R Forde1, E W Williams2. 1. Ear, Nose and Throat Division, Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston, Jamaica, West Indies. royantonioforde@hotmail.com; draforde@gmail.com. 2. Emergency Medicine Division, Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston, Jamaica, West Indies.