Patients' perception of using a smartphone light source in the clinical environment.

Introduction A satisfactory light source is of paramount importance during an oral head and neck examination. It has become common practice for the light source on a smartphone to be used during inpatient intra-oral examination. We determined if patients identified the use of a smartphone as a light source, during head and neck examinations, as unprofessional.Methods and materials A clinical photograph illustrating professional errors was presented to patients as a pilot survey (n = 10); a smartphone camera flash being used as a light source was featured. Patients were then asked which aspects they considered unprofessional. Following staff training and improvements to the survey wording, the same photo was presented to patients (n = 150) as the main study.Results Of the patients surveyed, 97% considered the use of a smartphone in the staged clinical photograph as unprofessional. They also noted: a clinician sitting on the bed (88%), clinicians not wearing gloves (81%), lack of privacy/curtain not drawn (62%), long hair not tied back (50%), a clinician's name badge not visible (23%), clinician bare below the elbows (15%) and clinician not wearing a tie (12%).Conclusions This is the first piece of research into the use of a smartphone light source within clinical examination. The use of a smart phone light source during clinical examination was the most reported 'error' and was recognised more than a clinician not wearing gloves. Eighty-five percent of patients considered the use of a smartphone light source unprofessional. Authors, therefore, do not advocate the use of a smartphone light source in the clinical care of patients.

Spindle cell haemangioma of the tongue.

BACKGROUND: Spindle cell hemangioma (SCH) is an uncommon benign vascular tumor that rarely occurs in the mouth. METHODS AND RESULTS: We present an SCH arising in the tongue of a 52-year-old otherwise healthy woman. SCH should be considered in the differential diagnosis of vascular tumors in the oral cavity and not misinterpreted as a more aggressive vascular tumor. We describe the clinical presentation, investigation, differential diagnosis and management of this condition and a literature search showing published case reports. CONCLUSION: Although SCH rarely presents in the oral cavity it needs to be considered in the differential diagnosis of oral cavity tumors.

Posterior auricular nerve found anterior to the cartilage of the external auditory meatus--a previously unreported variant.

We describe a previously unreported anatomical variant of the posterior auricular nerve found during parotidectomy, and discuss its clinical implications.

Performing to a world class standard under pressure--can we learn lessons from the Olympians?

With the 2012 Olympics being held in London, we explored pre-requisites for success in sport, and the comparative efficacy of employing these when performing under intense pressure in the clinical setting. We asked members of the Great Britain Olympic rowing team and OMFS surgeons to complete a validated questionnaire on how they performed under pressure. 89 questionnaires were completed by 43 surgeons and 46 rowers (81% response). We compared the results in terms of mental toughness and technical skill. The importance of training to be a winner was evident in athletes. While emphasising the multidimensional nature of talent, we recognise the essential role of psychology in the ability of individuals to fulfil their sporting potential. We discuss the possible implications for surgeons.

Sudden hypotensive syncope and significant iatrogenic maxillofacial trauma following administration of oral sodium phosphate purgative solution.

Oral sodium phosphate (NaP) solution is used globally as a bowel preparation for colonoscopy, surgery and medical-imaging (Balaban 2008). We present a case of a patient who suffered sudden hypotensive syncope and iatrogenic mandibular fractures within an hour of ingesting a NaP solution. We discuss the uses of these medicines and highlight the need to warn patients of possible adverse side effects to avoid patient harm and subsequent litigation.