(Ton)silly seasons? Do atmospheric conditions actually affect post-tonsillectomy secondary haemorrhage rates?

BACKGROUND: Tonsillectomy is a common procedure, with potentially life-threatening complications. Previous investigations into post-tonsillectomy secondary haemorrhage rates suggest an influence of climactic and atmospheric conditions on haemorrhage rate, particularly temperature and water vapour pressure. With a single emergency department and a large variance in atmospheric conditions, Darwin, Australia, is ideal for investigating the effects of local climate on rates of post-operative haemorrhage. METHODS: A five-year retrospective review was conducted of all tonsillectomy procedures performed between 2008 and 2013. Effects of atmospheric variables were examined using Pearson's correlation coefficient and analysis of variance. RESULTS: A total of 941 patients underwent tonsillectomy in the study period. The bleeding rate was 7.7 per cent. No variation was found between wet and dry season tonsillectomies (p = 0.4). Temperature (p = 0.74), water vapour pressure (p = 0.94) and humidity (p = 0.66) had no effect on bleeding. CONCLUSION: The findings revealed no correlation between humidity, season, water vapour pressure and haemorrhage rates. Further research should use multi-site data to investigate the effect of air conditioning, humidification and climactic conditions between different regions in Australia.

Bismuth iodoform paraffin paste: a review.

INTRODUCTION: This article reviews the literature pertaining to bismuth iodoform paraffin paste. OVERVIEW: Bismuth iodoform paraffin paste is used in most otolaryngology departments on a daily basis. Questions about its properties are common in postgraduate otolaryngology examinations. This article reviews bismuth iodoform paraffin paste's current and historical usage, constituents, properties, side effects, and radiographic properties, and its alternatives in otological and rhinological practice.

'Boil and Bite' mouth guards for direct laryngoscopy.

'Boil and Bite' mouth guards are an alternative to conventional silicone guards in direct laryngoscopy. These guards are less likely to displace. They are cheap and easy to prepare.

Two stage management of petrositis with associated mycotic aneurysm of the intrapetrous carotid artery.

Mycotic aneurysm of the petrous temporal bone is extremely rare, with only 12 cases previously reported. We review the literature to date and present a case of petrositis complicated by a mycotic aneurysm of the internal carotid artery, which was managed by endovascular balloon occlusion and subsequent total petrosectomy. We can find no other case in the literature where balloon occlusion has been used to treat a mycotic aneurysm of the intrapetrous carotid artery prior to total petrosectomy to treat petrositis.

Far advanced otosclerosis and intractable benign paroxysmal positional vertigo treated with combined cochlear implantation and posterior semicircular canal occlusion.

This paper presents a combined procedure for the management of intractable benign paroxysmal positional vertigo (BPPV) and profound hearing loss in a patient with far advanced otosclerosis. The procedure comprised of a posterior semicircular canal occlusion and cochlear implantation as one combined procedure in the same ear. The combined approach added little to the operative morbidity and proved effective in this patient's management. A search of the literature reveals this to be a unique case.

Mouse inoculation studies reveal no transmissible agent in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) resembles the spongiform encephalopathies in its dual pattern of inherited and sporadic cases, its uniform prevalence in different populations, its late onset (suggestive of a long incubation period) and its pathological picture of neuronal degeneration without inflammation. There is a well-established protocol for primary transmission of scrapie and related diseases to mice. Using this, we inoculated four longlived, inbred, mouse strains with cord material fresh-frozen within three hours of death, from a case of ALS or a control case. No motor neuron loss, gliosis or tract demyelination was found in the experimental group. Fifty per cent of each group were observed for more than 600 days. Two types of lesions were found in these animals at death: widespread foci of white matter vacuolation and bilateral thalamic mineral deposits. They were present in the control group at the same incidence and severity as in the experimental group and were thus considered to represent an age-related change. Attention is drawn to them because they have been claimed as significant when found in a transgenic model of spongiform encephalopathy. The results of our carefully-controlled experiment suggest that it is unlikely that ALS is caused by a scrapie-like agent capable of transmission to mice.