{"title":"Informed consent: British otolaryngologists surveyed.","authors":"P J Dawes, E Kitcher","doi":"10.1046/j.1365-2273.1999.00244.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00244.x","url":null,"abstract":"<p><p>A repeat postal questionnaire of British otolaryngologists has been carried out to assess changes in their practice of obtaining informed consent. The previously reported high level of good practice is maintained. Currently informed consent is more often obtained in outpatients or the preadmission clinic than it was in 1991. Consultants and specialist registrars are more involved in this process. Although there is little evidence given to support a persistent increase in a defensive approach towards gaining informed consent, there is some change in the reporting of surgical complications that may reflect an increased awareness of the concept of 'material risk'.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"198-207"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00244.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thiobarbituric acid reactive substances in patients with laryngeal cancer.","authors":"M Samir, N M el Kholy","doi":"10.1046/j.1365-2273.1999.00249.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00249.x","url":null,"abstract":"<p><p>The purpose of this study was to measure the level of thiobarbituric acid reactive substances (TBARS), which are products of lipid peroxidation, as a reflection of oxidative status in 30 patients with laryngeal cancer. The TBARS were measured 1 day before surgery and 3 weeks after laryngectomy compared to 30 normal control subjects by the thiobarbituric acid (TBA) test using spectrophotometry. The TBARS levels were significantly elevated in patients with laryngeal cancer compared to the controls (18.4 +/- 3.13 mumol/l versus 7.75 +/- 1.9 mumol/l; P < 0.05). There were no differences in the TBARS levels in relation to T staging, N staging, or degree of differentiation. Among patients with laryngeal cancer smokers had slightly higher TBARS levels. Comparison of the paired observations of laryngeal cancer larynx before and after operation revealed a significant rise in the TBARS levels after laryngectomy. Tissue damage resulting from surgery is the most probable explanation for this rise. The state of altered lipid peroxidation detected in our patients might be related to a deficient antioxidant status. The role of antioxidants in the prevention of laryngeal cancer among high risk patients is worth studying.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"232-4"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00249.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Epworth Sleepiness Scale: can it be used for sleep apnoea screening among snorers?","authors":"E Z Osman, J Osborne, P D Hill, B W Lee","doi":"10.1046/j.1365-2273.1999.00256.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00256.x","url":null,"abstract":"<p><p>Snoring is a common disorder and may lead to the development of Obstructive Sleep Apnoea (OSA) with its associated hazards. Differentiation of patients with OSA from patients with simple snoring is crucial to the ENT surgeon before selecting treatment. This study aimed to assess the reliability of the Epworth Sleepiness Scale (ESS) to screen for OSA among snorers. Forty-six patients referred for treatment of snoring were studied. Each patient completed the ESS questionnaire and subsequently underwent a hospital sleep study. The ESS scores did not correlate with the apnoea/hypopnoea indices calculated from the sleep studies (correlation coefficient 0.12). The lack of correlation is mainly because simple snorers can also suffer from excessive daytime sleepiness, due to an unclear mechanism. The ESS is a useful questionnaire for assessing disability as a result of snoring but it is of no value in distinguishing simple snorers from patients with OSA.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"239-41"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00256.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Day case paediatric tonsillectomy: a review of three years experience in a dedicated day case unit.","authors":"W P Hellier, J Knight, J Hern, T Waddell","doi":"10.1046/j.1365-2273.1999.00252.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00252.x","url":null,"abstract":"<p><p>Tonsillectomy is one of the most common surgical procedures performed in children. Day case tonsillectomy is common in many parts of the USA but remains controversial in the UK. Day case tonsillectomy in children has been performed in a dedicated paediatric day care unit at the May day Hospital since 1994. The results for the years 1995-1997 were reviewed. In these years 928 true day case tonsillectomies were performed. Reactionary haemorrhage occurred in 0.97% (nine children) but only three children required a return to theatre. All bleeding occurred within the standard observation period. There were no deaths. The overall effective day case rate was 95.7%, only 31 children needing unplanned admission, mainly for postoperative vomiting. The results suggest that day case tonsillectomy can be safely and successfully performed, with a dedicated paediatric day case unit and a favourable population geography.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"208-12"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00252.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The BAHA HC200/300 in comparison with conventional bone conduction hearing aids.","authors":"C T van der Pouw, A F Snik, C W Cremers","doi":"10.1046/j.1365-2273.1999.00193.