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 · Dec 2009
Case ReportsIntraoperative modification of a supracricoid laryngectomy to a subtotal laryngectomy with tracheohyoidoepiglottopexy.
In recent decades, with the widespread diffusion of the supracricoid laryngectomy in the treatment of selected advanced laryngeal neoplasm, the indications to non-conservative surgery are less frequent than in past. We report the case of a patient in whom a planned supracricoid laryngectomy was intraoperatively converted in an extended partial laryngectomy with tracheohyoidoepiglottopexy for a tumor involving the cricoid cartilage.
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Eur Arch Otorhinolaryngol · Nov 2009
Randomized Controlled TrialPreoperative intravenous dexamethasone combined with glossopharyngeal nerve block: role in pediatric postoperative analgesia following tonsillectomy.
Tonsillectomy is one of the most frequently performed ambulatory surgical procedures in children (Litman et al. in Anesth Analg 78:478-481, 1994). Several techniques have been described for alleviation of pain (Ginstrom et al. in Acta Otolaryngol 125:972-975, 2005). the objective of this study determination of the postoperative analgesic efficacy of the pre-surgical intravenous administration of dexamethasone together with glossopharyngeal nerve block (GNB) in children undergoing tonsillectomy. ⋯ Patients in group B had significantly less visual analogue scale values, longer absolute analgesia time, lesser swallowing difficulty and they were discharged earlier from the hospital when compared to patients in both groups D and G. Using both pre-operative dexamethasone IV injection with GNB has reduced postoperative pain and morbidity to a great extent than using either alone.
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Eur Arch Otorhinolaryngol · Oct 2009
ReviewFrom the expert's office: localized neural lesions following tonsillectomy.
Due to various reasons, localized neural lesions following tonsillectomy are presumably an under-reported complication in the literature. This study was undertaken to compile our experiences including a literature review to disseminate useful insights in the etiology and prognosis of this rare entity. A retrospective chart review of expert reports written by at least one of the authors for malpractice claims in relation to tonsillectomy was undertaken. ⋯ A long-term follow-up is recommended for patients with dysgeusia related to glossopharyngeal nerve injury and patients with recurrent nerve dysfunction. Other lesions are much less likely to resolve in the long-term. Localized neural lesions should adequately be included in the informed consent for tonsillectomy as well as for surgical treatment of post-tonsillectomy hemorrhage.
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Eur Arch Otorhinolaryngol · Oct 2009
Randomized Controlled Trial Comparative StudyApplication methods of local anaesthetic infiltrations for postoperative pain relief in tonsillectomy: a prospective, randomised, double-blind, clinical trial.
Perioperative local anaesthetics are often used to reduce the postoperative pain in tonsillectomy. There exist three different ways of applying local anaesthetics: (1) pre-incisional peritonsillar; (2) post-tonsillectomy wound infiltration; (3) post-tonsillectomy packing with soaked gauze. The objective of the study is the evaluation of differences of pain reduction comparing the three different techniques of application. ⋯ Postoperative bleeding was observed in 11 (7.3%) cases without any correlation to an application procedure. No other adverse effects were observed. In conclusion, post-tonsillectomy infiltration of the wounds with bupivacaine is superior to pre-incisional infiltration technique as well as post-tonsillectomy packing of the wounds with 0.5% bupivacaine-soaked gauze swab.