European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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Eur Arch Otorhinolaryngol · Jun 2014
Randomized Controlled TrialProphylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints.
Postoperative sore throat (POST) is one of the main postoperative complaints. This study was to evaluate the efficacy of budesonide inhalation suspension (BIS) in reducing the incidence and severity of POST. One hundred and twenty patients scheduled for thyroid surgery with general anesthesia were enrolled and randomized into three groups. ⋯ One hour after extubation, Group A exhibited significantly less severe sore throat and hoarseness compared to the other two groups (P < 0.05), which disappeared 24 h later. The mucositis scores of laryngopharynx at 1, 24 and 48 h post-extubation were significantly lower in Group A (P < 0.05). BIS can reduce the incidence and severity of the POST prophylactically.
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Eur Arch Otorhinolaryngol · Jun 2014
Randomized Controlled TrialThe effects of dexamethasone and levobupivacaine on postoperative pain in modified radiofrequency assisted uvulopalatoplasty (MRAUP) surgery.
The objective of this prospective, randomized study was to evaluate the effect of pre-emptive local infiltration of lidocaine, lidocaine plus dexamethasone, levobupivacaine and levobupivacaine plus dexamethasone on postoperative pain in Modified Radiofrequency Assisted Uvulopalatoplasty (MRAUP) cases. Sixty adult patients (44 males and 16 females) aged 32-51 years with simple snoring were divided into four groups. The anesthesia of the patients in the first group was achieved with lidocaine HCl, in the second group, with lidocaine HCl and dexamethasone sodium phosphate, in the third group, with levobupivacaine, and in the fourth group, levobupivacaine and dexamethasone sodium phosphate. ⋯ There were statistically significant differences between the groups for analgesic effects on the 1st, 3rd, 5th, and 7th day and for the amount of analgesics used, on the 1st, 3rd, and 5th day. The best results were obtained in the group that received levobupivacaine HCl and steroid (p < 0.001). Steroid and local anesthetic combinations are superior to controls in the management of postoperative pain in MRAUP surgery.
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Eur Arch Otorhinolaryngol · Jun 2014
Observational StudyThe impact and prospect of traumatic brain injury on olfactory function: a cross-sectional and prospective study.
Traumatic brain injury (TBI) can cause olfactory loss. The aim of this cross-sectional and prospective study was to determine the prevalence of olfactory loss among 110 patients with TBI within 3 months after the trauma. In 81 patients ("cross-sectional"-group), olfactory function could be measured using the validated "Sniffin' Sticks" test for odor threshold and odor identification. ⋯ TBI I° has in general no major effect on olfaction. In contrast, patients with TBI II° and III° exhibit smell loss in 57%. Chances for olfactory recovery were highest within the first 6 months after the trauma.
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Eur Arch Otorhinolaryngol · Jun 2014
Observational StudyHypotensive anaesthesia and bleeding during endoscopic sinus surgery: an observational study.
Significant bleeding during functional endoscopic naso-sinusal surgery (FESS) impairs recognition of anatomical references and may negatively affect surgical outcome. Through their hypotensive effect, adjuvant anaesthetic agents may influence intraoperative bleeding. The present study compared intraoperative bleeding in patients undergoing FESS administered a clonidine-based anaesthetic regimen and in patients receiving other an anaesthetic combination with higher acquisition costs. ⋯ The anaesthetic combination including clonidine for controlled hypotensive anaesthesia produces lower levels of surgical field bleeding during FESS. Compared with other hypotensive anaesthetics, clonidine is inexpensive and associated with better surgical conditions during FESS. If confirmed through randomized clinical trials, the use of clonidine during FESS can reduce surgical time and improve surgical results through a less bloody field, resulting in lower patient morbidity and improvement of operating room resources.
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Eur Arch Otorhinolaryngol · Jun 2014
Initial experiences with endoscopic rhino-neurosurgery in Amsterdam.
Endoscopic surgery of the skull base has been on the rise for several years. Endoscopic access for surgery can be achieved from the frontal sinus anteriorly along the skull base to the odontoid process posterior inferiorly. An endoscope is inserted through one nasal corridor and allows visualization of the working field and up to three surgical instruments can be used to address the lesion. ⋯ The most frequent complication was CSF leakage. This study demonstrates that this technique is safe and reliable. What is needed is a dedicated team, which includes a dedicated anesthesiologist, endocrinologist, ophthalmologist, and radiation oncologist.