Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Feb 2009
A devastating outcome after adenoidectomy and tonsillectomy: ideas for improved prevention and management.
To develop strategies that may assist the surgeon to prevent and manage severe bleeding complications after adenoidectomy and tonsillectomy. ⋯ Careful inspection of the nasopharynx immediately before adenoidectomy and curettage in a piecemeal fashion under visual control is helpful to prevent direct injury to aberrant arteries. Tonsillectomy cases are associated with delayed and episodic bleeding with spontaneous cessation and young age. Inpatient observation should be strongly considered in cases with repeated bleeding episodes to provide immediate treatment. The follow-up should be focused on disturbed wound healing. Outcome appears to be dependent on adequate airway management. Rigid instruments and tracheotomy in case of intubation failure are highly recommended to facilitate airway protection and ventilation.
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Otolaryngol Head Neck Surg · Feb 2009
Symptom duration and CT findings in pediatric deep neck infection.
To investigate whether children with less than 48 hours of localized symptoms of deep neck infection are less likely to have an abscess on CT scan. ⋯ Because duration of symptoms does not predict finding of abscess on CT, it is appropriate to obtain a CT scan upon presentation in all children with symptoms concerning for neck abscess.
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Otolaryngol Head Neck Surg · Feb 2009
Hemostasis during functional endoscopic sinus surgery: the effect of local infiltration with adrenaline.
To determine the feasibility of the use of a topical vasoconstrictor for hemostasis during functional endoscopic sinus surgery. ⋯ Topical use of adrenaline achieved similar hemostatic effect compared with injection of adrenaline. Intranasal injection of a vasoconstrictor, in consideration of its adverse effects, may be avoided during surgery.
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Otolaryngol Head Neck Surg · Feb 2009
Early tracheotomy in elderly patients results in less ventilator-associated pneumonia.
To determine if the timing of tracheotomy in elderly patients results in less ventilator associated-pneumonia, mortality, and morbidity. ⋯ Early tracheotomy in elderly patients is associated with less ventilator-associated pneumonia, more frequent intubations, less total admission time, and a trend toward lower mortality.