Search PubMed⌕ Search

Biomedical subjects

J E Fenton

Publications and source records attributed to J E Fenton.

At least 19 recordsLinked to original sources
PubMed2001

Delayed facial palsy after vestibular schwannoma surgery.

OBJECTIVE: there is a lack of uniformity in the literature of the definition of delayed facial palsy (DFP) after vestibular schwannoma surgery. The aim of this study was to attempt to provide a clear definition of this clinical entity. METHODS: a prospective study was undertaken of all patients, with an intact facial nerve postoperatively, undergoing vestibular schwannoma surgery during a 16-month period. Delayed facial palsy was defined as any worsening of facial function after the initial assessment of postoperative function. RESULTS: a total of 67 patients, operated on between February 1994 and June 1995 satisfied the requirements of the study. Eight of the 67 patients developed a worsening of facial function after the first postoperative day. There were three males and five females with an age range of 29-73 years (mean, 53 years). CONCLUSION: DFP should be defined as any deterioration of facial function after vestibular schwannoma surgery.

Adult↗
PubMed2001

Publication rates of scientific papers presented at the Otorhinolarygological Research Society meetings.

The aim of this study was to determine the publication rate of scientific papers in peer review journals presented at the Otorhinolarygological Research Society (ORS) meetings from 1978 to 1995 inclusive. The abstracts of the presentations at ORS meetings are published in Clinical Otolaryngology. A MEDLINE search was performed on abstracts presented at ORS meetings from 1978 to 1995 using both authors and key words within the text of the abstract. The publication rate, journal of publication, time to publication, change in contents, change in authors and change in conclusions of abstracts were tabulated. The publication rate for papers presented at ORS meetings from 1978 to 1995 was 69.09%. The average time to publication was 22.5 months. Papers derived from the ORS abstracts were most commonly published in Clinical Otolaryngology (34%) and Journal of Laryngology and Otology (18.64%). The results indicate that nearly 69% of presented material at the biannual ORS meetings eventually get published in peer reviewed journals. This compares favourably with publication rate of other specialities.

Bibliometrics↗
PubMed2001

The accuracy of MEDLINE and Journal contents pages for papers published in Clinical Otolaryngology.

MEDLINE is widely used as a source for identifying and reviewing medical journal literature. Its accuracy is generally taken for granted, as is that of the contents pages published by the journals themselves. In this study of citation accuracy we examined the articles published in Clinical Otolaryngology and Allied Sciences from 1976 to 1998. The entries in MEDLINE were compared with the entries in the Journal's contents pages, and with the actual articles. Of 1651 articles published in the journal, one was omitted from MEDLINE and 25 (1.5%) were incorrectly cited, while 88 (5.3%) were incorrectly cited in the contents pages. Twenty-one (84%) of the errors in MEDLINE involved names of authors. Apart from incomplete retrieval of information for practice and research, errors could result in an author not getting credit for publications.

Abstracting and Indexing↗
PubMed2001

An overview of the role and inter-relationship of epidermal growth factor receptor, cyclin D and retinoblastoma protein on the carcinogenesis of squamous cell carcinoma of the larynx.

Recent developments in both molecular and cellular biology have improved the understanding of the tumorigenesis of laryngeal squamous cell carcinoma. Loco-regional recurrence of this condition still poses a significant oncological management dilemma for a subset of these tumours. Therefore, the possibility that specific tumour characteristics (demonstrable by immunohistochemical and molecular biological study) may aid the clinician in choosing the optimal treatment for a specific tumour holds great promise. This article concentrates on the role and inter-relationship of epidermal growth factor receptor status on the function of cyclin D, and how this is related to the presence of retinoblastoma protein. A review of recent studies evaluating these markers, the potential clinical utility of these findings and the possible directions for further study are discussed.

Carcinoma, Squamous Cell↗
PubMed2001

A report of 50 patients with carcinoma of the hypopharynx treated by total pharyngolaryngo-oesophagectomy repaired by gastric transposition.

Extensive carcinoma of the hypopharynx requires aggressive surgery, which can lead to loss of function and a high morbidity and mortality. This paper reports 50 patients with carcinoma of the hypopharynx treated with total pharyngolaryngo-oesophagectomy and gastric transposition. Thirty-two patients had primary surgery and 18 had salvage surgery for recurrence following radiotherapy. Two technical modifications to the standard procedure that have evolved during this period are the use of a diverticuloscope for dissection of the middle third of the oesophagus and the routine insertion of chest drains peroperatively. Complications were relatively unusual in the primary surgery group, but were a problem in those patients undergoing salvage surgery. Stenosis did not tend to occur with gastric transposition repair, but three patients had delayed gastric emptying with prolonged hospital stays. The tumour-specific actuarial survival at 4 years was 39% and the observed survival was 25%. Pharyngolaryngo-oesophagectomy and gastric transposition is becoming safer owing to increased multidisciplinary experience in this form of surgery. Survival is improved with the use of postoperative radiotherapy in patients undergoing primary surgery.

