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Biomedical subjects

R G Wight

Publications and source records attributed to R G Wight.

At least 37 records · Page 2Linked to original sources
PubMed1992

The Groningen valve voice prosthesis in Sheffield: a 4-year review.

The Groningen valve was first used in Sheffield in 1986 in a patient who underwent laryngectomy for malignant disease. Since then a further 21 patients have made use of this device, 17 of whom underwent insertion at the time of surgery. All patients were male, two patients have since died and the median length of follow-up to date has been 22.0 (range 2-41) months. Prostheses were replaced mainly under general anaesthesia if they leaked or resulted in difficult phonation. A total of 73 valve insertions have been performed with a median time of 4.0 (range 0.25-27) months between each. Of the 15 men in whom the prosthesis is currently in use, speech was generally good-excellent. The Groningen valve provides a highly acceptable means of obtaining vocalization after laryngectomy in the patients in this series.

Adult↗
PubMed1992

A double blind comparison of intranasal budesonide 400 micrograms and 800 micrograms in perennial rhinitis.

A randomized double blind placebo controlled cross-over study comparing budesonide 400 micrograms and budesonide 800 micrograms daily in 59 patients is presented. Nasal obstruction was the predominant symptom and was subjectively and objectively improved by both doses of budesonide (P less than 0.001). No significant difference was found between the two treatments. Both patient subgroups with non-allergic, non-eosinophilic rhinitis and perennial allergic rhinitis benefitted from therapy. Basal and stimulated plasma cortisol levels remained unchanged with either dose of budesonide, and no increase in adverse effects occurred with higher dose therapy.

Administration, Intranasal↗
PubMed1992

Auditory function in patients infected with the human immunodeficiency virus.

A prospective study of auditory function in 18 HIV positive male patients at different CDC (Centres for Disease Control) stages was undertaken. One-third had abnormalities on either auditory evoked response testing or pure tone audiometry. No correlation was found between interwave latencies I-V, I-III, III-V and stage of disease determined either clinically or by T-cell subset. There was a weak correlation between pure tone averages at 1,2,4 kHz and 2,4,8 kHz and T-cell subset ratio in CDC Group IV disease (Rs = 0.56 and 0.57 respectively; P less than 0.05). Abnormalities of BSER were similar to those previously reported in HIV infection, and suggest isolated changes within the brain-stem.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Management of hypopharyngeal carcinoma: a 6-year review.

A retrospective review of 16 consecutive cases of squamous carcinoma of the hypopharynx treated by pharyngo-laryngo-oesophagectomy (PLO) and gastric transposition with a thoracotomy as part of the surgical technique is presented. An operative mortality of 6% and a hospital mortality of 12% occurred. Other complications are discussed. No significant morbidity or mortality occurred as a result of the thoracotomy. A comparison is made with the extra-thoracic technique of gastric transposition.

Adult↗
PubMed1990

Trimming of the inferior turbinates: a prospective long-term study.

The aim of this study was to determine whether the initial benefits of radical trimming and anterior trimming of the inferior turbinates on nasal airflow persisted in the long term. Radical trimming significantly reduced nasal resistance at 2 months following operation (n = 12) (P less than 0.005). There was no significant change in nasal resistance over the next 20 months. Symptom scores for nasal obstruction also showed a significant reduction (n = 16) (P less than 0.005), at 2 months, and did not change significantly over the next 20 months. Radical trimming of the inferior turbinates is a highly effective operation in patients with hypertrophy of the inferior turbinates with few initial complications. However, further analysis of the data revealed that up to 20% of patients lose the initial subjective benefit of relief of nasal obstruction within 2 years of follow-up. Late onset crusting occurs in some patients though this is not directly attributable to an increase in nasal airflow. This study also concludes that anterior trimming of the inferior turbinates cannot be recommended as a form of treatment.

Adolescent↗
PubMed1989

Granular cell tumour of the larynx in childhood.

The youngest patient reported to date with granular cell tumour of the larynx is presented, with a review of other reported cases in childhood. The basis of histological diagnosis of granular cell tumour is described.

Child↗
PubMed1989

Predicting the outcome of submucosal diathermy to the inferior turbinates.

For many years it has been suggested that the subjective outcome of the operation of submucosal diathermy to the inferior turbinates (SMD) may be predicted by pre-operatively testing the ability of the nasal mucosa to decongest with topical vasoconstrictor agents. This study of 22 patients undergoing SMD, confirms that the pre-operative decongestion produced by xylometazoline is both a good subjective (P less than 0.001) and objective (P less than 0.002) predictor of outcome. If a significant reduction in nasal resistance is achieved by the application of topical decongestants, then the operation of SMD is likely to be effective.

Adult↗
PubMed1989

The distribution of thermoreceptors within the nasal cavity.

