The Laryngoscope
-
Our experience with Venturi jet ventilation as the method of anesthesia in 872 cases of microlaryngeal surgery is presented. Our indications and exact technique are presented, as well as a review of our complications. Possible pitfalls and their avoidance are discussed. With attention to detail and good clinical judgement on the part of anesthesiologist and surgeon, Venturi jet ventilation can be safe and efficient with minimal complications.
-
While tonsillectomy is usually a safe operation, it is always accompanied by the risk of immediate postoperative bleeding. Despite continued efforts to eliminate this problem, it remains a persistent risk. In reviewing 775 consecutive cases of tonsillectomy, immediate postoperative bleeding occurred in 21 (2.7%). ⋯ Local anesthetic cases were shorter, had less intraoperative bleeding and were not associated with greater postoperative bleeding. We conclude that local anesthesia is safe and efficient and that identifiable factors are associated with primary post-tonsillectomy bleeding. An awareness of these factors can help identify potential postoperative bleeders.
-
A consecutive series of 90 patients undergoing endoscopic intranasal ethmoidectomy was reviewed. There were 26 complications (29%) in 19 patients in this group. ⋯ Endoscopic nasal sinus surgery performed by inexperienced operators carries with it the same risks and complications as traditional intranasal sinus surgery. Any surgeon who does not routinely perform traditional intranasal ethmoidectomy should accrue endoscopic experience through appropriate didactic training and multiple cadaver dissections (akin to otologic training).
-
Primary clinical presentation of malignant lymphoma in the middle ear is rare. One case of African Burkitt's lymphoma involving the mastoid has been reported, but the case herein presented would appear to be the first case of American Burkitt's lymphoma in the literature. ⋯ A 6-year-old boy with the first known case of American Burkitt's lymphoma of the mastoid is presented. He is doing well 23 months from the onset of symptoms.
-
In a review of thyroid surgery during the past 12 years, total thyroidectomy was performed in 20% of the cases. Forty percent were done for malignant disease and 60% for benign disease. ⋯ With the increased use of total thyroidectomy the incidence of permanent hypoparathyroidism can be decreased. We reviewed our preoperative work-up, indications for total thyroidectomy, surgical technique, diagnostic accuracy of needle biopsy, accuracy of rapid frozen section reports, and postoperative complications.