American journal of otolaryngology
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To review the presentation and management of peritonsillar (PTA) and parapharyngeal space (PPSA) abscesses in older adults and compare this with the usual presentation and management in the younger patient. ⋯ PTA and PPSA are uncommon infections in the older adult, with only 14 patients identified at a tertiary care hospital over an 18-year period. Complaints of new onset sore throat and dysphagia of several days duration in patients over 50 years old should alert the evaluating physician to these 2 clinical entities, even in afebrile, nontoxic patients. PTA in this group may be more likely to require inpatient care along with surgical treatment in the operating room.
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The purpose of the current study was to investigate the efficacy of concomitant oral etoposide and hyperfractionated radiation for patients with unresectable head and neck squamous cell carcinoma. ⋯ Concomitant etoposide and hyperfractionated radiation is well tolerated and seems to be effective in the treatment of unresectable HNSCC with acceptable mucosal toxicity.
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Randomized Controlled Trial Comparative Study Clinical Trial
Low-dose dexamethasone reduces nausea and vomiting after tympanomastoid surgery: a comparison of tropisetron with saline.
The aim of the study was to evaluate the efficacy of low-dose dexamethasone sodium phosphate (5 mg) on the prophylaxis of nausea and vomiting after tympanomastoid surgery. Tropisetron hydrochloride (2 mg) and saline were used as controls. ⋯ Dexamethasone sodium phosphate 5 mg was more effective than 2 mg tropisetron hydrochloride and saline in the prevention of nausea and vomiting after tympanomastoid surgery.
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Bronchoscopic subcutaneous dilatational tracheostomy is fast becoming the method of choice for securing an airway in chronic ventilated patients in an intensive care setting. Many studies have demonstrated that it is a cost-effective and safe procedure in experienced hands. Complications appear to be equivalent to those encountered in open tracheostomy. Subcutaneous emphysema following tracheostomy is a rare occurrence. Only 3 cases have been described following percutaneous dilatational tracheostomy. Management can be quite complex. ⋯ Massive subcutaneous emphysema following percutaneous tracheostomy is a major complication that is rarely encountered. When due to a posterior tracheal wall tear, management consists of bypassing the laceration and allowing it to heal secondarily.
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To review the literature involving removal of sharp foreign bodies from the hypopharynx and to present a case of a triple-barbed fishhook removed from the hypopharynx with suspension microlaryngoscopy. ⋯ Removal of sharp foreign bodies from the aerodigestive tract always presents a technical challenge, and this case of a hypopharyngeal triple-barbed fishhook introduces new operative techniques. By using microlaryngoscopy and bimanual instrumentation to manipulate and remove the fishhook, an open surgical procedure was avoided.