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Biomedical subjects

J C Shotton

Publications and source records attributed to J C Shotton.

25 records · Page 2Linked to original sources

The infratemporal fossa approach for adenoid cystic carcinoma of the skull base and nasopharynx.

The infratemporal fossa approach to the skull base is an established method of treating neoplasms of this region. The type C variation has proved an effective means of removing adenoid cystic carcinoma invading the infratemporal fossa and skull base from the nasopharynx. A classification of these tumors is proposed, the surgical technique is described, and the results are given in this article.

Adult↗

Temporal bone venous anomaly of surgical significance.

Variability in the size of the dural sinuses and jugular bulb is not uncommon and usually manifests as a high jugular bulb encroaching upon the floor of the middle ear. A rarer entity is the superior and medial extension of the jugular bulb into the bone of the posterior wall of the internal auditory meatus. We report a case where this anomaly was encountered during acoustic neuroma surgery making exposure of the fundus of the internal auditory meatus technically impossible. The possibility of a communication with the superior petrosal sinus is discussed.

Female↗

Persisting nystagmus following vestibular nerve section for Menière's disease.

Unilateral vestibular nerve section (VNS) creates a state of acute dysequilibrium which resolves by a process of central compensation. This disturbance resolves quickly and central compensation is complete generally within a month with resolution of symptoms and signs. The course of central compensation following VNS will be similar to that seen after labyrinthectomy because the detachment of hemi-labyrinthine input that is achieved by both will be identical. Six patients are presented who have undergone VNS at least 2.7 years ago (Average 3.5 years); all of them have persisting spontaneous peripheral type horizontal jerk nystagmus, present with optic fixation in five. This is obvious clinically and was confirmed in each case by agreement of three independent observers and has been recorded by electronystagmography (ENG). They are free from marked vestibular symptoms. The explanations of mechanisms involved in central compensation are discussed with respect to this previously unrecorded clinical observation.

Adult↗

Leiomyosarcoma of a lower limb presenting with multiple cranial nerve palsies.

Leiomyosarcoma is a relatively uncommon soft tissue sarcoma usually presenting as a mass at the primary site. It arises in the retroperitoneal region, in the cutaneous or subcutaneous tissue of the extremities or, less commonly, from a large vein. A case is described where a patient presented with unilateral third, fourth, and sixth cranial, and ophthalmic division of trigeminal nerve palsies in whom biopsy of a longstanding lower limb mass demonstrated leiomyosarcoma. The presentation of this type of pathology has not been described previously.

Abducens Nerve↗

Malignant triton tumour of the palate--a case report.

The malignant Triton tumour is a malignant schwannoma with rhabdomyoblastic differentiation. This is the first report of this type of rare, aggressive sarcoma arising in the maxilla and only the third report of this type of pathology arising outside the context of von Recklinghausen's disease. Aspects of clinical and histopathological diagnosis are mentioned.

Adult↗

Stab wounds of the neck--observations on management.

Seventeen stab wounds to the cervical region presenting over a 3 year period are described. Clinical assessment, appropriate investigations and surgical management are discussed. Examination of the oral cavity for the presence of blood or displacement of the lateral oropharyngeal wall by an expanding haematoma, assessment of air bubbling from a wound, particularly on coughing, chest and lower cranial nerve examination are all required. Blind probing or attempted clamping of a bleeding vessel in a neck wound is not recommended. The use of urgent angiography in stab wounds high in the neck behind and above the angle of the mandible is recommended. Primary repair is optimal for all laryngotracheal, pharyngo-oesophageal and significant neurological injuries.

Adolescent↗