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Biomedical subjects

P G Bicknell

Publications and source records attributed to P G Bicknell.

15 recordsLinked to original sources

Punctate diathermy of the soft palate: a new approach in the surgical management of snoring.

We present our experiences in the surgical management of 21 snorers, utilizing a new approach designed to stiffen the palatal musculature, without compromising its function. This was achieved by using a punctate pattern of intrapalatal diathermy to achieve fibrosis within the palate and hence the requisite stiffening. The initial results of this procedure are encouraging showing a subjective improvement in snoring in 85.7 per cent of patients and an increase in sleeping in the same room as their partner every night, from 14.3 per cent pre-operatively to 57.1 per cent post-operatively.

Adult↗

The summating potential in ultrasonic labyrinthectomy for Menière's disorder.

This paper reports SP changes pre- and post-operatively in a series of 12 patients who have undergone ultrasonic labyrinthectomy for Menière's disorder. The unoperated ear in 7 of these patients also had pre- and post- operative ECochG. The SP in the operated ear was reduced in amplitude and duration in 50 per cent and 66 per cent of ears respectively. However, the SP was also reduced in the unoperated ears by similar proportions. Statistical analysis showed no significant difference in SP change between the two sets of ears. It is concluded that the value of the SP in prediction or assessment of results of treatment in Menière's disorder is not at present proven, and that future investigations require the use of controls.

Adult↗

Glossopharyngeal neuralgia with syncope.

Thirty-two cases of glossopharyngeal neuralgia complicated by syncope, cardiac arrhythmias or convulsions, singly or together, have been reported in the world literature. A further case is described and the clinical features of these thirty-three are reviewed. It is recommended that treatment should be undertaken as a matter of urgency. In the first place, Carbamezapine, with often the addition of Atropine, may prove effective. However, surgical intervention appears to give a better chance of permanent relief. Four alternative methods of surgery are discussed and the cervical or the intracranial approach recommended. Surgery should not be delayed in patients who fail to respond to medical treatment or in whom recurrence of symptoms occurs.

Adult↗

Rupture of the round window membrane.

A case of sudden deafness due to rupture of the round window membrane is presented. Nineteen similar cases have previously been reported in the literature. In a review of these twenty patients, it is noted that a history of concurrent physical effort or barotrauma was present in eighteen. This supports the view that the injury is produced by pressure changes acting either along the cochlear aqueduct (the explosive route) or, directly on the middle ear structures (the implosive route). At operation, the rupture may be difficult to see, and a separate leak from the oval window may be present. The timing of any surgical intervention is important. The authors recommend that this should be deferred for one week after the onset of symptoms, as the fistula may heal spontaneously. If no definite improvement has occurred at the end of this time, then tympanotomy should be undertaken during the next week.

Adult↗