Otolaryngologic clinics of North America
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Otolaryngol. Clin. North Am. · Aug 1990
ReviewNeurologic aspects of sleep apnea and related respiratory disturbances.
Several types of neurologic diseases can contribute to disturbed respiration during sleep. Abnormal function of respiratory and upper airway muscles can occur with neuromuscular diseases and lead to upper airway obstruction and alveolar hypoventilation during sleep. Central nervous system disorders that cause dysarthria and dysphagia can also lead to obstructive and central sleep apnea, even in the absence of the usual anatomic deformities associated with OSA. Appropriate treatment requires an understanding of the effect of the underlying disease process on upper airway and respiratory function.
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Otolaryngol. Clin. North Am. · Aug 1990
Review Comparative StudyObstructive sleep apnea and obesity.
OSA affects approximately 1 per cent of the adult male population and is more common among obese patients. The mechanism for the relationship between obesity and OSA may be mechanical obstruction or hypoxemia. Patients with obesity often have other medical problems that can exacerbate or complicate OSA. ⋯ Weight loss methods include behavior modification with diet, very low calorie diets with behavior modification, and bariatric surgery. In morbidly obese patients, more dramatic means such as bariatric surgery or very low calorie diets seem to be preferable because of the significant reduction in the length of time it takes for patients to lose weight. Because of a tendency for obese patients to regain weight, it is important to follow the patients long term to prevent the regaining of weight.
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Otolaryngol. Clin. North Am. · Jun 1990
Review Comparative StudyThe management of hyperthyroidism. A surgeon's perspective.
Surgery for the treatment of hyperthyroidism is rapid and permanent, highly safe, and highly successful and has an important and complementary role with medical therapy and 131I. In Grave's disease cases total thyroidectomy, performed only if parathyroid glands are preserved, prevents recurrent hyperthyroidism. Bilateral subtotal thyroidectomy or total lobectomy with contralateral subtotal lobectomy are done if at least one parathyroid cannot be preserved on each side. In terms of recurrent laryngeal nerve preservation, all three operations are equally safe if the nerve is positively identified and traced throughout its course.
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Otolaryngol. Clin. North Am. · Dec 1989
ReviewHeadache and facial pain associated with head injury.
Head injury frequently results in headache and at times facial pain. Controversy concerns the relationship of injury in the head and neck area to chronic headache, particularly when no apparent structural traumatic lesion is demonstrable. Neuropathological studies suggest with concussion there is neuronal injury without gross pathology. ⋯ Most often the prognosis is favorable for resolution of symptoms but a small percentage of patients will have persistent symptoms after three years. The notion that litigation prolongs the duration of the illness is not valid. In the past two decades great advances have been made in neurodiagnosis, and parallel therapeutic advances are expected in the near future.
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Otolaryngol. Clin. North Am. · May 1988
ReviewImaging modalities for the study of the temporal bone.
During the past 30 years, rapid and extensive progress has been made in diagnostic imaging of the petrous temporal bone, especially in the techniques of complex motion (pluridirectional) tomography, computed tomography, and magnetic resonance imaging. Because there are a variety of imaging techniques for evaluation of the petrous temporal bone, it is essential to utilize the optimal examinations. Economic factors and the need to reduce unnecessary radiation exposure for the patient are both important considerations.