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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We measured the nasal mucociliary activity in total laryngectomy patients, and to compare among themselves, smokers, diabetics and normal population besides that to investigate the short and long term effects of total laryngectomy on nasal mucosa. The study includes 39 patients who had total laryngectomy between the January 1998-August 2005 and 36 volunteer healthy individuals. To examine the early and late changes on nasal mucosa the patients that had total laryngectomy separated into two groups as operated before August 2003 (> 2 years), as operated after August 2003 (< 2 years). ⋯ In total laryngectomy patients hypersecratory phase is produced in early period and nasal mucosal clearance is increased. On the other hand, dependent on chronic infections nasal mucosa is atrophied and nasal mucosal clearance is disrupted. However smoking and diabetes mellitus also damage the mucocilliary clearance.
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Eur Arch Otorhinolaryngol · Dec 2006
Management of patients with epistaxis by general practitioners: impact of otolaryngology experience on their practice.
This study aims to assess the management of patients with epistaxis by general practitioners (GPs) and to show whether previous experience as a junior doctor in ear, nose and throat (ENT) surgery influences their practice. A questionnaire was sent together with self-addressed reply envelopes to a random sample of 1,000 GPs. Four hundred and twenty eight GPs replied (43% response rate). ⋯ Fifteen percent GPs had previous experience in ENT. The only significant difference in the management of epistaxis with these GPs is that they were 2x more likely to cauterize a nose with silver nitrate (P=0.002). There is no general consensus on the management of epistaxis by GPs and despite previous experiences in the specialty as a junior doctor, this fails to have a significant impact on the day to day management of epistaxis.
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Eur Arch Otorhinolaryngol · Nov 2006
Randomized Controlled TrialTeaching and assessment in otolaryngology and neurology: Does the timing of clinical courses matter?
Little is known about the effectiveness of clinical courses as a learning environment. To accurately assess performance in these courses, equal conditions for all candidates are required. We investigated the influence of the proximity of the course to the students test taking, the students' learning styles, and their self-motivation for learning in relation to performance success. ⋯ The duration of time between a clinical course with little practical teaching and the students' taking of the exam plays a significant role on performance success; this effect does not occur in a course with a high proportion of practical patient-related teaching. More studies on clinical courses are needed to establish how students can be given adequate opportunities to develop necessary skills for patient care and for objective success on assessment. With such further information, the effectiveness of clinical courses as a learning experience might be enhanced.
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Eur Arch Otorhinolaryngol · Nov 2006
Clinical TrialBipolar radiofrequency induced thermotherapy of the tongue base: Its complications, acceptance and effectiveness under local anesthesia.
We assessed adverse events and complications of bipolar radiofrequency induced thermotherapy of the tongue base (RFTB) in patients with socially unacceptable snoring (SUS) or obstructive sleep apnea syndrome (OSAS) and determine its acceptance and effectiveness when conducted under local anesthesia. This investigation consisted of (1) a prospective, open-enrollment study of 24 consecutive patients with snoring and OSAS at the tongue base level only (Fujita III), assessed by sleep endoscopy. Polysomnography, questionnaires, and visual analog scales (VAS) were used to assess outcome. (2) In addition, a retrospective review of 83 patients, who underwent RFTB (in 59 cases as part of a multilevel treatment), was performed to evaluate adverse events and complications. ⋯ Its effect on OSAS has been shown by other authors, although long-term effects are not stable. The RFTB can be considered as first choice treatment in case of snoring and mild OSAS in Fujita type III obstruction. In the case of moderate to severe sleep apnea, RFTB can be considered as an additional treatment.
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Eur Arch Otorhinolaryngol · Aug 2006
Case ReportsA case of achondroplasia with severe pulmonary hypertension due to obstructive sleep apnea.
Achondroplasia is the most common skeletal dysplasia in children. Achondroplasic patients have a short cranial face and midface hypoplasia. ⋯ However, severe PH due to obstructive-type sleep disorder is rare in patients with achondroplasia. In this report, we describe a 5-year-old girl with achondroplasia whose severe PH was caused by upper-airway obstruction and was resolved gradually after adenotonsillectomy.