Biomedical subjects
Publications and source records attributed to P Gilbey.
Tooth protection during suspension microlaryngeal surgery is a challenge when teeth are damaged or missing. We present an effective, disposable and cheap tooth guard for microlaryngeal surgical procedures using Turbocast. The tooth guard transits the laryngoscope's pressure directly to the hard palate leaving the teeth uninvolved and free of any pressure.
Vascular transformation of lymph node sinuses is an uncommon condition and only isolated cases have been reported. It is characterized by conversion of nodal sinuses into capillary-like channels, often accompanied by fibrosis. Venous or lymphatic obstruction is thought to be the underlying mechanism, and in most cases factors that may contribute to lymphovascular obstruction can be identified such as tumour in the vicinity, vascular thrombosis, heart failure, previous surgery or radiotherapy. Most cases involve abdominal lymph nodes, and head and neck involvement is rare. We present two cases of vascular transformation of lymph node sinuses presenting only as cervical lymphadenopathy, without an obvious cause of lymphovascular obstruction.
We present the results of the insertion of self-made polyethylene T-tubes for a period of 15-24 months for the treatment of chronic middle-ear effusion. We compare the outcome of our patients to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time. In a retrospective review of 603 T-tubes inserted in 306 children up to the age of 12 years, charts were reviewed for age, sex, surgical procedure performed, duration of ventilation and complications. In all cases the indication for surgery was chronic middle-ear effusion. The tubes were electively removed by the authors after 15-24 months of ventilation. Spontaneous extrusion was considered a complication. The mean period of ventilation was 20 months. Post-operative otorrhoea was experienced in 6.6 per cent of ears; 4.8 per cent of tubes extruded spontaneously, whereas 3.15 per cent had to be removed earlier than originally planned; 4.9 per cent of ears were re-ventilated at a later date, and 1.49 per cent of ears developed a persistent perforation. We demonstrate that the outcome of patients treated with our self-manufactured tubes for a period of 15-24 months is, in many respects, better or at least comparable to the reported outcome of patients treated with other commonly used ventilation tubes for either shorter or longer periods of time, and that the many complications associated with the conventional T-tube can be reduced. We suggest that our favourable outcome may be due to the duration of ventilation, which was controlled to be shorter than the conventional long-term T-tubes and longer than that of grommets.
The internal nasal structures, including the turbinates, regulate the nasal airflow. The surgical treatment of turbinate hypertrophy remains controversial. A wide variety of surgical procedures is performed, with universally unsatisfactory results. Interference with nasal physiology and possible postoperative complications have been the main reasons for the objection to total inferior turbinectomy. Over a 6-year period, 357 total inferior bilateral turbinectomies were performed at our institution. We present the results of these procedures and describe our surgical technique. We conclude that even in a hot and dusty climate, total inferior turbinectomy is an effective and relatively safe procedure.