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Biomedical subjects

C B Croft

Publications and source records attributed to C B Croft.

At least 55 records · Page 3Linked to original sources
PubMed1989

Laryngeal papillomatosis: analysis of 113 patients.

Despite the low incidence of these diseases, both juvenile onset and adult onset laryngeal papillomatosis continue to concern otolaryngologists because treatment is often prolonged and unsatisfactory. Over many years various treatments have met with varied claims of success, yet no treatment today is universally accepted. We review the underlying clinical problems, the presentation, the treatment and eventual outcome of 113 patients seen at this hospital over the last 20 years with laryngeal papillomatosis. Using multivariate analysis of age at presentation, sex, smoking habits, initial site of disease, frequency of treatment and eventual outcome, two distinct patterns are revealed both between juvenile and adult onset disease and between male and female patients. Single-site lesions in adults have the best prognosis. Female children with multiple confluent lesions at presentation have the worst prognosis.

Adult↗
PubMed1989

Laryngeal papillomatosis: correlation between severity of disease and presence of HPV 6 and 11 detected by in situ DNA hybridisation.

A technique using a biotin-streptavidin polyalkaline phosphatase complex was applied to routinely fixed and processed biopsy specimens of laryngeal papillomata from 45 patients taken over the past 20 years to detect human papilloma virus (HPV) types 6 and 11. Two thirds of both adult and juvenile onset cases were positive for HPV 6 or HPV 11 or both. Five specimens of normal vocal cord epithelium were negative for HPV 6 and 11. The detailed clinical history, endoscopic findings, success of treatment and eventual prognosis were compared with the HPV state of biopsy material for each patient. Patients with multiple confluent lesions when first seen, whose histology showed florid koilocytosis and who had strongly positive reactivity for HPV 6 or 11 present in the surface epithelial cell nuclei, had a poor prognosis requiring multiple endoscopies to control their disease.

Adolescent↗
PubMed1987

Hypernasal speech caused by tonsillar hypertrophy.

Twenty patients with hypernasal speech were studied with both flexible fiber optic nasopharyngoscopy and multi-view videofluoroscopy, as well as behavioral speech assessment. Characteristic diagnostic findings showed the hypernasality to be caused by hypertrophic tonsils with posterior placement of the upper poles of the tonsils into the oropharyngeal and nasopharyngeal airway. In 16 of the 20 cases, there was a complete resolution of hypernasal speech following only tonsillectomy with no other treatments. Three patients required a brief period of speech therapy and one additional patient required both speech therapy and temporary prosthetic treatment (speech bulb reduction).

Adolescent↗
PubMed1987

Upper airway obstruction with hypoxaemia and sleep disruption in Down syndrome.

Six of 12 children with Down syndrome (DS) tested by means of long-term tape-recordings of oxygen saturation, breathing movements and expired CO2 were found to have previously undetected and severe upper airway obstruction during sleep. In five cases the obstruction occurred in the pharynx and in the sixth it was due to bilateral choanal stenosis. When compared with age-matched controls, overnight tape-recordings showed episodes of abnormal arterial hypoxaemia and an abnormally elevated end-tidal CO2. Episodes of obstruction were most marked during sleep associated with a non-regular breathing pattern. Abnormal episodes of hypoxaemia were associated with continued breathing movements. Sometimes there was no airflow (complete obstruction); at other times airflow continued normally or was reduced in amplitude (partial obstruction). During episodes of partial or complete airway obstruction the inspiratory waveform showed a characteristic shape. These results show sleep-related upper airway obstruction to be an often undetected complication of DS and all necessary measures should be taken to overcome the obstruction when it reaches the stage of producing abnormal hypoxaemia. Choanal dilatation and tracheostomy were successful in treating two of the children. Tonsillectomy and adenoidectomy were successful for one child, but only of marginal benefit for two others.

Airway Obstruction↗
PubMed1986

Antroscopy: its place in clinical practice. A comparison of antroscopic findings with radiographic appearances of the maxillary sinus.

One hundred and fifteen patients with chronic nasal symptoms underwent both radiological and antroscopic investigation of their maxillary sinuses. A total of 193 antra were studied. The radiological diagnosis completely correlated with the antroscopic findings in only 44% of the cases. The reasons for this discrepancy are discussed as well as the additional limitations of radiology in the diagnosis of the opaque antrum and the accurate detection of sinus fluid. Antroscopy provides accurate information about the nature of mucosal changes, the presence of secretions and the state of the natural ostium. This technique therefore ensures a precise diagnosis on which appropriate primary treatment can be based as well as offering the most reliable means of selecting patients who require surgery. The potential for detecting early antral tumours is stressed. It is concluded that antroscopy is the most useful investigation in the management of chronic conditions of the maxillary sinus. However, radiology still has its place as a primary screening test, particularly when the radiographic findings are negative.

Adolescent↗
PubMed1985

Fine needle aspiration cytology in the management of head and neck masses.

