Metabolic management in Menière's disease.
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Adolescent↗
Biomedical subjects
B Proctor
Publications and source records attributed to B Proctor.
The petromastoid canal.
The embryology and anatomy of the petromastoid canal is reviewed. This structure may be responsible for the passage of some infections of the middle ear cleft into the posterior fossa. It also transmits important blood vessels to a portion of the bony labyrinth, to the facial canal, and to the mucosa of the mastoid air cell system.
Adult↗
Anatomy of the round window niche.
The contributing elements to boundaries of the round window niche are superiorly the tegmen fossula fenestra rotunda (roof support), inferiorly the fustis (depth) and area concamerata, anteriorly the sustentaculum (support) and postis anterior (anterior pillar), and posteriorly the postis posterior (posterior pillar) and the subiculum (underlying supporting structure). Variations in their size and orientation can give rise to significant variability in the overall size and shape of the round window niche.
Cochlea↗
Petrosquamosal suture and lamina.
The junction of the petrosal and squamosal portions of the temporal lobe has important relationships that are of interest to the otologist. The resultant suture extends from the glaserian fissure across the top of the middle ear cleft and into the mastoid portion of the temporal bone. It may permit quick passage of infection from the middle ear to the middle cranial fossa. The petrosa may override the squama, forcing it down into the tympanum, where it could cause malleus fixation and a conductive type hearing loss. In the mastoid the suture is identifiable on the surface, but in the interior it is represented by the petrosquamosal lamina. The deeper portion in the petrosal portion of the mastoid may be easily overlooked in surgery of the mastoid and may lead to facial nerve injury.
Adult↗
An alternative training approach to clinical supervision: 1.
This article, the first of two-parts, introduces a new series on clinical supervision. It focuses on the issues of training in clinical supervision. The practice of clinical supervision is considered by the Chief Nursing Officer of the Department of Health to be fundamental to safeguarding standards, the development of expertise and the delivery of quality care. Clinical supervision allegedly brings significant benefits to clients and clinicians, and recent research has produced both quantitative and qualitative evidence to support this argument. Many trusts have already made attempts to introduce widespread implementation of clinical supervision and most developments are concerned with equipping clinicians to be supervisors not supervisees. This presents several logistical and financial problems, and currently neither the infrastructure nor the culture exist in nursing to facilitate its widespread and effective uptake. The authors argue that an alternative method of tackling this problem would be to train nurses to become supervisees not supervisors. Supervisee training could commence following the first year of the common foundation programme component of diploma and undergraduate nurse education.
Attitude of Health Personnel↗
An alternative training approach to clinical supervision: 2.
In this, the second of two articles focusing on the issue of training in clinical supervision, the alleged benefits of training students to be supervisees is highlighted. These are: a substantial reduction in training costs and time; a possible standardization of training; the creation of greater equality and intentionality in the working alliance; an increased student awareness and understanding that supervision is for their benefit; the sharing of values, ground rules, terms and aims between the supervisee/supervisor and the organization; a sense of comradeship between peers in a culture that is often described as having a sense of divide and rule; and a greater sense of team cohesion. The development of basic intrapersonal skills (e.g. reflecting on practice, choosing issues, asking for and using help appropriately) in a non-threatening forum is also of great benefit. The authors conclude that an educational model would include both theoretical and experimential components with the theory preceding the clinical supervision experience. Evaluation of this training could be carried out using a methodology similar to that used by Butterworth et al (1997) in evaluating the impact of receiving supervision.
Clinical Competence↗
The facial canal: normal anatomy, variations and anomalies. I. Normal anatomy of the facial canal.
Modern otologic surgery revolves around the use of the operating microscope. The surgeon must have a thorough knowledge of all structures in the temporal bone, particularly since surgery may now be directed to areas in its deeper portions. Of concern here is the whereabouts of the facial canal in its complex course through the temporal bone. A detailed descriptive anatomy with emphasis on the relations of the facial canal to adjacent structures is presented. The variations in the course of the facial canal are discussed. The location of dehiscences in the bony canal wall are described. Finally, great stress is laid upon presentation of these anomalies known to us which can occur in the course of the facial nerve through the temporal bone. These anomalies have clinical and surgical significance.
Ear Canal↗
The facial canal: normal anatomy, variations and anomalies. II. Anatomical variations and anomalies involving the facial canal.
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Chorda Tympani Nerve↗