The Journal of laryngology and otology
-
Forty-five patients who were to undergo elective urological operations were evaluated. In the pre-operative period and on the third or fourth post-operative day audiometry was performed. Epidural anaesthesia was performed in 15 cases, spinal anaesthesia was performed in 15 cases with 25 G needles, and in 15 cases with 22 G needles. ⋯ In the post-operative period, the hearing loss observed in the 25 G-spinal anaesthesia group was significantly (P < 0.01) less than that seen in the 22 G group. None of the patients had headache after spinal anaesthesia. It was concluded that pure tone audiometry is a more sensitive indicator of cerebrospinal fluid leakage than post-operative headache.
-
A review was made of 12 cases of penetrating injuries to the oropharynx seen at Musashino Red Cross Hospital during the period from 1984 to 1988, and their records were compared with those of past cases with similar injuries reported in a survey for the period between 1949 and 1959. Most of the patients were children under the age of four and were injured when they fell with a sharp-edged object in the mouth. Penetrating injuries to the oropharynx occasionally cause severe complications, including retropharyngeal abscess and mediastinitis. This type of injury should be called a 'pencil injury'.
-
A case of difficult diagnostic rigid bronchoscopy is described. However, flexible fibrescopy could be easily performed through a laryngeal mask airway despite complete lack of experience by the operator. Excellent visualization of the larynx and bronchial tree with minimal haemodynamic disturbance accompanied the technique.
-
A review of 3,488 tonsil and adenoid procedures performed between March 1987 and April 1990 is presented. A reactionary haemorrhage rate of 0.49 per cent was found. ⋯ Based on this study, out-patient tonsil and adenoid surgery should be followed by at least an eight hour postoperative observation period before discharge. If day case adenoid and tonsil surgery is adopted, close medical audit would be necessary to detect and then prevent any possible increase in morbidity or mortality.