A recording system has been developed to measure intraluminal temperature changes from six sites simultaneously in the upper gastrointestinal tract at rates up to 10 Hz from each site. The temperature probe contains six type K thermocouples mounted in 14 French gauge orogastric tube. The data is logged, after digital conversion and signal multiplexing, onto disc storage by a dedicated microcomputer. The fluctuating temperature profile, defined as temperature spikes, has been subjected to novel computer analysis to allow definition of temperature load and dissipation within the oesophagus, stomach and duodenum. This system enables the effects of drinking and eating hot and cold foods on the physiological functions of the gastrointestinal tract to be studied accurately.

Metal locators have been used extensively in the removal of intraocular foreign bodies. I but use in otolaryngology-head and neck surgery is very uncommon. Herein we describe our experience with the Roper-Hall Electro-Acoustic Discriminator and Locator (RHEADAL) in removing a metallic foreign body from the neck. The use of this instrument was essential in reducing (l) intraoperative time and expense; (2) morbidity associated with a much longer and involved procedure; and (3) radiation exposure to the patient, surgeon. and other operating room personnel. We believe there is a useful role for the metal locator in otolaryngology-head and neck surgery for the management of certain metallic foreign bodies. APPARATUSThe Roper-Hall Electro-Acoustic Discriminator and Locator (RHEADAL) (Fig. I) consists of two small coils; one in the probe head and a second remote from the first. Their inductance is balanced. When a ferrous object enters the magnetic field of the probe, the inductance increases, creating an audible high-pitched monotone. In contrast, a nonferrous object decreases the inductance, producing a bleeping tone. Both inductance changes are converted into a deftection of the meter needle, thereby creating a visual display.Three probes are available: (1) a long-range probe to identify the general area to search; (2) a short-range side-active probe determines on which side the foreign body is lying; (3) and a second short-range probe precisely localizes the object. The instrument is the size of a small suitcase, instantly ready for use, and produces no radiation. A foot-operated reset switch eliminates the need for an assistant.

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Twenty-five children with acquired and congenital subglottic stenosis (SGS) were managed with the anterior cricoid split (ACS) operation at the authors' institution from September 1987 to January 1990. Ages ranged from 2.5 months to 5.5 years. Twenty-one (84%) of the children were extubated after 5 to 14 days of nasotracheal intubation and have remained stable after an average follow-up of 10 months. Atelectasis was a common postoperative problem, encountered in 12 (48%) of the patients. Other complications included a tracheocutaneous fistula, prolapse of soft tissue into the tracheal lumen via the cricoid incision, a subglottic granuloma, and 2 cases of prolonged lower extremity paresis following reversal of vecuronium. The results of this retrospective study indicate that the ACS is a valuable first-line procedure for the management of SGS in a variety of pediatric patients.