The Laryngoscope
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Voice intensity levels produced by 20 patients with cuffed speaking tracheostomy tubes (Communi-Trach I) at three different airflow rates were investigated. Results indicated that audible and intelligible speech was produced with significantly greater intensity over ambient room noise at 5 l/minute, 10 l/minute, and 15 l/minute of airflow. Criteria for use, common causes of malfunctioning, and rehabilitation techniques necessary for the successful use of cuffed speaking tracheostomy tubes are discussed.
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Randomized Controlled Trial Clinical Trial
The effects of peritonsillar infiltration on the reduction of intraoperative blood loss and post-tonsillectomy pain in children.
Improved hemostasis and reduction of postoperative pain are desired goals when performing tonsillectomy. This is especially true in children, who may be reluctant to receive intramuscular injections for pain relief and who may lose a higher percentage of total blood volume during surgery than adults. This study evaluated the effects of peritonsillar infiltration upon operative blood loss and postoperative pain in 42 children. ⋯ Because of the small sample size we were unable to evaluate the beneficial effects of peritonsillar infiltration performed with bupivacaine upon the reduction of the severity of pain and the requirement for narcotic analgesics following tonsillectomy. Therefore, until further studies demonstrate such efficacy, all peritonsillar infiltrations should be performed solely for the purpose of reducing operative blood loss. As such, infiltrations should be performed with either normal saline containing epinephrine (1:200,000) or lidocaine containing epinephrine (1:200,000).
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Fifty-one Japanese professional surfers were examined in order to analyze surfer's ear. Forty-one cases (80%), 71 ears, were diagnosed as surfer's ear. ⋯ The age at which surfing is taken up has no influence on the appearance of surfer's ear. Surfers who surf on northern (colder) coasts have severer surfer's ear than those who frequent the southern (warmer) coasts.
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We reviewed the records of all patients admitted to Cardinal Glennon Children's Hospital for foreign object aspiration from 1980 to 1987. There were 11 true glottic bodies, which accounted for 12.1% of the 91 foreign bodies detected in the airways. A mortality rate of 45% (5 patients) and transient hypoxic encephalopathy in 27% (3 patients) indicate the often tragic outcome of obstruction in the pediatric larynx. ⋯ The second group of objects were thin, laminar, triangular bodies, which tended to wedge unsuspectedly in the larynx, mimicking inflammatory diseases and requiring endoscopy for their removal. Hypothetical models are used to explain the physical phenomena that occur in foreign body obstruction in the two different groups. Recommendations for intervention are made based on the conclusions.