Foreign body in the vallecula presenting as acute epiglottitis with unilateral supraglottitis

Life threatening inflammatory swelling of the epiglottic and supraglottic regions secondary to a foreign body in the vallecula is an unusual occurrence. Upper airway obstruction is potentially a life threatening sequela. We present a unique case of acute epiglottitis with unilateral supraglottitis secondary to foreign body in the vallecula, which gradually improved after emergency endotracheal intubation for respiratory arrest, followed by intensive conservative management with intravenous antibiotics, cortisone and intravenous fluids. This case emphasizes that a foreign body in the vallecula presenting with severe dysphagia should be taken seriously as it may lead to life threatening complications

Ear syringing versus suctioning for ear wax removal

To compare the success rate and complications of ear syringing versus suctioning technique for removal of ear wax. Setting: ENT department, Buraidah Central Hospital, Buraidah AlQassim, Saudi Arabia. Method, and Patients: Out of 1199 cases who attended the clinic for ear wax cleaning from May 1998 to Aug 2000, 300 cases were selected randomly for this study. Patients were equally distributed in a random fashion between two ENT surgeons for the two different techniques. Age and sex of the subjects as well as the indication and complications of these two commonly used techniques were analysed. Males were more than females [M:F = 1.2:1] and 45% of the cases were seen in the age group of 10-40 years. The success rate for ear suctioning was 90.6% [136/150]and syringing was 84%[126/150]. Rate of complication was 16%[24/1 50] for ear syringing technique and 9.3%[14/150] for suctioning with no statistical significance. However, external otitis was significantly more frequent with ear syringing technique. [p=.02]. Although impacted ear wax can be removed with relative ease by these two techniques, there are contraindications and cautions should be exercised. Otologic complications do result from these procedures and we noted a higher rate of external otitis with ear syringing. In conclusion ear suctioning is an effective and well tolerated procedure in the hands of experienced physicians