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00193.x","url":null,"abstract":"<p><p>A retrospective study was performed on 89 patients from a consecutive series who received a BAHA HC200/300 after having previously used conventional bone conduction hearing aids. The patients' performance with the BAHA HC 200/300 was compared to their performance with conventional bone conduction hearing aids. The patients were divided into two groups, depending on the time of implantation (before or after May 1992). The patients in group 1 (long-term users) were asked to fill in a questionnaire, the same one as they had filled in at the initial BAHA fitting more than 5 years previously. The answers were compared to their original opinions and difference scores were calculated. The long-term clinical results from group 1 are also presented. Although they are encouraging, the patients' opinion about the BAHA deteriorated somewhat over time. The audiometric results of group 2 were highly comparable with those of group 1. This confirms the positive results with the BAHA found in previous studies.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"171-6"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00193.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M J Prior, K Schofield, C M Boivin, P Anderson, A B Drake-Lee
{"title":"Assessment of mucociliary transport in patients with chronic mucoid rhinitis.","authors":"M J Prior, K Schofield, C M Boivin, P Anderson, A B Drake-Lee","doi":"10.1046/j.1365-2273.1999.00257.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00257.x","url":null,"abstract":"<p><p>Chronic rhinitis is the manifestation of a heterogeneous group of disease entities and often proves difficult to manage successfully. We present the investigations of the mucociliary system in 40 patients with mucoid rhinorrhoea as their principal symptom of whom 20 had pan respiratory disease. The saccharin clearance time (SCT) was measured and classified as normal if it was below 20 min. Objective measurement of clearance was made using 99mTechnetium-labelled human serum albumin (99mTc-HSA). We have standardized our method using a micrometer syringe driver to produce a droplet of consistent size (droplet size, 0.01 ml, SD 0.0002 ml) that reduces the dose of radiation. The movement of the droplet was measured over 20 min (RLT). The mean, maximum rate and percentage moved were calculated. Patients were divided into those who had chest disease (20) and those without and a chi 2-test was performed for the mean RLT time between the two groups. There was a strong correlation between mean and maximum rates (r = 0.91). One patient has a normal SCT and normal RLT. Patients with chest disease had a significantly lower mean RLT (P > 0.01). Assuming that RLT is the standard investigation, six patients were normal but had an abnormal SCT, this is a false positive error of 15%. The false negative error was 4/40 (10%). The association between sinus and chest disease with abnormal mucociliary clearance is stressed.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"242-6"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00257.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"External ear resonance in patients with tympanic membrane perforations.","authors":"T C Liu, C J Hsu","doi":"10.1046/j.1365-2273.1999.00250.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00250.x","url":null,"abstract":"<p><p>This study investigated the effects of a tympanic membrane perforation on the external ear resonance. Measurements of external ear resonance using a probe-tube microphone system were performed in 14 patients who had medium to large unilateral tympanic membrane perforations. The contralateral normal ears of these 14 patients served as control. The results showed that there were no significant differences in the peak frequency, peak amplitude and peak sharpness between perforated and normal ears. However, intersubject variability in the resonant frequency was greater in the perforated group. In addition, the resonance curves of these two groups were substantially different. In 10 out of the 14 patients in the perforated group, the resonance curves showed 2-3 prominent peaks separated by valleys of about 10 dB reduced gain. In addition, in 11 out of 14 perforated ears, reduced responses (3.8 dB in average) occurred consistently in the lower frequency region (0.3-2 kHz). Clinically, the abnormal external ear resonance and the larger intersubject variation must be taken into consideration in fitting hearing aids for this group of patients.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"216-9"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00250.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ginkgo biloba for tinnitus: a review.","authors":"E Ernst, C Stevinson","doi":"10.1046/j.1365-2273.1999.00243.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00243.x","url":null,"abstract":"","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"164-7"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00243.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effective head and neck cancer management: a consensus document.","authors":"M McGurk","doi":"10.1046/j.1365-2273.1999.00267.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00267.x","url":null,"abstract":"","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"163"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00267.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of conductive hearing loss on the vestibulo-collic reflex.","authors":"A P Bath, N Harris, J McEwan, M P Yardley","doi":"10.1046/j.1365-2273.1999.00234.x","DOIUrl":"https://doi.org/10.1046/j.1365-2273.1999.00234.x","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"24 3","pages":"181-3"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1046/j.1365-2273.1999.00234.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21252605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}