Objective
This study aimed to explore the current practices of the UK rhinology consultant body in regard to cocaine screening in nasal reconstructive surgery.
Method
A 12-question online survey was distributed to rhinology consultants (October 2021 to February 2022) currently practising in the UK.
Results
A total of 55 consultants responded. Fifty-three per cent asked patients about cocaine use prior to consideration of surgery, and 45 per cent performed cocaine testing prior to consideration of surgery. Of these, the majority employed urine testing alone (60 per cent), with hair testing being less common as a single screening modality (4 per cent). Sixteen per cent opted for both urine and hair testing. The most common reasons for not performing cocaine testing included patient history or clinical examination that was not suggestive of cocaine use (44 per cent), lack of formal guidelines (33 per cent) and lack of testing availability (27 per cent). Sixty-four per cent were in favour of a national policy for cocaine screening.
Conclusion
There is marked variation in cocaine screening practices for nasal reconstructive surgery among UK rhinologists.
Slingshots or hand catapults, historically used as a military or hunting weapon, are common toys among children and young teenagers. Their use can be dangerous as a strike to the eye or orbit can result in significant injuries including blindness. We describe a rare case of a sino-orbital foreign body caused by a slingshot injury in a young boy. The case was managed by a multidisciplinary team involving ear, nose and throat, ophthalmology and paediatrics, and the foreign body of a metal ball bearing was removed using an endoscopic transnasal approach. Although the patient made a good recovery, the case highlights the danger of slingshot devices misused by children.
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