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 · Jan 2011
Tubeless anaesthesia with sevoflurane and propofol in adult laryngeal surgery.
The presence of endotracheal intubation tube or jet ventilation cannula can compromise free view and access to operation area in certain endolaryngeal operations. The objective of this prospective study was to test whether adequate level of anaesthesia could be obtained in adults using tubeless sevoflurane inhalation anaesthesia with spontaneous breathing. In 23 ASA 1-2 patients, 31 treatments were included in the study of which 19 were laser-assisted papilloma or other tumour resections and 12 were fascia injection laryngoplasties. ⋯ Sevoflurane room air contamination was high in most measured cases. The modification of tubeless inhalation anaesthesia used in this study produced adequate level of anaesthesia with stable haemodynamics and good operating conditions. Sevoflurane contamination can be reduced with more efficient scavenging systems.
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Eur Arch Otorhinolaryngol · Dec 2010
Headscarf pin, a sharp foreign body aspiration with particular clinical characteristics.
The process of wearing head scarf is very complex; girls used to hold a number of pins in the mouth and utilize them one by one to fix the scarf. Loss of concentration results in pin aspiration. We presented our experience with scarf pin aspiration and discussed the unique clinical characteristics of this problem. ⋯ The clinical presentation and radiological findings are diagnostic in all cases. Rigid bronchoscopy is the preferred treatment modality. Health education is the key issue in the prevention of this problem.
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Eur Arch Otorhinolaryngol · Dec 2010
Using greater superficial petrosal nerve and geniculate ganglion as the only two landmarks for identifying internal auditory canal in middle fossa approach.
The middle fossa approach is a surgical technique indicated for acoustic neuroma with advantages of complete tumor removal and hearing preservation. Various methods have been developed for identifying internal auditory canal (IAC). Here, we describe a new method, which uses greater superficial petrosal nerve (GSPN) and geniculate ganglion (GG) as the only two landmarks to identify IAC. ⋯ We applied this method on 20 temporal bones by drilling the point away from the tip of the GG about 9.9 mm on a line angled with the GSPN about 96 degrees. All IACs were safely identified without damaging the cochlea, the labyrinthine portion of the facial nerve, or the vestibule. In conclusion, the GSPN and GG can be the only two landmarks for safely identifying the IAC without injury to the inner ear structures in the middle fossa approach.
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Eur Arch Otorhinolaryngol · Oct 2010
Routine clotting screen has no role in the management of epistaxis: reiterating the point.
Objective of the study is to investigate the role of clotting screen in adult patients presenting with epistaxis. The study is a prospective case series done in a teaching hospital in the Northeast of Scotland. Prospective data was collected for 100 consecutive patients with epistaxis admitted to the Department of Otolaryngology over 1 year (2006-2007 August). ⋯ Only 7 patients (7/138 = 5%) had an abnormal result. Our data suggests that routine clotting screen check does not alter the epistaxis management in patients with no risk factors or with stable warfarin dosage. Therefore, routine clotting screen in patients with epistaxis without relevant risk factors is not an evidence-based practice.
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Eur Arch Otorhinolaryngol · Sep 2010
Randomized Controlled Trial Comparative StudyProspective, randomized, controlled clinical trial of Ankaferd Blood Stopper in patients with acute anterior epistaxis.
This is a study evaluating the efficacy of Ankaferd Blood Stopper (ABS) as a hemostatic agent compared to hemostasis by phenylephrine in patients with anterior epistaxis. The study design is a prospective, randomized, controlled, nonblinded, clinical trial. In total, 49 patients were randomly seperated to receive hemostasis technique by means of either ABS wet tampon or phenylephrine impregnated gauze tampon for anterior epistaxis control. ⋯ ABS patients experienced fewer rebleeding rates within 7 days compared to phenylephrine patients (8.3 vs. 20%, p < 0.05). The patients for which ABS was applied, significant differences in effective control of anterior epistaxis were observed compared to phenylephrine. ABS is effective, safe, quick, and easy alternative to the phenylephrine in patients with anterior epistaxis.