HNO
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There must be close cooperation between the surgeon and the anaesthetist during surgery of the paranasal sinuses. The surgeon needs a bloodless field which the anaesthetist can achieve by lowering the patient's arterial blood pressure using controlled hypotension. ⋯ There are two hypotensive drugs of choice: sodium nitroprusside and nitroglycerin. If the circulation and ventilation are monitored sufficiently, the surgeon can expect good results with diminished blood loss.
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Case Reports
[Madelung's lipomatosis of the neck--expression of an alcohol-induced endocrine disorder?].
An uncommon case of a patient with Madelung's disease (Launois-Bensaude disease, multiple symmetrical lipomatosis) is reported. Moreover, the patient suffered from alcoholic hepatomegaly, an atrophic right kidney, Dupuytren's contracture of both hands, hyperuricemia and psoriasis. The etiology of Madelung's disease is discussed.
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The Radovan tissue expander permits the advancement of adjacent flaps by stretching the skin without the need for distant flaps or skin grafts. The use of tissue expanders is presented in a case of extensive burn of the face.
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19 laryngeal injuries are reported. 16 were secondary to orotracheal intubation and 3 were sequelae of gastroscopy, laryngoscopy and a nasogastric tube. In 6 patients, the trauma followed prolonged nasotracheal intubation, 10 cases followed a single endotracheal intubation. The main symptom was hoarseness. ⋯ In the cases of subluxation the arytenoid cartilage was dislocated posterolaterally, with the cord in the abducted position. For treatment we recommend closed reduction and injection of Cortison-Crystal-suspension into the joint. The outcome is good after single endotracheal intubation, but bad in prolonged nasotracheal intubation because of ankylosis of the cricoarytenoid joint.