Laryngo- rhino- otologie
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Laryngo- rhino- otologie · Nov 2009
[Nasal bone fracture: etiology, diagnostics, treatment and complications].
The aim of the present evaluation was to analyse a large patient population with nasal bone fractures leading to surgical reposition of the nasal bone. Special attention was paid to age summit, the distribution of the seasons, the rate of open compared to closed nasal bone fractures, accompanying injuries, diagnosis and therapy as well as to the postoperative course. ⋯ Closed reposition of the nasal bone is the therapy of choice in uncomplicated nasal bone fractures. Special attention has to be paid to the group of patients aged 60 years and older who often suffer from treatment requiring comorbidities. In these cases inpatient treatment must be considered.
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Laryngo- rhino- otologie · Sep 2009
Review[Hydroxyethylstarch-induced pruritus: an understimated side effect of its application also in ENT diseases].
Chronic pruritus may be caused by drugs such as colloid infusions with hydroxyethylstarch (HES). HES-induced pruritus can be diagnosed by typical patient's history, clinical characteristics, confirmed application of HES and its cutaneous tissue storage obtained by electron microscopy. Pruritus occurs on the whole body and significantly impairs patient's quality of life. ⋯ Topical and systemic treatments are only of symptomatic value. HES-induced pruritus is severe, protracted and mostly therapy-refractory. Limiting the dose and the duration of HES application may help reducing this intractable side effect.
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Laryngo- rhino- otologie · Jul 2009
Review[Role of minimal invasive surgery for primary and secondary hyperparathyroidism].
The standard surgical approach to treat primary (pHPT) and secondary hyperparathyroidism (sHPT) used to be a cervicotomy with exploration of all four parathyroid glands. This access has been challenged recently by the introduction of minimally invasive techniques in order to achieve superior cosmesic results and to reduce theatre time. We analyzed the advantages and morbidities of these surgical aproaches. ⋯ Review of the literature confirms the shift from bilateral exploration towards minimally invasive techniques. The incidence of persistent or recurrent disease as well as the rate of complications seems comparable. Operation time for minimally invasive techniques is reduced in the hands of an experienced surgeon. However, proper preoperative localization of the diseased parathyroid gland is not always possible and the expenses of intraoperative parathyroid hormone measures do not lower the overall costs. Considerable experience and a multidisiplinary approach (endocrinologist, surgeon, pathologist) is required to adopt efficient minimally invasive techniques. As for sHPT, bilateral exploration remains the treatment of choice.