A pain in the throat: a 19-year history of symptoms relating to the carotid artery.

A 38-year-old man presented with a 19-year history of sore throat and an ache radiating from the centre of the anterior neck to the both ears and the occiput. Computed tomography angiography revealed a tortuous submucosal right internal carotid artery, which was causing tonsillar displacement. The diagnosis of carotidynia has a controversial history within the literature and is currently not accepted as a distinct pathological entity by the International Headache Society.

Malignant otitis externa: experience with hyperbaric oxygen therapy.

Introduction: The treatment of malignant otitis externa (MOE) with hyperbaric oxygen therapy (HBOT) remains controversial. The rarity of MOE, combined with poor access to hyperbaric facilities, explains the paucity of existing data.

Methods: We retrospectively reviewed all patients with a diagnosis of MOE referred to the Prince of Wales Hospital hyperbaric unit over a period of six years, and report one of the largest case series to date.

Mastoiditis in a paediatric population: a review of 11 years experience in management.

Objective: This study explores the experience at Sydney Children's Hospital (SCH) managing children with acute mastoiditis and establishes a robust treatment algorithm.

Methods: Retrospective review of all patients admitted to SCH with an ICD-10 coding of "Mastoiditis" from 1 January 1996 through 31 December 2006 inclusive. Criteria assessed included demographic characteristics, clinical features, symptom duration and treatment initiated by the general practitioner.

Lingual tonsillectomy: a review of 5 years experience and evolution of surgical technique.

Objectives: To assess the indications for lingual tonsillectomy; to report our experience with lingual tonsillectomy, and to present the evolution of our surgical technique.

Methods: A review of 5-years experience from a prospectively maintained database of 28 patients was performed together with a focused review of the international literature. Therapeutic procedures included lingual tonsillectomy with access via the Boyle-Davis gag or suspended video laryngoscope and with the resection via diathermy, CO(2) laser, or microdebrider.

Emergency surgery after unsuccessful coronary angioplasty: a review of 15 years' experience.

Background: Emergency coronary artery bypass grafting (CABG) is occasionally necessary for failed percutaneous transluminal coronary angioplasty (PTCA). The aim of this study was to assess the outcome of patients receiving emergency CABG after unsuccessful PTCA over a 15-year study period.

Methods: From January 1982 through December 1996, 74 patients underwent emergency CABG after unsuccessful PTCA (crash group).

Atypical presentation of intramedullary spinal cord lesion.

We report a patient who presented with atypical clinical manifestations including worsening abdominal pain from an intramedullary spinal cord lesion. It is important to consider non-abdominal causes of abdominal pain for patients with an atypical presentation. The described case demonstrates the challenges facing the physician with the early diagnosis of acute abdominal pain.

Short-term resolution of psoriasis after total thyroidectomy for euthyroid multinodular goitre.

A 36-year-old Chinese female with an 8-year history of chronic, generalized plaque psoriasis demonstrated a marked improvement of the disease after removal of an intercurrent euthyroid multinodular goitre. Thyroxine was commenced immediately postoperatively. No thyroid antibodies were detected and thyroid function and calcium levels remained within normal limits both pre- and postoperatively.

Total thyroidectomy is now the preferred option for the surgical management of Graves' disease.

Purpose: Subtotal thyroidectomy has been advocated as the standard treatment for Graves' disease because of the possibility of avoiding thyroxine therapy as well as the assumed lower risk of complications compared to total thyroidectomy. However, the long-term results of subtotal thyroidectomy are not as good as they were previously believed to be, as evidenced by the increasing incidence of hypothyroidism. If the risk of complications from total thyroidectomy is no higher,then that procedure offers significant advantages in the surgical management of Graves' disease.

Management of acute superior mesenteric artery occlusion.

Background: This review examines the surgical management of acute superior mesenteric artery (SMA) occlusion and the impact of interventional radiology techniques.

Methods: Eight consecutive patients with SMA occlusion were treated at the Lismore Base Hospital, Lismore, NSW, Australia, from 1996 through to 2001 and of these, one patient was managed successfully with catheter-directed lytic therapy. The study group included five male and three female patients with a mean age of 71.