Cochlear implantation in mitochondrial deafness due to A7445G mutation.

OBJECTIVE: This study aimed to determine if cochlear implantation (CI) improved speech discrimination in the New Zealand pedigree with the A7445G mitochondrial DNA (mtDNA) mutation and sensorineural hearing loss (SNHL). METHODS: Nine patients had their speech discrimination and pure tone audiograms evaluated. Pre- and post-implant results were compared. Type of CI and patient age at implantation was recorded. RESULTS: Speech discrimination testing shows greatly improved functional hearing after CI in this group of patients. DISCUSSION: Individuals with mtDNA-related SNHL should be identified by screening and offered assessment for CI suitability because functional hearing improves after CI.

Peritonsillar infection in Christchurch 2006-2008: epidemiology and microbiology.

AIM: Peritonsillar infection is a complication of acute tonsillitis. It is common and complications can be life-threatening. This study audits all cases of peritonsillar infection presenting to our unit between 2006 and 2008 in order to determine if the epidemiology, bacteriology and antibiotic sensitivity has changed since previous audits in our unit in 1981-1984 and 1990-1992. METHODS: Retrospective chart review. RESULTS: 213 patients were admitted acutely with peritonsillar infection between January 2006 and December 2008. The average age was 29 years with 30.5% patients in the modal age group of 15-19 years. Male to female ratio was 1.5:1. 54% presented with their first episode. 39% received antibiotics prior to presentation. In two-thirds of cases, the duration of admission was less than 24 hours. Culture results were obtained from 69% of specimens. Cultures mostly contained mixed anaerobic and aerobic bacteria. The most common aerobes were streptococcal species. Organisms were almost uniformly sensitive to penicillin. 21% of patients subsequently underwent tonsillectomy, usually as a delayed procedure. CONCLUSION: Peritonsillar infection is a common complication of tonsillitis and can be life-threatening. The number of cases presenting at Christchurch Hospital has increased disproportionate to the population increase since the previous audits. Culture results demonstrate a preponderance of mixed organisms, which may be pathological. Organisms and their sensitivities have not changed since the previous audits. Infection usually responds favourably to drainage in combination with penicillin as the first-line antimicrobial agent.

Nasal fractures: patient satisfaction following closed reduction.

AIM: Nasal fractures are commonly treated by primary closed reduction. However, studies suggest this produces unacceptable functional and aesthetic results. Many patients require revision surgery. We aimed to assess patient satisfaction following closed reduction of nasal fractures. METHODS: Retrospective chart review of patients with nasal fractures treated by closed reduction at the Wellington Regional Plastic, Maxillofacial and Burns Unit, New Zealand over a 2-year period was undertaken. Digital manipulation under general anaesthetic was performed. Patients were followed-up by telephone with a structured interview. RESULTS: Of 116 consecutive patients, 74 (65%) were successfully contacted. 65 (88%) were satisfied with functional outcome, and 64 (86%) with aesthetic outcome. Of the 34 patients reporting incomplete correction, 12 (35%) would consider revision surgery. CONCLUSION: Patients treated with closed reduction of nasal fracture performed under general anaesthetic with digital manipulation reported high levels of satisfaction with functional and aesthetic outcomes. Revision rate is low.