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Biomedical subjects

P H Rhys Evans

Publications and source records attributed to P H Rhys Evans.

16 recordsLinked to original sources
PubMed1998

Intralaryngotracheal thyroid--ectopic thyroid or invasive carcinoma?

Intralaryngotracheal thyroid is a rare clinical condition with only about 125 cases described so far in the literature. We present an unusual case of intralaryngotracheal thyroid which had many clinical features of malignancy and yet appeared benign on histology. As in this case, well-differentiated thyroid cancer can present with locally aggressive clinical features and can pose a dilemma in management if treatment decisions are guided solely by histological features.

Adult↗
PubMed1994

Speech restoration following total laryngo-pharyngectomy with free jejunal repair.

Nine patients who have undergone total laryngo-pharyngectomy with free jejunal reconstruction between 1984 and 1993, have had Blom-Singer valves inserted. All patients had little or no voice prior to valve insertion, compared with a good but gravelly voice after valve insertion. Tracheo-oesophageal puncture and valve insertion provides a safe and reliable means of restoring voice after laryngo-pharyngectomy with free jejunal repair.

Esophagus↗
PubMed1989

Complications in head and neck surgery and how to avoid trouble.

Increasing litigation in recent years has made it more and more necessary for the surgeon to be aware of the problems, pitfalls and complications which may arise as a result of surgery. The risks are compounded in the head and neck not only because of its complex anatomy but also because of additional difficulties relating to surgery of the upper aero-digestive tract. Some problems are unavoidable. The potential risks of surgery and its complications should be carefully weighed against the natural history of the pathological process and a realistic expectation of the surgical outcome compared with alternative treatments. Other problems may result from genuine mistakes, but a number of complications are caused through actions or omissions which are avoidable and which in certain circumstances may be construed as professional negligence. Some of the more common pitfalls and complications in head and neck surgery are discussed with particular reference to their causation and possible avoidance.

Clinical Competence↗
PubMed1988

Tongue resection with the CO2 laser: the effects of past radiotherapy on postoperative complications.

A clinical study was undertaken in 21 patients to assess the effects of past radiotherapy on complications after tongue resection with the CO2 laser. Ten of the 11 irradiated patients experienced postoperative problems such as pain, haemorrhage, oedema, infection, delayed healing and poor function, while only one of the 10 non-irradiated patients had a problem due to minor bleeding after laser surgery. It is concluded that the CO2 laser is useful for primary excision of accessible tumours in the anterior tongue, but may be associated with more postoperative complications if the tongue has previously been irradiated. Where the tongue resection is part of a more radical excision, the CO2 laser is less advantageous.

Adult↗
PubMed1987

Preservation of neck dissection for histological study.

Dissection of lymphatic nodes in the neck--whether radical or partial, functional or prophylactic--forms an integral part of the surgical management of cancer of the head and neck. Accurate orientation and fixation of the surgical specimen is a prerequisite for correct histopathological study of the extent of the disease and for a complete clinicopathological interpretation, which is of significant therapeutic and prognostic importance.

Histological Techniques↗
PubMed1986

Secretory otitis media--evidence for an inherited aetiology.

In a study to determine whether or not there is a familial or hereditary predisposition to develop secretory otitis media (SOM), the parents of 73 children with persistent SOM and 35 controls were examined clinically, and abnormalities of the tympanic membrane (TM) noted. Analysis of the findings suggests that heredity plays a large part in determining a child's likelihood of developing SOM.

Adenoidectomy↗
PubMed1985

Cross-links between stereocilia in the human organ of Corti.

Human cochleae were fixed in glutaraldehyde, without the use of osmium. Cross-links were seen between the stereocilia, similar to those we have previously reported for the guinea pig: first, stereocilia of the same row on each hair cell were joined by horizontally-running links; secondly, the shorter stereocilia had pointed tips, each giving rise to a single, vertically-pointing link, which ran upwards to join the adjacent taller stereocilium of the next row. We suggest that distortion of this link is involved in sensory transduction. The links were sparser than had been seen in the guinea pig which may be a reflection of the vulnerability of the links to non-optimal fixation, and the greater difficulty in producing good fixation in human specimens.

Adult↗