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Back and neck pain is an established occupational disease for many professions. No previous studies have shown the association of back and neck pain with ENT surgery. Our objective was to determine the prevalence of neck and back pain in ENT consultants in the United Kingdom and which sub-specialties were most at risk. A national survey from 325 ENT consultants in the UK revealed that 72 per cent had either back pain or neck pain or even both. Of those with pain 53 per cent attributed their symptoms directly to ENT surgery. Highest figures were received from otologists, related to microscope work and prolonged sitting. The importance of these findings has demonstrated the lack of awareness and adequate training to prevent long-term disability in ENT surgeons.

Tonsillectomy is one of the most common surgical procedures performed in children. Day case tonsillectomy is common in many parts of the USA but remains controversial in the UK. Day case tonsillectomy in children has been performed in a dedicated paediatric day care unit at the May day Hospital since 1994. The results for the years 1995-1997 were reviewed. In these years 928 true day case tonsillectomies were performed. Reactionary haemorrhage occurred in 0.97% (nine children) but only three children required a return to theatre. All bleeding occurred within the standard observation period. There were no deaths. The overall effective day case rate was 95.7%, only 31 children needing unplanned admission, mainly for postoperative vomiting. The results suggest that day case tonsillectomy can be safely and successfully performed, with a dedicated paediatric day case unit and a favourable population geography.

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