Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Oct 1994
Risk factors associated with prolonged intubation and laryngeal injury.
A prospective study evaluated potential risk factors associated with laryngeal injury after prolonged endotracheal tube intubation for longer than 3 days. Ninety-seven patients were evaluated after oral endotracheal tube intubation (mean, 9 days). This study updates a previously reported evaluation of 44 patients. ⋯ Eight patients had true vocal cord immobility noted initially after extubation, and the remaining eight had true vocal cord immobility an average of 4 weeks after extubation. Initial and delayed true vocal cord immobility were associated with duration of intubation and size of endotracheal tube (p < 0.01). Delayed true vocal cord immobility developed only in patients with a size 8 endotracheal tube.(ABSTRACT TRUNCATED AT 250 WORDS)
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Otolaryngol Head Neck Surg · Sep 1994
Case ReportsHead and neck manifestations of erythema multiforme in children.
Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis are related disorders of skin and mucous membranes, which are typically associated with antecedent medication use or infection. We review 108 cases of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis from Texas Children's Hospital, Houston, Texas, from 1981 to 1991, and illustrate the characteristic skin and mucosal lesions. In addition, we describe in detail two unusual cases requiring intensive airway management. ⋯ We note a striking increase in the number of cases in our series caused by cephalosporins. Fifty percent of Stevens-Johnson syndrome patients required supplemental hydration or alimentation because of the severity of the oral cavity involvement. The head and neck mucosal manifestations largely respond to local care, and the routine use of prophylactic antibiotics or systemic steroids is not recommended.
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Otolaryngol Head Neck Surg · Sep 1994
Performance of the internal jugular vein after functional neck dissection.
The objective of this study was to assess internal jugular vein performance after functional neck dissection in routine and extended head and neck surgical procedures, including bilateral neck dissections, treatment of radiation failures, and those combined with microvascular free grafts. Because the indications for functional neck dissection in our practice have increased. It is important to assess the use of the procedure in these circumstances. ⋯ The function of the dissected internal jugular vein was analyzed with duplex ultrasound at least 4 weeks after treatment. Maximal venous flow rates were evaluated. The results of this study will be presented and discussed.
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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.