Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Jan 2015
Surgical fires in laser laryngeal surgery: are we safe enough?
Laser surgery of the larynx and airway remains high risk for the formation of operating room fire. Traditional methods of fire prevention have included use of "laser safe" tubes, inflation of a protective cuff with saline, and wet pledgets to protect the endotracheal tube from laser strikes. We tested a mechanical model of laser laryngeal surgery to evaluate the fire risk. ⋯ While "laser safe" tubes provide a layer of protection against fires, they are not fire proof. Inadvertent cuff perforation may result in fire formation in low-level oxygen enriched environments. Placement of wet pledgets do not provide absolute protection. Endotracheal tube (ETT) cuffs should be placed distally well away from an inadvertent laser strike while maintaining the minimum supplemental oxygen necessary.
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Otolaryngol Head Neck Surg · Jan 2015
Test battery of cranial nerves VII and VIII for assessing herpes zoster oticus.
This study adopted a test battery of cranial nerves (CNs) VII and VIII comprising a facial nerve function test, audiometry, a caloric test, and ocular and cervical vestibular-evoked myogenic potential (oVEMP and cVEMP, respectively) tests to assess the function of CNs VII and VIII comprehensively so as to predict facial nerve recovery in patients with herpes zoster oticus (HZO). ⋯ Grading of the facial nerve alone fails to predict the outcome of facial paresis in patients with HZO mainly because it overlooks the involvement of CN VIII. Alternatively, a combined test battery of CNs VII and VIII may serve as a strong predictor for facial nerve recovery.
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Otolaryngol Head Neck Surg · Jan 2015
Role of polysomnography in the development of an algorithm for planning tracheostomy decannulation.
To examine the role of polysomnography (PSG) in helping determine readiness of tracheostomized patients for decannulation. ⋯ Polysomnography may be a useful adjunctive study in the process of determining a patient's readiness for decannulation. Our current algorithm for decannulation includes upper airway endoscopy with identification of levels of obstruction, followed by surgical correction of those obstructions; capped PSG to determine patency of the airway and help assess lung function; and overnight intensive care unit admission for capping trial, with decannulation the following day if well tolerated.
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Otolaryngol Head Neck Surg · Jan 2015
Postoperative observation of children after endoscopic type 1 posterior laryngeal cleft repair.
To report the perioperative management and surgical outcomes in a large series of pediatric patients with endoscopically repaired type 1 posterior laryngeal cleft (PLC). ⋯ The endoscopic surgical repair of a type 1 PLC is successful and has a low morbidity and complication rate. Patients may be safely managed in an observation unit and without postoperative intubation. This approach achieved a marked cost reduction in postoperative care.