Management of pinna haematoma study (MaPHaeS): A multicentre retrospective observational study

OBJECTIVES

To assess current variation in the management of pinna haematoma (PH) and its effect on outcomes.

DESIGN

Multicentre retrospective observational record-based study.

SETTING

Eleven hospitals around the UK.

PARTICIPANTS

Eighty-three patients above the age of 16 with PH.

OUTCOME MEASURES

The primary outcome measure was recurrence rate of PH over a 6-month period post-treatment, assessed by treatment type (scalpel incision vs needle aspiration). Secondary outcome measures assessed the impact of other factors on recurrence, infection and cosmetic complications of PH over a period of 6 months.

RESULTS

After adjusting for confounding factors, involvement of the whole ear, and management within an operating theatre were associated with a lower rate of recurrence of pinna haematoma. The drainage technique, suspected aetiology, choice of post-drainage management, grade and specialty of practitioner performing drainage, the use of antibiotic cover and hospital admission did not affect the rate of haematoma recurrence, infection or cosmetic complications.

CONCLUSIONS

Where possible PH should be drained in an operating theatre. Multicentre randomized controlled trials are required to further investigate the impact of drainage technique and post-drainage management on outcome.

Tongue metastasis from a poorly differentiated urothelial carcinoma of the bladder

Chemotherapy may cause oral ulceration but a thorough investigation of symptoms and signs is important to determine the underlying diagnosis accurately. We describe a case of a patient with a poorly differentiated urothelial carcinoma of the bladder developing a tongue metastasis. This is a challenging diagnosis to make given the rarity of the presentation but it illustrates the need to evaluate any new symptoms fully.

A UK experience of daycase cochlear implant surgery

OBJECTIVES

This study aims to assess the safety of daycase cochlear implant surgery.

METHODS

A retrospective review was conducted on all patients who underwent cochlear implant surgery at a teaching hospital in Oxford, UK between September 2008 and February 2012.

RESULTS

One hundred and sixteen patients underwent cochlear implant surgery. This included 73 adults and 43 children. Twenty-six patients underwent the procedure as a daycase procedure. There were no readmissions.

DISCUSSION

The demand 'to do more with less' has led to increasing drives for efficiency and cost-effectiveness. Therefore, the role of daycase surgery is becoming increasingly widespread. Daycase surgery has been shown to be advantageous for both patients and hospitals.

CONCLUSION

Daycase cochlear implant surgery is feasible and can be safely conducted in a select group of patients.