Combined transoral and nasendoscopic resection of an eustachian tube hairy polyp causing neonatal respiratory distress.

Hairy polyps are rare congenital malformations that can arise in the nasopharynx. It is rarer for them to originate from the eustachian tube. They present with intermittent airway obstruction and respiratory distress. A thorough ear, nose, and throat examination can be required to identify these lesions. We present a case of eustachian tube hairy polyp causing neonatal respiratory distress in a 1-month baby successfully removed by a combined transoral and nasendoscopic resection.

Audit of nasal fracture management in accident and emergency in a district general hospital.

RATIONALE: Nasal fractures are a common occurrence in accident and emergency and dealt with by inexperienced senior house officers. This can lead to inappropriate X-rays being performed, no proper documentation of septal haematomas and often no follow-up with a specialist team leading to in some cases complex cosmetic surgery whereas simple manipulation may have sufficed. METHOD: We report an ambispective audit carried out on nasal fracture management in a busy district general hospital over a 6-month period. RESULTS: 46 patients were seen 24 in the first 3 months and 22 the next three. 10 had nasal X-ray performed initially on audit. Nine had no documentation of septal haematoma and seven had no follow-up arranged. After appropriate education and the setting up of a department protocol based on best practice, the next cycle was repeated. Two nasal X-rays were performed looking for foreign bodies, all patients had appropriate documentation of septal haematoma and appropriate follow-up. CONCLUSION: Appropriate education and implementation of departmental guidelines can result in more effective and efficient use of resources when dealing with nasal fractures in accident and emergency.

Ten-year review of laryngotracheal reconstruction for paediatric airway stenosis.

OBJECTIVES: To review the outcomes of paediatric patients with laryngotracheal stenosis treated at our institution by laryngotracheal reconstruction (LTR). METHODS: A single surgeon personal series retrospective review of case notes over a 10-year period from a single site tertiary referral paediatric otolaryngology department in patients with laryngotracheal stenosis treated with laryngotracheal reconstruction. Evaluation was based on the last laryngotracheal endoscopy, and a retrospective review of the patient's data. RESULTS: Seventy-three open laryngotracheal procedures were undertaken for paediatric laryngotracheal stenosis from the period 1995-2005. Fourteen were cricoid split operations and will be described elsewhere. The remaining 59 procedures were cartilage graft laryngtracheal reconstructions, performed on 53 patients (37 single stage and 16 staged) with 6 having required revisions. CONCLUSIONS: LTR provides good results for subglottic stenosis (SGS) as primary or salvage operations. The procedure has no deleterious effects on laryngeal growth. The causes of failed procedures are discussed.