Ear, nose, & throat journal
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Randomized Controlled Trial Multicenter Study
Effects of chlorhexidine/benzydamine mouth spray on pain and quality of life in acute viral pharyngitis: a prospective, randomized, double-blind, placebo-controlled, multicenter study.
We conducted a prospective, randomized, double-blind, placebo-controlled, multicenter study to assess the efficacy of chlorhexidine gluconate/benzydamine HCl mouth spray for reducing pain and improving quality of life in patients with acute viral pharyngitis. Prior to treatment, patients rated the intensity of their pain on a visual analog scale and evaluated their quality of life on the 36-Item Short-Form Health Survey. Patients were then randomized to receive either paracetamol (acetaminophen) plus chlorhexidine/benzydamine or paracetamol plus placebo for 7 days. ⋯ A comparison of self-evaluations revealed that the active treatment group reported less pain on both day 3 (p < 0.001) and day 7 (p = 0.002). Likewise, the chlorhexidine/benzydamine group reported a significantly better quality of life on day 7 (p < 0.001). Chlorhexidine/benzydamine was well tolerated, and no serious adverse events were observed.
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Cerebrospinal fluid (CSF) fistulae have been encountered by otolaryngologists often since the advent of modern endoscopic sinus surgery, otologic surgery, and skull base surgery. Treatment of CSF leaks may include bed rest, head-of-bed elevation, stool softeners, external spinal fluid drainage, and surgery. External CSF drainage is accomplished via a lumbar spinal drain. ⋯ Otolaryngologists should be familiar with the physiologic properties of CSF, the methods used to diagnose fistulae, and the techniques used to repair leaks. External spinal drainage is an important element in the management of CSF fistulae, and it has been used in treating perilymphatic fistulae and "gushers." Much controversy surrounds its routine use. Otolaryngologists need to understand the risks, benefits, and outcomes of spinal drain use in order to decide which patients may benefit from this procedure.
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Review Case Reports
Taste impairment following tonsillectomy and adenoidectomy: an unusual complication.
Tonsillectomy and adenoidectomy is a relatively safe procedure, but it is nevertheless associated with certain complications. Some of these include throat pain, otalgia, dehydration, hemorrhage, nasopharyngeal stenosis, velopharyngeal insufficiency, burns, soft-tissue injury, dentomandibular trauma, atlantoaxial subluxation, and respiratory compromise. ⋯ To the best of the author's knowledge, only 29 cases of altered taste associated with palatine tonsillectomy have been previously reported in the literature since 1966. In this article, the author reports a new case and discusses the features of this unlikely complication.
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Review Case Reports
Multiple phosphaturic mesenchymal tumors associated with oncogenic osteomalacia: case report and review of the literature.
Oncogenic osteomalacia is a rare paraneoplastic syndrome that occurs secondary to tumor development in a variety of locations. Only about 140 cases have been reported in the literature. The most common causal tumor is phosphaturic mesenchymal tumor (PMT), a histologically benign lesion. ⋯ To the best of our knowledge, this is the first reported case of multiple PMTs. Despite resection of both tumors, the patient's signs and symptoms did not resolve, suggesting either incomplete tumor removal or the presence of another undetected tumor. We discuss the diagnosis of oncogenic osteomalacia, its associated biochemical abnormalities, and its histopathology.
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Review Case Reports
Synovial sarcoma of the head and neck: a review of its diagnosis and management and a report of a rare case of orbital involvement.
Synovial sarcoma is typically an aggressive malignant tumor of the soft tissues, usually in the extremities, that affects young adults. Tumors of the head and neck are rare. Reported head and neck sites have included the hypopharynx (the most common site), the oropharynx, the larynx, and the soft tissues of the neck; only 4 cases of orbital involvement have been previously reported. ⋯ The patient, an 18-year-old woman, underwent conservative excision and postoperative radiation therapy. Long-term follow-up detected no evidence of recurrence. Because there is no established, consistent approach to the treatment of synovial sarcoma of the head and neck, we also present a consensus management plan based on our review of the literature.