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Biomedical subjects

P J Doyle

Publications and source records attributed to P J Doyle.

At least 19 recordsLinked to original sources
PubMed1991

The cochlear implant: a comparison of single-channel and multichannel results.

We have performed 39 cochlear implants at St. Paul's Hospital since 1982. Fourteen patients received a House/3M implant and 23 patients received a total of 25 multichannel Nucleus implants. We present a comparison of subjective and objective results in seven patients who first received a single channel implant and were subsequently implanted with a multichannel device. We also report in detail results obtained by a 55-year-old man who received a House/3M implant and subsequently received bilateral Nucleus implants. Results in this patient demonstrate some factors that influence successful use of an implant.

Cochlear Implants↗
PubMed1979

Bone scanning: its lack of value in the follow-up of patients with breast cancer.

Three hundred and fifty-four women with primary operable breast cancer had a bone scan performed within 6 weeks of a simple mastectomy. Eight (2.3 per cent) were positive, but 7 of these patients had radiological evidence of bony metastases. Follow-up bone scans 1 year postoperatively on 278 patients showed only 12 (4.3 per cent) positive, and of these, 9 had other radiological evidence of metastatic disease. At 2 years postoperatively there were 13 (9.2 per cent) positive bone scans amongst 141 patients. Only 2 of these 13 had no other evidence of metastases. Although a bone scan is a useful investigation in patients with bone pain, there is no place for routine bone scanning in either the staging or follow-up of women with operable breast cancer.

Adult↗
PubMed1978

C controlled trial of taurolin in established bacterial peritonitis.

Taurolin administered intraperitoneally has effected a significant reduction in morbidity in peritonitis even when all other methods of intensive care, including powerful antibiotics, have been used. Easy to use clinically, it is effective locally against all fecal pathogens and is nontoxic.

Adolescent↗
PubMed1978

Cancer of the tonsil--a retrospective study.

Treatment of cancer of the tonsil continues to be a controversial matter. A review of the otolaryngological literature and a study of 155 patients treated at the University of British Columbia reveals that the cure rate remains unsatisfactory, particularly in patients with large tumors. We have concluded that early carcinoma of the tonsil should be treated with a full course of radiotherapy reserving surgical treatment for residual or recurrent disease. Advanced carcinoma of the tonsil requires planned combined therapy. Early results indicate that the addition of chemotherapy may significantly improve results over the usual combination of radiotherapy and surgery.

Adolescent↗
PubMed1977

Carcinoma in situ of the larynx.

A retrospective study of carcinoma in situ of the larynx at the British Columbia Cancer Institute indicates that radiotherapy, using a tumoricidal dose of Co 60, is the treatment of choice for this condition. Between 1940 and 1972, 43 patients with carcinoma in situ of the vocal cords were seen. A follow-up of five years or more was possible in 28 of these cases. Twenty-two were treated primarily with a tumoricidal dose of radiotherapy. Twenty-one of the 22 were free of disease for at least five years. This study, therefore, shows a five-year cure rate of almost 100 percent for patients treated with radiotherapy. It also brings out two further points regarding carcinoma in situ of the larynx; namely, an apparent increase in its incidence, and the presence of co-existing invasive carcinoma in some cases. We feel that since the incidence of laryngeal carcinoma has not increased, this apparent increase probably represents a greater awareness by both the pathologist and the clinician. We have also achieved more accurate diagnosis since the introduction of routine microlaryngoscopy. The single radiotherapy failure in our series was due to failure to diagnose co-existing invasive carcinoma. This would seem to be the most likely cause of similar failures reported in the literature.

Biopsy, Needle↗
PubMed1977

Management of nasopharyngeal angiofibroma.

Successful surgical treatment of nasopharyngeal angiofibroma requires complete pre-operative evaluation and careful choice of a suitable surgical approach. Experience with 12 patients presenting with this tumor demonstrates the value of polytomography and angiography in evaluation. The use of pre-operative estrogens and temporary vessel ligation has decreased blood loss. The surgical approach is modified depending upon tumor location. A tumor confined to the nasopharynx is removed by a transpalatal approach. Extension into the sinuses or orbit necessitates a sublabial incision or lateral rhinotomy. Pterygo-maxillary tumor may be exposed by extension of the sublabial incision posterior to the maxillary tuberosity. This allows one to push the tumor back into the nasopharynx. Intracranial extension is removed by a combined otolaryngologic-neurosurgical approach.

Adolescent↗
PubMed1977

Post-laryngectomy tracheostome stenosis--etiology and treatment.

The etiology of post-laryngectomy tracheostome stenosis is reviewed. This condition is not common if preventive measures are used at the time of surgery and during the postoperative period. However stenosis will occasionally occur. We have not been satisfied with standard revision techniques but have had success with radical excision of the stenosed area followed by reconstruction with superiorly based bilateral pedicle flaps.

Female↗
PubMed1977

Indications for and technique of endaural and post auricular incisions.

The indications for and techniques of tympanotomy, endaural incisions, and post auricular incisions are described. There are specific indications for the use of each approach and the otologist should modify his approach depending upon the disease process and the anatomical variations. Specific points in technique are presented which simplify the procedure and prevent complications.

Ear Canal↗
PubMed1977

Treatment of carcinoma in situ of the larynx.

The treatment of choice for carcinoma in situ of the larynx is radiotherapy. Forty-three patients were seen with this condition between 1940 and 1972 and are now suitable for five year follow-up. Thirty-seven of these patients were treated with a tumoricidal dose of Cobalt 60. Three died in less than five years--without evidence of laryngeal disease. Of the remaining 34, all but one are free of disease for five to 17 years. The only failure in this group had co-existing invasive carcinoma. The high incidence of radiotherapy failures previously reported is probably related to the frequency of co-existing invasive carcinoma. We do not feel that there is a true increase in the incidence of carcinoma in situ in recent years. The increased frequency of diagnosis is probably due to increased awareness of the disease and the routine use of microlaryngoscopy.

Carcinoma in Situ↗
PubMed1976

Middle ear disease in native Indian children in British Columbia--incidence of disease and an evaluation of screening methods.

A total of 1,109 Indian children in five British Columbia communities were surveyed for middle ear disease. Evaluation included a history, pure screening, impedance audiometry, and otolaryngological examination. Of these, 12.7 per cent had middle ear disease requiring treatment, namely serous otitis media, perforated tympanic membrane, or cholesteatoma. Serous otitis media was the commonest disease and it was most prevalent in the 0-4 years age group. Pure tone audiometry and impedance audiometry were both unsatisfactory screening methods in this study. The tests could not be performed in the majority of patients four years of age or younger, and they both showed a high incidence of false positive results as well as a significant incidence of false negative results. On the basis of this preliminary report a proposal is made for a screening and continuing evaluation program involving local health care personnel, audiologists, and otolaryngologists.

Adolescent↗