The Journal of laryngology and otology
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Laryngotracheal injuries are relatively rare but their mortality rate is fairly high. Complete disruption of the trachea is extremely rare and a systematic approach is needed for early diagnosis and favourable outcome. ⋯ X-rays, CT scans, barium swallows and endoscopies are recommended for evaluation of such injuries. However, direct laryngoscopy and fibre optic bronchoscopy are the most accurate.
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Case Reports
A new diagnostic approach to congenital stridor using a laryngeal mask airway and rigid endoscope.
Neonates with symptoms of stridor from birth, present a difficult diagnostic problem. We have demonstrated that by the use of a laryngeal mask airway in an anaesthetized baby breathing spontaneously, we are able to reach a diagnosis. This is accomplished by the introduction of a rigid fibre-optic endoscope through a Portex swivel connector and visualizing the glottis and larynx.
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Congenital first branchial cleft fistulae, their embryology, anomalies, varied relationships to the facial nerve and surgical techniques for their excision have been well described in the literature. We report a case of a type II first cleft fistula in a three-year-old child which required a modification of the standard surgical approach to achieve safe and complete excision with identification and preservation of the facial nerve.
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Nasal myiasis is the infestation of the nasal cavities by larvae (maggots) of Diptera flies. Several species of flies deposit their ova in the nose and the larvae feed on the host's tissues. We present a case of nasal myiasis by larvae of Oestrus ovis--Sheep Nasal Bot Fly. ⋯ Reputedly, the larvae never survive beyond the first stage with acute catarrhal symptoms lasting only a few days. This is the first reported case in the UK of an urban-dwelling patient infected by mature, third instar larvae of O. ovis. His nasal infestation resolved after endoscopic removal of the live maggots.
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Case Reports
Unilateral nasal obstruction: an unusual presentation of a complication of nasotracheal intubation.
Partial avulsion of the middle turbinate is an unusual complication of nasotracheal intubation while minor nasal mucosal trauma is not uncommon. Nasal turbinate avulsion often presents with persistent epistaxis but in the case reported, unilateral nasal obstruction with minimal epistaxis was the presenting feature. Unilateral nasal obstruction following nasotracheal intubation should raise suspicion of significant disruption of the intranasal architecture.