Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
J Laryngol Otol [journal]
- International Ear Care Day - 3rd March. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 28.:1-2.
- Surgical management of paediatric chronic rhinosinusitis: review of 10 years' experience. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 26.:1-5.
Objective: To assess the outcome of children with chronic rhinosinusitis who were managed surgically, over a 10-year study period. Method: From January 1999 to December 2008 inclusive, 136 children diagnosed with chronic rhinosinusitis underwent surgery following unsuccessful medical treatment. The operations ranged from adenoidectomy to functional endoscopic sinus surgery. Results: The surgical procedures performed were: adenoidectomy (n = 69), antral washouts (n = 54), middle meatal antrostomy (n = 82), endoscopic ethmoidectomy (n = 66), nasal septal reconstruction (n = 10), and inferior turbinate outfracture (n = 23) or inferior turbinate reductions (n = 55). Follow-up duration ranged from 6 months to 9 years (average 3.2 years). Three patients required revision surgery: adenoidectomy in two patients and adenoidectomy with turbinate reductions in another. Conclusion: This study demonstrates the benefits of focused surgical treatment for paediatric chronic rhinosinusitis. Surgical treatment can be an appropriate and effective option for children with chronic rhinosinusitis when medical management is unsuccessful.
- Efficacy and safety of inferior turbinates coblation in children. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 26.:1-7.
Objective: To assess the effectiveness and safety of coblation in relieving inferior turbinate hypertrophy in children. Methods: An observational cohort study was undertaken. The severity of allergic rhinitis and the severity and degree of nasal obstruction were assessed using subjective and clinical symptom grading tools, a visual analogue scale, and endoscopy. Any post-operative complications were noted at 1 week, and at 1, 3, 6 and 12 months post-operatively. Data from extended follow-up periods were included when available. The statistical significance of changes in parameter values was assessed using the Wilcoxon signed-rank test. Results: Thirty-two patients were recruited (mean age, 11.28 years; range, 6-17 years). Significant post-operative improvement (p < 0.001) was noted in the severity and degree of nasal obstruction. This improvement was maintained after a mean follow-up period of 10.5 months (range, 1 month to 4 years). No mucosal ulceration or adhesion was encountered. Minimal crusting was noted in 8.57 per cent of patients at 1-week follow up. Allergic rhinitis symptoms improved significantly. Conclusion: Inferior turbinate reduction by coblation is an effective and safe procedure in children aged six years and older. The positive outcomes seem to be long-lasting.
- Acoustic shock controversies. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 25.:1-8.
Background: The diagnosis 'acoustic shock' has been made increasingly in the health care industry in recent years. This paper aims to question the validity of acoustic shock as an organic pathological entity. Methods: The experiences of 16 individuals diagnosed as having acoustic shock, within a medico-legal practice, are reviewed. Results: The commonest symptom was otalgia, followed by noise sensitivity, tinnitus, hearing disturbance and dizziness. Conclusion: The presence of noise-limiting technology in the workplace, the variation in the nature of the acoustic incident involved (ranging from a shriek, through feedback noise, to a male voice), and the marked variation in the time of symptom onset (following the acoustic incident) all suggest that the condition termed acoustic shock is predominantly psychogenic. Cases of pseudohypacusis indicate that malingering is a factor in some cases. Clusters of acoustic shock events occurring in the same call centres suggest that hysteria may play a part. The condition is usually only seen when work-related issues are apparent.
- Paper patching of the tympanic membrane as a symptomatic treatment for patulous eustachian tube syndrome. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 25.:1-8.
Background: Application of one or several paper patches on the tympanic membrane can improve autophony and other symptoms in some patients with a patulous eustachian tube. Method: The charts of 21 patients treated for patulous eustachian tube syndrome between 2006 and 2011 were studied for subjective improvement of symptoms following the application of paper patches. Results: Paper patching of the tympanic membrane provided symptomatic relief in 76.2 per cent of patients; relief was permanent in 50 per cent of these patients. Conclusion: Paper patching of the tympanic membrane is a simple and effective means of temporarily or permanently alleviating patulous eustachian tube syndrome symptoms. It is postulated that the patches decrease the admittance of low- to mid-frequency acoustic input at the tympanic membrane by increasing the stiffness of the tympanic membrane, thereby counteracting the middle-ear cushion effect caused by the open eustachian tube.
- Counting the cost. [Journal Article]
- J Laryngol Otol 2014 Feb; 128(2):111.
- High and low doses of clarithromycin treatment are associated with different clinical efficacies and immunomodulatory properties in chronic rhinosinusitis. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 20.:1-6.
Background: Low-dose clarithromycin has been recommended for the treatment of chronic rhinosinusitis without nasal polyps. However, it is uncertain whether a high dose of clarithromycin is more effective than a low dose. Methods: Forty-three chronic rhinosinusitis patients were randomised to low-dose or high-dose clarithromycin groups, and clinical efficacy was evaluated. Pre- and post-treatment measures included: nasal symptom assessment, endoscopic inspection (Lund-Kennedy system), a quality of life questionnaire (the Sino-Nasal Outcome Test 20) and examination of cytokine levels (interleukin-5 and -8) in nasal secretions. Results: The high dose of clarithromycin was significantly better in terms of clinical efficacy than the low dose for the treatment of chronic rhinosinusitis (p < 0.025). Significant differences in nasal cytokine levels (interleukin-5 and -8) were also observed between the low-dose and high-dose groups after short-term clarithromycin treatment (p < 0.025). Conclusion: Short-term, high-dose clarithromycin appears to be more effective for the treatment of chronic rhinosinusitis than low-dose clarithromycin.
- Concepts of Ménière's disease in the Archives of The Journal of Laryngology and Otology. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 20.:1-10.
- Hyperpneumatisation of the craniocervical bones: an emerging aetiological pattern. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 20.:1-4.
Background: Hyperpneumatisation of the skull base and upper cervical vertebrae is a very rare condition of uncertain aetiology and pathophysiology. Case report: A case of extensive hyperpneumatisation of the craniocervical junction and upper three cervical vertebrae is described, in a patient who habitually performed the Valsalva manoeuvre to relieve the symptoms of a patulous eustachian tube. Reported symptoms of ear, neck and shoulder pain deteriorated after minor head trauma. There was a drastic radiological and clinical improvement after ceasing to perform the Valsalva manoeuvre. Discussion: All reported cases of craniocervical bone hyperpneumatisation have in common a history of raised middle-ear pressure, minor trauma or both. We therefore suggest that chronically raised middle-ear pressure leads to destruction of bony tissue and pneumatisation, and that this process is able to cross joints into the cervical spine, either via micro-fractures following trauma, or as a result of congenital assimilation of the craniocervical junction.
- Accidental button battery ingestion presenting as croup. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Feb 20.:1-4.
Objectives: To report a case of misdiagnosis of an impacted oesophageal button battery in a child, and to describe the associated risk factors for impaction and the management of such cases. Case report: An 18-month-old, otherwise fit and well child with stridulous respiration was initially treated for croup. Medical treatment over the course of three months failed, and appropriate imaging subsequently demonstrated an impacted button battery in the upper oesophagus. This was promptly removed. There were no signs of damage on direct visualisation, or on a follow-up contrast swallow image. Conclusion: This case highlights the difficulty of diagnosing oesophageal foreign bodies. We also discuss the characteristics of button batteries which confer a greater risk of impaction, and the associated sequelae and complications.