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Annals of the Royal College of Surgeons of England (1)
BMJ : British Medical Journal (1)
Emergency Medicine Journal : EMJ (1)
Journal of the Royal Society of Medicine (1)
Postgraduate Medical Journal (1)
Siddiq, M (2)
Siddiq, M A (2)
Narula, A A (1)
Samra, M J (1)
Selvadurai, D (1)
Siddiq, M. A. (1)
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Samra, M J
BMJ : British Medical Journal
First branchial cleft anomaly presenting as a recurrent post-auricular abscess
Emergency Medicine Journal : EMJ
Failure to recognise these unusual cases may result in misdiagnosis, inadequate treatment, and subsequent recurrence. Further definitive surgery may thus be complicated. A case is reported of a patient who attended accident and emergency on three occasions with an infected post-auricular cyst, which was treated by incision and drainage. It was subsequently found to be a first branchial cleft anomaly.
Current management in pharyngeal pouch surgery by UK otorhinolaryngologists.
Annals of the Royal College of Surgeons of England
INTRODUCTION: Many surgical techniques have been described for the treatment of pharyngeal pouches but there is no single treatment of choice. The aim of this study was to determine current practice in pharyngeal pouch surgery by UK otolaryngologists. METHODS: A postal questionnaire was sent to all UK-based consultant members of the British Association of Otolaryngologists - Head and Neck Surgeons (BAO-HNS). RESULTS: Endoscopic stapling diverticulotomy is the most commonly performed procedure, performed by 89% of surgeons, followed by excision. Of those consultants that considered there to be a treatment of choice, 83% stated endoscopic stapling as their preference. Practices differ regarding the insertion of nasogastric tubes after endoscopic procedures and the need for postoperative barium studies. The length of in-patient stay tends to be short with 80% of surgeons discharging patients by day 2. CONCLUSIONS: Endoscopic stapling diverticulotomy is now the most commonly performed procedure for the management of pharyngeal pouches by UK otolaryngologists and is now considered by many to be the treatment of choice.
Pharyngeal pouch (Zenker's diverticulum)
Postgraduate Medical Journal
Pharyngeal pouches occur most commonly in elderly patients (over 70 years) and typical symptoms include dysphagia, regurgitation, chronic cough, aspiration, and weight loss. The aetiology remains unknown but theories centre upon a structural or physiological abnormality of the cricopharyngeus. A diagnosis is easily established on barium studies. Treatment is surgical via an endoscopic or external cervical approach and should include a cricopharyngeal myotomy. Unfortunately pharyngeal pouch surgery has long been associated with significant morbidity, partly due to the surgery itself and also to the fact that the majority of patients are elderly and often have general medical problems. External approaches are associated with higher complication rates than endoscopic procedures. Recently, treatment by endoscopic stapling diverticulotomy has becoming increasingly popular as it has distinct advantages, although long term results are not yet available. The small risk of developing carcinoma within a pouch that is not excised remains a contentious issue and is an argument for long term follow up or treating the condition by external excision, particularly in younger patients. Keywords: Zenker's diverticulum; surgical procedures: endoscopic; surgical stapling
Subcutaneous cervical emphysema after self-induced vomiting.
Narula, A A
Journal of the Royal Society of Medicine
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