None of the patients in the asymptomatic group snored or obstructed at any level of propofol, and this was clearly significant on comparison with the symptomatic group (P < .001). All of the symptomatic patients were induced to become symptomatic (snoring/obstruction).

Surgical treatment of the lingual tonsil is seldom performed because problems attributable to chronic lingual tonsillar hypertrophy are infrequently diagnosed. We have reviewed a series of 25 patients with symptoms from enlarged lingual tonsils. The variety of presentation of lingual tonsillar lesions and the methods of surgical treatment are discussed.

Aims: To determine whether acute dacryocystitis complicated by abscess formation can be successfully treated using laser assisted endonasal dacryocystorhinostomy. Methods: A protocol was adopted for the management of acute dacryocystitis presenting to an ophthalmology department. All patients were assessed jointly by an ophthalmologist and otolaryngologist for their suitability for primary internal drainage via a nasal endoscopic approach. All suitable patients during the study period August 1999 to November 2000 were managed by intravenous antibiotics and holmium:YAG laser dacryocystorhinostomy. Results: Nine patients were studied (mean age 72 years (range 38-82 years), three men, six women). ?A history of chronic epiphora was found in 78% of patients, and recurrent nasolacrimal infections in the ?same 78%. Resolution of symptoms and signs of acute dacryocystitis occurred in all nine patients. ?No recurrence of acute dacryocystitis occurred during the median follow up period of 11 months ?(range 6-31 months). Ostium patency defined as the absence of epiphora and the observation of irrigated lacrimal fluorescein at the ostium was achieved in 67% of patients. Epiphora recurred in 33% of cases. Conclusion: Laser assisted endonasal dacryocystorhinostomy is an effective primary treatment in cases of acute dacryocystitis complicated by abscess formation. In addition, pre-existing symptoms of epiphora and recurrent nasolacrimal infections are relieved in the majority of patients.

SUMMARYAir flow through a human upper airway (central part) has been carried out using a realistic geometry. In addition to explaining the anatomy, problems and importance of patient-specific study of human upper airways, this article also presents some qualitative and quantitative simulation results. As expected, the shear and pressure forces are large in the oropharynx and laryngopharynx, where the flow passage is narrow. This clearly indicates that these locations should be the focus of any study aimed at understanding the human upper airway collapse in a patient-specific manner.

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