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Biomedical subjects

A Kalan

Publications and source records attributed to A Kalan.

16 recordsLinked to original sources
PubMed2005

Pulsatile tinnitus.

Pulsatile tinnitus is an uncommon otological symptom. Objective pulsatile tinnitus has numerous causes, including benign intracranial hypertension, glomus tumours and atherosclerotic carotid artery disease. History and physical examination can give important information as to the underlying diagnosis. Radiographic evaluation is essential in all patients with pulsatile tinnitus. Many patients have a treatable underlying aetiology. Early diagnosis and appropriate intervention may save patients from unnecessary morbidity.

Hearing Tests↗
PubMed2005

Efficacy of tibolone and transdermal estrogen therapy on psychological symptoms in women following surgical menopause.

OBJECTIVE: This study investigated the efficacy of tibolone and transdermal estradiol therapy on menopausal and psychological symptoms in women following surgical menopause. METHOD: Seventy-five women who had undergone surgical menopause were randomized to a 6-month double-blind interventional study treatment with oral 2.5 mg/day tibolone, transdermal 3.9 mg/week estradiol or oral placebo. The patients were assessed using Kupperman's Scale, Hamilton Depression Rating Scale (HDRS) and Hamilton Anxiety Rating Scale (HARS) before and at the end of the 6 months of treatment. RESULT: Sixty-five subjects completed the study: 23 on tibolone, 21 on transdermal estradiol and 21 on placebo. At the end of the 6 months of therapy, highly significant improvements in menopausal symptoms, depression and anxiety scores were observed in both groups (tibolone and transdermal estradiol groups) as compared with baseline values (p<0.001). However, in the placebo group, there were no significant differences on changes from baseline to the end of treatment (p>0.05). CONCLUSION: These results suggest that tibolone and transdermal estradiol therapy significantly improve menopausal and psychological symptoms in women following surgical menopause.

Administration, Cutaneous↗
PubMed2002

Columelloplasty: a new suture technique to correct caudal septal cartilage dislocation.

Deviation of the nasal septum is a common finding in patients with nasal obstruction and, when such deviation is severe, a septoplasty or submucous resection with or without turbinate reduction is commonly recommended for the relief of the patient's symptoms. In cases where there is anterior subluxation of the septum, the caudal margin frequently presents on one or either side of the midline at the external nares. We report a simple suture technique which, when subluxation is not severe, will correct this caudal displacement. The technique can either be used as an adjunct to conventional septoplasty or it can be undertaken as an isolated procedure in patients having routine rhinoplasty.

Humans↗
PubMed2001

Treatment of external nasal valve (alar rim) collapse with an alar strut.

Alar (external valve) collapse may be iatrogenic or can occur as a consequence of ageing or trauma. We have utilized an autogenous cartilage graft inserted as an underlay graft to the alar rim to treat 17 patients who have presented with nasal obstruction due to alar collapse. We report the short- and medium-term functional results and the cosmetic sequelae of our approach and conclude that this procedure offers an improvement in nasal airway performance in patients with external valve collapse without producing serious adverse cosmetic sequelae.

Adult↗
PubMed2001

Assessing the reproducibility of nasal spirometry parameters in the measurement of nasal patency.

The reproducibility of nasal spirometry was assessed in ten subjects at two visits. Topical nasal decongestion was applied to minimise mucosal variation. Eleven parameters of flow volume were measured. Data analysis using Spearman's rank correlation coefficients revealed peak inspiratory flow rate (PIFR) followed by forced expiratory volume in first one second (FEV1) to be the most reproducible measures, yielding significance values of < 0.05. For all other spirometric parameters significance was not reached. Analysis revealed that using a naso-pulmonary index (a ratio of nasal to pulmonary flow) was detrimental to reproducibility. We conclude that future nasal spirometric studies should use PIFR and FEV1 as their derived variables of flow-volume loops in the assessment of nasal patency, and the naso-pulmonary index is of no value.

Forced Expiratory Volume↗
PubMed2000

Foreign bodies in the nasal cavities: a comprehensive review of the aetiology, diagnostic pointers, and therapeutic measures.

Otolaryngologists frequently encounter nasal foreign bodies, particularly among children and mentally retarded patients. There are isolated reports describing the removal of unusual foreign bodies from the nose. But no comprehensive reviews of this important subject have been published for many years. This article includes a detailed discussion of the different types of nasal foreign bodies, the various clinical presentations, management options, and complications associated with nasal foreign bodies.

Adolescent↗
PubMed2000

Gradenigo's syndrome.

Gradenigo's syndrome, which is characterised by the triad of suppurative otitis media, pain in the distribution of the trigeminal nerve, and abducens nerve palsy may give rise to potentially fatal complications. Knowledge of the aetiology and appropriate investigations can lead to early diagnosis. A case is reported which illustrates this.

Abducens Nerve Diseases↗
PubMed2000

Lipoma in fossa of Rosenmüller.

We report the first case of a lipoma originating in the fossa of Rosenmüller. Although lipomas are a common benign tumour in the body, lipomas of the nasopharynx are rare.

Adult↗
PubMed2000

Penetrating neck injury: case report and evaluation of management.

Greater urban violence has resulted in an increased incidence of penetrating neck trauma. Penetrating neck wounds can present difficult diagnostic and therapeutic dilemmas. The evaluation and management of such injuries, however, remains controversial. There is no universally accepted specific approach to the management of patients with penetrating neck injuries, with some surgeons advocating mandatory neck exploration whilst others believe in selective surgical intervention. We believe that an equal willingness for both conservative and surgical intervention as dictated by serial bedside evaluation with adequate radiological and endoscopic support can provide the clinician a safe and effective means of managing a potentially complex and lethal problem.

