Chevalier L. Jackson

Foreign bodies in the lung

In most instances foreign bodies entering the lung by any route other than the naturaI passages are projectiIes. These cases usuaIIy caI1 for care by the surgeon. In case of smaI1 penetrating projectiIes, however, if it is decided advisabIe to remove the intruder and there is no indication for opening the chest other than for remova1, the foreign body can be removed through the mouth by bronchoscopy. The Iimit is the size of the foreign body; this Iimit is imposed by the size of the bronchus tributary to the invaded Iobe.2 If the projectiIe has come to rest in a bronchus, remova is quite simpIe. If, however, the missiIe has Iodged in parenchyma1 tissue, the bipIane ffuoroscope and penetrating forceps will be required at bronchoscopy. This procedure is aImost aIways advisabIe when there are any indications that fabric of any kind has been carried in by the penetrating object, because in such cases suppuration is inevitable no matter how smaI1 the foreign body. Anyway, bronchoscopic remova is reIativeIy such a minor procedure that no hesitation shouId be feIt in advising it. Diagnostic bronchoscopy is advisabIe in a11 cases of projectiIe in the lung, no matter how Iarge the intruder may be, to determine IocaI conditions. Hemorrhage from a gunshot wound of one Iung may be controIIed by packing the tributary bronchus with bismuth subnitrate. 2 PENNSYLVANIA

Committee on Membership

NAME COMMITTEE Council Members Mr Chris J Brown DL (Chair of Council) Estates Development Committee Governance & Membership Committee (Chair) Honorary Awards Committee Remuneration Committee Professor Bob Cryan CBE DL Estates Development Committee Governance & Membership Committee Honorary Awards Committee (Chair) Remuneration Committee Mr Mark Fisher CBE Estates Development Committee (Chair) Mr Robert Cox Audit Committee Mrs Joanne Harris MBE Governance & Membership Committee Honorary Awards Committee Dr Jackie Lane No current committee membership Mrs Virginia Lloyd DL Governance & Membership Committee Honorary Awards Committee Professor Pete Sanderson No current committee membership Baroness Kathryn Pinnock Governance & Membership Committee Honorary Awards Committee Professor Isobel Pollock OBE Estates Development Committee Mr Richard Quayle JP No current committee membership Mrs Helen Thomson DL Audit Committee Estates Development Committee Mr Jonathan Thornton (Vice Chair of Council) Audit Committee (Chair) Remuneration Committee (Chair) Professor Tim Thornton Estates Development Committee Governance & Membership Committee Mr Jonathan Stephen No current committee membership

Part VI—rehabilitation and prognosis cancer of the larynx

In the management of cancer of the larynx, cure of the disease is of course the prime consideration, but next comes conservation or rehabilitation of the phonatory, deglutitory and respiratory functions. From the standpointof so cial adjustment and economic i-ehabili tation, the need for maintenance of ade quate communication is quite apparent. Irradiation, of course, offers the best outlookwith respecttovoicesincei-e gression of most superficial cordal le sions following radiotherapy is followed by returnofa normalornearlynormal voice. Discomforts of minor nature, such as dryness of the throat, may fol low irradiation, but these are usually inconsequentialand of short duration if the treatment has been properly administered. The voice following partial laryngec tomy is dependent on the technique re quired in the individual case. Following simple laryngofissure, without disturb ing the contralateral cord or its an terior attachment, a voice of good qual ity and volume is often observed. At times, an adventitious cord of fibrous tissue regenerates on the operated side (Fig. 1), affording a fairly straight, smooth structure against which the contralateral cord may approximate. Removal ofthehomolateralthyroidala at the time of operation may, by allow

REMOVING ADHESIVE TAPE

To the Editor:— Your recent editorial on methods of removing adhesive plaster from the skin, and rumors of a damage suit for injuries attributed to violent removal, lead us to suggest oil of wintergreen as a simple, painless and highly efficient means. The oil should be applied with a very small cotton swab only to the point of separation of the adhesive from the skin. If it is applied to the external surface of the plaster the fabric will come away, leaving the adhesive material adhering to the epidermis.