Ear, nose, & throat journal
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Comparative Study
Cocaine and lidocaine with phenylephrine as topical anesthetics: antimicrobial activity against common nasal pathogens.
Topical anesthetics are commonly used in the evaluation of nasal pathology. The anesthetics routinely used, 4% lidocaine with phenylephrine, or 4% cocaine, have been demonstrated to have varying inhibitory effects on bacterial cultures. The present study examined the antimicrobial activity of these topical anesthetics used in nasal procedures. ⋯ Further studies, specifically in vivo experiments, are needed to determine if use of the drugs produces a significant change in the ability to culture organisms from these sites. This type of study would, however, be difficult to perform, since most patients requiring aspiration are already on high-dose antibiotics that would inhibit the growth of most microorganisms. A modified aspiration technique using a less concentrated topical anesthetic will likely be required to increase the chances of obtaining positive cultures.
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Review Case Reports
Retained wooden foreign body in a child's parotid gland: a case report.
Foreign bodies can present a diagnostic challenge to even the experienced surgeon. In one review of 200 surgical cases involving retained foreign bodies, one-third of the cases had been initially missed. Wooden foreign bodies in particular pose a challenge to the physician. ⋯ However, with time, the attenuation value of a wooden foreign body may increase as moisture is absorbed from the surrounding tissues. Once this occurs, the wooden foreign body may mimic fat, water or muscle. We present an interesting case of a wooden foreign body in the parotid gland in order to illustrate a common presentation of such a foreign body, to review current guidelines for their clinical and radiologic diagnosis, and to suggest strategies for the management of their unique complications.
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Based on the analysis of the operative findings in 97 temporal bone fractures with respect to location, site of injury to the facial nerve and associated damage, we propose a new classification of the temporal bone fracture, using types 1, 2, 3 and 4, as previously described. Three-dimensional helical CT is valuable for assessment of fracture type. The incidence of each fracture type and the site of the injury to the facial nerve are described and the surgical significance of the classification is discussed.