The Laryngoscope
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To validate the technique of sleep nasendoscopy using target controlled infusion in symptomatic patients and a control group of asymptomatic individuals. ⋯ None of the patients in the asymptomatic group snored or obstructed at any level of propofol, and this was clearly significant on comparison with the symptomatic group (P < .001). All of the symptomatic patients were induced to become symptomatic (snoring/obstruction).
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Simulation is a tool that has been used successfully in many high performance fields to permit training in rare and hazardous events. Our goal was to develop and evaluate a program to teach airway crisis management to otolaryngology trainees using medical simulation. ⋯ Medical simulation can be an extremely effective method for teaching airway crisis management and teamwork skills to otolaryngology trainees at all levels.
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Heat and moisture exchangers (HME) are frequently used in the treatment and prevention of tracheobronchial dryness and infections. In this study, the short-term influence of the HME Prim-Air System (Heimomed, Kerpen, Germany) in laryngectomized patients was tested. ⋯ The results indicate that short-term use of the HME Prim-Air system rapidly changes the tracheal climate. The significant increase in tracheal temperature and humidity may have beneficial effects on tracheal dryness in laryngectomized patients.
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Randomized Controlled Trial Clinical Trial
Marked hypotension induced by adrenaline contained in local anesthetic.
Local anesthetics containing adrenaline, which often cause cardiovascular side effects, are routinely used in functional endoscopic sinus surgery (FESS) for the main purpose of hemostasis. The controversies concerning hemodynamic effects of adrenaline in local infiltration are widely discussed, but there is no definite conclusion. A prospective, randomized, double-blinded study was carried out to discover the hemodynamic effects after local infiltration of 1:200,000 adrenaline contained in 2% lidocaine under general anesthesia. ⋯ Lidocaine (2%) or saline with adrenaline (1:200,000) does cause temporary hypotension and other hemodynamic changes during general anesthesia, which last no longer than 4 minutes. The causative mechanism is caused by the effect of adrenaline. This is a preliminary study.
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The objective was to present the unique case of previously unreported asymptomatic cylindrical tracheal foreign body causing near-total airway obstruction. The asymptomatic nature of the case made diagnosis and management challenging. ⋯ Tracheal foreign bodies are distinctly different clinical entities from bronchial foreign bodies. Asymptomatic bronchial foreign bodies are relatively common, but to the authors' knowledge, an asymptomatic tracheal foreign body had not been reported previously. Discussion focused on pathophysiology with reference to Poiseuille's law, diagnosis, and management of asymptomatic tracheal foreign bodies, including the possibility of elective bronchoscopic retrieval.