Graeme Clark Collection
Permanent URI for this collection
Search Results
1 - 9 of 9
-
ItemSpecially processed heterogenous bone and cartilage transplants in nasal surgery(Cambridge University Press, 1969)In nasal surgery, cartilage or bone transplants are required for support or correction of cosmetic deformities. When autogenous material is readily available, it should be used in preference to homogenous or heterogenous material. Sometimes this means, however, an iliac bone or rib cartilage graft. These procedures have a certain morbidity and the grafts are not always readily accepted by the patient. For this reason, there is a place for heterografts, especially when their antigenicity is reduced. Embryo calf bone and cartilage can be specially treated by lyophilisation and surface active agents to reduce its antigenicity (Dingwall and Millonig, 1964) and this material has been used in the present clinical study. This is a publisher’s version of an article published in The Journal of Laryngology & Otology © 1969 Cambridge University Press. www.cambridge.org/
-
ItemNasal splints and nose guards( 1969)Nasal fractures are common, and although their surgical treatment is standardized, there is disagreement about their splintage and postoperative management. A variety of nasal splints are at present in use. Small splints of aluminium or dental impression compound, which can be moulded to the nose, are available. More commonly a plaster splint is applied, and this is fixed in place with adhesive strapping or tapes around the head. The plaster may be cut so that it has a broad area for attachment to the forehead or broad flanges for resting on the maxillae to provide further support. In the latter case, the plaster is usually fixed in place by connecting it to tapes which are tied behind the head. In no case should a splint be applied in the hope that it can exert pressure on and compensate for an incompletely reduced fracture. Satisfactory postoperative results will be obtained only if reduction is complete at the time of the operation. Therefore the main function of splints for nasal fractures without loss of support is to prevent further injuries displacing the bones during healing.
-
ItemHearing due to electrical stimulation of the auditory system( 1969)One of the major problems facing otologists today is the treatment of perceptive deafness. The results of treating patients with deafness due to middle-ear disease are now good, but this is not the case when there is damage to the inner ear or central auditory pathways. A hearing aid will assist a great many people, but there are a number of patients with very severe or total deafness who cannot be helped in this way. Consequently, a different approach to the problem must be made, and for this reason, electrical stimulation of the cochlea or auditory pathways to reproduce the natural stimulus may provide a solution.
-
ItemAcute frontal and ethmoid sinusitis with subperiosteal abscess( 1969)The treatment of a patient with acute frontal and ethmoid sinusitis complicated by subperiosteal abscess is described. At the initial operation these sinuses were drained into the middle meatus of the nose using a large polythene tube. The advantages of intranasal in addition to external drainage are discussed.
-
ItemPosterior choanae and choanal polyps( 1968)In the literature there are reports of nasal, antrochoanal, ethmochoanal and sphenochoanal polyps. A search, however has not revealed reports of polyps actually arising from the choanae. A report and photograph of a polyp arising from the posterior choana is presented in this paper and it seems logical to refer to this as a choanal polyp.
-
ItemSeptal transplant for a saddle nose due to injury( 1968)A supratip depression or saddle is a fairly common complication of a fractured nose. It may result from a hematoma of the septum or a fracture dislocation of the septal cartilage. The supratip saddle may also be associated with a more generalized depression of the nasal dorsum due to extensive comminution of the nasal bones and septum, or to a telescoping injury involving the fronto-ethmoidal region. The management of a patient with a fractured nose and fracture dislocation of the septal cartilage leading to a supratip saddle can be difficult. The correction of this deformity at a later stage may not produce a satisfactory cosmetic result and therefore correct management at the time of injury is important.
-
ItemThe facial profile and cosmetic surgery( 1968)Rhinoplastic technique is now well developed and skill in its use can be acquired with practice. Judgement is required, however, to alter the nasal profile to suit the facial profile as a whole. Surgical correction of forehead and chin lines is more difficult, and for this reason, the nasal profile should not accentuate any excessive deviations from the normal in these structures. Certain features of the facial profile are more prominent in one particular sex and it is felt that these characteristics should not be accentuated when operating on the nose of a patient of the opposite sex. The purpose of this paper is to outline the variations in profile that are more frequently associated with a particular sex, and to draw attention to certain principles of aesthetics and perception that can assist in deciding what alterations should be made to the facial profile as a whole. The application of these principles to two patients is discussed.
-
ItemA method for endoscopic inspection and photography of the nasopharynx( 1967)Examination of the postnasal space with a nasopharyngeal mirror has been described as one of the most difficult skills to acquire in clinical practice. Even experienced clinicians may find difficulty in deciding whether the postnasal space is normal, and examination: under anesthesia may therefore be necessary. Some of the difficulties which may be encountered are an exaggerated palatal reflex, an elongated soft palate, and increased muscle tension making adequate depression of the tongue difficult. Various methods of examination have been developed to overcome some of these difficulties. The nasopharyngeal speculum permits a direct examination of the postnasal space, but insertion is unpleasant and anterosuperior structures are difficult to visualize. The nasopharyngoscope is introduced through the nostrils, has a limited field of vision, and interpretation of the view obtained requires a lot of experience.
-
ItemThe role of the nasal septum in one-stage rhinoplasty( 1967)The rhinologist is commonly consulted by a patient who has breathing problems due to a deviated septum, combined with a nasal deformity. A number of patients desire to have the septal deviation corrected at the same time as an operation to improve cosmesis. Previously this problem was dealt with in two stages. Originally the rhinoplasty preceded the submucous resection of the septum, for the reason that a later rhinoplasty and removal of dorsal hump would open into an excised area of the nasal septum and cause saddling. With experience this complication was found not to occur and for many years a submucous resection has preceded a rhinoplasty by a few weeks. Today, the surgery for these deformities is quite often performed in one stage. It is still not clear to what extent this can be safely done without endangering the support of the nose.