Biomedical subjects

A R D'Souza

Publications and source records attributed to A R D'Souza.

10 recordsLinked to original sources

PubMed2006

Sub-alar batten grafts as treatment for nasal valve incompetence; description of technique and functional evaluation.

OBJECTIVE: To describe and evaluate the functional results of a surgical technique for treating nasal valve incompetence, in which a cartilage graft called a sub-alar batten graft is placed along the undersurface of the lateral crus of the lower lateral cartilage. METHODS: The functional outcomes of 27 patients who had sub-alar batten grafts placed on 39 sides were evaluated by means of clinical examination and subjective self-assessment. RESULTS: Of a total of 39 sides operated upon, 10 (26%) were rated as optimal, 15 (39%) as improved, 13 (33%) as equal and 1 (2%) as worse. Overall on 25 sides (65%) the post-operative situation was considered to be better than pre-operatively. In all cases in which there was a wish for cosmetic improvement, besides the functional indication, this was obtained, and in no case did the grafts give cause to cosmetic grievances or other complications. CONCLUSION: Placement of sub-alar battens had a positive effect on nasal valve function in roughly two thirds of cases in this series. Although in our opinion this result was slightly disappointing from a purely functional point of view, they can improve the cosmetic result and continue to be considered in cases in which avoidance of surface irregularities is a primary concern or as a preventative measure in rhinoplasty patients at risk for post-operative valve collapse.

Adult↗

PubMed2005

Dissemination of fat in CSF: a common finding following translabyrinthine acoustic neuroma surgery*.

OBJECTIVES: Following translabyrinthine craniotomy the temporal bone defect is commonly obliterated using a free autologous fat graft. In this series the dura was put back in place but not closed primarily. As the fat graft remains in direct contact with the cerebro spinal fluid (CSF) there is potential for dispersal of fat within the CSF space. This paper aims to determine the frequency of such CSF fat dissemination and its clinical significance. DESIGN: A retrospective review of translabyrinthine acoustic neuroma removal with free fat autograft obliteration of the temporal bone defect between the years 1997 and 2000. SETTING: Tertiary referral oto-neurosurgical centre. Postoperative magnetic resonance (MR) imaging. PARTICIPANTS: All translabyrinthine patients who had postoperative MR imaging were included. Twenty-six cases were identified. Age range was 13-70 years. Fourteen were male patients. MAIN OUTCOME MEASURES: Evidence of CSF fat dissemination on MR and patients' clinical findings. RESULTS: Twenty-two of the 26 scans (85%) demonstrated evidence of fat dissemination into the subarachnoid CSF spaces in the form of microemboli. The cerebellopontine angle was the most common site involved. No evidence of ventricular dilation or any other abnormality was noted. There was no relationship between the presence or extent of fat microembolization and the patients' clinical course. CONCLUSIONS: This study suggests that free fat placed in temporal bone defects commonly migrate into the subarachnoid space and subsequently move around in these spaces. This is not associated with any complications such as hydrocephalus, meningitis or prolonged postoperative headache.

Adipose Tissue↗

PubMed2005

The influence of the Internet on decision making in acoustic neuroma.

OBJECTIVE: To determine the access to and the use of the Internet by acoustic neuroma patients as a medical information source, and the influence of the Internet on decision-making, as well as the patients' views on the quality of particular sites. MATERIALS AND METHODS: A retrospective 27-item questionnaire was sent to 138 consecutive acoustic neuroma patients diagnosed between 1997 and 2002. The study included patients treated by conservative, radiotherapeutic and surgical modalities. MAIN OUTCOME MEASURES: Patient demographics, the extent of Internet use as well as quality and quantity of available information. RESULTS: There were 86.95 per cent questionnaires available for analysis. Twenty-four per cent accessed the Internet to obtain information about acoustic neuromas. Ninety-seven per cent of patients said that the information provided in the clinic matched with the information obtained from the websites, 49 per cent said that the information obtained from the Internet did not influence decision making regarding acceptance of treatment of their tumour. Some patients said the Internet information was depressing, devastating, and they would never look up the Internet again for medical information. CONCLUSION: A significant proportion of our patients accessed the Internet for information. Caution should be exercised when advising patients regarding websites as the information on the Internet is often not controlled or checked for accuracy. Acoustic neuroma specialists and ENT surgeons in general should familiarize themselves with related websites so that patients can then be directed to high-quality sites.

