The Laryngoscope
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To examine the relationship of various pretreatment case-mix characteristics and treatment modalities with medical charges incurred during diagnosis, treatment, and 2-year follow-up for patients with laryngeal cancer. ⋯ This work supports continued study of measures that may result in earlier detection of laryngeal cancer as a potential means of reducing management charges. These results also indicate that a more accurate method of stratifying the disease severity of laryngeal cancer patients for reimbursement purposes would include measurements of the severity of the index disease as well as comorbid diseases.
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The anterior approach to the cervical spine now serves as the surgical access of choice for cervical spine disease. Vocal fold paralysis (VFP) may follow the procedure as a complication. The authors describe their experience with patients having VFP after anterior cervical diskectomy and fusion (ACDF), with an emphasis on outcome and prognosis. ⋯ The data suggest that at least 80% of VFP after ACDF will recover within 12 months of the procedure. The authors recommend regular follow-up and speech therapy for symptomatic patients. Medialization should be considered in patients with aspiration or persistent problems.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prevention of nausea and vomiting after middle ear surgery: granisetron versus ramosetron.
Middle ear surgery is associated with a relatively high incidence of postoperative nausea and vomiting. This study was undertaken to compare the efficacy of ramosetron with granisetron for preventing nausea and vomiting after middle ear surgery. ⋯ Prophylactic use of ramosetron is more effective than granisetron for long-term prevention of nausea and vomiting after middle ear surgery.
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Comparative Study Clinical Trial
Ketoprofen and fentanyl for pain after uvulopalatopharyngoplasty and tonsillectomy.
The treatment of postoperative pain after uvulopalatopharyngoplasty (UPPP) and tonsillectomy presents a challenge. Opioids can cause sedation and respiratory depression. Nonsteroidal antiinflammatory drugs can increase postoperative bleeding. The authors have evaluated the severity of postoperative pain and the consumption of opioid in 53 adult patients undergoing either UPPP or tonsillectomy. ⋯ Individually tailored analgesic treatment protocol is essential for patients undergoing UPPP and tonsillectomy to ensure safe and effective pain alleviation.
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To describe the role of the hand-held otoscope combined with a flashscanner CO2 laser, OtoLAM (ESC/Sharplan, Yokneam, Israel), for pressure equalization tube (PET) insertion in an office setting. ⋯ The data indicate excellent clinical effectiveness, reduced risk, and high parent and physician satisfaction. Strong incentives for physicians to use this technique are in all stakeholders' best interests. These incentives need to evolve as soon as possible for the more widespread acceptance of OtoLAM with PET insertion in an office setting for appropriately selected patients.