Carcinoma, Squamous Cell↗
PubMed2001

Ischaemic optic neuropathy following bilateral neck dissection.

Two cases of ischaemic optic neuropathy, which occurred as a complication of oncological neck surgery, are reported. These cases are submitted because of the apparent scarcity in the literature of this complication after head and neck surgery. They are also unusual because they presented with different clinical manifestations of ischaemic optic neuropathy after separate forms of bilateral neck dissection. A literature review identifies a small number of similar cases and risk factors and preventative measures are discussed.

Carcinoma, Squamous Cell↗
PubMed2001

Transtemporal facial nerve schwannoma without facial nerve paralysis.

Facial schwannoma is a relatively rare but well documented lesion, presenting either as a mass or with facial nerve symptoms. In this report, an extensive facial schwannoma, extending from the brain stem to the periphery with minimal facial nerve symptoms and normal facial function is presented.

Adult↗
PubMed2000

The accuracy of citation and quotation in otolaryngology/head and neck surgery journals.

A high rate of errors of citation and quotation has been reported in the publications of many medical specialties. The aim of this study was to determine the prevalence of citation and quotation errors in otolaryngology/head and neck surgery journals. A retrospective analysis was performed based on the first issue for 1997 of each of four journals: Laryngoscope; Annals of Otology, Rhinology and Laryngology; Clinical Otolaryngyology; and Journal of Laryngology and Otology. A sample of 50 references from each journal was randomly selected and each was checked for accuracy against the original referenced paper. Citation errors were categorized as major, intermediate or minor and quotation errors as major or minor. Citation errors occurred in 37.5% of the references, 11.9% of which were considered major errors. Quotation errors occurred in 17%, with 11.1% major errors. This prevalence is similar to the established error rate in medical literature.

Bibliometrics↗
PubMed2000

Globus pharyngeus: a postal questionnaire survey of UK ENT consultants.

Globus pharyngeus is a common complaint often referred to the ENT outpatient department. The precise nature of globus pharyngeus and its aetiology remains something of a mystery. There is no uniform policy of management of this condition. A postal questionnaire was sent to all UK-based ENT consultants registered with the British Association of Otorhinolaryngolgists-Head and Neck Surgeons (BAO-HNS). The aim of this study was to ascertain if there was a favoured management policy by the majority of consultants. Our results indicate that there is a lack of consensus in the investigation and management of globus pharyngeus. Fourteen per cent do not perform any investigations, but would prescribe antacid medication if clinically indicated. The remainder would investigate in a variety of ways. The most common investigation is rigid endoscopy which is performed by 61% of respondents, followed by barium swallow (56%). The combination of endoscopy and barium swallow is routinely performed by 17.5% of respondents.

Barium Radioisotopes↗
PubMed2000

Performance data and survival in head and neck cancer.

A retrospective longitudinal investigation of 2701 patients extending from 1963 was conducted to study the effect of performance status on survival, locoregional recurrence and associations with host and tumour factors. It was found that those patients who are physically fit tended to have smaller tumours, less risk of neck node metastases and more chance of laryngeal cancer. In patients with advanced disease, locoregional recurrence did not appear to be more common in those with poor general condition but the death rate from the tumour appeared to increase as the general physical condition decreased. It is assumed this is due to the development of distant metastases. There is evidence that immunity is less well developed in those with poor general condition and this in turn, may be due to alcohol abuse and poor general nutrition.

Activities of Daily Living↗
PubMed2000

Unusual cause of subglottic stenosis in an adult.

Subglottic foreign bodies presenting, as chronic subglottic stenosis is extremely rare in adults. A high index of suspicion and a careful history is of paramount importance in the diagnosis of a subglottic foreign body. Laser should not be used to excise granulation tissue to expose the foreign body because of the danger and potential of a fire particularly when the nature of the foreign body is not known. Rigid bronchoscopes are more beneficial than flexible ones in the removal of foreign bodies especially in long-standing cases.

Contraindications↗
PubMed2000

Pleomorphic adenoma involving the stylomastoid foramen.

