The Laryngoscope
-
To study the efficacy and safety of topical tetracaine anesthesia for office myringotomy and myringotomy with a tube. ⋯ Topical tetracaine is efficacious and safe for use in office myringotomy.
-
Because sentinel lymph nodes are the first lymph nodes that drain a primary cancer site, results of sentinel lymph node (SLN) biopsy indicate status of the regional lymph nodes. Preoperative lymphoscintigraphy and intraoperative combined application of the handheld gamma probe and blue-dye technique (i.e., the "combined technique") was used previously to accurately identify the SLN, mostly in melanoma of the extremities and trunk and, sometimes, in melanoma of the head or neck, which is anatomically complex. Because of this complexity, melanoma in the head or neck is inherently problematic to treat: Localization of the SLN can be difficult or impossible because the primary cancer site can be near or overlapping the nodal basin. The objective of the present study was to determine the technical modifications and other considerations that can make SLN localization feasible in cases of melanoma occurring near or overlapping the nodal basin in the head or neck. ⋯ For patients with primary melanoma that is near or overlaps the nodal basin in the head or neck, SLN biopsy can be accurately performed using Tc-99m sulfur colloid at low activity levels (10 microCi to 60 microCi [0.37 to 2.2 MBq]. However, background radiation from the primary injection site can incorporate the SLN, making localization at preoperative lymphoscintigraphy difficult if not impossible; therefore, the high doses commonly used for melanoma of the extremities and trunk (500 to 2000 microCi [18.5 to 74 MBq]) should not be used for melanoma of the head or neck if the primary site is near or overlaps the nodal basin. In addition, absorption of Tc-99m sulfur colloid by salivary glands increases background radiation in the nodal basin; therefore, use of the handheld gamma probe for intraoperative localization of SLN can be problematic in regions where lymph nodes are adjacent to or within the substance of the salivary gland (i.e., the submandibular and parotid glands).
-
Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralyzed vocal fold but must be evaluated in light of potential complications following laryngeal framework surgery. ⋯ Using the appropriate technique, the potential benefits of improved glottic function following type I thyroplasty with arytenoid adduction outweigh the small risk of significant complications observed.
-
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Improved postoperative pain control in pediatric adenotonsillectomy with dextromethorphan.
A prospective, randomized, double-blinded, placebo-controlled protocol. ⋯ Dextromethorphan syrup is a safe, non-narcotic medication that significantly reduced the requirement of intravenous morphine after pediatric adenotonsillectomy. Its routine use in this manner is recommended.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Use of dexamethasone on the prophylaxis of nausea and vomiting after tympanomastoid surgery.
The aim of this study was to evaluate the prophylactic effect of dexamethasone on postoperative nausea and vomiting (PONV) in patients undergoing tympanomastoid surgery. ⋯ Dexamethasone at a dosage of 10 mg administered intravenously is effective in preventing PONV in patients undergoing tympanomastoid surgery.