Arch Otolaryngol
-
A comprehensive overview of atlantoaxial instability in Down syndrome as it relates to head and neck surgery and recommendations as derived from a review of the literature. ⋯ A small percentage of patients with Down syndrome are at risk for atlantoaxial instability and subluxation. All patients with Down syndrome should have a preoperative neurologic assessment screening by the operating surgeon and/or a cervical roentgenogram in the lateral, extension, and flexion positions. Any abnormality should be investigated before surgery.
-
A new bilobed design of the sensate radial forearm flap is presented for reconstruction of the oral cavity following significant glossectomy. One lobe of the flap is used to restore the shape and volume of the tongue, while the second lobe is used to resurface the floor of the mouth and the gingiva. ⋯ In addition to the thin, pliable, and sensate tissue of the radial forearm skin, the bilobed design helps to prevent tethering of the root of the tongue to the inner table of the mandible. This factor is felt to be important in maximizing the mobility of the residual tongue. There were no flap failures or partial necroses. Tongue mobility, oral alimentation, articulation, and return of sensation are described.
-
Patients from the Comprehensive Cancer Center of the Arthur G. James Cancer Hospital and Research Institute, Ohio State University, Columbus, who were undergoing major head and neck oncologic surgery were prospectively studied to determine predictors of postoperative medical complications and wound infection. Of 119 patients studied, 28 (24%) had at least one postoperative medical complication. ⋯ The strongest predictors of wound infection were an elevated preoperative platelet count and prolonged surgery. Wound infection was the strongest correlate of prolonged hospital stay. These findings suggest that the Specific Activity Scale questionnaire identifies patients at risk for medical complication, that alcohol abuse should be managed aggressively, and that thrombocytosis identifies patients at risk for wound infection.
-
Randomized Controlled Trial Clinical Trial
Single treatment approaches to benign paroxysmal positional vertigo.
To determine the effectiveness of two different physical therapy approaches for benign paroxysmal positional vertigo. ⋯ These single-treatment approaches are equally effective treatments for benign paroxysmal positional vertigo. Further studies are needed to look at the long-term effectiveness of these treatments.