The Journal of laryngology and otology
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Comparative Study
Value of head and neck cancer incidence data on UK cancer registry websites: a comparison.
We evaluated the relative usefulness of data on head and neck cancer available on the websites of cancer registries in the United Kingdom. Data were analysed to determine the accuracy and completeness of essential information related to the incidence of head and neck cancer. We found that 16 per cent (2/11) of the registries had some cancer data but none relating to head and neck cancer patients. ⋯ The cancer registries collectively possess an extremely important asset of immense value to both the medical profession and, possibly, patients with cancer. The accessibility of this data and the overall experience of those seeking information on this subject could be improved. However, this would require significant thought, collaboration and agreement between each registry, which would involve significant extra investment.
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Mucormycosis is an opportunistic, fulminating fungal infection of the sino-nasal region. It tends to affect people with immune suppression. The hard palate is a rare site of the disease and few cases have been reported in the literature. This report discusses the nature of hard palate mucormycosis, with the aim of outlining possible explanations and reviewing associated characteristics. ⋯ Mucormycosis of the hard palate is an ominous sign. Although rare, the lesion is progressive in nature and barely controlled by treatment. Clinicians should maintain a high degree of clinical suspicion in the management of patients with palatal ulcer and debilitating illness.
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Multicenter Study Comparative Study
Estimation of tracheostomy tube cuff pressure by pilot balloon palpation.
Two methods can be used to assess the intra-cuff pressure of tracheostomy tubes: digital palpation of the pilot balloon and use of a hand-held manometer. We conducted a telephone survey to determine the prevalence of both methods in intensive care units within 21 teaching hospitals across the United Kingdom. Forty-two per cent of the intensive care units surveyed used a protocol for monitoring cuff pressure with a manometer. ⋯ The cuff pressure was correctly estimated in pre-inflated tracheostomy tubes, in a tracheal model, by 61 per cent of a cross-section of intensive care unit and otolaryngology staff. Using pilot balloon palpation is inaccurate and leaves a significant proportion of patients at risk of tracheal injury. We advocate the wider availability of hand-held pressure manometers in intensive care units and the institution of protocols for monitoring cuff pressure for any patient with a tracheostomy tube with an inflated cuff in situ.
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Adenotonsillectomy is successful at eliminating airway obstruction in the majority of otherwise normal children with obstructive sleep apnoea syndrome. Children with this condition are at significantly higher risk of post-operative respiratory complications. Identifying children at risk of post-operative respiratory complications after adenotonsillectomy for obstructive sleep apnoea syndrome remains a challenge for clinicians, especially those at district general hospitals. ⋯ Patients in the high risk group should be operated upon at paediatric specialist centres with intensive care facilities. Those in the moderate risk group may undergo adenotonsillectomy at their district general hospital, provided facilities for administering continuous positive airway pressure are available on-site. Most children with obstructive sleep apnoea syndrome may be classified as low risk candidates and may safely be operated upon at their local district general hospital.
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Dentures in the oesophagus have been associated with various complications; however, Horner's syndrome following denture impaction has not been reported in our locality. ⋯ Compression of the stellate ganglion, with resultant Horner's syndrome, can be associated with denture impaction in the cervical oesophagus.