A policy of day-case sinonasal surgery is safe, well tolerated and cost-effective.

OBJECTIVE: Practices vary regarding the timing of discharge after sinonasal surgery. This study aimed to examine the cost-effectiveness of same-day discharge compared to next-day discharge after sinonasal surgery. METHODS: A retrospective single-surgeon audit of sinonasal surgery over a 12-month period was performed. Demographic and clinical details, including distance travelled home, timing of discharge, hospital re-presentation, and complications, were collected and compared between the same-day discharge and next-day discharge groups. A cost-effectiveness analysis was performed. RESULTS: A total of 181 patients were identified; 117 underwent day-case surgery, of which 6 re-presented to the emergency department. Sixty-four patients stayed overnight after surgery, and six of those patients re-presented to the emergency department. The per patient cost was $3262 for day-case sinonasal surgery and $5050 for those admitted overnight after surgery (p < 0.001). CONCLUSION: Routine same-day discharge after sinonasal surgery is achievable, safe and cost-effective.

Excimer laser micromachining for rapid fabrication of diffractive optical elements.

We demonstrate the fabrication of binary, multilevel, and blazed diffractive structures by a fast and flexible direct-write process by using an excimer-laser-based tabletop micromachining workstation with an integrated optical surface profiler.

An audit of prophylactic antibiotic treatment following tonsillectomy in children.

A prospective audit study was undertaken to assess the effect of two different management policies following tonsillectomy in children in this hospital, one of which requires a prophylactic five-day course of oral antibiotics and the other doses not. A total of 95 children were entered into the trial: 54 received post-operative antibiotics and 41 did not. The post-operative recovery was assessed by completion of a parent questionnaire which included the following parameters: degree of patient distress, nausea and vomiting, otalgia, halitosis, pharyngeal bleeding, analgesic requirement, day of return to a regular diet and General Practitioner consultation. There was no significant reduction in any of the morbidity measures in patients treated with antibiotics. I fact, the analgesic requirement and the incidence of otalgia and irritability on Days 6 and 7 and secondary haemorrhage were significantly higher in the antibiotic-treated patients. Although the number of patients included in this study are small, the result suggest that post-operative antibiotics do not improve the outcome of uncomplicated tonsillectomy. Our previous practice of routinely administering antibiotics to post-tonsillectomy children has been discontinued as the consequence of this audit.

Stimulated Brillouin scattering phase conjugation of an amplified hydrogen fluoride laser beam.

Optical phase conjugation through stimulated Brillouin scattering was used to correct phase aberrations on a beam that was double passed through a pulsed hydrogen fluoride laser amplifier.

Stimulated Brillouin scattering and phase conjugation of hydrogen fluoride laser radiation.

Stimulated Brillouin scattering (SBS) of hydrogen fluoride laser radiation has been demonstrated for the first reported time. A flash-lamp-pumped pulsed chemical laser, operating single-line at 2.91 microm, was used to generate backward-stimulated Brillouin scattering in high-pressure xenon gas with power reflectivities of ~50%. Intentional aberration and subsequent restoration of a high-spatial-quality beam provided evidence of phase conjugation by the SBS process.