A rare case of an intratemporal pleomorphic adenoma is presented and the management of such a tumour is discussed. Some anatomical aspects of the facial nerve, pertinent to the pathophysiology of facial paralysis are outlined. This case demonstrates that tumour extension into the temporal bone can be resected successfully at initial surgery with excellent facial nerve functional outcome. We advocate exploration of the fallopian canal to be carried out at primary surgery and be performed by a surgeon familiar with the surgical anatomy of the intratemporal segment of the facial nerve. This approach will reduce the risk of facial nerve injury and palsy both at surgery and subsequently.

Adenoma, Pleomorphic↗
PubMed2000

Ballooned trachea caused by cuffed tracheostomy tube.

Despite the dramatic decrease in cuff-related complications with the introduction of high-volume low-pressure devices for intubation and tracheostomy, notable problems can still occur. A case is reported of a patient who developed persistent dilatation of the trachea after prolonged mechanical ventilation. This is an under-recognized, life threatening clinical entity occurring after cuffed intubation for prolonged time. At present there is no definitive treatment regarding the management of a dilated trachea on a ventilator-dependent patient and therefore emphasis is directed at prevention. The patient presented was managed with periodical alterations of the cuff level which although not achieving any reversal of the dilatation, have prevented further progression of tracheal damage. During the follow-up period, regular assessment with flexible endoscopy has provided more reliable information on the condition of the trachea than computed tomography (CT) scanning.

Dilatation, Pathologic↗
PubMed1999

Bilateral facial nerve schwannomas.

Facial nerve schwannoma is an uncommon tumor and bilateral facial nerve tumors are extremely rare. A case is presented in which neuromas affecting the intra-canalicular and labyrinthine portions of both facial nerves occurred. Radiologic assessment demonstrated the origin of these tumors. Eventual tumor involvement of the sole functioning cochlea resulted in the development of total hearing loss. Management entailed symptomatic care and surgical resection. Auditory rehabilitation was attempted using cochlear implantation, but results have not been satisfactory. Genetic screening identified a mutation in the NF2 gene. It is proposed that this patient's condition should be considered a variant of neurofibromatosis 2 and that bilateral facial neuromas should be included in the clinical criteria for this condition.

Adult↗
PubMed1999

The Westaby T-Y tracheobronchial stent in otolaryngology.

The Westaby T-Y tracheobronchial silicone stent can be used for the relief of upper airway obstruction beyond the limit of a standard tracheostomy tube. We report on our experience in the use of the Westaby tube in 10 patients over a five-year period. The general features of the tube, indications for its use, and its method of insertion are described. The versatility and advantages over other stents are discussed. Two cases reports are described and the clinical course and outcomes of the individual patients are outlined.

Aged↗
PubMed1999

Prediction of postoperative facial nerve function in acoustic neuroma surgery.

There is a need for an uncomplicated, consistent method to predict facial nerve function after acoustic neuroma surgery. A prospective study with a 2-year follow-up of 35 patients undergoing acoustic neuroma surgery was performed assessing how well intraoperative facial nerve monitor electrophysiological thresholds and facial function postsurgery can predict ultimate nerve function. Tumour size was a strong predictor of immediate (P-value < 0.0005) and long-term facial nerve function (P-value = 0.004). Immediate facial nerve function was strongly predicted by stimulus intensity (P-value = 0.007) and there was a suggestion of a relationship between long-term facial nerve response and stimulus intensity. It was not possible to predict delayed facial dysfunction nor the extent or timing of recovery of abnormal function. It is concluded that the combination of facial function at 1 month postsurgery with tumour size and stimulus thresholds is the best available indicator of ultimate facial function.

Adult↗
PubMed1997

The effect of tonsillectomy on eustachian tube function.

A two-part study was designed to investigate the effect of tonsillectomy on eustachian tube function and to identify if any change is related to postoperative pain. Middle ear pressure was measured by tympanometry and results were classified as type A (+50 daPa to -99 daPa), type B (flat) or type C (-100 daPa to -350 daPa). Thirty-one patients with type A tympanograms, undergoing tonsillectomy enrolled in study A. Patients had tympanometry the next day and filled in a questionnaire incorporating visual analogue pain scores. In study B, 30 patients underwent a similar protocol and were followed up at 1 week tympanometry and a questionnaire. A control group of 26 patients undergoing appendicectomy was recruited. Follow-up was available on 23 patients from study B. Combining A and B, on the first postoperative day 39% of patients developed type C tympanograms. No member of the control group developed any change in middle ear pressure. There was no significant relationship between pain scores for throat pain or otalgia and the development of negative middle ear pressure. By day 7 all patients had type A tympanograms. Otalgia was a delayed symptom significantly associated with increased throat pain. Transient negative middle ear pressure commonly occurs following tonsillectomy.

Acoustic Impedance Tests↗