Fine needle aspiration cytology is a useful technique in the management of patients with masses in the head and neck, which is usually performed in co-operation with a specialized cytopathologist. It has not until recently been an investigation used frequently by British otolaryngologists. This study shows that an aspiration cytology service may be run with the aid of a general histopathologist and demonstrates that it is a valuable aid to diagnosis even without the services of a specialized cytopathologist.

Biopsy, Needle↗
PubMed1984

Ferritin-bearing lymphocytes in patients with cancer.

Ferritins, a group of isomeric proteins that have important functions in iron metabolism and storage, have been demonstrated to be carcinoembryonic antigens. It has been recently shown that a subpopulation of lymphocytes from the peripheral blood of patients with Hodgkin's disease or breast cancer bear ferritin on their surface membranes. In view of the potential diagnostic and prognostic value of ascertaining the number of ferritin-bearing lymphocytes, the authors developed a simple indirect immunofluorescent technique for identifying them and used this technique to examine the peripheral blood lymphocytes of 44 patients with carcinomas of the head and neck (26), colon (14), and lung (4). It was found that patients with cancer had a mean percentage of 10% ferritin-bearing lymphocytes in their peripheral blood as compared with 3.1% in controls. Ferritin binding did not appear to be influenced by a cell's capacity to form sheep erythrocyte (E) rosettes since no correlation could be found between the percentages of lymphocytes bearing ferritin and those forming three different varieties of E-rosettes. There appeared to be no correlation of the percentages of ferritin-bearing lymphocytes with clinical staging except for a small, but significant (P less than 0.05), increase in the number of patients with head and neck cancer and nodal metastases. Although the functional significance of ferritin-bearing lymphocytes is currently unknown, the appearance of this subpopulation of cells in the blood appears to be associated with cancer. This assay may prove to be useful as a diagnostic tool, as a prognostic tool, or as a means of identifying patients at a risk for developing cancer and, therefore, it deserves further exploration.

Cell Count↗
PubMed1983

Cerebrospinal fluid rhinorrhoea and otorrhoea: extracranial repair.

Cerebrospinal fluid otorhinorrhoea is a well recognized problem. The otolaryngologist has a major role to play in the diagnosis and management of this condition. Five cases are described which illustrate the problems involved; four presented as leaks and one as pneumoencephalus and meningitis. Of the various methods of diagnosis and localization non-invasive techniques, i.e. tomography, CT and flexible endscopy are preferred. The extracranial extradural approach for anterior, middle and posterior fossa leaks allows a direct assault on the fistula. It may be usefully augmented by temporary lumbar drainage.

Adult↗
PubMed1982

Sleep apnoea.

Explore the source record for details and available documents.

Humans↗
PubMed1981

Patterns of velopharyngeal valving in normal and cleft palate subjects: a multi-view videofluoroscopic and nasendoscopic study.

The mechanism of velopharyngeal valving in normal subjects and patients with velopharyngeal insufficiency (VPI) has been the subject of keen debate. The authors have studied 80 normal subjects and 500 patients at the Center for Craniofacial Disorders using direct nasopharyngoscopy and multi-view videofluoroscopy to ascertain the patterns and mechanism of velopharyngeal valving. Multiple patterns of valving were found in both populations and were characterized as "coronal," "sagittal," "circular," and "circular with Passavant's ridge." The incidence of the differing patterns of closure were surprisingly similar in frequency in both normal and pathologic populations. The importance of these diagnostic methods is discussed in relation to treatment of patients with VPI, particularly in designing the type and level of pharyngoplasty.

Adolescent↗
PubMed1981

Anorexia nervosa and salivary gland enlargement.

Enlargement of the salivary glands can occur in patients with anorexia nervosa (AN). This enlargement appears to be related to both the nutritional deficiencies and the bizarre eating habits (particularly the bulimia and vomiting) characteristic of these patients. In some patients, the salivary gland enlargement persists despite return to normal weight. Three patients illustrating this finding are described and the implications of this association between AN and salivary gland enlargement are discussed.

Adult↗
PubMed1980

Velopharyngeal insufficiency due to hypoplasia of the musculus uvulae and occult submucous cleft palate.

With the help of nasopharyngoscopy, it was possible to delineate specific morphologic changes in the palates of patients with velopharyngeal insufficiency, without an overt cleft and without the triad of symptoms of submucous cleft palate, visible through the oral cavity. Such malformations are part of the broad spectrum of the faulty midline mesodermal fusion of the palate. This anomaly is aptly called occult submucous cleft palate, because it can only be detected by viewing the functioning palate from the nasal surface. The musculus uvulae is either absent or deficient and is frequently associated with some degree of muscular diastasis that does not involve the oral surface. Like the cleft of the secondary palate, the submucous cleft palate often occurs as part of a generalized syndrome of multiple malformations.

Abnormalities, Multiple↗