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Biomedical subjects

P Murthy

Publications and source records attributed to P Murthy.

At least 19 recordsLinked to original sources
PubMed1999

Radiological staging of the chest and abdomen in head and neck squamous cell carcinoma--are computed tomography and ultrasound necessary?

The need for, and choice of, radiological staging investigations for distant metastases in the management of head and neck squamous cell carcinoma is a contentious issue. To address this problem a retrospective audit of routine computerized tomography (CT) and ultrasound scanning of the chest and abdomen respectively was undertaken. The records of 103 patients who, over a six and a half year period, underwent major surgery for head and neck squamous cell carcinoma were reviewed. A total of 57 patients (59 per cent) had CT scanning of the chest of whom two were identified as having synchronous tumours. In both cases, the lesions were identified on chest X-ray prior to scanning. Seventy patients (68 per cent) had routine ultrasound scanning of the abdomen. In none of these was metastatic disease identified. As a result of the audit findings routine CT and ultrasound scanning of the chest and abdomen has been discontinued.

Aged↗
PubMed1999

A randomised clinical trial of antiseptic nasal carrier cream and silver nitrate cautery in the treatment of recurrent anterior epistaxis.

Sixty-four consecutive patients with a history of recurrent epistaxis were randomly assigned in the outpatient clinic to receive treatment with either Naseptin antiseptic nasal carrier cream alone (Group A) or a combination of Naseptin cream and silver nitrate cautery (Group B). Results were available on 50 patients, 22 in Group A and 28 in Group B. Twenty patients (91%) in Group A and 25 patients (89%) in Group B demonstrated improvement in their symptoms. There was no statistically significant difference in outcome between the two treatment arms (P = 0.7569). On comparing the different age groups (under and over 16 years) in the two treatment arms, once again there was no statistically significant difference in the treatment outcome (P = 1.000). In conclusion, silver nitrate cautery offers no added advantage to the management of simple epistaxis in both children and adults.

Administration, Intranasal↗
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

Modified tragal cartilage--temporoparietal and deep temporal fascia sandwich graft technique for repair of nasal septal perforations.

Fifteen cases of nasal septal perforation were repaired with a tragal cartilage--temporoparietal and deep temporal fascia sandwich technique using a modification of the approach previously described (Hussain and Kay, 1992). Successful closure was achieved in 14 patients (100 per cent) after an observation time of up to two years. The operative technique and advantages of the modified approach are described.

Adult↗
PubMed1997

Of insects and eggs: a case report.

A middle aged woman presented with delusions of infestation and multimodal hallucinations due to an underlying glioma of the corpus callosum. After surgery, the phenomena in question changed and finally disappeared. A recurrence of the tumour caused dementia.

Animals↗
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↗
PubMed1996

Routine nasal surgery: an audit of outpatient follow-up.

The study objective was to assess the value of outpatient follow-up of patients who undergo routine uncomplicated nasal surgery. A total of 177 postoperative patients (117 males, 60 females) undergoing routine nasal surgery at the Raigmore Hospital, Inverness, was selected over a six-month period, 92 of whom (60 males, 32 females) were requested to return to the clinic for a follow-up session. A total of 72 (78.3%) patients attended for post-operative review. Of these, 55 patients (76.4%) had achieved a satisfactory result from surgery and 17 (23.6%) required additional treatment for persistent problems. The former group were pleased with the outcome of their operation and required no further treatment. Of the 25 patients who were prescribed medication at the time of discharge from hospital, 19 (76.0%) were still complying with the medication and required no further specialist assistance. The results suggest that routine follow-up of uncomplicated cases of nasal surgery is unnecessary. The good therapeutic results in the majority of cases indicate a need to decrease the number of routine reviews to reduce the high non-attendance rate and increase the proportion of new patients seen at outpatient clinics. The role played by general practitioners is vital to this cause. This would include minor postoperative care, monitoring of prescribed medication and review of patients with occasional postoperative problems.

Adolescent↗
PubMed1996

Pedicled temporoparietal galeal myofascial flap for orbital and cheek lining following radical maxillectomy.

Radical maxillectomy is indicated for stage III and IV antroethmoidal carcinoma. In those cases where the anterior bony wall of maxillary antrum or the anterior facial soft tissue is involved or a previous Caldwell-Luc antrostomy was performed, a generous amount of cheek soft tissue has to be resected with the surgical specimen in order to achieve tumour-free margins. In such cases survival of the cheek flap is in jeopardy. Following orbital exenteration the resultant defect requires covering to promote healing and to protect the underlying bone. Traditionally, a skin graft has been used to line the orbital defect and the cheek flap. The pedicled temporoparietal galeal myofascial flap offers well-vascularized, reliable, supple and plentiful tissue which can be used to line both the orbit and the cheek, thus covering both sites with one flap. Such a case is presented and the surgical anatomy and technique are described.

Adult↗
PubMed1995

Nasal septal surgery: is routine follow-up necessary?

An audit project was undertaken to appraise the outcome of 95 cases of septal surgery over a 12-month period, taking into account the subjective alteration of symptoms, appearances at anterior rhinoscopy and complications. Seventy-three patients (76.8 per cent) attended the follow-up clinic three to six months (median four months) after surgery. There was an improvement in short-term nasal breathing and in the clinical appearance of the septum in 84.9 and 96.9 per cent respectively; a complication rate of 10.9 per cent and an overall satisfaction rate of 81.3 per cent were also noted. These results support those of other reported series and suggest that routine follow-up of uncomplicated cases of septal surgery is unnecessary.

Female↗
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↗
PubMed1994

The influence of medical audit on the management of epistaxis in three district general Hospitals.

The implementation of audit in most hospital departments in the UK has been instigated by the guidelines set out by the Royal Colleges. This paper aims to demonstrate the results of regular subregional audit meetings in the ENT departments involving three District Hospitals in East Anglia. We report the effects of audit meetings in improving the management of epistaxis, whereby a protocol for treatment and discharge was established, the duration of the nasal pack left in situ was reduced, and the material of the pack was changed.

Adolescent↗
PubMed1994

Acute bilateral vestibulo-cochlear dysfunction following occipital fracture.

The case of a 57-year-old man who presented with acute bilateral deafness and vestibular dysfunction following occipital bone fracture is described. Plain radiographs and a CT scan of the head demonstrated a single fracture of the occipital bone. Complete loss of cochlear and vestibular function bilaterally was demonstrated and followed by partial recovery of auditory function over the following months. Review of the literature has not revealed a previously reported case.

Accidents, Occupational↗