Tonsillectomy leading to blood clot entering the trachea and causing syncope: a report of 5 cases. The results show that anesthesia position and dosage are two key factors. Anesthetic dosage being too large can cause glossopharyngeal nerve symptoms such as paralysis of the soft palate, temporary disability of swallowing function. In clinical practice, we experienced that using 2% lidocaine dosage for tonsillectomy is safer than oral administration. For patients with heavier tonsil adhesion or sensitive pharyngeal reflex, if the estimated intraoperative dissection is difficult and operation time is longer, a few drops of hydrochloric acid adrenal turbulence can be added to the diluted local anesthetic to prolong the duration of anesthesia and reduce intraoperative bleeding and unnecessary stimulation on the pharynx. This can eliminate objective factors of false blood clots. Tonsil operation should be performed gently and carefully. If the patient fears running after anesthesia, saliva or phlegm in the mouth may not be easily spit out or dysphagia occurs, it may indicate that the dosage of anesthetics is too large and caution should be taken to clear the glossopharyngeal nerve palsy. Local infiltration anesthesia of palatal arch for tonsil operation should not use too much anesthetics, too deep into the muscle layer of swallowing the susceptor. Too much dosage can cause swallowing reflex disappears. Injection of 1% lidocaine 1 II d under general membrane is enough. Tonsillectomy is a small operation but due to limitations in hemostasis and inconvenient operation, it should be conducted in a sound operation room with anesthesiology. Once encountering fainting or asphyxia, timely rescue can be provided. During the operation, if coughing more than usual or shortness of breath is observed in the patient, the pharyngeal stimulation should be immediately terminated, and the patient should be placed in a supine position with the head to one side, removing blood clots within the mouth to ensure airway patency. Additionally, repeated stimulation of the pharynx during operation can induce vagus excitement due to laryngeal nerve branching distribution escape throat dry film, which may cause heart rate to slow down and cardiac output reduction. This is also cited in tonsillectomy products. Simultaneous against vagal excitation in oropharyngeal secretions can be done. Fenestration of Lima clinical discussion by Zhu suits Jin Zicang (received on 1998 - 08 - 06) reports a comparison of postoperative clinical results of nearly two years of upper cervical radical windowing of inferior nasal meatus and only for Lima fenestration and Lima postoperative efficacy. General data includes clinical data of 96 patients, male 41, female 55; age 18 ~ 5L; among them bilateral 17, nasal polyp was 3 times 16. X-ray showed carotid sinus, ethmoid sinus density and high density, part of all patients with high nasal polyps and purulent material. All of the patients underwent general anesthesia intubation downlink maxillary sinus and nasal polyp and ethmoidotomy. The first postoperative day hit hemostatic gauze. Operations were divided into two groups. Group A had 56 cases for windowing of inferior nasal meatus; group B had 40 Lima patients without nasal through fenestration. After a follow-up of 6 months to a year, group A had 9 recurrences. 4 cases were not thoroughly cleared after the ethmoid sinus, 5 cases had heavy frontal sinusitis or mucosal polypoid; group B had 5 recurrences. 4 cases fell of frontal lesions and 1 case of anterior ethmoid sinus not thoroughly cleared. Both groups have complete information. Group A had 47 cases, group B had 38 cases. Judging criteria for efficacy include cure: disappearance of headache and nasal symptoms, no recurrence of polyps; Improved: significant reduction of headache and stuffy nose, only a little purulence secreta without recurrence of polyps; Invalid: symptoms were not significantly improved, recurrence of polyps in the nose. Under the nose of a Proterozoic and Lima opening unobstructed degree criteria include medium patency of eustachian tube into the window opening or Lima operation can be freely; stenosis: a catheter into the only trumpet; closed: stoma closed completely, often on wear rate of L Jie sinus irrigation maxillary sinus cavity. Postoperative follow-up and results involve regular understanding and check whether patients' symptoms relieve and nasal cavity condition. There is no polyp recurrence, with eustachian tube catheter probe fenestration or Lima opening well flushing on the patency of the carotid sinus cavity. Understanding sinus cavity case. Results are shown in Table 1 and table 2. As seen from Table 1 and 2, either cure or bow flow fluent degree, group B was superior to that of group A (P < 0.05). Therefore, we think that for heavier sinusitis or nasal polyp patients, carotid sinus radical operation for optimum operation method of + Lima without windowing of inferior nasal meatus is better. Its lead through the opening of the posterior ethmoid sinus can fully reach drainage purpose, clear the ethmoid lesion and reduce stoma bleeding. It can shorten the operation time. From the two group of recurrence reasons, follow-up found in group A was 9 in 4, posterior ethmoid sinus not thoroughly cleared.