The Laryngoscope
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As otolaryngologists, we are the first consulted for stridor and dysphagia. One must consider both extrinsic and intrinsic etiologies in the differential diagnosis of these symptoms. ⋯ Traditional teaching is that surgery is rarely indicated for DISH of the cervical spine. Recommendations regarding the role of surgery as well as a review of our surgical experience are discussed.
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Historical Article
The Edwin Smith Papyrus: the birth of analytical thinking in medicine and otolaryngology.
The Edwin Smith Papyrus, discovered in 1862 outside of Luxor, Egypt, is the oldest known surgical text in the history of civilization. The surviving scroll, a copy of an earlier text from around 3,000 B. C., gives us remarkable insight into the medical practice of ancient Egyptians in the Nile River bed during the dawn of civilization. ⋯ Many of the concepts physicians and patients today take as common knowledge originated in the Edwin Smith Papyrus. The authors attempt to uncover some of these fundamental ideas and trace them through time until their incorporation in our modern medical knowledge base. It is the rational, logical, and advanced thinking exhibited in the Edwin Smith Papyrus that mandates its respect from modern otolaryngologists and all physicians alike.
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Commercial preparations of intranasal zinc gluconate gel are marketed as a remedy for the common cold. However, intranasal zinc has been reported as a cause of anosmia in humans and animals. Seventeen patients presenting with anosmia after the use of intranasal zinc gluconate are described. ⋯ The zinc-induced anosmia syndrome, characterized by squirt, sniff, burn, and anosmia, occurs after the exposure of olfactory epithelium to zinc cation. It can be distinguished from postviral anosmia based on history.
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Randomized Controlled Trial Comparative Study
Effects of lidocaine and prednisolone on endoscopic rigid laryngoscopy.
The aim of this study is to compare the effects of lidocaine and methylprednisolone on postoperative respiratory complications caused by short-term laryngeal surgery by way of rigid laryngoscope under general anesthesia. The effects of these drugs on recovery from anesthesia are also compared. ⋯ Lidocaine intravenous or topical administration was effective in reducing postoperative respiratory complications after short-term laryngeal surgery by way of rigid laryngoscope. Methylprednisolone prolonged recovery time from anesthesia.
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The increasing prominence of multimodality therapy for patients with advanced head and neck cancer reflects its high survival and functional preservation rates. We report the pathologic data on patients undergoing neck dissection (ND) after induction chemotherapy followed by concomitant chemoradiotherapy (IC-CRT) in three similar protocols utilizing decreasing doses of radiation therapy. ⋯ 1) The incidence of positive pathology after IC-CRT increases as radiation dose decreases. 2) Selective neck dissection after CRT has been demonstrated to be feasible and safe; the complication rate of ND after IC-CRT is acceptably low. 3) There is viable posttreatment cancer in 20.5% of patients, indicating necessity of ND in these patients.