8 (27%), the nerve ran more or less directly medially to the internal auditory meatus without entering the round window niche. The ampulla of the posterior semicircular canal would therefore have been at risk if the nerve were approached surgically.

Humans↗
PubMed1990

Episodic macroglossia in Down's syndrome.

We report a unique case of recurrent gross enlargement of the tongue associated with lymphangiectasia and tongue protrusion in an adult male with Down's syndrome. There were three episodes of acute macroglossia with no clinically identifiable cause. Spontaneous resolution always occurred after five to six days. Histological examination of the tongue, at post mortem, revealed a primary lesion of the lingual lymphatics. The possible mechanisms of acute macroglossia and the surgical techniques which could have been used to reduce the tongue bulk are discussed.

Acute Disease↗
PubMed1990

Complications of emergency and elective tracheostomy: a retrospective study of 150 consecutive cases.

The complications associated with 150 consecutive tracheostomies in adults were reviewed. A standard technique was used in all but five operations. The number and type of complications were compared between emergency and elective cases and between local and general anaesthetic cases. Only minor complications were observed. No deaths occurred attributable to the tracheostomy and there were no cases of symptomatic tracheal stenosis. Persistent tracheocutaneous fistulae occurred in five cases, of which four had been in situ for over 6 months, three had a previous tracheostomy and one had received radiotherapy to the region. Two unsightly scars required revision. The authors recommend the use of a simple standard technique with the insertion of a 'rescue' suture. Close postoperative supervision by nursing staff specially trained in the care of tracheostomies is of paramount importance in avoiding hypoxic complications secondary to displacement of the tracheostomy tube. Recent moves away from tracheostomy should only continue if the alternatives prove to have an even lower complication rate.

Adult↗
PubMed1988

Hyperextension fracture of the hyoid bone.

A case of hyperextension fracture of the hyoid bone is presented. The management is discussed, with reference to the mode of injury, emphasising that symptomatic treatment only may be necessary. The literature is briefly reviewed.

Accidents, Traffic↗