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H B Whittet

Publications and source records attributed to H B Whittet.

At least 19 recordsLinked to original sources
PubMed1996

Minimal follow-up after functional endoscopic sinus surgery. Does it affect outcome?

One disadvantage of functional endoscopic sinus surgery is the frequent post-operative cavity toilet considered necessary by most surgeons, which is not only costly but also very unwelcome to patients. In the Royal Berkshire Hospital in Reading, we have reviewed a series of 120 patients who underwent FESS over an 18-month period with minimal post-operative follow-up (first visit for cavity toilet at 2 weeks and, if possible, only one further visit) in order to assess outcome. The percentage of patients whose presenting symptom had significantly improved or was cured was 78%, and the mean number of follow-up visits was 2.8. We conclude that our policy of minimal post-operative follow-up following FESS allows results comparable with other series, and this policy should be further evaluated.

Endoscopy↗
PubMed1995

KTP-532 laser tonsillectomy--a potential day-case procedure?

We report the results of a prospective pilot study of 54 adult patients undergoing tonsillectomy using the KTP-532 laser, designed to assess whether the technique would facilitate day-case adult tonsillectomy. Subjective and objective assessment at six hours post-operatively showed that only 43 per cent could, in our judgement, have been discharged at this interval. Furthermore, the overall complication rate was 31 per cent with a secondary haemorrhage rate of 19 per cent. We conclude that KTP-532 laser tonsillectomy as performed in this pilot study compares unfavourably with dissection tonsillectomy and we discuss possible reasons for this.

Adolescent↗
PubMed1995

Giant cell reparative granuloma of the concha bullosa.

Giant cell reparative granuloma is a benign lesion occurring most commonly in the bones of the jaw and rarely in the paranasal sinuses. We present an unusual case of giant cell reparative granuloma arising within a concha bullosa. Complete excision was achieved using an endoscopic transnasal approach.

Female↗
PubMed1995

Skin tethering after dilatational percutaneous tracheostomy.

Percutaneous tracheostomy is increasingly preferred for patients in the Intensive Care Unit. It is a convenient method with a low incidence of complications. Skin tethering has not previously been emphasized as a complication of this technique and, although primarily cosmetic, may result in significant morbidity.

Adolescent↗
PubMed1993

An unusual cause of benign paroxysmal positional vertigo.

Benign paroxysmal positional vertigo (BPPV) is a self-limiting condition characterized by vertigo and nystagmus induced by certain head positions. The most common causes of BPPV are post-traumatic following head injury and post-viral labyrinthitis. We present an interesting case of BPPV following an otherwise uneventful neurosurgical removal of a parietal osteoma using hammer and chisel. Caution should be exercised during such procedures as disabling vertigo can result for a considerable period of time.

Adult↗
PubMed1993

Functional endoscopic transnasal dacryocystorhinostomy.

Endoscopic nasal surgical techniques are revolutionising the management of nasal and sinus disorders. Historically the surgical approach to the nasolacrimal sac and duct has been indirect by an external approach because of poor visualisation intranasally. The nasolacrimal apparatus is, however, intimately related to the lateral nasal wall and may readily be approached using an endoscopic technique which minimises functional interference with the physiological action of the lacrimal pump. This paper describes a technique of endoscopic intranasal dacryocystorhinostomy which has success rates comparable to those obtained by the more conventional external approach.

Adolescent↗
PubMed1993

CT-dacryocystography for nasolacrimal duct obstruction following paranasal sinus surgery.

Nasolacrimal duct obstruction and consequent epiphora is a complication that may develop in some patients following paranasal sinus surgery. We describe the technique of CT-dacryocystography which entails contrast injection of the lacrimal system and simultaneous computed tomography (CT) scanning of the facial structures. This technique provides concurrent information regarding obstruction of the nasolacrimal duct and the presence of disease recurrence or persistence in the adjacent paranasal sinuses. The role of CT-dacryocystography prior to endoscopic dacryocystorhinostomy is discussed briefly.

Aged↗
PubMed1993

Technical note: computed tomographic dacryocystography.

