1/2. Sickle cell disease: a diagnostic dilemma.The case history is described of a patient with sickle cell anaemia who developed a unilateral infarct of the mandible following a sickle cell crisis. The interruption of the blood supply resulted in an anaesthesia of the inferior dental nerve and pulpal necrosis of otherwise sound premolar and molar teeth. The diagnostic and management difficulties of the case are discussed, and recommendations are made for treatment of such patients in light of the problems encountered.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. Cervical osteomyelitis following tonsillectomy.We present a case of fatal cervical osteomyelitis following an elective tonsillectomy in a previously fit young man. Following induction of general anaesthesia, and prior to surgery, the patient received bilateral glossopharyngeal nerve blocks with 0.5% bupivacaine and adrenaline 1:200,000. The initial recovery was uneventful but persistent throat and neck pain developed at home which was diagnosed as a throat infection and possible hyperextension injury of the neck. It is impossible to say how much the dissection of chronically infected tonsils or the infiltration of local anaesthetic into or near a potentially infected area contributed to the development of cervical osteomyelitis. The absence of any other symptoms and signs, a normal blood count and cervical spine X-ray, and the rarity of cervical osteomyelitis, all contributed to a delay in diagnosis.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |