The Journal of laryngology and otology
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Food allergy is often thought to be a cause of rhinitis by patients, whose views are frequently influenced by information obtained from the Internet. The incidence of food allergy in children is 2-8 per cent, although a vast majority will grow out of it, and food allergy is actually very rare in adults. ⋯ Treatment for rhinitis due to food allergy is therefore rarely indicated. This review summarises the literature related to the incidence, diagnosis and management of food allergy and food allergy induced rhinitis.
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Surgical procedures in otolaryngology are often associated with the need for blood transfusions. Homologous blood transfusions carry risks and may be unacceptable to some patient groups. ⋯ Throughout the world, Jehovah's Witnesses have fought for the right to refuse blood products. This article examines the need for blood in otolaryngological procedures, surgical strategies to reduce blood loss, the beliefs of Jehovah's Witnesses regarding the acceptability of blood, and procedures and legal stances adopted when treating Jehovah's Witnesses.
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We report the case of a 43-year-old woman who presented with a spontaneous pneumocephalus, 37 years after a mastoidectomy. Clinical examination showed a cerebrospinal fluid leak, meningeal herniation in the superior part of the middle ear, and an audible noise from her ear when she stood up due to the entrance of air into the cranium. A computed tomography scan and magnetic resonance imaging showed the complete destruction of the tegmen tympani and the pneumocephalus in the temporal lobe. ⋯ The meningoencephalocoele and pneumocephalus were probably due to long term pressure upon too thin a tegmen tympani. Pneumocephalus should be considered as a potential delayed post-operative complication of middle-ear surgery. Computed tomography and magnetic resonance imaging scanning supply accurate information and enable a planned surgical approach; they also allow a pathophysiological understanding and a correlation between the clinical signs and the radiological and peri-operative findings.
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Madelung's disease is a benign disorder characterized by the presence of lipomata in the head and neck areas. It is disfiguring for the sufferer and is usually asymptomatic. ⋯ Early surgical excision is recommended to exclude sinister pathology and to improve patient function. This is the first report (according to our literature search) of a patient who presented with dysphagia and obstructive sleep apnoea and in whom surgical intervention resulted in an improvement in both these symptoms.
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The aim of this study was to compare the subjective tracheoesophageal pressure symptoms associated with substernal goitres with objective cross-sectional radiographic measurements. ⋯ Pre-operative CT measurements of tracheal and oesophageal displacement, retrotracheal extension and the degree of tracheal compression correlate well with the presence and severity of tracheoesophageal pressure symptoms. None of the radiographic findings that are exclusive to substernal goitre (percentage of substernal mass, goitre size at the level of the thoracic inlet, ratio of goitre size to the vertebral body at the thoracic inlet and retrosternal isthmus size) had any correlation with clinical symptoms in this study.