The Journal of laryngology and otology
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Thirty patients with external laryngeal trauma were analysed retrospectively. Injuries were mostly caused by motor vehicle accidents (car = 36.7 per cent; motorcycle = 23.3 per cent). The main presenting symptoms and signs were hoarseness, neck tenderness, dysphagia, and neck emphysema. ⋯ One case was graded as poor. Twenty-eight cases had good airway patency and two cases fair airway patency. A delay in the early detection of laryngeal trauma may precipitate into life-threatening airway problems, therefore prompt and accurate diagnosis should be followed immediately by skillful airway management.
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Gastric pull-up is a reliable method of one-stage reconstruction following total laryngopharyngoesophagectomy (TLPE). However, the technique of blunt finger dissection for extrapleural extraction of the oesophagus is liable to produce chest complications like pneumothorax. We report a series of 45 patients who underwent gastric pull-up using the technique of oesophageal extraction by stripping which produced virtually no thoracic complications. This simple technique has greatly reduced morbidity associated with gastric pull-up.
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A case is reported in which a patient presented, 18 months after initial injury, with a progressive proptosis of the left eye. X-rays did not reveal a foreign body but a fracture of the lateral orbital wall and an area of soft tissue density were seen on the CT scan. Exploration of the orbit revealed a 2 cm wooden fragment in the floor of the orbit.
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A new animal model of ototoxicity is presented using intravenous carboplatin in adult chinchillas. A range of physiological and morphological effects was produced using doses calculated from the recommended therapeutic range (200-400 mg/m2). ⋯ Carboplatin in this animal model predominantly affected the inner hair cells. This may provide an important model for the study of selective loss of the main afferent input in the auditory system.