Ear, nose, & throat journal
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Randomized Controlled Trial Multicenter Study Comparative Study
Is a head bandage useful after otoplasty? A quasi-randomized controlled study of complications and patient satisfaction.
We conducted a prospective, quasi-randomized, controlled study to evaluate the incidence of postoperative complications and the degree of long-term patient satisfaction associated with the use or nonuse of a head bandage following otoplasty (pinnaplasty). Our study population was made up of 84 consecutively presenting patients who had undergone bilateral otoplasty (either an antihelical or conchaplasty procedure) for the correction of prominent ears under general anesthesia from January 2000 through March 2005. Patients ranged in age from 5 to 56 years (median: 13); 69 patients (82%) were aged 19 years and younger. ⋯ Two independent variables were found to influence long-term patient satisfaction only: the presence/absence of any complication and the individual surgeon who performed the procedure. There was no correlation between individual surgeons and complications. We conclude that the use of a head bandage is not necessary or advantageous following otoplasty for the correction of prominent ears, particularly in patients who have undergone cartilage plication.
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Primary jugular fossa meningiomas are among the rarest subtypes of meningioma. They are intimately related to the lower cranial nerves, the jugular bulb and vein, and the temporal bone, and they have a tendency to extend both intra- and extracranially. The most common morbidity associated with jugular fossa lesions is lower cranial nerve deficits. ⋯ We describe a case of primary jugular fossa meningioma in a 45-year-old man who presented with complaints of chronic left aural fullness, hearing loss, and difficulty understanding voices. Imaging revealed the presence of a destructive jugular fossa mass. The patient underwent surgical resection without complication, and he was free of recurrence at 1 year of follow-up.
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Review Case Reports
Pyogenic granuloma of the hard palate: a case report and review of the literature.
We describe the case of a 35-year-old man who presented with a 4 x 4-cm ulcerated swelling over the hard palate that had progressed over 6 months. The lesion was associated with recurrent bleeding and occasional pain. ⋯ Histopathologic examination of the excised specimen confirmed the diagnosis. We discuss the etiopathogenesis of this entity and the various treatment options, and we review the relevant literature.
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Randomized Controlled Trial
Intraoperative bupivacaine for reduction of post-tonsillectomy pain: a randomized, placebo-controlled, double-blind study of 26 patients.
We conducted a randomized, controlled, double-blind, prospective study to evaluate the effect of intraoperative bupivacaine injection on postoperative pain control following Bovie cautery-assisted tonsillectomy in 26 adults. Sixteen patients were injected with 10 ml of 0.5% bupivacaine with 1:200,000 epinephrine, and 10 were injected with 10 ml of normal saline solution. ⋯ At study's end, there was no statistically significant difference in pain scores, narcotic use, and oral intake between the bupivacaine group and the controls (p = 0.13, 0.37, and 0.35, respectively). We conclude that the effects of perioperative bupivacaine on postoperative pain control in tonsillectomy patients are similar to those of placebo.