The Laryngoscope
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The purpose of this article is to compare aspects of the performance of three widely-used rigid laryngoscopy telescopes. The Nagashima SFT-I, Wolf 4450.57, and Karl Storz 8702 D were used with a JVC GX-N8U camera and Panasonic PV 8600 VCR to make recordings of a one-tenth-inch grid at various distances between the lens and the grid and at two telescope holding angles. ⋯ The telescopes were compared for viewing field, lens angle effects, holding angle effects, plane distortion effects, effects due to lens distance, color, edge definition, focus control, light source compatibility, stroboscopic use, cross-sectional diameter, fogging, and cost. An overview enables laryngologists to assess their needs before buying.
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Tonsillectomy (with or without adenoidectomy) continues to be a commonly performed operation in the United States. Over the years, the incidence of post-tonsillectomy hemorrhage (reported between 0% and 20%) has decreased, but continues to pose serious problems. We reviewed 1,445 tonsillectomies performed over a 2-year period to study the incidence of post-tonsillectomy hemorrhage. ⋯ Ten patients (0.69%) had delayed hemorrhage of a minor nature that had stopped by the time they reached the hospital; these children were treated with observation alone and did not require hospitalization or operative intervention. The proposed reasons for this low rate of post-tonsillectomy hemorrhage include complete preoperative coagulation screening, meticulous attention to surgical technique, use of suction-cautery to obtain hemostasis and, possibly, use of postoperative antibiotics. Management of hemorrhage is discussed with respect to observation, surgical intervention, and blood transfusion.
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The inside and outside diameters of all endoscopes and tracheotomy tubes in the endoscopy suite were systematically measured. These measurements were correlated with the manufacturer's stated size and comparisons noted. ⋯ As a result, the proper choice of a tracheotomy tube or endoscope for a patient's size and age may be confusing. A chart was developed and included in order to allow quick and accurate recognition of tracheotomy tube and endoscope sizes across product lines to aid in the proper selection of tracheotomy tubes and endoscopic equipment.
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Low frequency jet ventilation was used successfully for maintaining normal ventilation during tracheal resection for stenosis. Following resection of the stenosis around the endotracheal tube, the tube was withdrawn and the proximal end of a sterile double lumen nasogastric tube with the distal end removed passed over the ether screen. ⋯ Adequate CO2 removal was verified by monitoring the expired level and blood gases. We obtained normal arterial and end tidal gas tensions by this method which allowed the surgeon complete freedom to anastomose the posterior and lateral tracheal walls.