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Biomedical subjects

R P Morton

Publications and source records attributed to R P Morton.

At least 19 recordsLinked to original sources
PubMed1992

Incidence of 'unsuspected' extranodal head and neck lymphoma.

A series of 100 consecutive patients presenting with non-Hodgkin's lymphoma in the head and neck region was reviewed. An examination of the contribution made to the staging classification by an otolaryngological examination showed that one-third of patients presenting with cervical nodes had unsuspected extranodal disease in Waldeyer's ring. Overall 14% of patients undergoing an otolaryngological examination had their disease upstaged because of that examination.

Head and Neck Neoplasms↗
PubMed1990

Comparison of the metabolic effects of continuous postoperative enteral feeding and feeding at night only.

The effects of two different feeding patterns on oxygen consumption, nitrogen balance, blood biochemistry, and urinary catecholamine excretion were investigated over 5 d in patients after major head and neck surgery. Both groups of nine patients each were fed a regimen that provided 4.7 MJ on day 1 and 10 MJ on days 2-5 via a nasogastric tube by continuous infusion with an enteral feeding pump. One group was fed continuously for 24 h, the other was fed only at night, ie, from 1700 to 0900 the next morning. Oxygen consumption was significantly higher (P less than 0.01), nitrogen balance better (P less than 0.05), and urinary catecholamine excretion higher (P less than 0.05) in the 24-h-fed patients than in the night-fed patients. Postoperatively, feeding at night only is more energy efficient than is feeding continuously for 24 h, but is associated with poorer nitrogen balance. These differences may be mediated by sympathoadrenal mechanisms.

Adenocarcinoma↗
PubMed1990

Chest infection following head and neck surgery: a pilot study.

This paper reports the results of a pilot study which examined factors associated with chest infection following head and neck surgery. The overall rate of chest infection was 11%, but was 20% in those patients having a tracheotomy. No infection developed in patients with an intact airway. Other factors which emerged as possibly important were the duration of surgery and heavy regular alcohol intake. We recommend that prophylactic antibiotics be continued for at least 48 h in patients requiring a tracheotomy as part of their head and neck surgery. This is against the trend of shorter antibiotic regimens recommended for prevention of wound infections.

Amoxicillin↗
PubMed1989

Wound amylase estimation and the prediction of pharyngocutaneous fistulae.

Pharyngocutaneous fistula is a common complication after major head and neck surgery. In this study it was possible to predict fistula formation as early as the second postoperative day, using serial measurements of the amylase concentration in wound drainage. Wound amylase estimation may be used to help avoid major pharyngocutaneous fistulae by providing an 'early warning' and allowing modification of the postoperative feeding regimen in certain situations.

Aged↗
PubMed1988

Late ear sequelae in cleft palate patients.

This retrospective study looks at the incidence and nature of ear disease in 50 adolescent patients who had cleft palates repaired in infancy. Half of these patients had a history of grommet insertion. We found that most patients had normal hearing (81%) and middle-ear pressures (86%), although about half had tympanic membrane abnormalities. Grommet insertion did not result in better long-term hearing in this study but was strongly associated with tympanosclerosis. Cleft type did not influence the degree of ear disease although more patients with complete clefts had a history of repeated grommet insertion. Otitis media with effusion is almost universal in cleft palate infants and may influence later language, speech and educational development. At the time of palatal repair grommets should be inserted to improve hearing in these infants.

Adolescent↗
PubMed1988

Laterality of sinonasal cancer and its aetiologic implications.

A study of the laterality of cancer arising in the nose and sinuses in Cape Town shows that ethmoid tumours have a pronounced left-sided dominance irrespective of histology or racial group. This supports an exogenous cause for this site. These findings are discussed in the light of results from other clinical and epidemiological research. It seems unlikely that maxillary sinus cancer has the same aetiology as ethmoid carcinoma.

Aged↗
PubMed1988

Prediction and prevention of fistulae after major head and neck surgery: a preliminary report.

A method of checking the integrity of mucosal repair after head and neck surgery using wound amylase levels is described. A low wound amylase concentration allows early resumption of oral intake; an increasing amylase concentration is a strong predictor of subsequent wound breakdown and fistula formation. A regimen has been developed which has prevented fistulae from developing in the small number of patients studied thus far.

Amylases↗
PubMed1987

Factors predicting response of end stage squamous cell carcinoma of the head and neck to cisplatinum.

Cisplatinum significantly prolongs survival in end stage head and neck cancer but only 30-40% of patients respond. Many receive chemotherapy with little or no benefit and it would obviously be advantageous to determine in advance those patients likely to benefit. In 2 phase III trials of chemotherapy in end stage disease, 129 patients have been treated with cisplatinum, either alone or in 2-drug combination with bleomycin, methotrexate or 5-fluorouracil. Factors analysed in the entire group were age, sex, site, previous treatment, performance status and the use of cisplatinum in combination. A high albumen and oro- or nasopharyngeal site were significantly favourable, while a hypopharyngeal, middle ear, skin or paranasal site were all significantly unfavourable. In the separate analysis of the subgroup with recurrent disease, site of recurrence and time to recurrence were analysed in addition to the factors named above. Although similar trends to those in the entire group were observed none reached significant levels. In the subgroup with advanced previously untreated disease, histological grade was analysed in addition to the above factors. Good performance status emerged as significantly favourable. The emerging trends provide some insight regarding outcome but are not sufficiently clearcut to allow a decision to be made on who should and who should not be treated.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

Surgery of snoring.

Habitual, loud snoring is common in the adult population, and may be the only symptom of the more serious Obstructive Sleep Apnoea syndrome. We report here our results of uvulo-palato-pharyngo-plasty (UPPP), with or without nasal surgery, for snoring. Quantitative grading of the severity of the snoring shows that all patients were cured of symptomatic snoring, but that snoring was not altogether abolished in all patients.

Adult↗
PubMed1986

Surgery for pharyngeal pouch.

Diverticulectomy for pharyngeal pouch requires several days in hospital and carries a risk of postoperative fistula formation. Small to moderate sized pouches can be inverted easily. Experience with this technique has been encouraging and results are reported here. Large pouches of long standing probably should be excised rather than inverted.

Adult↗