Biomedical subjects

R Benson-Mitchell

Publications and source records attributed to R Benson-Mitchell.

9 recordsLinked to original sources

PubMed1996

Cervical lymphadenopathy secondary to atypical mycobacteria in children.

Non-tuberculous mycobacterial (NTM) infections usually present as an enlarged lymph node in the neck of a non-immunocompromised child. The differential diagnosis includes bacterial adenitis, malignant disease and tuberculosis. The definitive diagnosis relies upon isolating the organisms in culture. The treatment is complete surgical excision with, or without, anti-tuberculous chemotherapy. Ten cases of NTM infections are presented with a discussion of the aetiology and treatment of this condition.

Child↗

PubMed1996

Septoplasty as a day-case procedure--a two centre study.

Day-stay surgery is an integral part of Otolaryngology. Many procedures which have traditionally been thought to require overnight stay can be carried out on a day care basis. We report our experience of treating 163 patients admitted for septal surgery as a day-case procedure. The paper summarizes the experience of two centres. One of these is a London Teaching Hospital, where surgery was performed through a dedicated day-case unit, and the other is a District General Hospital where patients were admitted to a day-case unit but had their surgery on a routine in-patient list. As the result of this study we conclude that day-stay septoplasty is associated with a low complication rate and is a safe and acceptable procedure provided that strict selection criteria are followed. The cost implications are discussed.

Adult↗

PubMed1996

Non-Hodgkin's lymphoma presenting as an isolated temporal soft tissue swelling.

Non-Hodgkin's lymphoma (NHL) of the head and neck has been described in several sites including the larynx, the pharynx, Waldeyer's ring, the nose and paranasal sinuses. NHL of the temporal region has not been previously described. We describe a 65-year-old woman with a diffuse swelling of the right temporal region. A histological diagnosis of NHL was made following complete excision of the lesion. No further treatment was given and there was no evidence of recurrence at six months.

Aged↗

PubMed1996

Day-stay myringoplasty.

Grafting of the tympanic membrane (myringoplasty) has traditionally been performed as an in-patient procedure in the UK. We have performed day-stay myringoplasty on 21 consecutive patients (15 adults and six children) under general anaesthesia using an underlay temporalis fascia graft. In 18 cases there was complete healing of the tympanic membrane and in three cases the patients developed perforations at four weeks. This success rate is consistent with previously reported studies. All patients were discharged on the day of admission with no major complications. We have compared the results with a group of patients having the same operation as an in-patient and have concluded that day-stay myringoplasty under general anaesthesia is as safe and effective as in-patient surgery for the majority of patients.

Adolescent↗

PubMed1994

Wegener's granuloma--presenting as a unilateral parotid swelling.

Wegener's granuloma is a systemic necrotizing vasculitis which predominantly affects the upper and lower respiratory tracts and kidneys. The nose and paranasal sinuses are often the first or main sites to be affected. Equally ear involvement is common and a recognized early manifestation of the disease. Salivary gland involvement is rare and is usually part of more widespread systemic involvement. We present a 34-year-old female with a six-week history of hearing loss and a unilateral parotid swelling. One year previously she was diagnosed as having myalgic encephalomyelitis following a long period of post-viral malaise. The case points to the difficulties encountered when Wegener's granuloma presents in an unusual and varied way. A high index of suspicion coupled with early diagnosis and treatment is essential. The patient made a good recovery.

Adult↗

PubMed1994

Lipoma of the left tonsillar fossa.

Lipomas are common benign connective tissue tumours composed of adult adipose tissue. They are relatively rare in the upper aerodigestive tract, although they occur with considerable frequency in other areas, particularly in the subcutaneous tissues of the neck. Although there are several reports of this tumour occurring in the oropharynx, there is no recorded case of a lipoma of the tonsillar fossa. An 83-year-old man with a left tonsillar fossa lipoma is presented. Clinical presentation, management and a literature review are discussed.

Aged↗

PubMed1994

Aspergillosis of the larynx.

Primary infection of the larynx with Aspergillus spp. is rare. It is more commonly seen as part of a wider infection involving the respiratory system in an immunocompromised host. In noncompromised patients laryngeal aspergillosis may represent colonization rather than invasion requiring no systemic anti-fungal treatment. The diagnosis is important as the presenting symptoms are suggestive of malignant laryngeal disease. We present a 62-year-old man with a short history of hoarseness. Direct laryngoscopy and biopsy confirmed the diagnosis of aspergillosis. Clinical presentation, diagnosis and the important pathological characteristics of this infection are discussed.

Aspergillosis↗

PubMed1993

Assessment of sequelae at home following adenotonsillectomy. A basis for day-case management?

Adenotonsillectomy is traditionally performed as an in-patient procedure. Although day-case adenotonsillectomy is practised in some units in the USA, Canada, Finland and Israel, it is rarely practised in the UK. This study looks at a cohort of 100 consecutive children admitted for adenotonsillectomy and follows their progress after discharge. It also assesses parental attitudes to day-case surgery. The results highlight parental anxiety associated with day-case adenotonsillectomy. Only 28% of parents would have liked the procedure to be carried out on a day-case basis with 46% of parents considering a single night stay to be too short. More support must be given to parents in the UK if day-case adenotonsillectomy is to become an acceptable procedure.

Adenoidectomy↗

PubMed1990

Effect of fibreoptic bronchoscopy on pulmonary function.

Several studies have shown that after fibreoptic bronchoscopy there may be a deterioration in lung function but it is not known whether this is due to the premedication, the topical anaesthetic, or the obstruction produced by the bronchoscope. The effects of each part of the procedure on spirometric measurements were studied in patients with lung disease and in normal non-smokers. Measurements were made after premedication (papaveretum and atropine) in seven patients and after topical anaesthesia of the bronchial tree (340 mg lignocaine) with and without the bronchoscope in the trachea in 21 patients and 10 control subjects. Premedication had no effect. In the normal subjects lignocaine produced significant falls in FEV1, forced vital capacity (FVC), peak expiratory flow (PEF), and peak inspiratory flow (PIF), and insertion of the bronchoscope caused further falls that were also significant. In the patients, however, although anaesthesia produced significant falls in FEV1, FVC, PEF, and PIF of similar magnitude to those found in the normal subjects, there was no further important decrease when the bronchoscope was inserted. It is concluded that the major effect of bronchoscopy on lung function is due to topical lignocaine in the airways, and in patients with lung disease (excluding asthma or a central obstructing carcinoma) the insertion of the bronchoscope causes little additional obstruction.

Administration, Topical↗