Laryngo- rhino- otologie
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Laryngo- rhino- otologie · Apr 2006
[Avoiding and dealing with bleeding during endoscopic sinus surgery].
Endoscopic sinus surgery is one of the most frequent surgical ENT-procedures. Bleeding during surgery may increase complications and may have negative effects on surgery and outcome. The present paper describes strategies to prevent and deal with bleeding during sinus surgery. Preoperative conservative treatment of mucosal inflammation as well the use of adrenalin for decongestion may reduce intraoperative bleeding and hence complications.
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Laryngo- rhino- otologie · Jan 2006
[Modern anesthesiologic concepts supporting paranasal sinus surgery].
Optimal vision is essential for successful endonasal sinus surgery. Beside topical vasoconstriction general anaesthesia can contribute to reduce intraoperative bleeding. ⋯ For general anaesthesia in endonasal sinus surgery Sodium Nitroprusside is no longer recommended. Instead a TIVA using Propofol and Remifentanil should be used.
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Laryngo- rhino- otologie · Aug 2005
Comparative Study[Reimbursement of patients with high costs in a department of otorhinolaryngology of maximum care and refinancing by the German DRG system].
With the introduction of a diagnosis related groups (DRG)-system in Germany, the medical analysis of the total costs of caring for a given patient is of significance. The medical identification of cost intensive patients becomes of increasing importance for the financial perspective of a department, because the averaged lump sum system might not break even these treatments. ⋯ The assignment of treatment costs to a DRG is complex. Based on our data extensive surgeries for head and neck malignancies showed a homogeneous cost distribution in the DRG group of G-DRG 2004 which was however inadequately reimbursed. Detailed prospective analyses from multiple centers to identify expensive treatments in the field of otorhinolaryngology are necessary to incorporate modifications into the German DRG-system.