The Laryngoscope
-
Randomized Controlled Trial Comparative Study
Vestibular suppressants after canalith repositioning in benign paroxysmal positional vertigo.
To investigate the characteristics of residual symptoms and to evaluate the effects of adjuvant vestibular suppressants on residual symptoms after successful canalith repositioning procedures (CRPs). ⋯ Vestibular suppressants significantly reduced residual symptoms compared to both placebo and no medication after CRP. However, there was no significant reduction in DHI score compared with the control group, suggesting that the residual symptoms could not be evaluated by DHI score alone.
-
Multicenter Study
Emergencies in otolaryngology-head and neck surgery bootcamp: a novel Canadian experience.
A 1-day intensive course (bootcamp) was developed, to teach junior otolaryngology-head and neck surgery (OTO-HNS) residents emergency procedural skills, clinical reasoning, and communication skills. This learning paradigm utilized a number of novel task trainers, panel discussions, and emergency simulations. The study objective was to assess the educational value of this bootcamp. ⋯ This first Canadian OTO-HNS bootcamp demonstrated the feasibility and effectiveness of conducting a centralized bootcamp for regional training centers spanning multiple states/provinces and languages. Future bootcamps will be held annually and will ideally continue the natural evolution of surgical, hands-on training.
-
To examine the effects of a learner-centered educational curriculum for Johns Hopkins otolaryngology-head and neck surgery residents in improving their otolaryngology training examination (OTE) scores. We hypothesized that trainees who attend a learner-centered program demonstrate improved performance on OTEs. ⋯ Residents OTE stanines improved significantly after the implementation of a learner-centered educational curriculum. This finding suggests that trainees are able to perform better when involved in planning and implementing the educational curriculum.
-
Observational Study
The relationship between hypotension, cerebral flow, and the surgical field during endoscopic sinus surgery.
Hypotensive anesthesia is often used in endoscopic sinus surgery (ESS) to improve surgical visibility; however, its safety and efficacy in this role are yet to be justified. This study aimed to evaluate the effect of hypotensive anesthesia on both real-time middle cerebral artery blood flow velocity (Vmca) and the severity of surgical bleeding in patients undergoing ESS. ⋯ Hypotensive anesthesia is an effective method of controlling intraoperative bleeding during endoscopic sinus surgery; however the effect is clinically small in low MAP ranges. In otherwise healthy patients undergoing ESS with general anesthesia, reducing MAP to below 60 mm Hg may increase the risk of cerebral ischemia.
-
Case Reports
Peritonsillar abscess with rapid progression to complete airway obstruction in a toddler.
Peritonsillar abscess in children younger than 5 years old has rarely been reported in the literature. We present the case of a 22-month-old child with a right peritonsillar abscess with parapharyngeal spread that was complicated by airway obstruction secondary to rapid epiglottic swelling. The severity of the airway obstruction necessitated an urgent tracheostomy, incision and drainage of the peritonsillar abscess and right lateral pharyngeal space, and a right tonsillectomy. Here we report the case and review the literature regarding peritonsillar space infections, their potential complications, and treatment.