Introduction Nasal fracture is a common form of ear, nose and throat (ENT) trauma with prompt referral required for assessment and potentially manipulation of nasal bones. The aetiology of nasal fracture is multifactorial, and injury occurs across all ages. Previous study has suggested a temporal relationship between nasal injury and major sporting events. Methods A total of 1966 adult patients with nasal injuries referred to emergency clinics across three London ENT centres between September 2016 and August 2019 were analysed. Results The majority of those referred were male (66.58%). Mean age at referral was 36.29±18.38 in males and 49.14±21.43 in females; 10.27% were 75 years and over. Incidence was highest during April–September 2018 (p=0.02). Mean incidence was higher in this period in the male 16–35 subgroup (p=0.039), with 53.1% of their injuries concentrated between Friday and Sunday. Conclusions Most nasal injuries occurred in young males. Mean age at referral was higher in females, and there was slightly increased incidence in over-75s, predominantly females. This incidence could be due to increased longevity or greater tendency to injury in females of this age. The injury patterns across the week also differed, with males injured proportionately more at the weekend. Nasal injury referrals of young men increased around the 2018 summer period, coinciding with the 2018 FIFA World Cup. This lends support to the association between major sporting events and the incidence of nasal injury, particularly in young males.

Objective To analyse the outcomes of telephone consultation, including patient satisfaction, for two-week-wait head and neck cancer referrals. Methods Analysis of the data of this prospective study was centred on outcomes of the consultation, patient satisfaction and preference for telephone consultation. Results Patient satisfaction and preference for telephone consultation were influenced by patient awareness of cancer referral. When comparing the three most common presenting symptoms, patients with sore throat were more satisfied than those with neck mass. Regarding telephone consultation outcomes, patients with neck mass were less likely to be discharged and more likely to require investigations than those with sore throat or hoarseness. Patients with hoarseness more often required a face-to-face appointment. Conclusion Telephone consultation might be a valid initial encounter for the majority of two-week-wait head and neck cancer referrals, especially when the referral symptoms are considered. This work shows the validity and safety of telephone consultation for two-week-wait head and neck cancer referrals.

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A 53F with a previous craniofacial resection, bi-coronal approach and radial free forearm flap of an olfactory neuroblastoma. New presentation with pneumocephalus and persistent CSF leak.

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