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Biomedical subjects

G S Kenyon

Publications and source records attributed to G S Kenyon.

At least 37 records · Page 2Linked to original sources
PubMed1995

Treatment of head and neck cancer with photodynamic therapy: results after one year.

Photodynamic therapy (PDT) is a new and promising treatment modality for the treatment of malignant disease. This paper reports the preliminary experience of our group in the use of this therapy for the treatment of tumours arising in the head and neck. The majority of treatments in these cases have used a second generation systemic photosensitizer, meta-tetrahydroxyphenylchlorin (m-THPC). Two other cases were treated with either Photofrin 2 (a first generation systemic sensitizer) or with the topical photosensitizer, delta-aminolaevulinic acid (delta-ALA). The initial results have been encouraging with good clinical responses evident in patients presenting with a variety of differing tumour types. We feel there is now sufficient evident of the efficacy of this treatment to warrant a multicentre prospective study into the treatment of early head and neck cancer with PDT.

Aminolevulinic Acid↗
PubMed1992

Metastatic cervical lymph nodes: general practitioner referral patterns.

Premature excision biopsy of a cervical lymph node infiltrated by metastatic carcinoma may compromise patient survival since it is associated with an increased incidence of local wound recurrence and distant metastases. Seventy per cent of such patients have an identifiable head and neck primary, obviating the need for an excision biopsy. It is important therefore that they are examined by surgeons who are experienced in inspecting the upper aerodigestive tract and who are competent in performing definitive head and neck surgery. A questionnaire sent to all general practitioners of an Inner London and a District Health Authority revealed that only 18% and 33% respectively referred patients who they suspected of having a metastatic neck node to a department with an experienced head and neck surgeon. We conclude that greater emphasis on the correct management of these patients at both an undergraduate and postgraduate level may encourage subsequent generations of general practitioners to review their referral patterns.

Adult↗
PubMed1991

The value of CT scanning in chronic suppurative otitis media.

High definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings. Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent.

Cholesteatoma↗
PubMed1991

Nutritional support in patients with low volume chylous fistula following radical neck dissection.

One of the well known complications of radical neck dissection is a chylous fistula, which results from injury to the thoracic duct as it enters the left subclavian vein. Such fistulae may cause considerable increased morbidity to a patient who is already debilitated by malignancy and by the increased catabolic response to surgery. Further surgery may be appropriate for those with a high fistula output but conservative therapy is normally advocated for the remainder. Nutritional and electrolyte support for these patients is essential and poses potential problems in management. We present three such patients. One was fed parenterally and two enterally and in all cases the fistulae closed spontaneously. We examine the known physiological stimuli to chyle production and conclude that the enteral feedings of these patients with fat or an isomolar enteral feed does not, contrary to current belief, increase chyle flow or delay the healing of these fistulae.

Chyle↗
PubMed1990

Midline sublingual dermoid cyst.

The case of an 18-year-old man who presented with a large cystic mass in the floor of the mouth extending into the left submandibular triangle of the neck is reported. Histopathology of this mass, which was totally excised by a combined intra-oral and cervical approach, confirmed it to have originated in ectodermal remnants (congenital dermoid cyst) and to be actively secreting sebum. This case is reported both because dermoids at this site are rare because they may present some problems in management.

Adolescent↗
PubMed1990

Long-term results of revision endolymphatic sac surgery.

The results of revision endolymphatic sac surgery on 30 patients with unilateral Menière's disease are presented. Good control is achieved in 73.3 per cent of cases at six months, falling to 56.7 per cent at one year and only 33.3 per cent by four years. The long-term results are disappointing but are more favourable if the initial surgery was successful, if the hearing remains fluctuant and improves on glycerol dehydration prior to the revision procedure and also if the sac is intubated. The current place of endolymphatic sac surgery is discussed and revision surgery only recommended for carefully selected cases.

Adolescent↗
PubMed1988

Topical nasal steroids in non-atopic perennial rhinitis; subjective symptom scores and objective measurement of nasal resistance by active anterior rhinomanometry.

We present a study of 22 patients with perennial non-atopic rhinitis who have been treated with a course of topical beclomethasone dipropionate (Beconase). All subjects were skin-test negative for the common inhaled allergens and had normal total and specific IgE levels. The results of treatment were assessed by symptom scoring and by active anterior rhinomanometry, and are compared to measurements of resistance made in 22 untreated controls and an equal number of normal volunteers.

Administration, Intranasal↗
PubMed1988

Neuro-otological findings in normal children.

The findings of a neuro-otological evaluation of 100 normal school children and 21 adults are presented. The results show changes in the vestibulo-ocular reflex with age which are of importance in the interpretation of future tests. They also give a fascinating insight into the maturation processes taking place in the growing child.

