The Laryngoscope
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A retrospective review of 88 cases of foreign body aspiration was undertaken. The patients ranged in age from 5 months to 73 years; the peak incidences of foreign body aspiration occurred in children less than 3 years of age and in adults older than 50 years. Sixty-one of the 88 patients were male. ⋯ Multiple foreign bodies were found in 5% of the patients. Tracheobronchial foreign bodies should, therefore, be strongly suspected in susceptible patient populations who present with a suggestive history, even when no physical or radiographic evidence can be seen. Patients should be carefully examined for multiple foreign bodies at the time of rigid endoscopic removal.
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Surgical repair of cerebrospinal fluid rhinorrhea requires the production of a seal able to resist cerebrospinal fluid pressure during the period of healing. Direct suturing, packing with muscle and fat grafts, and coverage with mucosal or muscle flaps have been effective in repairing most CSF leaks. Fibrin glue may enhance the results of a CSF leak repair by providing better adhesion of the graft and improving the initial seal during healing. ⋯ The CSF leaks were evaluated 3 weeks after operation. Persistent CSF leakage was noted in 89% of group 1, 55% of group 2, 33% of group 3, and 22% of group 4. The reduced CSF leakage in the muscle plus fibrin glue group suggests that fibrin glue, by its adhesive sealing properties, enhances the results of muscle packing alone for the treatment of cerebrospinal fluid rhinorrhea.