The Journal of laryngology and otology
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To assess the value of lateral soft tissue neck X-rays in patients presenting with upper aero-digestive tract foreign bodies. ⋯ A lateral soft tissue neck X-ray is a helpful tool in the management of patients presenting with upper aero-digestive tract foreign bodies. Junior doctors need better radiology training.
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To assess the significance of Streptococcus milleri in acute rhinosinusitis with complications. ⋯ Seventy-one case notes were reviewed, for 30 female and 41 male patients, representing 38 adults and 33 children. Streptococcus milleri was the most commonly implicated organism (52.1 per cent; 37/71). Patients from whom this organism was isolated tended to require more than one operative procedure, and had a protracted hospital stay.
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Randomized Controlled Trial Comparative Study
Hypotensive anaesthesia with remifentanil combined with desflurane or isoflurane in tympanoplasty or endoscopic sinus surgery: a randomised, controlled trial.
To compare the effect of remifentanil combined with desflurane or isoflurane on the quality of the operative field and surgical conditions, blood loss, and recovery during tympanoplasty or endoscopic sinus surgery. ⋯ Although desflurane and isoflurane both enabled good surgical conditions (in terms of quality of operative field) and convenient induction of hypotension for tympanoplasty and endoscopic sinus surgery, the recovery characteristics of desflurane were better than those of isoflurane. Therefore, desflurane may be preferable to isoflurane in such circumstances.
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To demonstrate the importance of a detailed history when assessing patients with a repeated pattern of foreign body ingestion. ⋯ Oesophageal foreign bodies are commonly encountered in otolaryngology practice. Such circumstances are often compounded by pre-existing psychiatric problems such as bulimia and/or anorexia nervosa. Patients with bulimia may often present with a very similar pattern of multiple episodes of ingestion of large foreign bodies. Identification of this eating disorder (especially when there is a recurrent history of large, accidentally ingested foreign bodies) and prompt psychiatric referral is essential for efficient long-term management of this condition.
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Foregut duplication cysts are heterotrophic rests of foregut-derived epithelium which are usually found in the abdomen and thorax; rarely are they found in the head and neck. ⋯ The occurrence of a foregut duplication cyst in the head and neck region mandates vigilance with respect to the airway. Magnetic resonance imaging is a useful part of pre-operative evaluation but cannot be relied upon for definitive diagnosis. Although foregut duplication cysts are benign lesions, definitive cure ultimately requires surgical excision, and this is often the means by which a definitive diagnosis is made. The prognosis for these lesions is excellent, with no reports in the literature of recurrence following excision.