The technique of computed tomographic dacryocystography is described. It was developed in response to the pre-operative imaging requirements for transnasal endoscopic dacryocystorhinostomy, a new minimally invasive operation performed as a primary procedure to relieve epiphora. However, it is also helpful in the assessment of patients after failed conventional external dacryocystorhinostomy when the information provided will help to determine the subsequent surgical approach. In addition the technique will assist surgical planning in cases of epiphora associated with sinus surgery, facial trauma and maxillofacial tumours by determining the site and extent of pathology.

Dacryocystorhinostomy↗
PubMed1992

Infraorbital nerve dehiscence: the anatomic cause of maxillary sinus "vacuum headache"?

Vacuum disorders of the paranasal sinuses are well described. Patients with facial pain in the distribution of the infraorbital nerve are often labelled as suffering from a "vacuum maxillary sinusitis" and empirically treated by intranasal antrostomy. A variety of mechanisms have been postulated for the production of symptoms in this condition, but all ignore the fact that the maxillary sinus is a relatively insensitive structure. This article introduces a dehiscence of the bony infraorbital nerve canal within the antrum as an anatomic variant and suggests that it may provide the anatomic basis for vacuum sinusitis in the presence of a small natural ostium. Definitive diagnosis is made by outpatient antroscopy, and surgical treatment takes the form of a middle or inferior meatal antrostomy. Persistent symptoms may benefit from an infraorbital neuropexy to provide added protection to the exposed nerve.

Aged↗
PubMed1991

Styloid apparatus anomaly causing dysphagia.

An unusual case of dysphagia due to anomalous styloid apparatus anatomy is presented. Clinical and radiological findings are documented. Variations in anatomy and clinical syndromes are discussed together with management.

Cervical Vertebrae↗
PubMed1991

Serum cotinine as an objective marker for smoking habit in head and neck malignancy.

Cigarette-smoking is a well-established aetiological factor in squamous cell carcinoma of the larynx. In Great Britain the majority of patients with laryngeal cancer are treated by radiotherapy with salvage surgery if necessary. A troublesome side effect of radiotherapy is mucositis which may exacerbate hoarseness, dysphagia, airway obstruction or pain. Although it is a common belief that continued smoking and alcohol consumption during radiotherapy may increase the frequency and severity of these side effects this has not been demonstrated objectively. This study confirms and illustrates the relationship between such radiotherapy reactions to continued smoke exposure by using an objective biochemical marker of smoking status.

Alcohol Drinking↗
PubMed1991

Polytomographic radiology in the diagnosis and management of maxillary antral disease as determined by antroscopy.

Plain radiology of the maxillary sinus correlates poorly with pathological conditions affecting it as shown by subsequent endoscopic assessment. Tomographic radiology provides a much higher diagnostic yield and in particular is of great value in assessing the 'opaque antrum'. The false positive rate is similar in the two techniques but tomography yielded no false negative diagnoses in this study compared with an incidence of 31% with plain radiology. Sinoscopy remains the definitive method of assessing antral disease but tomographic radiology is a highly accurate screening technique. It provides this accuracy at low cost, low orbital irradiation and more convenience than the newer techniques of CT and MRI scanning which are still not widely available for routine ENT use.

Adult↗
PubMed1990

Heterotopic brain tissue: a rare cause of adult recurrent meningitis.

Heterotopic brain tissue is a rare cause of symptoms in neonates in whom it may present with respiratory obstruction. In infants it may produce unilateral nasal obstruction due to a nasal 'polyp' or cerebrospinal fluid rhinorrhoea with an associated risk of meningitis. It is exceedingly rare in adults but may nevertheless be a cause of significant morbidity as this case demonstrates.

Brain↗
PubMed1990

Epistaxis as an unusual presentation of an antrochoanal polyp.

Antrochoanal polyps rarely present with severe epistaxis. We present the case of a young male patient who presented in such a manner, thus leading to the suspicion of an angiofibroma as the underlying pathology. The radiological investigations, treatment and pathological features are discussed.

Adult↗
PubMed1990

Non-infective orbital complications resulting from natural defects of the antral roof. Case report.

Infective complications of paranasal sinus disease presenting within the orbit are not uncommon. They may be facilitated by bony defects of the orbital floor or antral roof which may also allow non-infective complications to occur. These may occur spontaneously or may follow operative procedures upon the antrum and must therefore be borne in mind when performing such procedures. We present representative clinical examples of these non-infective complications.

Adult↗