Attitude to Health↗

PubMed2005

Immunotherapy for allergic rhinitis--a United Kingdom survey and short review.

Allergic rhinitis (AR) is a common condition which is treated using different modalities, including immunotherapy. The aim of this study was to survey the current management strategies among ENT consultants in the UK in treating AR, and their views on immunotherapy. The study design was a postal questionnaire survey and the setting a university teaching hospital. Participants were consultant members of the British Association of Otolaryngologists - Head and Neck Surgeons (BAO-HNS). The main outcome measures were common treatment modalities adopted by the survey group to treat AR, and the number of consultants practising immunotherapy. The majority (81.1 per cent) of the consultants surveyed practise medical therapy with or without surgery. Immunotherapy is advised by 26 per cent of ENT consultants, but only 6.6 per cent currently administer immunotherapy.

Attitude of Health Personnel↗

PubMed2003

Simple snoring: current practice.

Snoring is a significant problem with both social and medical manifestations. This article addresses the current management of the simple snorer from initial out-patient assessment to definitive treatment.

Endoscopy↗

PubMed2002

Medium-term outcome of palatal surgery for snoring using the Somnus unit.

The aim of this study was to retrospectively survey patients who had undergone radiofrequency ablation of the soft palate for snoring complaints. Fifty-nine patients who had undergone radiofrequency ablation were sent an anonymous questionnaire to assess snoring (using visual analogue scales), pain and satisfaction with the procedure. Sixty-one per cent of the group returned the questionnaire. The mean time since operation was 17.5 months. Taking an improvement in snoring of 50 per cent or greater as a successful operation, snoring improvement occurred in 22 per cent. Post-operative pain was minimal with a median pain score of zero. Information was requested on whether the patient would undergo this procedure again, 50 per cent responded that they would and 44 per cent would advise a friend in the same situation to have this procedure. Radiofrequency ablation of the soft palate, as in other forms of surgery for snoring, seems to have a relapse rate over the long-term.

Catheter Ablation↗

PubMed2001

Retropharyngeal lipoma causing dysphagia.

Lipomas of the retropharyngeal region are rare, slow-growing tumours that attain a large size before producing symptoms such as dysphagia and dyspnoea. Clinical diagnosis may be difficult. However computed tomography or magnetic resonance imaging is the investigation of choice and helps in definitive diagnosis preoperatively, although final histological confirmation is essential. Surgery is the treatment of choice. In the following paper we report a case of retropharyngeal lipoma presenting with dysphagia which was managed surgically with complete amelioration of symptoms.

Aged↗

PubMed2001

Osseo-integration in Paget's disease: the bone-anchored hearing aid in the rehabilitation of Pagetic deafness.

The first report of a patient with gross Paget's disease and progressive hearing loss who successfully underwent hearing rehabilitation with an osseo-integrated hearing aid is presented. The otological manifestations of Paget's disease and the principles of osseo-integration are discussed. The use of a bone-anchored hearing aid (BAHA) in selected patients with Paget's disease can provide useful amplification and hearing rehabilitation.

Aged↗

PubMed2000

Unusual cause of subglottic stenosis in an adult.

Subglottic foreign bodies presenting, as chronic subglottic stenosis is extremely rare in adults. A high index of suspicion and a careful history is of paramount importance in the diagnosis of a subglottic foreign body. Laser should not be used to excise granulation tissue to expose the foreign body because of the danger and potential of a fire particularly when the nature of the foreign body is not known. Rigid bronchoscopes are more beneficial than flexible ones in the removal of foreign bodies especially in long-standing cases.

Contraindications↗

PubMed2000

Pleomorphic adenoma involving the stylomastoid foramen.

A rare case of an intratemporal pleomorphic adenoma is presented and the management of such a tumour is discussed. Some anatomical aspects of the facial nerve, pertinent to the pathophysiology of facial paralysis are outlined. This case demonstrates that tumour extension into the temporal bone can be resected successfully at initial surgery with excellent facial nerve functional outcome. We advocate exploration of the fallopian canal to be carried out at primary surgery and be performed by a surgeon familiar with the surgical anatomy of the intratemporal segment of the facial nerve. This approach will reduce the risk of facial nerve injury and palsy both at surgery and subsequently.

Adenoma, Pleomorphic↗