Search PubMed⌕ Search

Biomedical subjects

G E Murty

Publications and source records attributed to G E Murty.

At least 37 records · Page 2Linked to original sources
PubMed1994

The tussometer: accuracy and reproducibility.

Tussometry is a new non-invasive technique for objectively assessing laryngeal function by analysis of the airflow waveform produced by a maximum effort voluntary cough manoeuvre. We describe the technique and present the calibration data. The tussometer has been calibrated for flows of up to 1100 litre min-1 using a flowmeter with a quoted accuracy of +/- 1.75%. The variables measured (cough peak flow rate (CPFR) and peak velocity time (PVT)) were found to be reproducible; the within-subject variability for CPFR was found to be 23.9% and for PVT 9%. There was no inter-observer variation. We found that the size of the mask used did not influence the readings obtained, providing an adequate seal was achieved.

Calibration↗
PubMed1994

Effect of topical anaesthesia on the motor performance of vocal cords as assessed by tussometry.

Tussometry involves a continuous measurement of airflow produced by a cough manoeuvre displayed as an airflow-time wave. There is a rapid rise to its peak (cough peak flow rate) and the time taken to reach the peak (peak velocity time) is determined by the laryngeal opening at the onset of cough. Cough peak flow and peak velocity time were measured in 10 healthy volunteers before and after topical anaesthesia of the larynx with lignocaine 100 mg sprayed under indirect laryngoscopy. Adequacy of anaesthesia was established by touching the cords deliberately with a fibreoptic laryngoscope. All subjects had excellent anaesthesia of the larynx. However, cough peak flow rate and peak velocity time remained unchanged following topical anaesthesia. We conclude that topical anaesthesia of the larynx does not impair the motor performance of the vocal cords during a voluntary cough.

Adult↗
PubMed1994

Tussometry and lung function.

The tussometric parameter peak value time (PVT) has been proposed as an objective measure of laryngeal function. Whether the lower respiratory tract function influences its value is, however, unknown. This study investigates the relationship between lung function parameters forced expiratory volume in 1 second, vital capacity, peak expiratory flow rate, forced expiratory flow at 50% of vital capacity and total lung capacity (FEV1, VC, PEFR, FEF50, TLC) and PVT in 79 subjects. PVT proved to be independent of lung function. It is therefore specifically a measure of laryngeal function, and lung function need not be considered when interpreting PVT values.

Adult↗
PubMed1994

The Nottingham System: objective assessment of facial nerve function in the clinic.

The House-Brackmann is the most widely accepted system for the clinical assessment of facial nerve function. It is, however, being subjective and discontinuous, prone to interobserver variation. The need for an objective system persists. The Nottingham System is described and compared to the Burres-Fisch system in a study of 29 subjects with varying degrees of facial nerve function, ranging from normal to total paralysis. Within-group component of variance analysis was 7% for the Nottingham System compared to 26% for the Burres-Fisch system. Bland and Altmans' analysis showed the Burres-Fisch system to be biased, overestimating small percentage scores, and underestimating large ones. The Nottingham System proved unbiased. The Nottingham System is recommended as an accurate objective continuous grading system for the rapid assessment of facial nerve function in the clinic.

Adolescent↗
PubMed1994

Sudden contralateral deafness following cerebellopontine angle tumor surgery.

Sudden hearing loss in the contralateral ear is a rare but catastrophic complication of acoustic tumor surgery. The seventh case in the literature is reported. Hearing can return, but this is less likely when the tumor was large or a suboccipital approach was used. A short course of corticosteroids, carbogen, and histamine cannot be shown to be effective but is probably worthy of consideration. Cochlear implantation may have a role if irreversible hearing loss persists 18 months after surgery.

Adult↗
PubMed1993

Munchausen syndrome by proxy: otolaryngologists beware!

Munchausen syndrome by proxy (MSBP) is a rare condition in which a parent or guardian fabricates an illness in a child either by inducing physical signs or prevaricating. A case presenting as recurrent episodes of infant apnoea is reported. A high index of suspicion is required for the diagnosis and, therefore, the otolaryngologist must be familiar with the condition if the life of the infant is to be protected and potentially harmful unnecessary investigations are to be avoided.

Apnea↗
PubMed1993

A study of haemostasis following tonsillectomy comparing ligatures with diathermy.

The use of diathermy to achieve haemostasis after tonsillectomy remains controversial. We have reviewed the English language literature, and found no convicting evidence that diathermy is any more likely to cause post-operative haemorrhage than the use of ligatures. The results of a prospective, randomized study of 1036 consecutive tonsillectomies are presented. No significant difference was found in post-operative haemorrhage rates when either diathermy or ligatures were used. Diathermy was found to reduce operating time compared to ligatures. The possibilities for day-case tonsillectomy are discussed.

Adolescent↗
PubMed1993

Carcinoma in situ of the glottis: radiotherapy or excision biopsy?

