Cervical pain syndromes. A rare cause for pain in the neck

Fourteen patients who presented with neck or throat pain, without apparent cause were selected for this study from February 2001 to November 2002. The diagnosis was pain syndromes arising from the region of the hyoid, mastoid process hones; the thyroid or cricoid cartilages. This diagnosis is often missed and yet is readily treatable. Diagnosis was made by eliciting an impressive tenderness over the bone or cartilage affected and excluding any other pathology in the head and neck area simulating the condition. Control of pain was achieved by intralesional injection of a mixture of corticosteroid plus 1% lignocaine except in the mastoid process syndrome in which topical applied of an anti-inflammatory emulgel was used. Greater recognition of these syndromes will avoid unnecessary investigations and treatments to this group of patients

Implications of the anatomy of anorectal muscles in the correction of anorectal malformations

Despite the vitality of the anatomy of the anorectal muscles, their extant configuration was and still a subject of controversy. The implications of the anatomical knowledge in surgery of congenital anorectal anomalies were stressed by all investigators. Facing the unanimate conceptsdescribed, reinvestigate the anatomical configuration of the anorectal muscles through careful dissection, sectioning and histology of pelvis of still births was planned. The resultsconformed with the trilaminar arrangement of sphincter aniexternus, but the posterior attachment of the superficial portion to coccyx could not be identified. The study supported the view of partial attachment of the deep portion to puborectalis. It was found that the puborectalis is not a sling as described but a considerable sheet extending down to the level of dentate line. The plan of repair of anorectal muscles which carried more respect to their anatomical configuration was described. It was believed that the anal sphincters had a synergistic action and they act as a group through their partial overlap and partial attachment