The Journal of laryngology and otology
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The prevalence of infection with methicillin-resistant Staphylococcus aureus is increasing. Methicillin-resistant Staphylococcus aureus is also being recognised as an important pathogen in head and neck infections. ⋯ These infections include sinusitis, otitis, periorbital cellulitis, cervical lymphadenitis, tonsillitis, thyroiditis, retropharyngeal abscess, and abscesses and wounds of the neck. Treatment of head and neck infections associated with methicillin-resistant Staphylococcus aureus includes drainage and debridement, as well as administration of local and systemic antimicrobials that provide coverage against these organisms and against potential aerobic and anaerobic pathogens that may be present if the infection is polymicrobial.
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Over recent years, there has been an increase in otolaryngology publications concerning diffusion-weighted magnetic resonance imaging. The aims of this review paper are to summarise the basic principles of diffusion-weighted magnetic resonance imaging, and to provide an overview of current otolaryngological applications and areas of research. ⋯ The role of this imaging modality within otolaryngology is yet to be fully elucidated. Diffusion-weighted magnetic resonance imaging may prove to be a useful adjunct in both the pre- and post-operative care of otolaryngology patients.
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Review Case Reports
Anterior cervical osteophytes resulting in severe dysphagia and aspiration: two case reports and literature review.
We report two cases in which dysphagia and aspiration, caused by anterior cervical osteophytes, were so severe that surgical resection was performed. ⋯ In patients with anterior cervical osteophytes, surgical treatment is indicated only for selected cases with large, bony osteophytes and severe symptoms.
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Review Meta Analysis
Local anaesthesia for manipulation of nasal fractures: systematic review.
To determine the most effective local anaesthetic method for manipulation of nasal fractures, and to compare the efficacy of local anaesthesia with that of general anaesthesia. ⋯ Local anaesthesia appears to be a safe and effective alternative to general anaesthesia for pain relief during nasal fracture manipulation, with no evidence of inferior outcomes. The least uncomfortable local anaesthetic method included topical tetracaine gel.
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Throat packs are employed in nasal surgery to prevent contamination of the upper aerodigestive tract. Their use is thought to reduce the risk of aspiration and post-operative nausea and vomiting. However, use of throat packs may also be accompanied by increased throat pain. In order to inform our clinical practice, the evidence base for throat pack insertion was reviewed. ⋯ Further, adequately powered trials are required involving patients undergoing rhinological procedures with a higher risk of blood contamination (e.g. functional endoscopic sinus surgery), in order to provide definitive evidence on the morbidity of throat packs in rhinological procedures.