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A faulty production line

Unusual problems in the mouth

Interesting presentations photgraphed by GPs

This unfortunate 14-year-old happens to be my son, writes Dr Adrian Smyly. This is the second time in two years he has developed an obstructed left sub-maxillary salivary gland due to a stone. He started swelling behind the left mandible which varied in size from day to day, reaching up to 6cm in diameter at times, but produced remarkably little pain. The stone gradually worked its way up the salivary duct and appeared at the orifice.

The following day it discharged into the mouth with a gush of fluid. No treatment was required.

This 62-year-old has had this swelling on the roof of her mouth for the last 15 years, writes Dr Koshy Johnson. She said it had caused her some anxiety but, due to the length of the duration, she was somewhat reassured that if it had been malignant she would not still be around. She was referred for specialist opinion and was offered surgery but declined as she was averse to any surgical procedure. She was happy to allow the cystic swelling to remain.

Shortly after a resuscitation course at a local hospital I met a staff nurse who had a problem with her lips, writes Dr Andy Jordan. She had a great deal of difficulty in attempting to inflate 'Annie's' lungs, with the result pictured. She was not the only member of staff with bruised lips ­ the ward sister also suffered the same trauma. I suggested she extend the dummy's cervical spine to open the airway.

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