ABSTRACT
BACKGROUND: Autoinflation devices are commonly used for otitis media with effusion and Eustachian tube dysfunction. Generally, these are very safe devices, with few or no complications.Case reportThis paper presents a case study of pneumocephalus and orbital emphysema, associated with the use of an autoinflation device, in a 73-year-old woman with Eustachian tube dysfunction and otitis media with effusion, and a history of extensive endoscopic sinus surgery 13 years previously. CONCLUSION: A literature review showed autoinflation-related pneumocephalus in patients with skull base defects relating to cranial surgery or tumours; however, this has not been described previously with the Otovent system or its use in relation to functional endoscopic sinus surgery. Given the theoretical risk of undetected bony abnormalities in post-operative functional endoscopic sinus surgery patients, it is suggested that autoinflation devices are used cautiously in patients with a history of sinus surgery.
Subject(s)
Middle Ear Ventilation/adverse effects , Orbital Diseases/etiology , Otitis Media with Effusion/therapy , Pneumocephalus/etiology , Subcutaneous Emphysema/etiology , Acoustic Impedance Tests , Aged , Endoscopy , Eustachian Tube , Female , Humans , Middle Ear Ventilation/instrumentation , Orbital Diseases/diagnosis , Pneumocephalus/diagnosis , Self Care , Subcutaneous Emphysema/diagnosis , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To determine if there is evidence that post-tonsillectomy dietary advice affects post-operative morbidity. METHOD: A systematic review was conducted of Embase, Medline, the Cumulative Index to Nursing and Allied Health Literature and PsycInfo, to November 2014. RESULTS: Seventeen articles were included; their heterogeneous nature prevented meta-analysis. Of these, all three small, randomised studies showed no statistical difference in morbidity between restricted and non-restricted diets. CONCLUSION: Most post-tonsillectomy dietary advice is based on historical anecdotes and not rigorous scientific testing. The existing small-scale, randomised studies show no statistical difference in morbidity between non-restricted and restricted diets.
Subject(s)
Diet/standards , Postoperative Care/methods , Tonsillectomy , HumansABSTRACT
INTRODUCTION: The aim of this study was to assess tonsillitis and tonsillectomy trends, both from a local and national perspective. METHODS: Retrospective analysis was carried out of tonsillitis admissions and tonsillectomy rates over a ten-year period in a university teaching hospital from 2003 to 2012. RESULTS: Since 2003 tonsillitis admissions have increased locally by 118% in adults and 179% in children despite negligible changes in tonsillectomy rates. Similar trends have been observed nationally. CONCLUSIONS: The findings of this study may be considered to be the result of current National Health Service policy. A reconsideration of agreed indications for tonsillectomy could potentially reduce hospital admissions of patients with tonsillitis in the long term.
