Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Twelve children over a 6-year period (1985 to 1991) underwent aerodigestive tract endoscopy after ingestion of lye-containing cosmetic products. All children were less than 2 years of age and had facial and/or oral cavity burns. Eleven of these patients ingested alkaline hair products such as "activators" or "relaxers." Endoscopy revealed pharyngeal burns in five patients but no laryngeal or esophageal burns in any patient. ⋯ This patient sustained extensive superficial burns of the pharynx, larynx, and esophagus and required intubation and admission to the intensive care unit. No long-term sequelae developed. Cosmetic products containing caustic chemicals represent a significant health risk to small children, especially because child-proof packaging is not standard for these products.
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Unilateral progressive sensorineural hearing loss, tinnitus, and unsteadiness are the usual initial symptoms of acoustic neuroma. Of the last 100 consecutive cases of acoustic neuroma detected at our Centre, 14 had atypical symptoms, Five patients manifested sudden hearing loss; one of these had complete recovery. Three patients reported long-standing unilateral hearing loss, ranging from 10 to 20 years. ⋯ Acoustic tumors could have been overlooked easily in these patients. It is important to have a high index of suspicion in all cases of sudden hearing loss, asymmetric sensorineural loss of any duration, subjective sensation of hearing loss, and tinnitus. It is mandatory to investigate these cases with auditory brainstem responses, any abnormality of which makes it necessary to perform magnetic resonance imaging with gadolinium.
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Otolaryngol Head Neck Surg · Nov 1993
Assessment of survival and microscopic changes in porcine skin flaps undergoing immediate intraoperative tissue expansion.
The technique of rapid intraoperative tissue expansion has been used with increasing frequency in the clinical setting over the last several years. This technique takes advantage of the skin's ability to immediately stretch and increase in surface area when expanded under a constant load. Sixteen random-pattern, rapidly expanded skin flaps on 10 domestic male pigs were studied to assess the predictive value of the fluorescein test for flap viability after rapid intraoperative tissue expansion. ⋯ Additionally, histologic and ultrastructural changes were examined in rapidly expanded skin from the hip region in three pigs. The only microscopic change noted between control and experimental flaps was dilated capillaries in the dermis of expanded skin, which was noted by electron microscopy. Collagen and elastic tissue changes were not demonstrated in rapidly expanded pig skin by electron microscopy, direct immunofluorescence, collagen, and elastic tissue stains.