The Journal of laryngology and otology
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We have reviewed our experience of tracheostomy in children over the past 20 years at Sheffield Children's Hospital. One hundred and forty-eight tracheostomies were performed in 143 children aged one day to 13 years old (average 27 months). Sixty-five per cent of patients were < one year old. ⋯ There were four deaths directly due to the tracheostomy: two accidental decannulations and two obstructions. Eighty-nine children were decannulated under our care. The average time until decannulation was 25 months.
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We report a case of a very unusual penetrating injury of the middle third of the face. The patient was involved in a road traffic accident, and the indicator control lever became impaled in his right cheek. There was contralateral orbital damage resulting in loss of sight. ⋯ We emphasize the importance of crash scene information gathering and analysis of injury mechanisms. Facial injury zonal classification and imaging are reviewed in the context of the case. We discuss the reasons that led us to treat this patient via the subcranial approach.
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Nasal septal abscess complicating acute sinusitis is rare. There have been very few reports in the literature of this condition. We present a 12-year old-male with a nasal septal abscess complicating acute pansinusitis.
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The Science Citation Index (SCI) was introduced primarily as a method of information retrieval but has also been used an objective measure of the quality of an article. Citation classics have been described as papers that have been cited 100 times or more. The aim of this study was to identify the articles published during the 20th century in otolaryngology-head and neck surgery journals that have achieved classic citation status and to present an analysis of this data. ⋯ The earliest identified publication was in 1933 and the most recent was published in 1993. Twenty authors were involved in two articles and four authors were associated with three classic citations. This paper confirms that analysing citation classics reveals a partial insight into advances and historical developments in the specialty during the last century.
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Pain following tonsillectomy in children is a significant problem that tends to be underestimated. We audited post-operative pain in 33 children and found significant proportions of children in moderately severe to severe pain, particularly at, or soon after returning to the ward. ⋯ On re-auditing two years later, in a group of 100 children, post-operative pain was significantly improved. The proportion experiencing moderately severe to severe pain on returning to the ward, as their maximum pain score and pain score at discharge fell from 70 per cent to 48 per cent, 85 per cent to 56 per cent, and six per cent to two per cent respectively.