The Journal of laryngology and otology
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Review
Nasal and instrument preparation prior to rigid and flexible nasendoscopy: a systematic review.
Examination of the upper aerodigestive tract is an important part of ENT practice. The use of both flexible and rigid nasendoscopes is the most common way of achieving this in the out-patient setting. However, these procedures can cause pain or discomfort for the patient, and topical preparations have been used in an attempt to reduce this. ⋯ Eighteen studies relevant to this review were identified. The evidence suggests that local anaesthetic is not beneficial when performing flexible nasendoscopy, neither alone nor in combination with a vasoconstrictor. Water is better than lubricant for flexible endoscope passage and gives a superior optical outcome. Further research is required on the use of endosheaths for flexible and rigid nasendoscopy.
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This paper outlines our use of cricothyroid cannulation in those patients undergoing head and neck surgery in whom a 'difficult airway' is anticipated. Audit results are presented. ⋯ Cricothyroid cannulation can be a simple, safe, reliable technique which is a useful adjunct in the management of patients with a potentially difficult airway.