Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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The differential diagnosis and treatment of patients with chronic cough, paradoxical vocal fold motion, and disordered breathing can be a challenge to most practicing otolaryngologists. Tracheobronchial (ie, asthma, bronchitis, and tracheal stenosis), laryngeal (ie, vocal fold paralysis and neoplasms), and rhinologic (ie, allergies and rhinosinusitis) etiologies are commonly diagnosed and treated effectively. However, occasionally one is faced with patients who are refractory to medical treatment and have no obvious rhinologic, laryngeal or pulmonary cause. ⋯ Gastroesophageal reflux disease, vagal neuropathy, and paradoxical vocal fold motion are additional causes of chronic cough and disordered breathing that need to be considered, in the absence of obvious laryngotracheal and/or rhinologic pathology. A high index of suspicion is essential in making the diagnosis and formulating an effective multidisciplinary treatment plan for these patients.
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Otolaryngol Head Neck Surg · Dec 2002
Comparative StudyA comparison of screening methods in school-aged children.
We sought to compare the findings of 3 different hearing screening methods in school-aged children. ⋯ We continue to recommend pure-tone testing as an effective screening method, with follow-up by using otoacoustic emissions in those who fail the pure-tone test.
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Otolaryngol Head Neck Surg · Nov 2002
Viral titers and delayed facial palsy after acoustic neuroma surgery.
Delayed facial palsy (DFP) after acoustic neuroma surgery has been reported to occur in up to one third of cases. Reactivation of latent virus has been proposed as an etiology for DFP. However, only retrospective case reports and case series have offered data to support this theory. The objective of this study was to correlate DFP with change in viral titers. ⋯ Elevation of the IgM titers of the viruses measured in this study implies that recrudescence of the virus has occurred. The absence of this rise among patients who did not develop DFP implies that viral recrudescence plays a role in the etiology of DFP. These findings support treatment or prophylaxis of DFP with antiviral therapy.
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Otolaryngol Head Neck Surg · May 2002
Comparative StudyHydroxyapatite cement cranioplasty in translabyrinthine acoustic neuroma surgery.
Hydroxyapatite cement cranioplasty (HAC) after translabyrinthine resection of acoustic neuroma is a promising new technique for wound reconstruction. This study reviews the efficacy of HAC for the prevention of cerebrospinal fluid (CSF) leakage and the long-term wound outcomes of HAC versus abdominal fat graft (AFG) reconstruction. ⋯ HAC offers significant CSF leakage control and long-term cosmetic and comfort advantages over AFG alone. We recommend HAC as the standard closure technique for translabyrinthine acoustic neuroma surgery.
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Otolaryngol Head Neck Surg · Mar 2002
Randomized Controlled Trial Clinical TrialDoes dexamethasone with preemptive analgesia improve pediatric tonsillectomy pain?
The study goal was to determine whether the combination of dexamethasone with preemptive analgesia has an additive effect in further improving recovery. ⋯ Dexamethasone does not significantly improve the morbidity of pediatric tonsillectomy when preemptive analgesia with ropivacaine and clonidine is used concurrently.