Adult↗
PubMed1999

Adverse effects of nasal continuous positive airway pressure therapy in sleep apnoea syndrome.

Nasal continuous positive airway pressure (nCPAP) is now the treatment of choice for patients with sleep apnoea syndrome. Side-effects and adverse reactions have been described in isolated reports with this device. We have, therefore, systematically studied the side-effects of nCPAP therapy in 300 consecutive patients referred to the London Chest Hospital Ventilatory Support Unit. Ninety-six per cent of patients complained of at least one side-effect resulting from the therapy, with 45 per cent complaining of a side-effect specific to the nasal mask. There was no correlation between the side-effects and level of pressure used during nCPAP. The rate of compliance remained high in spite of the side-effects, with a daily use of 7.8 hours (SD 8.05) and with 83 per cent of the patients using the device every night. Although nCPAP treatment remains acceptable to most patients there exists a high incidence of adverse effects.

Adult↗
PubMed1999

Lingual thyroid gland: clinical evaluation and comprehensive management.

Although lingual thyroid gland is the most common benign mass found at the junction of the anterior two-thirds and the posterior one-third of the tongue, it is still a rare clinical entity. This developmental anomaly is the result of an arrested descent of the gland anlage early in the course of embryogenesis. Patients may have symptoms of dysphagia due to obstruction or even hemorrhage. These symptoms can occur at any time from infancy through adulthood. The clinical findings, laboratory tests, and radiographic imaging studies employed in confirming the diagnosis and in planning appropriate treatment have been evaluated. The primary therapeutic goal is to restore thyroid function. We describe a case of lingual thyroid gland and summarize the current management principles for this condition.

Adult↗
PubMed1997

Diathermy tonsillectomy: comparisons of morbidity following bipolar and monopolar microdissection needle excision.

Tonsillectomy is frequently associated with a considerable post-operative morbidity. In some cases reactionary or secondary haemorrhage occurs and all patients suffer a degree of post-operative pain. The use of bipolar diathermy excision has become popular because it reduces intra-operative blood loss, but all diathermy inevitably produces a degree of damage to adjacent normal soft tissues. In turn this inadvertent injury must act to increase the post-operative pain. Monopolar dissection using a fine tungsten diathermy needle (the Colorado needle) allows sharp dissection at low power levels and in previous studies has been shown to produce a reduction in collateral tissue damage. In this prospective study the morbidity associated with tonsillectomy using this needle was compared to that following a standard bipolar dissection. Using the monopolar needle produced no enhanced risk of reactionary or secondary haemorrhage while causing significantly less post-operative pain and a reduction in eschar. We believe that excision using this needle preserves the advantages associated with bipolar dissection while reducing local soft tissue damage.

Adolescent↗
PubMed1997

An unique tumour of the geniohyoid muscle: an intramuscular haemangioma.

We present the first case report in the English literature of an intramuscular haemangioma of the geniohyoid muscle. This occurred in a 24-year-old female and the diagnosis was not made prior to resection. Haemangiomas are uncommon tumours of the head and neck and intramuscular haemangiomas account for fewer than one per cent of the total. Diagnosis of the vascular nature of the tumour is often missed. Recurrence is common and usually due to incomplete excision. A review of the literature and a case report of these locally destructive lesions is presented.

Adult↗
PubMed1996

Spontaneous internal jugular vein thrombosis and recurrent laryngeal nerve palsy: a rare simultaneous presentation of an occult malignant neoplasm.

Internal jugular vein thrombosis is an uncommon potentially life-threatening disorder caused by various conditions. Non-spontaneous internal jugular vein thrombosis is an uncommon condition associated in the pre-antibiotic area with deep-neck infections. Currently iatrogenic trauma to the internal jugular vein from catheterisation and repeated intravenous injections by drug abusers are the leading causes of thrombosis. Spontaneous internal jugular vein thrombosis may occur when there are no apparent pre-disposing mechanical or inflammatory causes although a few of these patients may harbour an occult malignant neoplasm. Hence, careful investigation and follow-up are vital. Thrombosis in Trousseau's syndrome is usually confined to the vascular system of the extremities and the viscera. However, secondary to the paraneoplastic hypercoagulable state, thrombosis can occur in the large veins of the head and neck region. We understand this to be the first case where spontaneous internal jugular vein thrombosis and ipsilateral recurrent laryngeal nerve paralysis were the only initial manifestations of an occult malignancy.

Aged↗
PubMedDate not supplied

Improving the reproducibility of acoustic rhinometry in the assessment of nasal function.

Acoustic rhinometry readings are very position dependent, and it was hypothesized that this accounts for its relative lack of reproducibility on a day-to-day basis. Multiple readings on each visit were taken to investigate their impact, if any, on improving the day-to-day reproducibility of the method. Measurements of the minimal cross-sectional area of the nose as measured by acoustic rhinometry were studied in 10 subjects following nasal decongestion. For each individual, acoustic rhinometry was performed ten times. The ten recordings were repeated again, in an identical manner on a separate day. The subjects were repositioned and the nasal probes reinserted between each measurement. The mean coefficient of variation for minimal cross-sectional area readings in all 10 subjects was calculated as 9.92%. This is comparable to the day-to-day variability of acoustic rhinometry as measured by other workers and thus supports the hypothesis that the high measurement error of the device (rhinometer) is a function of positional variation during data acquisition. We were able to demonstrate a minimal gain in intervisit reproducibility by doing multiple recordings per person, with a plateau effect of reproducibility after 7 repeat readings.

Humans↗