Spontaneous retropharyngeal hemorrhage causing airway obstruction: a case report with a review of the literature.

Spontaneous retropharyngeal hemorrhage, although uncommon, can be rapidly progressive and potentially life-threatening. Timely recognition and appropriate treatment are essential for a successful outcome. We report a case of retropharyngeal hemorrhage in an 81-year-old male with a history of arteriosclerotic disease who presented with cough, dysphagia, dyspnea, and cervical ecchymosis.

Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial.

We conducted a prospective, double-blind clinical trial to evaluate the differences in operating time, intraoperative blood loss, postoperative pain at 3 hours and 1 week, and delayed (>24 hr) bleeding associated with ultrasonic harmonic scalpel tonsillectomy and conventional tonsillectomy. The study was carried out on 28 patients with recurrent tonsillitis and/or adenotonsillar hypertrophy who underwent harmonic scalpel tonsillectomy on one side and cold dissection tonsillectomy with suction electrocautery hemostasis on the other. The harmonic scalpel was associated with significantly less intraoperative blood loss (mean: 6.

"Spontaneous" perilymph fistula: a case report.

A surgically documented case of barotrauma-induced perilymph fistula is presented in this case report. A brief review of the literature on this entity confirms the difficulty of making a definitive preoperative diagnosis in most instances. Clinical, audiometric, radiologic, and intraoperative findings are presented, and the classic presumed mechanisms for this uncommon cause of sudden sensorineural hearing loss are discussed.

Glandular tularemia in a Native American child.

This case report details the clinical manifestation and course of glandular tularemia, an uncommon but significant cause of cervical lymphadenopathy in children. We discuss the unique attributes of this disease along with appropriate steps that lead to early identification of the organism and effective treatment. The potential use of the organism as a bioterrorism agent is another interesting aspect of this entity.

Middle ear pathogens in otitis-prone children.

A cohort of 191 children with recurrent otitis media and persistent middle ear effusion underwent myringotomy and tubes, at which time middle ear cultures were taken. The indications, fluid type, culture and sensitivity results, and pre- and post-procedure frequency of otitis media were evaluated. Sixty-seven percent of the effusions were mucoid in nature, and 24% of cultures grew pathogens, including Hemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus in that order of frequency.