The Laryngoscope
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Comparative Study
Intraoperative monitoring: normative range associated with normal postoperative glottic function.
Despite increasing use of intraoperative nerve monitoring (IONM), there is limited information on normative electrophysiologic electromyographic (EMG) parameters. The objective of this study was to define normative parameters of recurrent laryngeal nerve (RLN) intraoperative neuromonitoring during thyroid surgery associated with normal postoperative vocal cord function. ⋯ We propose IONM EMG data criteria that predict normal postoperative vocal cord function monitoring and provide information about nerve functioning at the end of the operation, thereby allowing adaptation of the surgical strategy when a bilateral procedure is indicated to avoid bilateral nerve paralysis.
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Comparative Study
Hyaluronic acid gel weight: a nonsurgical option for the management of paralytic lagophthalmos.
Management of lagophthalmos should be a priority in the treatment of patients with facial palsy. The aim of the study was to evaluate the safety and efficacy of injecting hyaluronic acid gel into the upper eyelid as a nonsurgical alternative for patients with temporary facial palsy. ⋯ Hyaluronic acid gel has proven effective in reducing paralytic lagophthalmos and controlling keratopathy in patients with temporary facial palsy, especially those with palpebral fissure with attempted closure no greater than 6.5 mm. Injection of hyaluronic acid gel is safe, quick, and easily performed. In addition, it is more cost-effective than surgery.
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To analyze and assess the perioperative risks and complications in patients receiving general anesthesia undergoing surgery for obstructive sleep apnea (OSA). ⋯ Patients undergoing surgery for OSA are considered to be at increased risk of complications. Review of 32 patients failed to show any life-threatening risks or complications.
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Review Case Reports
Abducens palsy after lumbar drain placement: a rare complication in endoscopic skull base surgery.
To study reports of abducens nerve palsy following dural puncture procedures and to discuss possible etiologic theories, treatment, and prognosis. ⋯ Lumbar puncture procedures carry a rare risk of abducens nerve palsy from ischemic or traction injury. Routine use of lumbar drain during endoscopic skull base surgery is not without risk, and need for its placement should be carefully determined. Knowledge of such rare complications is helpful in risk-benefit analysis as endoscopic skull base techniques gain popularity.