Suction diathermy adenoidectomy performed in the district general hospital.

BACKGROUND: Adenoidectomy is often carried out in children for conditions such as nasal obstruction, otitis media with effusion, and obstructive sleep apnoea. Traditionally, it is performed as a blind procedure with a St Clair Thomson curette. An acceptable alternative technique is suction diathermy adenoidectomy. This study aimed to ensure that the complication rate of this latter technique was within published rates and national guidelines. METHOD: A retrospective case note review was conducted, and information regarding surgery, indications and complications was collected. RESULTS: Post-operative haemorrhage was recorded for 2 of 121 patients (at days 10 and 11 post-operatively): 1 returned to the operating theatre and the other was managed conservatively. Two patients were diagnosed with infection post-operatively and managed with oral antibiotics. A further four patients re-presented with pain; in all cases, this was recorded as secondary to tonsillar fossa infection, rather than being pain related to adenoidectomy. CONCLUSION: Given the rare but serious potential complications, the authors support National Institute for Health and Clinical Excellence guidance, which recommends that only surgeons with specific training perform this technique. By using the standard procedures for clinical governance, it is possible to ensure safe practice of even little-used techniques.

Current use of and attitudes to e-learning in otolaryngology: questionnaire survey of UK otolaryngology trainees.

INTRODUCTION: The E-lefENT programme is a collaborative e-learning project developed by the Department of Health and ENTUK. Prior to its introduction, we aimed to assess current use of and attitudes towards e-learning amongst UK otolaryngology trainees. METHOD: A web-based questionnaire was distributed to UK otolaryngology trainees via regional programme directors. RESULTS: A total of 117 responses was received (35 per cent response rate). Most trainees reported increasing exposure to e-learning throughout their training and rated their current computer literacy skills highly, although satisfaction with current e-learning resources was found to vary widely for a variety of reasons. CONCLUSION: Meeting the educational needs of otolaryngology trainees in the current era continues to be a challenge. Most trainees are already familiar with e-learning, although the quality and delivery of available websites is currently variable. The majority of trainees who responded seemed receptive to the implementation of a free, otolaryngology-specific e-learning resource.

Familial systemic amyloidosis associated with bilateral sensorineural hearing loss and bilateral facial palsies.

The Finnish type of familial amyloid polyneuropathy due to variant gelsolin is a rare form of familial amyloidosis. The subtype was first described in 1969 and is characterized by progressive cranial neuropathies, corneal lattice dystrophy and distal sensorimotor dysfunction. It is extremely uncommon, with only two families known to be affected in the UK. We discuss the case of a 70-year-old woman who presented with bilateral facial nerve palsies, bilateral sensorineural hearing loss and Finnish type familial hereditary amyloidosis. A literature search of the Medline database (1966-2005) was performed, using the keywords 'amyloid', 'hearing loss' and 'facial palsy'; however, this association appears to be a novel finding. We review the current literature and discuss otorhinolaryngological presentations of amyloidosis.

3-D optical coherence tomography of the laryngeal mucosa.

Laryngeal carcinoma is one of the commonest primary head and neck malignancy and the need for early identification is very important for successful treatment. Outpatient fibreoptic examination of the larynx is unreliable in differentiating benign, pre-malignant and malignant lesions, and therefore surgeons have to rely on biopsies for a definitive diagnosis. This is an invasive procedure requiring general anaesthesia and may have a detrimental effect on the patient's voice. Conventional imaging modalities (ultrasound, computed tomography and magnetic resonance imaging) have a limited resolution and hence cannot give sufficient information on the extent or nature of laryngeal lesions. The aim of our study is to investigate the feasibility of optical coherence tomography (OCT) in imaging the normal larynx, to lay the foundations for an investigation of its ability to differentiate between benign and malignant disease. Ten tissue specimens from normal larynges were imaged with an 850 nm OCT system that was capable of providing both B-scan (longitudinal or cross-section) images as well as C-scan (en-face or images at constant depth). The en-face OCT mode allowed us to reconstruct 3-D OCT images of the tissue examined. Imaged specimens were processed with standard histopathological techniques and sectioned in the plane of the B-scan OCT images. Haematoxylin-eosin stained specimens were compared with the OCT images thus collected. Preliminary results showed good correlation between OCT images and histology sections in normal tissue.