The Journal of laryngology and otology
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Review
Nasal and instrument preparation prior to rigid and flexible nasendoscopy: a systematic review.
Examination of the upper aerodigestive tract is an important part of ENT practice. The use of both flexible and rigid nasendoscopes is the most common way of achieving this in the out-patient setting. However, these procedures can cause pain or discomfort for the patient, and topical preparations have been used in an attempt to reduce this. ⋯ Eighteen studies relevant to this review were identified. The evidence suggests that local anaesthetic is not beneficial when performing flexible nasendoscopy, neither alone nor in combination with a vasoconstrictor. Water is better than lubricant for flexible endoscope passage and gives a superior optical outcome. Further research is required on the use of endosheaths for flexible and rigid nasendoscopy.
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Review Case Reports
Giant petrous carotid aneurysm: persistent epistaxis despite internal carotid artery ligation.
We report a rare case of giant petrous carotid aneurysm. ⋯ Some aneurysms are too large to be treated with endovascular occlusion techniques; in such cases, ligation of the parent vessel is indicated. However, our patient continued to experience persistent, mild epistaxis despite internal carotid artery ligation, as a result of the reperfusion phenomenon.
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We present a rare case of oesophageal perforation following ingestion of over-the-counter ibuprofen capsules. ⋯ To our knowledge, this is the first report in the world literature concerning oesophageal perforation with ibuprofen. We discuss pill-induced oesophageal injury and its prevention. Manufacturers, clinicians and patients can all take steps to avoid this potentially life-threatening complication.
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Comparative Study
Immediate post-operative vocal changes in patients using laryngeal mask airway versus endotracheal tube.
(1) To examine the vocal symptoms and acoustic changes perceived in the short period immediately after laryngeal mask airway, and (2) to compare these findings in patients using laryngeal mask airway and endotracheal tube. ⋯ Shortly after reversal of anaesthesia, laryngeal symptoms following laryngeal mask airway are no less significant than those experienced following endotracheal tube anaesthesia. Both methods can be regarded as nontraumatic, in view of the lack of significant vocal symptoms and acoustic changes 24 hours after anaesthesia.
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To assess the value of lateral soft tissue neck X-rays in patients presenting with upper aero-digestive tract foreign bodies. ⋯ A lateral soft tissue neck X-ray is a helpful tool in the management of patients presenting with upper aero-digestive tract foreign bodies. Junior doctors need better radiology training.