No abstract

I must dispute the claim by Schache et al. that the case of congenital pilonidal sinus of the nose which they reported is unique in the English literature.' It would indeed be surprising to find that a lesion in the middle of the face has not been reported previously.A thoroughly incomplete survey of the literature in my office, produced seven case reports of similar lesions. In 1951 Littlewood described six cases with references to previous descriptions (in the English literature) by Bland-Sutton (1983), Brunner and Harned (1942), Champion and Prendiville (1952), Crawford and Webster (1952). Holmes (1942), Luango (1933) and New and Erich (1937).' Matson devotes a chapter in his textbook to this condition under the title of 'Congenital dermal sinus tract', citing one personal case.3It would seem that the search of the literature was incomplete in this instance and it may be that this was because the alternative key words were not used. In the articles quoted, the words used are

Background: Extracorporeal shock wave lithotripsy is an effective treatment for kidney stones which does not require general anaesthesia and can be performed as a daycase procedure. The fragmentation of calculi can be painful and various analgesic regimens have been described. A small minority of our patients are unable to tolerate ESWL with enteral analgesia. We offered a repeat ESWL treatment with remifentanil Patient Controlled Analgesia (R-PCA) to this group.