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 2007
Case ReportsUnusual complication of reusable suction catheter during rigid bronchoscopy.
The risk of leaving an iatrogenic foreign body in the bronchus, while using a reusable flexible suction catheter tube during rigid bronchoscopy is reported. A 6-year-old girl underwent rigid bronchoscopy to rule out foreign body inhalation as the possible cause of her unilateral pneumonia and lung collapse. ⋯ This was later recovered from the right main bronchus while clearing the thick secretions. This potential complication occurs with use of reusable plastic suction catheters.
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Eur Arch Otorhinolaryngol · Oct 2007
Randomized Controlled Trial Historical ArticleDoes epinephrine infiltration in septoplasty make any difference? A double blind randomised controlled trial.
Infiltration of lignocaine with epinephrine is used with cocaine in septoplasty, in attempt to improve haemostasis and thereby improve the surgical field. This practice is widespread despite the lack of evidence to support its efficacy in the literature. Thirty patients undergoing septoplasty were randomised into two groups -- one in whom infiltration was performed with lignocaine (2%) with adrenaline (1:80,000) and a control group who received lignocaine (2%). ⋯ However there was significant rise in systolic blood pressure in patients who received epinephrine. The use of epinephrine with cocaine paste does not improve haemostasis or surgical field. As the use of epinephrine is associated with cardiac arrhythmias, the authors suggest that combined use of cocaine paste and epinephrine infiltration should be avoided in septal surgery.
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Eur Arch Otorhinolaryngol · Sep 2007
Case ReportsNegative pressure pulmonary edema: report of three cases and review of the literature.
Pulmonary edema following the relief of an upper airway obstruction is an uncommon and unpredictable clinical entity. This unusual disease is actually attributed to pulmonary and hemodynamic changes engendered by high negative intrathoracic pressures during the state of obstructed respiration, such as laryngospasm, epiglottitis, laryngotracheal neoplasm, etc. In this article, we report three cases of negative pressure pulmonary edema (NPPE) developed after the operations of tracheotomy, adenoidectomy, and microlaryngeal surgery. The etiology, pathophysiology, diagnosis, management, and outcome of NPPE are also brought into further discussion.
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Eur Arch Otorhinolaryngol · Aug 2007
Case ReportsOtogenic cerebellar abscess due to purulent labyrinthitis and defect of the superior semicircular canal and its propagation through the endolymphatic sac.
The otogenic cerebellar abscess still is one of the most dangerous complications of otitis media and implicates a high risk of mortality. Early diagnosis and therapy are decisive factors for the chances of rehabilitation. Radiologic imaging (CT/MRI) plays an important role. ⋯ Consequently, it could be cured ultimately only after petrosectomy and abscess drainage toward the mastoid cavity. It is mandatory to completely sanitize the infection surgically in order to avoid lethal complication especially in case of a delayed clinical course or recurrent symptoms of labyrinth involvement. Close interdisciplinary collaboration between ORL, neurosurgery and neuroradiology is desirable for successful therapy.
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Eur Arch Otorhinolaryngol · Aug 2007
Case ReportsLaryngeal plasmacytoma presenting as amyloid tumour: a case report.
Laryngeal amyloidosis can be secondary to an underlying lymphoid neoplastic process and in view of this concept; the cases of localized laryngeal amyloidosis should be carefully examined and investigated for the presence of a lymphomatous process. The study design is case report. We report the case of a 64-year-old man with progressive hoarseness. ⋯ The majority of the cases reported of amyloid deposition with plasmacytoma, the lesions were found in the nasopharynx, in contrast to our case in which the lesions were sited in the larynx and with the peculiarity of being multiples. Moreover, amyloid and plasmacytoma were clearly delimitated and the amyloid tissue was more extensive than the tumour tissue. This case supports the concept that localized laryngeal amyloidosis may be a manifestation of low-grade B-cell neoplasms.