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
-
Eur Arch Otorhinolaryngol · Oct 2009
Randomized Controlled TrialThe effectiveness of gabapentin on post-tonsillectomy pain control.
Postoperative pain is one of the most troublesome aspects of tonsillectomy for patients. Although various analgesics have been administered for pain control following tonsillectomy, it has still not been effectively controlled. Therefore, this study was conducted to evaluate the effectiveness of premedication using gabapentin on postoperative pain control in patients undergoing tonsillectomy. ⋯ There were no significant differences in the rVAS observed between the two groups throughout the postoperative period. Thus, premedication with gabapentin decreased post-tonsillectomy pain. So the addition of gabapentin prior to tonsillectomy may have an adjunctive role in pain control.
-
Eur Arch Otorhinolaryngol · Oct 2009
Comparative StudyCurved rigid laryngoscope: missing link between direct suspension laryngoscopy and indirect techniques?
Microlaryngoscopy is the standard procedure for endolaryngeal surgery. The advantages are a steady operating field, bimanual handling and stereoscopic view in high-resolution magnification. The major drawback is that the oropharyngeal structures have to be brought into an unnatural position by the straight rigid laryngoscope with considerable forces occurring. ⋯ In conclusion, we could show that even with a moderate-curved rigid laryngoscope a significant reduction of the forces to the oro-pharyngeal tissues can be obtained and that endolaryngeal exposure is possible in virtually all patients. Bimanual precise operations should be possible in the common way like in standard microlaryngoscopy with the only difference of not using a microscope, but operating via a monitor. We do not think that traditional microlaryngoscopy with straight instruments can or should be replaced by curved laryngoscopes, but these techniques could bridge the gap to indirect techniques in particular in specialised institutions dealing frequently with difficult patients and situations.
-
Eur Arch Otorhinolaryngol · Oct 2009
3D computer-assisted assessment of complicated penetrating foreign bodies cases in ENT practice.
A retrospective research was performed in order to evaluate three-dimensional (3D) computer-assisted detection of penetrating foreign bodies (FB) in the ENT practice in order to assess its usefulness and to specify its application. FBs in the head and neck were detected using 3D CT imaging in order to assess the usefulness of 3D images in the ENT operative practice. Three blinded surgeons were involved in comparison between plain and 3D CT images in order to assess 3D usefulness for precise formulation of a surgical plan. ⋯ It helps to understand the relationships between a FB and surrounding anatomical structures better then the plain X-rays or CT-scan. There was no significant difference in cost between plain CT and 3D images. 3D computer-assisted detection of FBs increase our diagnostic abilities and appears to be a valuable addition to our diagnostic technique. Its main importance, however, lies in its capacity to help a surgeon plan an operation much more carefully avoiding improvisation during the operation itself.
-
Eur Arch Otorhinolaryngol · Sep 2009
ReviewCurrent trends in initial management of laryngeal cancer: the declining use of open surgery.
The role of open surgery for management of laryngeal cancer has been greatly diminished during the past decade. The development of transoral endoscopic laser microsurgery (TLS), improvements in delivery of radiation therapy (RT) and the advent of multimodality protocols, particularly concomitant chemoradiotherapy (CCRT) have supplanted the previously standard techniques of open partial laryngectomy for early cancer and total laryngectomy followed by adjuvant RT for advanced cancer. A review of the recent literature revealed virtually no new reports of conventional conservation surgery as initial treatment for early stage glottic and supraglottic cancer. ⋯ Surgery was reserved for treatment failures. This concept changed the paradigm for management of advanced laryngeal cancer, greatly reducing the number of laryngectomies performed. While supracricoid laryngectomy has been employed for selected patients, total laryngectomy is the usual procedure for salvage of failure after non-surgical treatment.
-
Eur Arch Otorhinolaryngol · Aug 2009
Comparative StudyCochlear implantation in patients with chronic otitis media: 7 years' experience in Maastricht.
The purpose of this paper is to propose management options for cochlear implantation in chronic otitis media (COM) based on our 7-year experience. Thirteen patients with COM who were candidates for cochlear implantation were identified. ⋯ In case of an active infection or in case of a unstable cavity we advise cochlear implantation as a staged procedure. A single stage procedure is recommended in case of patients with COM presenting with a dry perforation or a stable cavity.