The distribution of thermoreceptors within the nasal vestibule (that part of the nasal cavities lined with skin) and nasal cavum (that part of the nasal cavities lined with respiratory epithelium) was studied in 20 subjects. The distribution was compared with that of the malar skin adjacent to the nose. No thermoreceptors were located in the nasal cavum but the nasal vestibule contained a dense distribution of cold receptors (3.5 receptors per cm2) and warm receptors (3.2 receptors per cm2). The corresponding density of receptors in the malar skin was 2.7 receptors per cm2 and 2.6 receptors per cm2. The difference in distribution density between the nasal vestibule and the malar skin was significant (P less than 0.05). The implications of these findings are discussed.

Adult↗
PubMed1989

Nasal sensation of airflow following blockade of the nasal trigeminal afferents.

A matched-pair parallel, group trial was carried out on 2 groups of 13 subjects (26 subjects in total), using 2% aqueous lignocaine to anaesthetize both the nasal vestibule and the nasal mucous membrane. Both groups had lignocaine infiltrated into the nasal vestibule and lignocaine applied topically to the nasal mucous membrane. The groups differed in the order in which the medication was given, one group having the infiltration first and the other group the topical application first. Local anaesthesia of the nasal vestibule caused a marked decrease in the nasal sensation of airflow (P less than 0.05) with no accompanying change in nasal resistance to airflow. Topical anaesthesia of the nasal mucous membrane had no effect on either nasal sensation of airflow or nasal resistance. The study demonstrates that the nasal vestibule is the dominant area for sensing nasal airflow. The nasal cavum (the major part of the nasal cavities that is lined by respiratory mucosa) appears to be unimportant as regards the sensation of nasal airflow. The clinical significance of the study is discussed with reference to other work, in this field.

Adult↗
PubMed1988

The nasal valve: a physiological and clinical study.

Fifteen subjects underwent nasal pressure gradient studies to determine the resistance profile of the nose. Seventy-nine per cent of nasal resistance to airflow occurred in the segment 0 cm.-2.8 cm. from the posterior margin of the anterior nares. The greater part of this resistance (43 per cent) occurred in the segment 1.5 cm.-2.8 cm. within the nose, and this area approximated to the site of the pyriform aperture. Eighteen patients underwent a trial of radical trimming of the inferior turbinates (12 patients) versus anterior trimming of the inferior turbinates (6 patients). Both operations produced a similar fall in nasal resistance to airflow, confirming that the region of the pyriform aperture was the site of maximum nasal resistance. Whereas the radical operation significantly reduced the sensation of nasal obstruction, the anterior operation did not. The results of the study are discussed with reference to previous work on the subject.

Adolescent↗
PubMed1988

A comparison of anterior and radical trimming of the inferior nasal turbinates and the effects on nasal resistance to airflow.

A study of 18 patients with chronic rhinitis who underwent anterior or radical trimming of the inferior turbinates is presented. Radical trimming produced a significant decrease in both total nasal resistance to airflow and subjective nasal obstruction (P less than 0.005). Anterior trimming produced a significant decrease in total nasal resistance to airflow (P less than 0.05), but had no significant effect on subjective nasal obstruction. These results suggest that the main site of nasal resistance in patients with chronic rhinitis is the same as in the normal nose. On the basis of this study, adoption of anterior trimming in place of radical trimming of the inferior turbinates cannot be recommended.

Adolescent↗
PubMed1987

Three-year follow-up (1983-1986) of children undergoing bilateral grommet insertion in Sheffield.

A retrospective study with review, after 3 years, of 43 children between the ages of 4 and 13 years, who had bilateral otitis media with effusion treated surgically purely by the insertion of grommets is described. The results shows that the younger the child at initial grommet insertion, the greater the likelihood of more than 1 grommet insertion being required (P less than 0.05). A younger patient is likely to make a greater number of outpatient visits (P less than 0.05), and the number of outpatient visits correlates with the number of grommets inserted (P less than 0.01). At 3 years, 49% of children remained on regular outpatient follow-up, while 34% of children had persisting effusion in 1 or more ears. Whilst grommets are in place, otorrhoea is not adversely influenced by swimming. The role of adenoidectomy in the management of otitis media with effusion is not assessed by this study.

Adenoidectomy↗
PubMed1987

The effect of local anaesthesia of the nasal vestibule on nasal sensation of airflow and nasal resistance.

The effect of local anaesthesia of the nasal vestibule on nasal sensation of airflow and nasal resistance was assessed in 15 subjects. A single blind parallel group trial was undertaken in 30 subjects, with lignocaine as the active drug, and normal saline as the placebo. Fifteen subjects were included in each group. Both agents were infiltrated bilaterally into the floor of the nasal vestibule on each side via the sublabial route. Local anaesthesia of the nasal vestibule by infiltrating lignocaine produced a sensation of nasal obstruction in 9 out of 15 subjects (P less than 0.02). The infiltration of normal saline had no such effect. The difference between the effect of the 2 agents on nasal airflow sensation was significant (P less than 0.05). Neither injection had any significant effect on nasal resistance to airflow as assessed by active anterior rhinomanometry.

Adult↗
PubMed1987

'Superglue ear'.

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Adhesives↗