Variations in treatment of peritonsillar abscess in four Nordic countries.

CONCLUSION: In four Nordic countries, peritonsillar abscess (PTA) patients are treated rather differently. OBJECTIVES: To study how such patients are treated in those countries. METHODS: The 81 chief physicians of otorhinolaryngology departments of all central hospitals in Denmark (n = 15), Norway (n = 19), Sweden (n = 27), and Finland (n = 20) received a multiple-choice questionnaire. RESULTS: A total of 73 physicians (90%) replied. The largest differences arose in treating patients with intravenous versus per oral antibiotics, and treating as inpatients versus outpatients. In Finland, 50% of PTA patients aged >16 years were treated as inpatients and 50% as outpatients, whereas the respective quotas in Sweden were 9 and 91%, Norway 19 and 81%, and Denmark 33 and 67%. Of Finnish physicians, 30% treated their patients primarily with oral antibiotics, 70% with intravenous antibiotics; in Sweden 91 vs 9%, Norway 53 vs 47%, and Denmark 18 vs 82%. In Denmark, almost all patients were operated on immediately, whereas in the other three countries, especially Sweden, operations more often were performed after a recovery period. Combining metronidazole with penicillin or cephalosporins was most common in Denmark: 58% reported usage, compared with 30% in Finland, 16% in Norway, and 4% in Sweden.

Brown tumor mimicking maxillary sinus mucocele as the first manifestation of primary hyperparathyroidism.

We describe the first case of brown tumor mimicking a maxillary sinus mucocele as the first manifestation of the patient's primary hyperparathyroidism. A 34-year old woman presented with a 14 days history of elevation of the right orbit, retrobulbar pain and cheek anesthesia. The CT and MR evaluation showed a mass, initially described as mucocele of the right maxillary sinus. The laboratory studies revealed hyperparathyroidism. The patient underwent acute surgery, and the mass appeared clinically as mucocele. The histological examination of the resected lesion revealed changes representing either giant cell granuloma or brown tumor. The finding of hyperparathyroidism confirmed the diagnosis of brown tumor. To our knowledge, this is the first report of cystic brown tumor mimicking a mucocele of the maxillary sinus.

[Novel tonsillectomy technique]. / Ny metode til tonsillektomi.

INTRODUCTION: Coblation (Co) is a relatively new technique, which may offer a better postoperative course after tonsillectomy than traditional techniques. The purpose of this study was to determine whether Co outperforms classic dissection. Coblation uses radiofrequency energy to excite the electrolytes in a saline solution, creating a precisely focused plasma. The plasma's energized particles have sufficient energy to break molecular bonds within tissue, causing the tissue to dissolve at temperatures between 40 degrees C and 70 degrees C. MATERIAL AND METHODS: A case-control study was conducted in which 26 patients undergoing Co tonsillectomy were matched concerning gender, age and the surgeon's charge with 26 patients undergoing classic tonsillectomy. Furthermore, to compare the rates of postoperative haemorrhage, we reviewed the health records of all patients undergoing Co (60 patients) and routine dissection tonsillectomy (403) at Roskilde County Hospital. RESULTS: Intraoperative bleeding was significantly lower in the Co group (median (MD) 5.0 ml; range (R) 1-32 ml) than in the control group (MD 10.0 ml; R 5-200 ml) (p < 0.0001). The median operation time was also significantly shorter for the Co group (23 min.; R 13-40 min. vs. 32 min.; R 21-63 min.; p = 0.002). Postoperatively, there was no significant difference between the two groups regarding pain scores, analgesics intake, time to return to work and normal diet or weight changes. Neither the primary (0% vs. 2%, p = 0.60) nor the secondary (3.3% vs. 2.5%, p = 0,66) haemorrhage rate was significantly different between Co and traditional tonsillectomy. CONCLUSION: The intraoperative bleeding was lower and the surgery times were shorter in the Co group compared with classic dissection. There was no difference in the postoperative haemorrhage rate between the two tonsillectomy methods.

[Multiple synchronous tumours of different histological type of the salivary glands]. / Multiple synkrone tumorer med forskellig histologi i de store spytkirtler.

Multiple tumours of different histological type of the salivary glands are extremely rare. Here we report a 72-year-old woman who was diagnosed with simultaneously occurring Warthin's tumour of the left parotid and mixed tumour of the homolateral submandibular gland. To our knowledge this combination of histology and localization has not been reported previously. This case also illustrates the importance of thorough examination even after the identification of a single tumour, as multiple synchronous primary tumours--even if rare--can be a diagnostic possibility.