Otolaryngologic clinics of North America
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Otolaryngol. Clin. North Am. · Aug 2010
Review Case ReportsMalpractice claims in nasal and sinus surgery: a review of 15 cases.
Otolaryngologists may encounter claims of medical malpractice during the course of their careers. A sample of 15 cases involving patient claims of medical malpractice relating to care delivered for problems of the nose and paranasal sinus is presented. A short summary of each case is provided, which may be useful to practicing otolaryngologists.
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Endoscopic sinus surgery is an excellent treatment option in the management of medically refractory chronic rhinosinusitis. Continual refinements in endoscopic technique are simultaneously allowing an expanded range of applications and a lower rate of complications for this kind of surgery. ⋯ The sinus surgeon must always be aware of this, and actively seek to identify high-risk situations preoperatively. The technical points presented in this article should be followed to minimize the risk of complications.
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The surgical management of thyroid disease and its indications continue to evolve. Selecting the appropriate management can often be challenging to both physician and patient. This article describes the surgical management of various thyroid pathologies. Using contemporary guidelines and clinical experience a framework for selecting appropriate surgical treatment is provided.
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The treatment of hyperparathyroidism secondary to renal failure is a complex clinical dilemma. No simple optimal approach to patient selection and stratification for surgical intervention is available at this time. The goals of this publication are to review the pathophysiology of parathyroid gland function in patients with impaired renal function, make recommendations for how to proceed with a parathyroidectomy in these patients, and to provide some guidelines for preoperative and postoperative management.
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Otolaryngol. Clin. North Am. · Apr 2010
ReviewEvaluation of hypercalcemia in relation to hyperparathyroidism.
Hypercalcemia, which results from the rate of calcium influx into the extracellular fluid exceeding the rate of calcium efflux from the extracellular fluid, has been reported as occurring in approximately 1% to 4% of the adult population in general, and anywhere from 0.5% to 3% of hospitalized adult populations. Hypercalcemia associated with primary hyperparathyroidism has frequently resulted in the development of pancreatitis and peptic ulcer disease; however, the pathophysiologic mechanism of this association remains uncertain. This article examines the etiology and differential diagnosis of hypercalcemia, in particular regarding its association with primary hyperparathyroidism.