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 · Aug 2007
A new curved rigid layngoscope to overcome the difficult laryngeal exposure (DLE) in endolaryngeal surgery.
Difficult laryngeal exposure during endolaryngeal surgery is not uncommon; it is more likely to require prolonged or multiple attempts and be associated with complications. To overcome this problem, we have developed a new curved rigid laryngoscope, and we describe here its clinical usefulness in patients with difficult laryngeal exposure. A new rigid laryngoscope with a curvature of 70 degrees was designed to fit the curvature from the base of tongue to the larynx without excessive internal pressure of larynx. ⋯ We accomplished surgery for laryngeal lesions and biopsy successfully without any complications. Postoperative morbidity was minimal. In conclusion, a new curved rigid laryngoscope with a fiberoptic imaging system may provide better laryngeal visualization and less traumatic manipulation in patients with difficult laryngeal exposure.
-
Eur Arch Otorhinolaryngol · Jun 2007
Review Case ReportsConservative management of a major post-intubation tracheal injury and review of current management.
Tracheal rupture represents a rare but serious complication of intubation. We discuss a case of a major post-intubation rupture. After investigation with CT scan tracheoscopy and bronchoscopy a low tracheostomy was formed protecting the rupture from pressure changes associated with ventilation. ⋯ Most of the literature on the subject is made up of review of case reports that conclude management of such a major tear must be with surgical repair. This however confers significant morbidity and an associated high mortality. We suggest an alternative management protocol.
-
Eur Arch Otorhinolaryngol · Mar 2007
Comparative StudyTonsillotomy or tonsillectomy?--a prospective study comparing histological and immunological findings in recurrent tonsillitis and tonsillar hyperplasia.
We evaluated the differences in histological and immunological findings in children with recurrent tonsillitis and tonsillar hyperplasia and assessed the risk for relapsing tonsillar hyperplasia or recurrent tonsillitis after tonsillotomy in a prospective clinical study. Sixty-four children with recurrent tonsillitis underwent traditional (total) blunt dissection tonsillectomy between October 2003 and July 2004. Partial tonsillectomy (tonsillotomy) using CO(2)-laser technique was performed on 49 children with tonsillar hyperplasia and no history of recurrent tonsillitis between August 2003 and March 2005. ⋯ Preoperative laboratory investigations show few differences in patients with tonsillar hyperplasia and recurrent tonsillitis. Components of the antimicrobial defense system are also produced by chronically infected tonsils. Therefore tonsillotomy with CO(2)-laser could also be an option in some patients with mild symptoms of recurrent tonsillitis.
-
Eur Arch Otorhinolaryngol · Mar 2007
Superselective arterial infusion chemotherapy for squamous cell carcinomas of the oral cavity: histopathologic effects on metastatic neck lymph nodes.
We have performed superselective intra-arterial infusion chemotherapy (SIC) on carcinomas of the oral cavity according to a protocol in which the distribution of the drug was evaluated by the use of a combined CT and angiography system, and the chemotherapy was combined with medium-dose conformal radiation therapy (CRT). The purpose of this study was to evaluate the pathological effect of this treatment on the metastatic neck lymph nodes (LNs). Twenty consecutive patients who had metastatic neck LNs from squamous cell carcinomas of the mouth and who underwent both SIC and CRT were included in this study, in which a total of 22 LNs were evaluated. ⋯ All 23 control LNs with no treatment showed grade 0 response. Superselective infusion seems necessary to obtain good histopathologic effects on the metastatic LNs. SIC combined with CRT can be applied to the metastatic LNs.
-
Eur Arch Otorhinolaryngol · Dec 2006
Airway obstruction secondary to thoracic aortic aneurysm leak. A case report.
Retropharyngeal hematoma is a rare entity that has various etiologies. Anticoagulation is believed to be the most common cause. ⋯ We believe that our case is the second case of retropharyngeal hematoma caused by a leaking aortic aneurysm. A case discussion and management is presented in this article.