Excision biopsy, radiotherapy, and laryngofissure cordectomy have all been used, but the best treatment regimen for glottic carcinoma in situ remains controversial. A 20-year experience of 37 cases is reported. For the first 10 years biopsy with radiotherapy was the first-line treatment (n = 20), but for the last 10 years surgical or laser excision biopsy alone has been performed (n = 17). The T stage of the carcinoma in situ does not determine its premalignant potential. Malignancy appears to be a recurrence, rather than a new expression of carcinogenesis. Excision biopsy alone provides local control results (75%) comparable to those of primary radiotherapy (85%). Excision biopsy alone, however, retains the option of subsequent radiotherapy with preservation of laryngeal function, but very close follow-up, especially in the first year, is required.

Biopsy↗
PubMed1993

Tussometry: an objective assessment of vocal cord function.

A number of techniques have recently been developed for altering laryngeal function, including structural framework surgery, reinnervation procedures, augmentation of the vocal cords, electrical stimulation, and pharmacologic intervention. The application of such procedures to appropriate disorders would be facilitated by better objective measures of the outcome. This study describes the new technique of tussometry, which investigates the airflow pattern produced during coughing. The value of 1 parameter, peak value time, is shown by a study of 35 vocal cord palsies versus a control, and of 17 vocal cord palsies before and after augmentation, to be an accurate assessment of vocal cord position. The technique is independent of lung function parameters and intraoral pressures. It is truly objective, having an interobserver variation of 0%, and is eminently reproducible, with an intrasubject coefficient of variation of 3.1% to 5.7%. Tussometry is a rapid, noninvasive technique providing inexpensive objective assessment of vocal cord function in the office setting.

Adult↗
PubMed1993

Pharyngeal pouch carcinoma.

Malignant change occurs in 0.3-10% of pharyngeal pouches, with longstanding pouches most at risk. Contrast radiology and endoscopy can detect large and medium sized tumors but are inadequate for small lesions and carcinoma in situ. Expectant treatment and conservative surgery fail to provide an excised pouch for histological analysis and small lesions may be missed. Consequently, careful consideration must be given to radical excision, particularly if the pouch has been longstanding. The role of radiotherapy in conjunction with surgery remains unproven.

Aged↗
PubMed1992

Tracheostomy self care: the Nottingham System.

Tracheostomy self care at home can be a problem for some patients. The Nottingham System attributes a competence ratio to each patient. Those liable to develop problems can be identified early and the appropriate support provided. The Nottingham System is described.

Humans↗
PubMed1992

Bilateral internal jugular phlebectasia.

Internal jugular phlebectasia is a venous anomaly commonly presenting as a unilateral neck swelling in children. The clinicopathology, aetiology and management are discussed. Bilateral doppler ultrasonography is the diagnostic investigation of choice and should be performed in all suspected cases. Conservative management of the bilateral case is recommended.

Child, Preschool↗
PubMed1992

Inhalation of a Montgomery Safe T-tube plug.

The first case of an inhaled Montgomery Safe T-tube plug is reported. Both the surgeon and the patient should be aware of this possible complication and regular inspection of the plug is recommended. More than one plug should be provided with each T-tube.

Female↗
PubMed1992

Branchial cyst--to endoscope or not?

Cervical cystic metastases are uncommon, originating predominantly from an oropharyngeal primary. Pre-operative differentiation from a branchial cyst can prove difficult. Three cases which presented clinically as branchial cysts but were subsequently found to be cystic metastases are described, and the literature is reviewed. Endoscopy, ipsilateral tonsillectomy and blind biopsies of Waldeyer's ring, combined with excision of the cervical lesion are recommended in patients over 40 years old.

Aged↗
PubMed1992

Combined glottographic measurement of vocal cord paralysis in the outpatient clinic.

Recordings by combined glottography of vocal cord movements in patients with a vocal cord palsy were compared with a control group. In paralysis of the vocal cord the open quotient (OQ) is increased and the speed quotient (SQ) decreased. This system may have potential in the diagnosis and continued assessment of laryngeal abnormalities as well as providing a permanent objective record in medico-legal cases.

Adult↗
PubMed1992

Association of Wegener's granulomatosis with HLA antigens and other genetic markers.

The frequencies of the HLA-A, B, C, DR, DQ antigens and of several other genetic markers in biopsy proved and well characterised patients with Wegener's granulomatosis were compared with control frequencies of the region. A highly significant increase in HLA-DR1 was found. The percentage combined frequency of DR1-DQw1 was significantly higher in patients than in the controls. Interestingly, association with the red cell enzyme GLOI and complement locus C4B was also seen. As both of these markers are either linked or within the major histocompatibility complex region (MHC) this is further evidence for the involvement of chromosome 6 in the pathogenesis of Wegener's granulomatosis. To understand the pathology of the disease fully molecular genetic studies of the MHC region are warranted.

Adult↗