Objective
To report our experience of diagnosis, investigation and management in patients who had undergone laryngectomy secondary to previous squamous cell carcinoma, who were subsequently infected with severe acute respiratory syndrome coronavirus-2 during the coronavirus disease 2019 pandemic.
Case reports
Four post-laryngectomy patients with laboratory-proven severe acute respiratory syndrome coronavirus-2 infection were admitted to our institution from 1 March to 1 May 2020. All patients displayed symptoms of coronavirus disease 2019 and underwent investigations, including swab and serum sampling, and chest X-ray where indicated. All were managed conservatively on dedicated coronavirus disease 2019 wards and were discharged without the requirement of higher level care.
Conclusion
It is hypothesised that laryngectomy may offer a protective effect against severe or critical disease in severe acute respiratory syndrome coronavirus-2 infection. We hope sharing our experience will aid all practitioners in the management of this, often intimidating, cohort of patients.
Transcanal endoscopic ear surgery (TEES) is a relatively new concept, but endoscopes have been used previously as an adjunct to microsurgery (MEES) in patients with cholesteatoma. 1 TEES has the added benefit of reduced morbidity and increased likelihood that the patients will tolerate the procedure as a day-case, but this can variate according to local practice and protocols. It also allows for close inspection of 'hidden' areas such as sinus tympani with angled scopes. 1 We aimed to analyse the outcomes including cholesteatoma recurrence/ residual disease, ear discharge, intact tympanic membrane and audiological outcomes (air-bone gap ABG) of the minimally invasive TEES compared to open microsurgery/MEES.
| DE S IG N
| Study designThis is a prospective study of consecutive patients undergoing surgery for cholesteatoma from 2014 to 2016 with a minimum followup of 3 years. All patients with cholesteatoma were included in the study. STROBE reporting guidelines have been followed for this study.
1 . A specific mechanism of injury can produce a tear of the articular disc of the wrist without any associated bony lesion. 2. Torn discs have been found associated with Colles's fractures and with dislocation of the inferior radio-ulnar joint. 3. The injury gives rise to clear-cut symptoms and definite physical signs. 4. Operation in fourteen cases has shown five types of tear of the disc. 5. Arthrographs of the wrist are helpful in establishing the diagnosis. 6. In isolated tears removal ofthe disc relieves the symptoms and does not prejudice function. 7. If there is other joint injury, removal of the disc cannot be expected to give as satisfactory a result.
Osteochondral fractures of the patella should be recognised early, loose bodies removed, and defects in the articular surfaces smoothed off, or the patella removed if it is extensively involved. Plication of the capsule on the medial side is recommended in order to prevent recurrence of the injury and to prevent dislocation of the quadriceps tendon. in cases where the patella is removed.
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