Ear, nose, & throat journal
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Neurostimulation of the upper airway muscles (accessory muscles of respiration) was accomplished in anesthetized dogs and sleeping humans by electrical stimulation of the hypoglossal nerves. Such stimulations relieved partial airway obstructions in dogs. ⋯ In one subject, stimulations delivered in advance of apneic events (by automatic cycling) prevented apneas. Neurostimulation for obstructive sleep apnea may be an important concept for future research and development.
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Bulimia nervosa is an eating disorder found predominantly in young females and characterized by binge-purge cycles as well as medical and psychological problems. The patient with bulimia may present to the otolaryngologist with an upper aerodigestive complaint. It is of paramount importance that the otolaryngologist be cognizant of the disease in order to refer the patient for further therapy.
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Before the advent of safe and readily-available intubation anesthesia, most endoscopic procedures were carried out under topical or local anesthesia. Reawakening interest in cost effectiveness in medical practice and improved safety suggests that these techniques should be reexamined. The authors' experience in nearly 2,000 topical anesthetics for peroral endoscopy is reviewed. A preferred technique is presented which has proven effective and has resulted in an overall complication rate of less than 1%.
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Acute uvulitis in adults is a rare condition, especially when associated with acute epiglottitis. Watchful monitoring of the airway, usually in the intensive care unit, is recommended. Along with appropriate antibiotics and steroids, we recommend all patients with acute uvulitis have a lateral radiograph of the neck to rule out acute epiglottitis. To avoid a possible fatality, a high index of suspicion should be maintained at all times in order to appropriately diagnose and treat these patients.