RESUMO
A questionnaire was used to collect information related to stapedectomy from all the NHS Trusts in the North West region. The data collected included the identity and rank of the surgeon, the age and sex of the patients, the side of the operation, the audiometric values of the air conduction audiogram preoperatively and postoperatively, and an account of any complications. The results were analysed and compared to national and international standards. The criteria for analysis of success in surgery for conductive hearing loss were reviewed.
Assuntos
Auditoria Médica , Otosclerose/cirurgia , Cirurgia do Estribo/métodos , Adulto , Idoso , Audiometria , Área Programática de Saúde , Inglaterra , Feminino , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Otosclerose/complicações , Otosclerose/diagnóstico , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
The Chief Medical Officers' expert advisory group (The Calman Hine report (1994) for the commissioning of cancer services suggested that services in the district general hospitals (DGH) should be called 'cancer units' and that such units should be closely linked to 'cancer centres'. The objective of these proposals would be to improve the quality of care to cancer patients. The report also acknowledges that these proposals are based on an inadequate understanding of the epidemiology of cancer within England and Wales and the way in which current configuration of services affects outcome. The authors make a plea for better documentation and recording of treatment and outcomes (i.e. audit) to fill this gap. Registration in cancer registries is of limited value in assessment of outcomes of care owing to lack of detail. This paper describes an audit of head and neck cancer in one department and attempts to define which patients might benefit from referral from the cancer units to the 'centres', and conversely, which patients would be better managed in the cancer units. If all patients with cancer of the head and neck were referred, the service in the cancer centres would be overwhelmed. Some system of triage will therefore be essential.
Assuntos
Neoplasias Laríngeas/cirurgia , Neoplasias Faríngeas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Inglaterra , Feminino , Humanos , Neoplasias Laríngeas/radioterapia , Laringectomia/métodos , Laringe Artificial , Excisão de Linfonodo , Masculino , Auditoria Médica , Pescoço , Avaliação de Resultados em Cuidados de Saúde , Cuidados Paliativos , Neoplasias Faríngeas/radioterapia , Faringectomia/métodosRESUMO
A case of intralaryngotracheal thyroid in a 57-year-old man is presented. The treatment modalities are considered and the previous literature is reviewed.
Assuntos
Coristoma , Neoplasias Laríngeas , Glândula Tireoide , Neoplasias da Traqueia , Coristoma/diagnóstico por imagem , Coristoma/cirurgia , Humanos , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Radiografia , Neoplasias da Traqueia/diagnóstico por imagem , Neoplasias da Traqueia/cirurgiaAssuntos
Otopatias/etiologia , Doenças Nasais/etiologia , Vasculite/complicações , Azatioprina/uso terapêutico , Surdez/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média com Derrame/etiologia , Prednisolona/uso terapêutico , Vasculite/tratamento farmacológico , Vertigem/etiologiaAssuntos
Adenoidectomia , Perda Auditiva Bilateral/cirurgia , Perda Auditiva/cirurgia , Ventilação da Orelha Média , Otite Média com Derrame/complicações , Otite Média/complicações , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Perda Auditiva Bilateral/etiologia , Humanos , Otite Média/cirurgia , Estudos Prospectivos , Distribuição AleatóriaRESUMO
A series of twenty-nine cases of osteoradionecrosis of the temporal bone is described. Two patterns occur: a localized involvement of the tympanic plate which resolves after the spontaneous separation of a sequestrum of bone, and a more diffuse necrosis of the temporal bone with a high risk of involvement of adjacent structures, in particular the brain, labyrinth and facial nerve and to a lesser extent the temporomandibular joint and the parotid gland. Localized osteonecrosis occurs more commonly when the temporal bone is in the periphery of an irradiated field whereas irradiation aimed primarily at the temporal bone is more likely to be followed by diffuse disease. The use of megavoltage irradiation has not led to the disappearance of the complication which may occur as much as twenty years after the completion of the course of radiotherapy.
