D Roberts

Publications (3)2.52 Total impact

• Article: Don't sue the surgeon: remineralisation of the skull base or a defect that never existed?

  C Hopkins, S Dhillon, G Rogers, D Roberts
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  ABSTRACT: Intracranial complications are recognised as rare, but serious, sequelae of endoscopic sinus surgery. A 56-year-old woman was referred after developing meningitis following elective functional endoscopic sinus surgery. Computed tomography demonstrated a significant defect of the skull base in the right posterior ethmoid, clearly visible on both coronal and sagittal sections. Operative exploration demonstrated the skull base to be intact in the posterior ethmoid area identified on the scan, and the overlying mucosa appeared undisturbed. Scans were reviewed in the light of operative findings; coronal and sagittal images were found to be reconstructions. Directly acquired coronal computed tomography, undertaken three weeks after surgery, demonstrated a complete bony plate in the right posterior ethmoid at the site previously identified as dehiscent. We speculate that the posterior ethmoid defect was actually an artefact of reconstruction. We cannot exclude the alternative possibility of remineralisation, but given the time frame this seems unlikely. This case highlights the need for caution when interpreting reconstructed images of the thin bony plates of the skull base and lamina papyracea, as regards both clinical significance and medicolegal reporting. While virtual defects have been reported in the superior semicircular canals as a result of reconstructed images, we believe this to be the first reported case demonstrating a similar problem in the anterior skull base.
  The Journal of Laryngology & Otology 09/2011; 125(12):1294-7. · 0.60 Impact Factor
• Article: Balloon sinuplasty: our first year.

  C Hopkins, E Noon, D Bray, D Roberts
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  ABSTRACT: Balloon sinuplasty is a new technology which has only recently been introduced in the UK. We review the current literature, and we present our first year's results for the technique together with a description of indications, outcomes and problems. Retrospective case note review of 27 consecutive patients undergoing sinuplasty alone in the first year in which this procedure was performed. The main outcome measures used were subjective improvement and Sino-Nasal Outcome Test (SNOT-22) score. Dilatation was successful in 98 per cent of sinuses in which it was attempted; however, subjective improvement was noted in only 62 per cent of patients thus treated. We believe that balloon sinuplasty has a place in routine rhinology practice but that its applications are limited, and that its additional costs must be considered. We present advantages and possible limitations of the technique.
  The Journal of Laryngology & Otology 01/2011; 125(1):43-52. · 0.60 Impact Factor
• Source

  Available from: rhinologyjournal.com

  Article: Balloon sinuplasty in acute frontal sinusitis.

  Claire Hopkins, Edward Noon, David Roberts
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  ABSTRACT: Balloon sinuplasty has been licensed for the treatment of chronic rhinosinusitis since 2006. Balloon dilation enlarges the sinus ostium by effecting tiny fractures of the surrounding bone and compressing soft tissue such that no mucosa is removed. We believe this to be the ideal technique for achieving drainage of an acutely infected frontal sinus when surgical intervention is required. We report the application of this new technique in a 32-year-old female with acute frontal sinusitis. The frontal sinus was successfully cannulated and drained. Post-operative irrigation was achieved using a modified Vortex catheter.
  Rhinology 12/2009; 47(4):375-8. · 1.32 Impact Factor