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Biomedical subjects

M P Yardley

Publications and source records attributed to M P Yardley.

At least 19 recordsLinked to original sources
PubMed1999

Early post-operative morbidity following tonsillectomy in children: implications for day surgery.

Adenotonsillectomy and tonsillectomy are amongst the most commonly performed surgical procedures. In our prospective study we looked at early post-operative morbidity (haemorrhage, vomiting and pyrexia) in 521 consecutive children following tonsillectomy, adenotonsillectomy and adenoidectomy. While the incidence of reactionary haemorrhage is low, pyrexia and vomiting are common. The implications of this high early post-operative morbidity for day surgery are discussed.

Adenoidectomy↗
PubMed1999

Effect of conductive hearing loss on the vestibulo-collic reflex.

The vestibulo-collic reflex represents a promising test for evaluating the integrity of otolith function. We have investigated the threshold of this response in a group of normal subjects, and the effect of a conductive hearing loss. A positive response was recorded in 31 of 32 normal subjects. The threshold of the vestibulo-collic reflex varied from 80 to 97 dBHL in these subjects with a 95% response rate at a threshold at 96 dBHL. A total of 23 ears with a conductive hearing loss in 17 patients were also investigated. The average conductive hearing loss (at 0.5, 1, 2 and 4 kHz) ranged from 8.75 to 40 dBHL (average 24.46 dBHL). A positive response was recorded in only two ears. Therefore, the vestibulo-collic reflex has a high stimulus threshold which is dependant on reliable transmission of the click stimulus to the inner ear thus limiting is clinical use.

Adult↗
PubMed1998

Palatoplasty for snoring: a randomized controlled trial of three surgical methods.

In a randomized, controlled trial, 62 patients (47 men and 15 women) with severe antisocial snoring, but no sleep apnea, were allocated to one of three surgical treatments. These were uvulopalatopharyngoplasty, laser palatoplasty, and diathermy palatoplasty. Postoperative morbidity was measured on a visual analogue scale of severity of pain, dysphagia, and nasal regurgitation at 1, 2, and 7 days after the operation. Efficacy of each procedure was measured by asking the sleeping partner to record the severity of snoring before and after the operation, again on a visual analogue scale. Measurements were taken at 1, 3, and 6 months. There were no significant differences in early postoperative morbidity among the treatment groups. Diathermy palatoplasty is a new technique for the relief of snoring that is associated with low morbidity and requires little in the way of expensive equipment.

Adult↗
PubMed1998

The vestibulo-collic reflex.

Until now there has no been no simple, reliable clinical test that assesses the function of the otolith organs. However, recent work has suggested the occurrence of an easily identifiable electromyographic (EMG) waveform in isometrically contracting sternomastoid muscles in response to loud clicks. This is thought to represent an otolith evoked disynaptic reflex. Equipment routinely used for evoked response audiometry (ERA) has been adapted to investigate this response. A short latency (8 ms) positive-negative EMG waveform has been recorded in 31 of 32 normal subjects. The latency of the positive peak (P1) is 11.7 ms (SD = 0.89), and the negative peak (N1) is 20.5 ms (SD = 1.89). It is predominantly ipsilateral, although a contralateral response was present in 35.5%. The response has also been recorded in three patients with a severe unilateral sensorineural hearing loss and normal caloric responses, and in a patient undergoing cochlear implantation for profound bilateral sensorineural hearing loss. Further work is required to delineate the value of this technique in investigating vestibular lesions.

Adult↗
PubMed1998

Use of transient evoked otoacoustic emissions to detect and monitor cochlear damage caused by platinum-containing drugs.

Transient evoked otoacoustic emissions (TEOAE) have been evaluated as a means of monitoring cochlear function in patients receiving the chemotherapeutic agents cisplatin and carboplatin (-cis-diammine, 1,1-cyclobutane dicarboxylate (2) -0,0-platinum). Patients receiving these drugs were monitored prospectively with pure tone audiometry (PTA), tympanometry and TEOAE. Data was collected on 22 subjects receiving cisplatin and nine subjects receiving carboplatin. Significant deterioration in both PTA thresholds and TEOAE energy levels (with no change in tympanometry) were detected in the cisplatin group. No significant deterioration in audiological parameters occurred in the carboplatin group. It is indicated that cisplatin has a significant ototoxic effect in the majority of patients, whereas any ototoxic effect of carboplatin was undetectable. Our findings were different from previous studies in that the measurable changes in TEOAE occurred later than changes in the pure tone audiogram for the cisplatin group.