Adolescent↗
PubMed1987

Phase variation in nasal airways resistance assessed by active anterior rhinomanometry.

Measurements of nasal airways resistance in normal subjects have shown a significant difference between values obtained in the two respiratory phases. Higher overall values are found during expiration in both the unprepared and decongested nose but these differences fail to maintain statistical significance after application of a decongestant. This indicates that the phase of respiration in which measurement is made must be routinely recorded especially when measurement is made without decongestant, and comparisons of data made only with recordings from equivalent parts of the nasal cycle.

Adolescent↗
PubMed1987

The impedance bridge and ENG controlled fistula test: results in children with unilateral deafness and comparison with normal controls.

The diagnosis of a perilymph fistula is normally made on clinical grounds. Thus in most cases suspicion is raised by the clinical history and the presence of a fistula confirmed at operation. In children such fistulae may be relatively silent and the diagnosis difficult to establish. This paper reports the results of using an impedance bridge and ENG-controlled fistula test in the routine screening of 24 children with unilateral sensorineural deafness, and compares the results obtained to those found from testing 21 normal and asymptomatic children of comparable age and sex. These tests have shown that fistula testing may mimic a previously recorded gaze or positional nystagmus and hence give false positive results. In the routine testing of patients with deafness only 1 subject had nystagmus invoked by fistula testing alone, and in this case it was obvious from all other criteria that no fistula was present. The conclusions drawn are that the method is prone to error if spontaneous, gaze and positional nystagmus are not recorded and that in routine clinical use the test may produce erroneous results. New criteria for the interpretation of the test in children are suggested, but it seems that the best means of diagnosis still remains an accurate history and a readiness to explore the ear to confirm the diagnosis.

Acoustic Impedance Tests↗
PubMed1985

Neuro-otological abnormalities in xeroderma pigmentosum with particular reference to deafness.

The neuro-otological findings are described in 3 unrelated patients who had xeroderma pigmentosum. All had impaired hearing. Routine audiometric assessment suggested that the hearing loss was of cochlear origin; brainstem evoked potentials in 2 patients and electrocochleography in 1 support this conclusion. Two adult patients had a supranuclear ophthalmoplegia. Vestibular function was mildly deranged and visual suppression of the vestibulo-ocular reflex impaired.

Adult↗
PubMed1985

A comparative study of beclomethasone dipropionate aqueous nasal spray with terfenadine tablets in seasonal allergic rhinitis.

Forty-nine patients participated in a randomized double-blind, parallel group comparison of beclomethasone dipropionate aqueous nasal spray with terfenadine tablets in the treatment of hay fever. Symptom scores for nasal and ocular symptoms as well as grass pollen counts were registered daily for at least 1 month. Evaluation of daily symptom scores and the physicians' and patients' assessments of treatment demonstrated that both treatments were effective in controlling the symptoms of hay fever, with a similar incidence of side-effects. The beclomethasone dipropionate group, in general, had lower nasal symptom scores than the terfenadine group and this reached statistical significance on high pollen count days. In contrast, the terfenadine group had lower eye symptom scores than the other group and these were statistically significant during the first half of the study period. However, the use of additional medication for control of eye symptoms was similar in both groups. It is concluded that treatment with both beclomethasone dipropionate and terfenadine throughout the season was effective in controlling hay fever symptoms, but beclomethasone dipropionate is likely to provide better overall control since it prevented breakthrough of troublesome nasal symptoms during high pollen count days.

Administration, Intranasal↗
PubMed1984

Acoustic Neuroma Suspicion Index: an aid to investigation and diagnosis.

A clinical scale, the Acoustic Neuroma Suspicion Index (ANSI) is presented. It was based initially on the retrospective analysis of 397 patients suspected of having an acoustic neuroma of whom, following full investigation, 263 (66%) were found to have space occupying lesions. After minor modifications, the Index was re-tested on 98 patients of whom 56 proved to have tumors while 47, who did not, formed a control group. All tumor cases were confirmed surgically. Neuro-otological investigations can be expensive, time consuming and occasionally unpleasant for patients; furthermore they are not always readily available. Though the diagnosis of an acoustic tumor or other cerebellopontine angle lesion is often straightforward, atypicality of presentation occurs often. The ANSI uses simple selected data from the history and clinical examination, with routine audiological, vestibular and radiological investigations to calculate a score. If this score exceeds the predetermined threshold, further investigations should be undertaken.

Caloric Tests↗
PubMed1983

Hashimoto's disease presenting as an unusual retropharyngeal mass.

The case of a 57-year-old male with a large and rapidly growing mass in the retropharyngeal space is presented. Whilst this lesion had many of the features of malignancy, histopathological examination has shown it to be due to Hashimoto's thyroiditis, which appears to have developed in ectopic thyroid remnants. A rapid and sustained resolution of the mass has followed conventional therapy.

Humans↗