Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale
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Acta Otorhinolaryngol Ital · Aug 2002
Comparative Study[Complications of tracheostomy in critically ill patients: comparison of dilation and surgical techniques].
The tracheotomy, one of the oldest surgical procedures, has in recent years been the focus of particular attention given the undoubted, and not always justified, increase in indications, and by the introduction of dilatational tracheotomy techniques, particularly in critically patients. The present work compares the standard surgical tracheotomy with the more recent percutaneous techniques (Ciaglia dilatational tracheotomy and Fantoni translaryngeal tracheotomy). In particular, the relationship between the technique adopted, timing and complications were analyzed for 215 tracheotomies performed at different Intensive Care Units at our Hospital between 1993 and 1998 (106 performed using the standard surgical technique, 51 with the Ciaglia technique and 58 with the Fantoni technique). ⋯ Among the disadvantages one must recall the possible dislocation of the cannula immediately after surgery: forced reinsertion of the cannula exposes the patient to the risk of creating a dangerous false route. The results obtained are statistically significant and in line with those found in the literature. The conclusion is drawn that, when performed by skilled surgeons and aided by endoscopy, the percutaneous tracheotomy techniques are the method of choice for patients in critical areas.
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Acta Otorhinolaryngol Ital · Feb 2002
[Cisplatin and carboplatin-induced ototoxicity in children: clinical aspects and perspectives for prevention].
In 70% of the cases of malignant neoplasms in pediatric patients antiblast therapy is used. The administration of platinum compounds, Cisplatin (CDDP) or Carboplatin (CBDCA), often at high cumulative doses, necessarily implies a certain degree of toxicity which normally takes on secondary significance in the healing of the child. Among the side effects, early and delayed ototoxicity is well known and, in the child, take on particular aspects. ⋯ The results confirm the well-known ototoxicity of platinum compounds, in particular CDDP. As ever improved therapeutic results are achieved in the treatment of malignant neoplasms in pediatric patients, greater attention can be paid to the quality of life of these young patients after the disease has been healed. Careful monitoring of auditory function can be extremely important in the pursuit this objective; indeed, this makes it possible to adjust antiblast drug administration, particularly in the later stages of treatment, customizing the treatment schedule to individual patient sensitivity.
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Acta Otorhinolaryngol Ital · Feb 2002
Case Reports[Laryngeal carcinoma associated with congenital tracheobronchomegaly (Mounier-Kuhn syndrome): a case report].
Congenital tracheobronchomegaly or Mounier-Kuhn Syndrome is a rare disorder of controversial etiology. It is characterized by an abnormal enlargement of the trachea and primary bronchi, because of atrophy or absence of their elastic fibers and smooth muscles. Such alterations lead to the collapse of the respiratory tract during forced exhalation, making expectoration by coughing of little use. ⋯ The patient underwent total laryngectomy and bilateral neck dissection without any intra- and postoperative complication. This is the first case reported in the literature of an association between laryngeal carcinoma and Mounier-Kuhn Syndrome, although a cause-effect relationship between the two pathologies cannot be advanced at this time. This paper also reports how the patient was managed in terms of anesthesiology and surgical technique, both conditioned by the marked tendency for anteroposterior tracheal wall collapse and its high reactivity to mechanical insults.
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Acta Otorhinolaryngol Ital · Oct 2001
Randomized Controlled Trial Clinical Trial[Eutectic mixture of local anesthetics (EMLA): evaluation of the analgesic effectiveness during ND: YAG laser turbinoplasty].
The analgesic effect of EMLA anesthetic cream is evaluated during contact turbinoplasty with a Neodymium: yttrium-aluminum-garnet (Nd: Yag) laser. A total of 48 patients were selected and randomized in two groups. EMLA was applied on the nasal mucosa, respectively, for 15 and 30 minutes after using vasoconstrictor cottonoids. ⋯ The pain induced by the surgical procedure was evaluated with a visual analogic scale. The score obtained was significantly lower in the 1st group than in the 2nd group and this difference was statistically significant (p < 0.01). The EMLA anesthetic cream applied on the mucosa for 15 minutes allows to obtain a good analgesia during the functional contact turbinate surgery with a Nd: Yag laser and thus can be considered a valid alternative to anesthesia by local infiltration.
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Acta Otorhinolaryngol Ital · Oct 1998
Comparative Study Clinical Trial[Canalith repositioning maneuver: proposal of a new therapy for benign paroxysmal positional vertigo of the posterior semicircular canal].
A new therapy is proposed for the treatment of Benign Paroxysmal Positional Vertigo (B. P. P. ⋯ S. C. both as initial treatment and as alternative to other treatment methods which have proved ineffective or difficult to perform. Indeed, in therapy it is best to be quite skilled in more than one technique, availing oneself of a full range possibilities; in this way the cure can be tailored to the patient in each individual case and not vice versa.