The role of palpatien in examination of the throat.
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Charles Dickens is known as a novelist, humorist, humanist, and a social reformist. One of his many abilities was an astute power of observation, and some of his writings included descriptions considered as original medical knowledge. Among the hundreds of characters portrayed by Dickens, many had depictions or diseases of interest to the otolaryngologist. Dickens described deaf children and was interested in the methods used in their teaching. He had a keen interest in children and their welfare and described his visits to the Childrens Hospital in London and to Parkins Institute at Boston. He described both temporary and permanent deafness following exposure to loud noise. Dickens was a medical critic and most of his writings on the subject were humorous, though mixed at times with a spicy element of satire.
A comprehensive evaluation of the otolaryngological abnormalities in 50 patients with colobomata, heart defect, atresia of the choanae, retarded growth or development, genital hypoplasia, and ear anomalies or deafness (CHARGE) was performed. All the patients had ear abnormalities; 96% (48/50) had malformed pinnae, and 54% (27/50) had facial nerve palsies. Only 8% (4/50) had normal hearing, the commonest hearing defect being severe conductive or mixed loss. Eighty-four percent (42/50) of computed tomographic scans of the temporal bone were abnormal, the characteristic abnormality being the combination of a hypoplastic incus and absent semicircular canals. Eighty-six percent (43/50) of patients had upper airway abnormalities. Posterior choanal abnormalities occurred in 56% (28/50), and 42% (21/50) had retrognathia leading to intubation difficulties. Laryngotracheal abnormalities occurred in 38% (19/50), and 14% (7/50) required tracheostomies. Careful upper airway assessment is essential to avoid potentially lethal complications such as aspiration.
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