ORL; journal for oto-rhino-laryngology and its related specialties
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2013
Randomized Controlled Trial Comparative StudyComparison of the effects of desflurane and sevoflurane on middle ear pressure: a randomized controlled clinical trial.
The aim of the present study was to compare the effects of two inhalation anesthetics, desflurane and sevoflurane, on middle ear pressure. ⋯ It was observed that the increase in middle ear pressure caused by sevoflurane was significantly lower than that caused by desflurane.
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Dexamethasone is widely administered to children during elective tonsillectomy to reduce the rate of postoperative nausea and vomiting, as well as decrease postoperative use of pain medications. Over the past two decades, there has been a wealth of literature advocating the practice that has led to endorsement by a variety of anesthesia and otolaryngology professional associations. However, the publication of a trial that was halted due to a potential dose-dependent association between postoperative hemorrhage and dexamethasone raised significant scrutiny regarding the practice in 2008. ⋯ Ultimately, the body of evidence that currently exists appears to support the concept that a single dose of perioperative dexamethasone is not associated with undue risk. A decision to withdraw dexamethasone from use in pediatric tonsillectomy needs to be weighed against the potential of causing increased postoperative nausea, vomiting, pain, and resultant hospital readmission. At this point, surgeons and anesthesiologists should feel comfortable giving perioperative dexamethasone but must remain vigilant for bleeding complications.
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2012
Case ReportsEndoscopic microvascular decompression: a stepwise operative technique.
Microvascular decompression (MVD) of the trigeminal nerve is a widely accepted treatment for patients with trigeminal neuralgia caused by vascular compression. The neuroendoscope is rapidly becoming a complementary tool in minimally invasive neurosurgery of the ventral anterior skull base. Its adoption in the lateral approach to the posterior fossa has been slower and has been used primarily as an adjunct to conventional microscopic surgical techniques, e.g. endoscope-assisted microsurgery. ⋯ We believe endoscopic MVD is a safe and effective method of accessing the trigeminal nerve in the cerebellopontine angle and of performing MVD. This endoscopic technique can be implemented in other neurosurgical and neuro-otological procedures such as resection of cerebellopontine angle masses.
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2012
Resection of anterior cranial base meningiomas with intra- and extracranial involvement via a purely endoscopic endonasal approach.
The complete resection of anterior cranial base meningiomas with intra- and extracranial involvement is always challenging. We describe our experience of treating such meningiomas via a purely endoscopic endonasal approach (EEA). ⋯ Our limited experience indicates that EEA is feasible and safe for the complete resection of anterior cranial base meningiomas with intra- and extracranial involvement in one stage in selected cases.