Acoustic Stimulation↗
PubMed1996

Long-term results of trimming of the inferior turbinates.

The long-term benefit of trimming of the inferior turbinates for nasal obstruction is unclear and our aim was to assess this. Fourteen patients who had had pre-operative nasal symptom scores and anterior rhinomanometry prior to inferior turbinate resection were reassessed at least 7 years post-operatively. Both nasal symptom scores for obstruction and nasal resistance had increased significantly in the intervening time period. Nasal crusting and hypertrophy of the cut inferior turbinate are considered to be responsible for this. Patients should be warned some degree of nasal obstruction may recur postoperatively.

Adult↗
PubMed1994

Day case tonsil and adenoid surgery: how many are eligible?

We wished to estimate the percentage of children undergoing tonsil and adenoid surgery who would make suitable day cases. To achieve this a prospective study of 100 consecutive children admitted for the above surgery was undertaken. A medical and social history was obtained along with the parents' attitude to the possibility of day case tonsil and adenoid surgery. We found that 59% of our population would be eligible for day case surgery on the strict criteria we used. Reasons for failure were social in 26%, medical in 6% and both in 9%.

Adenoidectomy↗
PubMed1993

Dental prostheses and the impacted swallowed foreign body.

A common belief exists that patients who wear false teeth are more likely to present with an impacted swallowed foreign body than those with a normal dentition. This study reviewed a series of 65 patients (with data available from 45) who presented with a swallowed impacted foreign body which required endoscopic removal under general anaesthesia. With the aid of a questionnaire the incidence of dental prostheses in these patients was determined. The number of patients in our study who had either false teeth or natural dentition was compared with the expected age-related incidence of wearing dental prostheses in the general population of the United Kingdom. There were no statistically significant differences between these groups. Patients presenting with an impacted swallowed foreign body are no more likely to be wearing false teeth than any other member of the population.

Adult↗
PubMed1992

Tonsillectomy, adenoidectomy and adenotonsillectomy: are they safe day case procedures?

A review of 3,488 tonsil and adenoid procedures performed between March 1987 and April 1990 is presented. A reactionary haemorrhage rate of 0.49 per cent was found. No deaths were recorded. All cases of reactionary haemorrhage occurred within the first eight hours post-operatively. Based on this study, out-patient tonsil and adenoid surgery should be followed by at least an eight hour postoperative observation period before discharge. If day case adenoid and tonsil surgery is adopted, close medical audit would be necessary to detect and then prevent any possible increase in morbidity or mortality.

Adenoidectomy↗
PubMed1992

Pharyngolaryngeal migration: a delayed complication of an impacted bullet in the neck.

We present a case of a patient who sustained a bullet wound to the mouth and face resulting in impaction of the foreign body in the neck. This was initially managed conservatively until migration into the supralaryngeal area occurred. This resulted in airway obstruction, dysphagia, and dysphonia necessitating resuscitation and per-operative intrapharyngeal removal. Bullet wounds are uncommon in this country and experience with these cases is lacking. This paper discusses the various management options and the mechanism of how the bullet became lodged in the tissues of the neck.

Adult↗
PubMed1992

Investigation of cervical lymphadenopathy presumed to be metastatic in nature: a review of current clinical practice.

The method adopted by UK otolaryngologists for investigating cervical lymphadenopathy presumed to be metastatic in nature is reported. This is based on a confidential questionnaire sent to all members of the British Association of Otolaryngologists. The results of this survey show that the majority of otolaryngologists make a diligent search for a possible primary tumour by performing a panendoscopy. They do not, however, make full use of other investigative techniques such as fine needle aspiration cytology (9%) or computed tomography (6%). The management of patients with cervical masses could be improved by more widespread use of computed tomographic scanning where available and the development of fine needle aspiration cytology in all departments performing head and neck surgery.

Biopsy↗
PubMed1992

Extra cranial arteriovenous malformations presenting as pulsatile tinnitus.

We present two cases of extra cranial arteriovenous malformations, which presented as pulsatile tinnitus. They were originally diagnosed by clinical examination and both lesions were subsequently confirmed by angiography and their feeding vessels defined. One case was managed by surgical excision, which produced relief of symptoms. The diagnosis and management of arteriovenous malformations is discussed.

Adult↗