HNO
-
In the planning of laser surgery for ENT operations, the specialist is often consulted by the anesthesiologist to predict possible intubation problems. Intubation problems in such operations can occur frequently due to the pathological findings present in the upper aerodigestive tract and the different constructions of laser-resistant endotracheal tubes. The aim of this study was to determine if a known predictive parameter could have a sufficient sensitivity and specificity to reliably predict possible intubation problems for ENT-related laser surgery. ⋯ The results were independent of the endotracheal tube used. Although use of the laser for ENT operations provides a special situation for the anesthesiologist, there is still no system that is sensitive and specific enough to be of practical use. This problem is demonstrated in a literature review.
-
During ENT surgical procedures under general anesthesia contamination of the operating room air through waste anesthetic gases seems unavoidable. A resulting chronic low-level exposure to anesthetic gases in subanesthetic concentrations (m1/m3 = ppm) may cause various negative health effects. The aim of this study was to quantify possible side effects on operating room personnel. ⋯ High leakages at the patient's mouth led to an undesirably high contamination of operating room personnel by nitrous oxide. Although threshold values were mostly not exceeded in available working conditions (i.e., adequate air conditioning and intubation cuff pressure control), present health and safety regulations concerning pregnant women showed that the values of nitrous oxide were still too high to allow such women to work safely in operating rooms during surgery. However, exposure to isoflurane was too slight to classify.
-
We report an unusual injury of the face caused by the spoke of an automatic telescoping umbrella that come loose when the umbrella was opened. Due to the shot-like force of the spoke, the left nostril, septum and right wall of the nasal cavity were pierced. The part with the joint penetrated into the maxillary antrum. In order to remove the spoke, wire scissors had to be used to cuff off the spoke's joint inside the surgically opened maxillary sinus.
-
From 1989-1993 we performed rigid bronchoscopies in 86 children in whom foreign body aspirations were suspected. In 72 cases, foreign bodies were identified in the tracheobronchial tree. In the remaining 14, no foreign body was found. ⋯ The most common type of foreign body was a peanut. The predilection of the foreign body was to fall into the right main bronchus. If the history indicated foreign body aspiration, a chest x-ray was not found to be necessary except for forensic interest.