The Journal of laryngology and otology
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The characteristics of otoacoustic emissions that make them ideally suited for universal newborn hearing loss screening could potentially be useful for the screening of older children. This study was performed in order to assess the role of otoacoustic emissions in a screening programme for middle-ear disorders and hearing loss in school-age children. ⋯ These results strongly suggest the potential usefulness of otoacoustic emission testing in screening school-age children for hearing loss. Further studies, taking into account cost-effectiveness issues, are indicated.
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18F-Fluorodeoxyglucose positron emission tomography can detect cervical metastases before they are palpable. However, false positive results are not uncommon. This paper reports the use of ultrasound-guided fine needle aspiration to determine the nature of impalpable cervical nodes that are positive on positron emission tomography scanning. ⋯ Ultrasound-guided fine needle aspiration is a minimally invasive procedure which enables cytological examination of suspicious cervical lymph nodes detected by positron emission tomography scanning, allowing further treatment to be planned.
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Airway fires pose a risk during laser microlaryngoscopy, and neurosurgical cotton patties, used to prevent tissue injury from stray laser beams, are a potential ignition source. Using a configuration approximating clinical practice, we experimentally assessed the relative impact of changing different 'fire triad' components on the occurrence of airway fires, in order to better inform patient care. ⋯ We suggest that surgical patties should always be soaked and should be used for relatively short periods, in order to prevent drying. If at all possible clinically, prolonged laser use at high power settings and ventilation with 100 per cent oxygen should be avoided.
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The 1998 National Health Service White Paper stated that anyone suspected of having a cancer would be seen by a specialist within two weeks. The 'trigger symptoms' prompting such referral have been nationally agreed by the National Institute for Health and Clinical Excellence. This study aimed to quantify the diagnostic yield of urgent referrals for suspected head and neck malignancy, and to identify reasons why patients ultimately diagnosed with malignancy may not have been referred via this pathway. ⋯ In a group of patients with symptoms suggestive of head and neck malignancy, only 12 per cent were ultimately diagnosed with cancer. Of all the patients within the trust diagnosed with head and neck cancer, 44 per cent had come from outside the urgent referral pathway.
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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.