ORL; journal for oto-rhino-laryngology and its related specialties
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2009
Comparative StudyElectrode interaction in cochlear implant recipients: comparison of straight and contour electrode arrays.
The degree of overlap among cochlear nerve fibers stimulated by different electrodes results in electrode interaction, which has been shown to have a significantly deleterious effect on speech recognition performance in multi-electrode cochlear implant users. The Nucleus CI24R(CS) Contour array, which lies substantially closer to the modiolus than the CI24M straight array, is expected to exhibit narrower excitation patterns. The neural response telemetry (NRT) 3.0 software provides a method of measuring the spread of neural excitation by presenting the masker and probe pulses on different intra-cochlear electrode bands. ⋯ The spread of neural excitation with respect to array type and location revealed significant effects (p < 0.001; p = 0.002) and no interaction between array type and probe location (p = 0.559). The results demonstrated that the Contour array improved electrode discrimination, especially for the electrodes at the basal end of the cochlea. The findings have implications for future electrode array design and current implant mapping strategies.
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2009
Case ReportsCase report: respiratory inductance plethysmography as a monitor of ventilation during laser ablation and balloon dilatation of subglottic tracheal stenosis.
We describe a 61-year-old female who underwent KTP laser ablation and CRE balloon dilatation of symptomatic idiopathic subglottic stenosis (50% obstruction). The procedure was conducted, using our standard approach for such cases, under total intravenous general anesthesia with subglottic high-frequency jet ventilation (HFJV) via Lindholm laryngoscope. The patient was enrolled in an ongoing investigational protocol in which respiratory inductance plethysmography (RIP; Ambulatory Monitoring Inc., Ardsley, N. ⋯ After successful tracheal dilation under intermittent apnea, subsequent jet ventilation produced only modest RIP amplitude changes. RIP may be an important safety monitor during jet ventilation for patients with obstructive tracheal lesions to lessen the risk of both barotrauma and hypoventilation. RIP remains under active study by our group for this purpose.
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2009
Cochlear implantation in China: review of 1,237 cases with an emphasis on complications.
The purpose of this study is to retrospectively review the complications of patients who underwent cochlear implantation at 51 hospitals in mainland China over a decade. ⋯ Cochlear implantation is a safe and reliable otosurgical procedure in China, and the rate of complications is similar to developed countries. Carefully preoperative preparation and standardization of the procedure are important for the development of cochlear implant programs in developing countries.
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2009
Laryngeal mask airway in laryngoscopies: a safer alternative for the difficult airway.
This study was undertaken to highlight the method, usefulness and postoperative morbidity of using a laryngeal mask airway (LMA) to ventilate patients with difficult airways undergoing laryngeal procedures. ⋯ Insertion of an LMA and maintenance of airway and ventilation were performed with ease in all patients. The airway lesions were easy to visualize, there was minimal vocal cord trauma, and it served as a wide conduit for therapeutic bronchoscopes and laryngoscopes. Therefore, we recommend preoperative identification of difficult airways and consideration of elective LMA use with a flexible endoscope during laryngeal and upper tracheal procedures.