Labial pit and ectopic salivary gland tissue.

We report the unusual case of a girl who presented with a lesion on her soft palate and subsequently was found to have a sinus in her labial sulcus. This case report discusses investigation and management of the patient. Further to this we discuss the postulated embryological development of both the parotid gland and labial pit.

A prospective, single-blind, randomized controlled trial of petroleum jelly/Vaseline for recurrent paediatric epistaxis.

The aim of the study was to determine if petroleum jelly was an effective treatment for paediatric epistaxis. A single-blind, prospective, randomized controlled trial was undertaken in an otolaryngology outpatient clinic of a paediatric hospital from March 2001 to March 2002. A total of 105 children referred with recurrent epistaxis were randomized into the study, 52 into the treatment arm and 53 into the control arm. Children in the treatment arm applied Vaseline twice a day bilaterally for 4 weeks and were monitored for any bleeds for the next 4 weeks. Children in the control arm were simply given an 8-week appointment and the number of bleeds were monitored for the 4 weeks prior to their appointment. The outcome measure was the proportion of children in each group without nosebleeds in the preceding 4 weeks. Both groups were equally distributed in age, duration of symptoms and duration of each bleed. Fourteen of 51 (27.5%) patients of the treatment arm and 18 of 53 (34%) of the control arm did not bleed in the 4 weeks before review (chi-square test, P = 0.472). It can be concluded that Vaseline alone confers no benefit over simple observation in recurrent childhood epistaxis.

The perceived risk of variant Creutzfeld-Jakob disease and the effect of additional delay in tonsillectomy: a questionnaire based parents perspective.

OBJECTIVES: In February 2001 the United Kingdom Department of Health in conjunction with the British Association of Otolaryngology, Head and Neck Surgeons decreed that all non-emergency tonsillectomies should be performed using disposable instruments because of the theoretical risk of transmission of variant Creutzfeld-Jakob disease (vCJD). There was an understandable delay in the provision of these instruments by the various manufacturers, leading to an increase in waiting time for surgery. It was decided to assess parental attitudes to the risk of vCJD, and assess the effect the additional delay had on their child. METHOD: A questionnaire was sent to the parents of all 249 children on the waiting list for tonsillectomy. RESULTS: Seventy percent replied, and of these, 37% felt there was a risk of reusing instruments, only 10% felt there was no risk, and the remaining 53% did not know if there was any risk. Nevertheless 41% of parents would have gone ahead using old instruments if allowed. All parents of the 73 children waiting greater than 6 months were questioned on the effect of the additional delay. Only 7% reported improvement in symptoms, and 68% felt the additional delay had badly affected their child's health and wellbeing. Ninety percent of parents felt their child's symptoms still warranted tonsillectomy. CONCLUSION: There is an awareness of risk of vCJD among parents whose children await tonsillectomy, although understandably the level of risk they feel is hard to quantify. The rate of symptom resolution whilst on the waiting list was very low.

Nasogastric tube misplacement into Eustachian tube.

Paediatric nasogastric tube placement can occasionally be difficult to perform. A unique case in a child is described where the tip of the nasogastric tube managed to travel via the Eustachian tube through the attic and into the mastoid cavity of the middle ear. To the best of the authors' knowledge, this has never been reported in the literature before.

Patient eligibility for day case paediatric adenotonsillectomy.

There is a growing trend towards day case surgery and departments are constantly under pressure from Health Trusts to perform more day case procedures. Adenoidectomy and tonsillectomy are being performed as day case procedures in many centres and literature has suggested that it is safe to do so, provided the population characteristics are favourable. A prospective study of 100 consecutive patients presenting to our department for tonsillectomy or adenotonsillectomy was undertaken to assess the eligibility of our patient group for day surgery. Medical and social history was obtained as per recommended guidelines. Only 27% of our patients were eligible for day surgery and only 17% of parents preferred the option of day case adenotonsillectomy. There is a marked difference between our group and those previously reported in the literature. This regional variation has implications in the safe expansion of day surgical procedures.

Nasal dermoids: the significance of a midline punctum.

Nasal dermoids are rare and their diagnosis is often delayed until complications occur. Signs such as a midline nasal punctum may be noted at birth but the significance of this finding frequently passes unrecognised. The cases are reported of two patients which illustrate the typical presentation of these lesions and their subsequent management is discussed.

An analysis of the aetiology of early childhood deafness.

It is generally believed that one in every thousand children is profoundly deaf. An understanding of the aetiology of early childhood deafness and timely detection is crucial in rehabilitation of these children. This study analyses the aetiology of early childhood deafness and shows that deafness is more often acquired than inherited. Non-syndromic deafness, especially occurring on its own, usually produces profoundly deaf children and thus there is the need for genetic studies--in the child, laterally, and longitudinally into generations. Meningitis appears to be the commonest cause of acquired deafness, especially if due to pneumococcus. Only 40 of the 80 cases presented before the age of 2 years. It was therefore interesting to note what factors invoked awareness of deafness to facilitate early presentation.

Laryngeal and ocular granulation tissue formation in two Punjabi children: LOGIC syndrome.

Two unrelated children, both born in the United Kingdom of Punjabi Muslim parents, developed within months of birth, nodules in the larynx, conjunctiva and nailbeds. Currently the younger female child, aged five, is developing skin papules while the elder boy, now aged 15, is debilitated by oral, oesophageal and tracheal granulation tissue formation. Numerous biopsies of the affected tissues have revealed subepithelial granulation tissue formation of unknown aetiology. Extensive haematological, biochemical and bacteriological investigations were uninformative as to the cause. Treatment with steroids, dapsone, antituberculous drugs, and local excision failed to control the disease. No description of this condition exists in the international medical literature available to us.

Tympanometry and the stapedial reflex in the first five days of life.

Tympanometry was carried out on 45 full term neonates. It proved to be a straightforward procedure. The acoustic reflex was elicited using contralateral white noise stimulation at 70-85 dB and with a probe tone of 600 Hz. It was not detectable in the first hours of life, but was present in 100% of cases over 12 h of age. The initial absence of the reflex may be due to a transient conductive loss which resolves rapidly or, more likely, immaturity of the reflex itself at birth.