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 · May 2008
Clinical TrialGabapentin effectiveness on the sensation of subjective idiopathic tinnitus: a pilot study.
This prospective, placebo-controlled, double-blind clinical trial evaluated the effectiveness of gabapentin in decreasing subjective features of idiopathic subjective tinnitus in the patients. Pure-tone audiograms, laboratory test and personal histories were used to exclude any particular etiology of tinnitus. Participants were restricted to those with moderate to severe idiopathic subjective tinnitus for at least 6 months. ⋯ There was not a significant subjective improvement in tinnitus annoyance for the patients (37%) versus controls (42%). Comparison between the results before and after intervention for patients and controls according to subjective response, tinnitus questionnaire, tinnitus severity index and the loudness perception by the patient showed no significant differences (P > 0.05). There is insufficient evidence to support the effectiveness of gabapentin in the treatment of tinnitus up to now.
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Eur Arch Otorhinolaryngol · Apr 2008
Comparative StudyPhonomicrosurgery for posterior glottic lesions using triangular laryngoscope.
It is important to fully expose the posterior glottis to achieve adequate phonomicrosurgical resection of lesions in the posterior glottis. However, it is often difficult to obtain a sufficient view of the posterior glottis by ordinary direct laryngoscopy. We attempted to expose posterior glottic lesions using a triangular laryngoscope for adequate achievement of the surgery. ⋯ All lesions have been well controlled during the follow up periods of 6-23 months. The triangular laryngoscope enables an alternative method for posterior glottic exposure. Modified placement of the laryngoscope can be easily performed and provides sufficient exposure of posterior glottic lesions for an adequate resection of those lesions.
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Eur Arch Otorhinolaryngol · Apr 2008
Comparative Study Clinical TrialFiberoptic endoscopic evaluation of swallowing in intensive care unit patients.
Aspiration in critically ill patients frequently causes severe co-morbidity. We evaluated a diagnostic protocol using routine FEES in critically ill patients at risk to develop aspiration following extubation. We instructed intensive care unit physicians on specific risk factors for and clinical signs of aspiration following extubation in critically ill patients and offered bedside FEES for such patients. ⋯ In 59 out of 258 patients (22.9%), tracheotomies were closed, and 30.7% of all 553 patients could be managed with the immediate onset of an oral diet and compensatory treatment procedures. Additional radiological examinations were not required. FEES in critically ill patients allows for a rapid evaluation of deglutition and for the immediate initiation of symptom-related rehabilitation or for an early resumption of oral feeding.
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Eur Arch Otorhinolaryngol · Mar 2008
Randomized Controlled TrialIntravenous paracetamol is highly effective in pain treatment after tonsillectomy in adults.
Tonsillectomy in adults is associated with significant postoperative pain. Intravenous paracetamol injection (Perfalgan) is marketed for the management of acute pain. This prospective placebo-controlled study was performed to evaluate the analgesic efficacy and safety of intravenous paracetamol in 76 adult patients undergoing elective standard bipolar diathermy tonsillectomy. ⋯ The worst pain after surgery was also more severe in the placebo group than that in the paracetamol group. There was no significant difference between groups in the incidence of adverse events. Intravenous paracetamol administered regularly in adult patients with moderate to severe pain after tonsillectomy provided rapid and effective analgesia and was well tolerated.
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Eur Arch Otorhinolaryngol · Mar 2008
Transcutaneous injection laryngoplasty through the cricothyroid space in the sitting position: anatomical information and technique.
A variety of approaches have been introduced to perform injection laryngoplasty under local anesthesia. Among these reported methods, transcutaneous injection through the cricothyroid space offers many advantages, but it possesses some technical difficulties during access to the vocal fold. The aim of this study was to assess the anatomic references related to transcutaneous injection laryngoplasty through cricothyroid space using 3-dimensionally reconstructed computed tomography to provide guidelines and to achieve higher efficacy during the procedure. ⋯ The average of the angle in medial direction at the surface needed to reach the target of the injection was 10.57 degrees in men and 12.71 degrees in women, and in superior direction was 47.57 degrees in men and 47.43 degrees in women. Injection laryngoplasty performed under acquired reference measurements were successful in 14 trials (93.3%) out of 15 trials in 15 patients. We suggest that knowledge of the anatomic references regarding the transcutaneous injection laryngoplasty through cricothyroid space will provide guidelines for beginners and improve the understanding of the procedure, eventually leading to easier and more precise access to the vocal cord.