The Laryngoscope
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The objectives of this study are to compare short vs. long antibiotic prophylaxis in the setting of malnutrition, diabetes, and tracheotomy. ⋯ Malnutrition and tracheotomy were associated with a higher infection rate while diabetes was not found to be a risk factor. Prolonged antibiotics were not associated with a lower infection rate in the overall group or in any subgroup.
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Iatrogenic injuries to the trachea are rare, but life-threatening complaints. Causes and treatment methods have been described for adults, but there is no literature on aetiology and treatment in children. We performed a retrospective study to examine the frequency, aetiology, and treatment of iatrogenic injuries to the trachea in children and to develop guidelines for their treatment and prevention. ⋯ Acute tracheal ruptures in children can be treated conservatively by bridging the rupture with a tube. Injuries to the trachea in which the mucosa is damaged or in which other complications, such as fistulae, are present must be treated surgically. The prognosis for such injuries is good.
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Randomized Controlled Trial Multicenter Study
Randomized, double blind, placebo controlled trial on the safety and efficacy of continuous intratympanic dexamethasone delivered via a round window catheter for severe to profound sudden idiopathic sensorineural hearing loss after failure of systemic therapy.
To study the safety and efficacy of continuous intratympanic dexamethasone-phosphate (Dex-P) for severe to profound sudden idiopathic sensorineural hearing (ISSHL) or sudden idiopathic anacusis after failure of systemic therapy. ⋯ The tendency toward better hearing improvement in the treatment group, the rather conservative inclusion criteria, the limited placebo-controlled observation period and the absence of serious adverse events supports further investigation local inner ear drug delivery as a first or second line treatment option for ISSHL.
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Most elderly patients with severe to profound hearing loss are not being referred for cochlear implantation (CI), the only intervention to significantly improve hearing and quality of life in this population. Possible concern over the risks of anesthetic in the elderly may be one of the foremost concerns. The authors investigated whether advanced age is a risk factor when undergoing general anesthesia for cochlear implantation. ⋯ General anesthesia is well tolerated by elderly patients undergoing cochlear implantation. Preexisting medical condition of the patient as defined by ASA is a better predictor of intraoperative and postoperative complication than age alone.
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Randomized Controlled Trial Comparative Study
Video rigid laryngeal endoscopy compared to laryngeal mirror examination: an assessment of patient comfort and clinical visualization.
To determine whether there are differences in patient preference and extent of laryngeal visualization between video rigid (30 degree endoscope) laryngoscopy (VRL) and laryngeal mirror examination (LME). ⋯ VRL is superior to LME for most patients based on comfort, extent of laryngeal examination by the clinician, and patient preference. The majority of patients found visualization of their laryngeal examination during VRL to be helpful.