RESUMEN
BACKGROUND: Autoinflation devices are commonly used for otitis media with effusion and Eustachian tube dysfunction. Generally, these are very safe devices, with few or no complications.Case reportThis paper presents a case study of pneumocephalus and orbital emphysema, associated with the use of an autoinflation device, in a 73-year-old woman with Eustachian tube dysfunction and otitis media with effusion, and a history of extensive endoscopic sinus surgery 13 years previously. CONCLUSION: A literature review showed autoinflation-related pneumocephalus in patients with skull base defects relating to cranial surgery or tumours; however, this has not been described previously with the Otovent system or its use in relation to functional endoscopic sinus surgery. Given the theoretical risk of undetected bony abnormalities in post-operative functional endoscopic sinus surgery patients, it is suggested that autoinflation devices are used cautiously in patients with a history of sinus surgery.
Asunto(s)
Ventilación del Oído Medio/efectos adversos , Enfermedades Orbitales/etiología , Otitis Media con Derrame/terapia , Neumocéfalo/etiología , Enfisema Subcutáneo/etiología , Pruebas de Impedancia Acústica , Anciano , Endoscopía , Trompa Auditiva , Femenino , Humanos , Ventilación del Oído Medio/instrumentación , Enfermedades Orbitales/diagnóstico , Neumocéfalo/diagnóstico , Autocuidado , Enfisema Subcutáneo/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To determine if there is evidence that post-tonsillectomy dietary advice affects post-operative morbidity. METHOD: A systematic review was conducted of Embase, Medline, the Cumulative Index to Nursing and Allied Health Literature and PsycInfo, to November 2014. RESULTS: Seventeen articles were included; their heterogeneous nature prevented meta-analysis. Of these, all three small, randomised studies showed no statistical difference in morbidity between restricted and non-restricted diets. CONCLUSION: Most post-tonsillectomy dietary advice is based on historical anecdotes and not rigorous scientific testing. The existing small-scale, randomised studies show no statistical difference in morbidity between non-restricted and restricted diets.
Asunto(s)
Dieta/normas , Cuidados Posoperatorios/métodos , Tonsilectomía , HumanosRESUMEN
INTRODUCTION: The aim of this study was to assess tonsillitis and tonsillectomy trends, both from a local and national perspective. METHODS: Retrospective analysis was carried out of tonsillitis admissions and tonsillectomy rates over a ten-year period in a university teaching hospital from 2003 to 2012. RESULTS: Since 2003 tonsillitis admissions have increased locally by 118% in adults and 179% in children despite negligible changes in tonsillectomy rates. Similar trends have been observed nationally. CONCLUSIONS: The findings of this study may be considered to be the result of current National Health Service policy. A reconsideration of agreed indications for tonsillectomy could potentially reduce hospital admissions of patients with tonsillitis in the long term.
