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 · Sep 2010
Grisel's syndrome--a rare complication following "small" operations and infections in the ENT region.
The atlanto-axial subluxation (Grisel's syndrome) is a rare complication following operative procedures and/or infections in the upper aerodigestive tract. Pathogenetically the higher flexibility of the ligaments during the inflammation causes a subluxation between axis and atlas. When the inflammation heals, this can probably result in a fixation in the rotated position. ⋯ An early diagnosis of Grisel's syndrome and immediate therapy is most important. Grisel's syndrome must be taken under consideration in children with acute torticollis following either an infection or operative procedure in the upper aerodigestive tract. Early adequate antibiotic and antiphlogistic therapy is mandatory and leads to a high remission rate.
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Eur Arch Otorhinolaryngol · Aug 2010
Comparative StudyEffects of bambuterol and terbutaline on isolated rat's tracheal smooth muscle.
Terbutaline (Bricanyl) and its prodrug Bambuterol (Bambec) are highly potent beta(2)-adrenoceptor agonists often used in asthma patients. Terbutaline in the form of inhaled short-acting bronchodilator relieves asthmatic symptoms. However, the effects of bambuterol given intratracheally have rarely been explored. ⋯ Both bambuterol and terbutaline could inhibit electrical field stimulation (EFS) induced spike contraction. Terbutaline had an anti-cholinergic effect that could relieve asthmatic symptoms. But the effect of bambuterol acting on tracheal smooth muscle directly was controversial.
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Eur Arch Otorhinolaryngol · Aug 2010
Surgical anatomy of the floor of the oral cavity and the cervical spaces as a rationale for trans-oral, minimal-invasive endoscopic surgical procedures: results of anatomical studies.
Over the past 10 years, several minimally invasive procedures for thyroid surgery have been developed. Because of extensive dissection in the thoracic and neck region, the name "minimal-invasive" is misleading. The aim of this study was to define a new trans-oral access to the cervical spaces especially to the thyroid on the basis of natural orifice surgery. ⋯ Therefore, the approach was modified by positioning the working trocars in the oral vestibule bilaterally. By this way, a road map for accessing all anterior cervical regions directly under the platysma muscle could be established and anatomical landmarks and areas of possible collateral damage could have been defined. This combined sublingual and bi-vestibular trans-oral endoscopic approach enables an easy access to all structures and spaces of the anterior neck region with respect to anatomical preformed layers neck, even to the thyroid as one of the more distant structures.
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Eur Arch Otorhinolaryngol · Jul 2010
Randomized Controlled Trial Comparative StudyComparison of two different local anaesthetic infiltrations for postoperative pain relief in tonsillectomy: a prospective, randomised, double blind, clinical trial.
In previous studies, it was shown that the post-tonsillectomy wound infiltration of bupivacaine can reduce postoperative pain. The objective of this study is to determine whether the postoperative wound infiltration with a mixture of bupivacaine, mepivacaine and adrenaline is more effective than the sole application of bupivacaine. A prospective, double-blind, randomized, control study included 30 patients scheduled for "cold steel" tonsillectomy. ⋯ Because of cost-effectiveness and complication rates, we recommend only post-tonsillectomy wound infiltration of bupivacaine. The injection should be placed in superficial muscle and connective tissue. A stringent systemic analgesia regime is indispensable for pain relief after tonsillectomy.
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Eur Arch Otorhinolaryngol · May 2010
Single dose of preoperative analgesia with gabapentin (600 mg) is safe and effective in monitored anesthesia care for nasal surgery.
This study was aimed to compare the intraoperative sedative and perioperative analgesic drug requirements and the incidences of postoperative side effects on the patients who received preoperative gabapentin or placebo. Sixty patients undergoing nasal septal or nasal sinus surgery were included. The patients received either 600 mg gabapentin (Group G) or placebo (Group P) orally, 1 h before surgery. ⋯ Time to first request for analgesic was 12.7 + or - 2.3 h in Group G, and 7.8 2.1 h in Group P (P < 0.0001). Total consumption of lornoxicam was lower in Group G (P < 0.004). We concluded that monitored anesthesia care combined with preoperative analgesia with a low dose of (600 mg) oral gabapentin is an efficient option with tolerable side effects for patients undergoing ear, nose and throat ambulatory surgery.