Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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The improved survival of patients sustaining massive head injuries has increased the number of temporal bone fractures being managed by otolaryngologists and neurosurgeons. We performed a prospective analysis of 35 patients with head injury with temporal bone trauma. The major emphasis of this study was to investigate the incidence, management, and outcome of facial nerve injury in such patients and to evaluate the importance of electrodiagnostics in the surgical management of the facial nerve. ⋯ This study underscores the importance of evoked electromyography, or electroneuronography, in assessing facial nerve function. Electroneuronography provided the indications for surgical intervention for facial paralysis. All patients having surgery for facial paralysis as determined by electroneuronographic findings had pathology of the facial nerve.
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Otolaryngol Head Neck Surg · Jun 1997
Otolaryngic manifestations in children presenting with apparent life-threatening events.
Apparent life-threatening event (ALTE) is a term used to characterize an event of unknown cause after an infant is found limp, cyanotic, bradycardic, and/or requiring resuscitation. Like sudden infant death syndrome (SIDS), ALTE is a general term used until a precise diagnosis can be established. The relationship between ALTE and SIDS has not been clearly defined, although 7 to 15 percent of children with ALTE die of SIDS. ⋯ Thirteen percent of the children had nonotolaryngic anomalies identified during evaluation. Surgical intervention was required in 10 patients and medical treatment was used in 18. When evaluating a child with ALTE, a complete history and physical examination, evaluation for gastroesophageal reflux, assessment for upper airway obstruction by radiographs and endoscopy, and a multidisciplinary approach are recommended.
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Otolaryngol Head Neck Surg · Mar 1997
Comparative StudyA comparison of mucosal incisions made by scalpel, CO2 laser, electrocautery, and constant-voltage electrocautery.
This study compares the histologic effects of scalpel, CO2 laser, electrosurgery, and constant-voltage electrosurgery incisions on the mucosal tissue of swine. Tissue studies comparing the CO2 laser with the scalpel and electrosurgery have been done. However, a gross and histologic comparison of the effects of all three techniques on oral mucosal tissue has not been reported. ⋯ The wounds created by all four instruments displayed intact epithelium by 4 weeks, and granulation tissue peaked at 4 weeks with all methods except constant-voltage electrosurgery, where granulation tissue was still prevalent at week 6. Constant-voltage electrosurgery and the CO2 laser provided the best combination of ease of use, hemostasis, and lack of tissue injury among the instruments compared. Incisions and excisions made with constant-voltage electrosurgery required less time than those made with the laser, but constant-voltage electrosurgery wounds also had significantly more granulation tissue in later weeks of the study, suggesting that wound healing may be delayed.