Patient age and sex and operative technique were the most significant factors affecting the risk and timing of serious postoperative hemorrhage, with no additional risk associated with the use of specified single-use instruments.

A significant rise in serious postoperative primary haemorrhage but not secondary haemorrhage was seen following the initial introduction of single-use instruments that reverted to baseline with the introduction of specified single-use instruments. Diathermy does not appear to have affected the haemorrhage rates. There is a distinct age and gender pattern for tonsil and adenoid surgery and risk of postoperative haemorrhage. The use of arbitrary divisions of age may be misleading in studies that examine post-tonsillectomy haemorrhage.

There is a positive relationship between the duration and frequency of white water kayaking and the presence and severity of EACE and associated ear infections.

The nasal cavities of 51 healthy volunteers were examined using acoustic rhinometry before and after nasal decongestant. Several specific dimensions were studied, which included the minimum cross-sectional area, and three volumes corresponding to the anterior, middle and posterior regions of the nasal airway. An average acoustic rhinometry trace was constructed for the whole group of subjects, before and after decongestion, from data extracted from the raw data files written to the computer hard disk for each subject. A 27.5% (P < 0.0001) increase in the minimum cross-sectional area was observed, with no shift in its position. The greatest increase in nasal dimensions was seen in the anterior and middle parts of the nose, however, significant changes were also seen in the posterior nasal cavity and post nasal space. There are a number of possible sources of artefact. First, confusion of the first and second minima may produce apparent movement of the minimum cross-sectional area following nasal decongestion. Second, a postulated change in the acoustic path length may lead to apparent changes in volume in certain regions of the nose. Third, a variable and uncontrollable degree of sound energy loss will occur into the opposite nasal cavity beyond the posterior border of the septum. An apparent increase in the dimensions of this region will be seen as the opposite cavity decongests. We feel that all users of the acoustic rhinometer need to be aware of these potential sources of artefact, and attention needs to be focused on an agreed definition of the components of the acoustic rhinometry trace.

The incidence of epistaxis admissions to hospital and their relationship to ambient temperature is examined. A retrospective analysis of 1211 patients with epistaxis sufficiently severe to warrant hospital admission was performed over a period of 1836 consecutive days. Daily average temperature data for this time-period were examined and compared with admission rates. A marked increase in hospital attendance was apparent during colder days. Patients were admitted at a rate of 0.829 patients per day for temperatures less than 5 degrees C, (95% Confidence Interval: 0.737-0.928), compared with 0.645 patients per day for temperatures between 5.1 and 10 degrees C, (95% 0.586-0.708). On average the population of epistaxis patients attended on days that were 0.6 degree C colder (95% Confidence Interval: 0.2 degree C-0.9 degree C) than the average temperature for the time examined (P < 0.005, student's t-test).