Feedback not so NICE.
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Government Agencies↗
Biomedical subjects
D R Godden
Publications and source records attributed to D R Godden.
The value of patient feedback in the audit of TMJ arthroscopy.
AIM: This study assessed the patients' and clinicians' perception of the outcome of temporomandibular joint arthroscopy. METHOD: All patients who underwent TMJ arthroscopy for both diagnostic and therapeutic purposes over a 6-year period were sent a questionnaire that asked about various symptoms attributable to the TMJ. Additionally a review of the clinical notes was performed. RESULTS: 83 patients underwent arthroscopy to 127 temporomandibular joints. The mean follow up was 3.6 years. 55% of patients assessed their jaw function as being effective, jaw movement, pain control, and overall satisfaction were satisfactory in 37%, 57%, and 48% of cases respectively. The clinicians' assessment revealed that 45% of patients had no joint tenderness, 74% of patients were able to open to > 35 mm and 74% of patients were free of any joint noise. 66% of patients were prepared to undergo a second procedure if indicated. CONCLUSION: Overall, 50% of patients seemed to view arthroscopy favourably although many patients still felt that jaw opening was restricted. The outcome was not related to the position and reducibility of the disc at surgery and other variables may be responsible. The disparity between the clinical evaluation and the patients' perception of effectiveness emphasises the importance of patient feedback.
Adolescent↗
Catecholamine sensitivity in the rat femoral artery after microvascular anastomosis.
Tissue can demonstrate vasospastic instability after microvascular anastomosis. This study investigates the in vitro effect of increasing concentrations of phenylephrine on the rat femoral artery after microvascular anastomosis. Bilateral groin flaps based on the inferior epigastric artery were raised on 55 Wistar male rats. On the test side, a microvascular anastomosis was performed, but not on the control side. On days 2-12 postoperatively, the rats were sacrificed and the femoral arteries harvested and suspended in increasing concentrations of phenylephrine. The vascular tone on the test and control sides were recorded and compared. Increased sensitivity was found on the test side as compared with the control side (P = 0.000). This supersensitivity to phenylephrine was blocked by the addition of phentolamine and it is believed to be the result of sympathetic denervation, which occurs when the sympathetic fibers are cut during the harvesting of the flap. The resulting vascular instability is believed to contribute to flap failure.
Adrenergic alpha-Agonists↗
Synchronous occurrence of 2 histologically distinct parotid neoplasms.
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Adenolymphoma↗
Eagle's syndrome: an unusual cause of a clicking jaw.
Calcification of the stylohyoid ligament is a well recognised radiographic finding in dental practice. Fortunately, affected individuals seldom develop symptoms. We report a case of a patient whose main complaint was a loud click following jaw movement. This unusual presentation has not been described before and should be considered in the differential diagnosis of 'clicking jaw'.
Calcinosis↗
Need for intensive care after operations for head and neck cancer surgery.
We compared the postoperative morbidity of 44 patients who had had major head and neck oncological resections and who were nursed postoperatively on a general ward with that of 33 who were nursed on an intensive care unit at North Manchester General Hospital and Withington Hospital, South Manchester, respectively. There was no difference in the general morbidity (9/44, 20% compared with 9/33, 27%, 95%, CI of difference -0.26 to 0.13). We conclude that it is safe to nurse the patients on a general ward provided that certain conditions are fulfilled.
Adult↗
Sliding dermoid cyst. A case report.
Dermoid cysts of the oral cavity usually present as a solitary, painless mass in the midline or, on occasion, more laterally in the submandibular region. A patient is described who presented with a mass in the submandibular region, which could be made to appear or disappear at will. This unusual manifestation occurred as the cyst plunged around the posterior border of the mylohyoid on tensing the floor of the mouth.
Adolescent↗
Maxillofacial trauma at RAF War Hospital, Wroughton.
The following article is a historic look at maxillofacial trauma at the Royal Air Force War Hospital at Wroughton from D-Day to VE Day. The article describes the pattern of injury and the management of personnel injured on the Continent and evacuated to Wroughton by air ambulance.
Aerospace Medicine↗