The Journal of laryngology and otology
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This survey investigates the attitudes of medical and nursing staff towards the daily otolaryngology ward rounds in a teaching hospital. Initial, open-ended questionnaires generated themes from which a structured questionnaire was constructed. Respondents indicated on a Likert scale the extent to which they agreed or disagreed with statements concerning their attitudes towards the ward round. ⋯ A significant majority of staff expressed concerns over maintenance of patient confidentiality. These findings could be used to inform changes in the departmental ward round structure. Specific attention should be directed to discussing sensitive issues in a more private setting and maximizing educational opportunities for junior medical staff.
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We investigated the possible role of hypotension and related autonomic phenomena in the pathogenic mechanism of sudden sensorineural hearing loss. ⋯ An induced and controlled steady hypotension under general anaesthesia did not affect the hearing function of any of the patients. It may be supposed, therefore, that an adverse effect on the cochlear oxygenation is more likely to be caused by the sympathetic changes induced by a consistent decrease of blood pressure rather than to hypotension itself.
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The laryngeal mask airway is a widely used, non-invasive, general purpose airway. We report the case of a temporary vocal cord palsy following the use of such an airway. ⋯ Knowledge of the existence of nerve injuries complicating laryngeal mask use is particularly important when counselling certain patients. Mandatory intraoperative cuff pressure monitoring should lower the risk of subsequent voice problems.
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Case Reports
Smooth muscle tumour of the pharynx: a rare tumour presenting with globus pharyngeus symptoms.
A rare case of a smooth muscle tumour in the pharynx is reported, together with histopathological findings. The patient's psychiatric background and recurrent complaint of a sensation of a lump in the throat all pointed to a psychogenic aetiology, and diagnosis was delayed. The importance of mirror or endoscopic examination of the pharynx is stressed in patients with globus pharyngeus symptoms.
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The larynx functions as a protective valve of the upper airway. An end-tracheostomy represents a risk factor for foreign body aspiration. ⋯ This is the first reported case of this kind. This case also emphasizes the importance of patient education and of stoma button design.