The Journal of laryngology and otology
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We report a unique complication arising from the use of a Hunsaker Mon-Jet ventilation tube during microlaryngeal surgery, and we briefly review the literature on the use of this tube for jet ventilation. ⋯ This case highlights the potential risk of laryngeal growths, especially vocal cord polyps, becoming trapped in the Hunsaker tube during intubation. Both the anaesthetist and the operating surgeon should be aware of this possible complication and, more importantly, how to deal with such a problem.
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Review Case Reports
Congenital vallecular cyst in an infant: case report and review of 52 recent cases.
Vallecular cyst is uncommon in infants. We treated a female infant with vallecular cyst, and curious magnetic resonance imaging findings. We also review 51 other cases of vallecular cyst in infants reported over the past 23 years. ⋯ Magnetic resonance imaging presents various difficulties in infants, but has the best diagnostic effectiveness. We recommend the use of magnetic resonance imaging, flexible fibroscopy and ultrasonography to enable extensive examination of suspected vallecular cysts in infants. Marsupialisation has a recurrence rate of only one in 39 cases, and its safety and effectiveness are well balanced. Thus, prompt marsupialisation of vallecular cyst is the recommended surgical procedure.
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Case Reports
A new era in supraglottitis? An isolated UK case of supraglottitis secondary to Neisseria meningitidis.
We report the first UK case of supraglottitis secondary to Neisseria meningitidis. ⋯ Supraglottitis occurs in <4 per 100 000 population. Following a successful UK childhood immunisation programme, most cases occur in adults. Supraglottitis secondary to N meningitidis is exceptionally rare, with only seven other reported cases worldwide. Morbidity is exceptionally high; over 60 per cent of patients require airway intervention. To our knowledge, this is the first reported UK case of supraglottitis secondary to N meningitidis. This case highlights the important clinical, diagnostic and therapeutic interventions required to prevent complications associated with this potentially fatal condition.
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To audit a protocol for elective, day-case, paediatric ENT surgery, previously reported as enabling an overall post-operative nausea and vomiting rate of 2 per cent and a discharge rate of 100 per cent on the day of surgery. ⋯ These findings have implications for the safe same-day discharge of children following tonsillectomy.
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To analyse the completeness and accuracy of the written handover in our ENT department, in line with Royal College of Surgeons of England guidance, and to improve standards. ⋯ We demonstrated a substantial improvement in the quality and completeness of written handover, comparing the second and first audit periods.