ORL; journal for oto-rhino-laryngology and its related specialties
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2011
Randomized Controlled Trial Comparative StudyEvaluation of recovery and anesthetic gas consumption using remifentanil combined with low-flow sevoflurane anesthesia in tympanoplasty.
The aim of this study was to compare the effects of low-flow sevoflurane and low-flow sevoflurane supplemented with remifentanil anesthesia on the recovery time, consumption amount of the anesthetic drugs and hemodynamic differences. ⋯ Low-flow sevoflurane anesthesia combined with remifentanil regimen in patients undergoing tympanoplasty surgery resulted in a faster early recovery and decreased sevoflurane consumption.
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2011
Randomized Controlled Trial Comparative StudyA randomized comparison of target-controlled infusion of remifentanil and propofol with desflurane and fentanyl for laryngeal surgery.
To compare the clinical profile of target-controlled infusion (TCI) of remifentanil (REM) + propofol (PRO) with fentanyl (FEN) bolus infusion with desflurane (DES) inhalation in direct laryngoscopic surgery. ⋯ TCI of REM + PRO anesthesia appears to be a reasonable alternative to FEN bolus infusion combined with DES inhalation during direct laryngoscopic surgery.
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ORL J. Otorhinolaryngol. Relat. Spec. · Jan 2011
Case ReportsLaryngeal fracture due to blunt trauma presenting with pneumothorax and pneumomediastinum.
Injuries due to traffic accidents are frequent in childhood, and they have high mortality and morbidity. Laryngeal injury due to a traffic accident is a rare pathology and might be missed if not suspected. Here we present a laryngeal fracture in a child after a blunt chest trauma during a traffic accident that presented with pneumomediastinum and pneumothorax. ⋯ Pneumomediastinum is a rare result of a laryngeal fracture and if not suspected, the fracture can easily be missed. It should be kept in mind after blunt cervical trauma with pneumomediastinum and/or pneumothorax. Direct endoscopy and cervical tomography may be necessary for the differential diagnosis.
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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.