Otological and vestibular symptoms in patients with low grade (Quebec grades one and two) whiplash injury.

OBJECTIVE: To establish the prevalence of new vestibular and otological symptoms in a group of patients who had sustained a low grade (Quebec grades one or two) whiplash injury. METHODS: A retrospective review of the case records of 109 patients undergoing assessment by a single practitioner for the purposes of compiling a medicolegal report on their whiplash injury. RESULTS: Four patients complained of short-lived, non-specific dizziness symptoms in the acute phase following their original injury. There were no reports of vertigo, tinnitus or hearing loss after a mean period of 149 days following the whiplash injury. CONCLUSIONS: No patients reported otological or persistent vestibular symptoms in the acute phase following their whiplash injury. This suggests that caution should be exercised when attributing these symptoms to such an injury. Before whiplash injuries are admitted as an aetiological factor in the development of such symptoms, other causes should be excluded.

Improving the reproducibility of acoustic rhinometry in the assessment of nasal function.

Acoustic rhinometry readings are very position dependent, and it was hypothesized that this accounts for its relative lack of reproducibility on a day-to-day basis. Multiple readings on each visit were taken to investigate their impact, if any, on improving the day-to-day reproducibility of the method. Measurements of the minimal cross-sectional area of the nose as measured by acoustic rhinometry were studied in 10 subjects following nasal decongestion. For each individual, acoustic rhinometry was performed ten times. The ten recordings were repeated again, in an identical manner on a separate day. The subjects were repositioned and the nasal probes reinserted between each measurement. The mean coefficient of variation for minimal cross-sectional area readings in all 10 subjects was calculated as 9.92%. This is comparable to the day-to-day variability of acoustic rhinometry as measured by other workers and thus supports the hypothesis that the high measurement error of the device (rhinometer) is a function of positional variation during data acquisition. We were able to demonstrate a minimal gain in intervisit reproducibility by doing multiple recordings per person, with a plateau effect of reproducibility after 7 repeat readings.

Day-stay tonsillectomy: is hospital stay reduced at the expense of increased community care?

There is concern about the burden day-stay surgery created upon community services. We have followed 128 children and 38 adults undergoing day-stay tonsillectomy and a similar cohort of adults and children undergoing tonsillectomy as inpatients and looked at the demands made on general practice and casualty services over the 2 weeks after discharge. Twelve adults (18%) and four children (3%) required overnight admission after day-stay surgery. Within the first 2 weeks, 27 adults (48.2%) and 62 children (50%) visited their GP and 13 adults (23.2%) and six children (4.8%) visited the casualty department. There was no statistically significant difference for either adults or children when comparing the day-stay and inpatient cohorts. Adult day-stay tonsillectomy is associated with a high admission rate. Both adult and paediatric tonsillectomy lead to considerable demand for general practice and casualty services, but this demand is high regardless of whether the day-stay or inpatient route is chosen.