Acta oto-laryngologica
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Acta oto-laryngologica · Sep 2003
Cochlear blood flow modifications induced by anaesthetic drugs in middle ear surgery: comparison between sevoflurane and propofol.
Because it is necessary to maintain controlled hypotension during middle ear surgery in order to avoid bleeding and as it is known that cochlear blood flow (CBF) is related to blood pressure (BP), it is useful to evaluate CBF modifications induced by anaesthetics in order to prevent cochlear damage. The aim of this paper is to evaluate, using laser Doppler flowmetry, which anaesthetic drug, out of sevoflurane and propofol, has the smallest effect on CBF. ⋯ The results obtained show that sevoflurane has a hypotensive effect without modifying CBF, while propofol, although having a similar effect on BP to sevoflurane, has less of a protective effect on inner ear microcirculation.
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Acta oto-laryngologica · Jun 2003
Review Case ReportsCandidal abscess of the parotid gland associated with facial nerve paralysis.
Facial nerve paralysis associated with parotid gland mass is usually caused by malignant neoplasms and facial nerve dysfunction due to parotid infection is exceedingly rare. A review of the literature revealed approximately 15 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess. We report the first case of candidal abscess of the parotid gland associated with facial nerve paralysis in a 74-year-old insulin-dependent diabetic patient. The differential diagnosis in these unusual cases occurring in diabetic, immunodeficient patients should include Candida albicans infection.
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Acta oto-laryngologica · Jan 2003
Effects of partial neuromuscular blockade on facial nerve monitorization in otologic surgery.
Neuromuscular blockade (NMB) is administered as part of a general anesthetic in order to keep the patient immobilized during surgery and has been known to hinder intraoperative neuromonitorization. The aim of this study was to determine the effects of different levels of NMB on electrical stimulation thresholds of the facial nerve during otologic surgery. ⋯ This study suggests that a regulated 50% level of peripheral NMB provides reliable intraoperative EMG monitoring of the facial musculature in response to electrical stimulation and adequate anesthesia, with full immobilization of the patient.
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Acta oto-laryngologica · Dec 2001
Scanning electron microscopic study of the muscle fiber ends at the myotendinous junction in the posterior cricoarytenoid and cricothyroid muscles in rats.
The fine structural organization of muscle fiber ends at the myotendinous junction in the posterior cricoarytenoid (PCA) and cricothyroid (CT) muscles in adult rats was studied by scanning electron microscopy, after removal of tendon connective tissues using the HCI-hydrolysis method. The muscle fiber ends in the PCA muscle had a relatively simple conical appearance and contained a great number of longitudinal slits on the surface. ⋯ One type had a conical appearance similar to the PCA muscle with many slits on the surface, while the other type was characterized by a complex arrangement of cylindrical cytoplasmic processes and deep clefts, as seen in common skeletal muscles. These findings suggest that the PCA muscle is evolutionarily primitive, and that the CT muscles represent a transitional form between primitive and evolved muscles.
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Acta oto-laryngologica · Jul 2001
Facial nerve paralysis in temporal bone fractures: outcomes after late decompression surgery.
The aim of this paper was to address some of the unanswered questions regarding management of facial nerve paralysis in temporal bone fractures (TBF), such as the outcomes after late facial nerve decompression surgery. The study design was a retrospective review of a consecutive clinical series. Thirteen patients who underwent late decompression surgery for facial nerve paralysis due to TBF involving the perigeniculate ganglion region were analyzed. ⋯ Normal or subnormal facial nerve function (HB 1 or HB 2) was achieved in 7/9 cases (78%) evaluated at > or = 1 year after surgery. Good functional results were also obtained in two patients operated on 3 months after trauma. Bases on the outcomes observed in the present series, in patients unable to be operated on early, presenting 1 to 3 months with >95% denervation on EnoG, facial nerve decompression may have a beneficial effect.