Effect of Mouth Cancer Awareness Week on urgent suspected head and neck cancer referrals.

The purpose of this study was to find out whether Mouth Cancer Awareness Week and associated activities made any difference to the number of urgent or two-week urgent referrals to the oral and maxillofacial department at University Hospital, Aintree, whether they were appropriate, and the number of patients who were found to have cancer. A prospective audit over six months before, during, and after the awareness week showed a rise in the number of referrals over time, with the highest number in February. Of the 120 patients evaluated, cancer was confirmed in 13 (11%).

Analysis of the impact of deprivation on urgent suspected head and neck cancer referrals in the Mersey region between January 2004 to December 2006.

Serious delay in patients presenting with head and neck cancer is associated with poor outcomes. We aimed to examine the influence of deprivation on professional delay in the Mersey region from 2004 to 2006. The study sample comprised 6681 patients who were referred between January 2004 and December 2006. The dataset was dominated by the largest hospital (H1), which received 48% of all cases. Median referral overall was 12 days (IQR 8-15 days), and 74% of patients were referred in 14 days or less. Professional delay (percentage 14 days or less) was associated with hospital (from 58% H1 to 97% H5), year of referral (from 64% in 2004 to 80% in 2006), age (from 69% under 55 years to 80% over 75 years), and deprivation (Index of Multiple Deprivation 2000 from 67% most deprived (IMD 1) to 85% least deprived (IMD 5)). Hospital location was associated with these factors and the results imply that by far, the most important variable in predicting professional delay was the hospital that received the referral. Trends over time in age, and to a lesser extent, for deprivation were noted in H1, but were largely absent across other hospitals. Some of them needed to make substantial improvements to meet the two-week referral pathway and it would be interesting to compare these results with current practice. This study highlights the importance of maintaining the standards of the current policy on two-week referrals for suspected head and neck malignancy.

Craniocervical necrotising fasciitis--an interesting case with review of the literature.

Craniocervical necrotising fasciitis (CCNF) is an aggressive and potentially fatal infection associated with high morbidity and mortality if early intervention is not implemented. Patients are often unwell at presentation, the clinical picture is often unclear thus presenting with diagnostic difficulty. We report a case of CCNF presenting at an advanced stage and discuss the condition including its management and associated complications.

Isolated periorbital angio-oedema induced by aspirin: a case report and review of the literature.

UNLABELLED: Periorbital angio-oedema may present as an isolated manifestation of aspirin intolerance and can be very alarming to the patient. This case describes a 38-year-old gentleman with such localized clinical features. Once considered an unusual phenomenon, review of the literature has revealed an increased frequency, possibly as a result of previous poor documentation. Clinical manifestations of nonsteroidal anti-inflammatory drugs (NSAIDs) intolerance, in particular periorbital angio-oedema and its associated symptoms, with proposed aetiology and pathogenesis, are discussed. CLINICAL RELEVANCE: With the wide use of this drug and other NSAIDs for the relief of painful and inflammatory dental and facial conditions, such localized manifestation of aspirin intolerance may present to the general dental practitioner and other dental specialties. Patients' medical history may reveal sensitivity to these groups of drugs, and in such cases, should be avoided and suitable alternatives provided.