Painful torticollis following adenotonsillectomy: a cardinal sign of atlantoaxial subluxation.

An 11-year-old boy with a history of autism spectrum disorder attended the emergency department with his mother 8 days after an adenotonsillectomy reporting postoperative bleeding. Detailed physical examination revealed no active bleeding, but a rigid neck posture was noted. A head and neck CT scan demonstrated unilateral rotatory atlantoaxial subluxation and possible damage to the anterior spinal ligament.

Reducing inappropriate referrals to secondary care: our experiences with the ENT Emergency clinic.

Introduction: In the current financial climate faced by the NHS, it is important that we reduce the amount of inappropriate referrals made to secondary care specialties. ENT Emergency Clinics are one-stop clinics provided by many UK ENT departments to allow more rapid access to ENT services from primary care. However, many referrals to these clinics were considered to be inappropriate, overloading the clinic and delaying referrals to more specialist clinics.

Management of penetrating neck injuries at a London trauma centre.

Penetrating neck injuries (PNIs) are uncommon in the UK. The majority of guidelines are from the USA or South Africa. No UK national guidelines exist.

Aspergillus mastoiditis in a patient with systemic lupus erythematosus: a case report.

Fungal mastoiditis caused by Aspergillus fumigatus predominantly occurs in immunocompromised patients. Invasive temporal bone mycoses are rare. They are usually associated with host immunodeficiency, are difficult to diagnose, and many cases are fatal.