Arch Otolaryngol
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Arytenoid cartilage dislocations and avulsions are often seen as a part of severe laryngeal injuries due to blunt trauma. An uncommon type of injury is the unilateral degloving of an arytenoid cartilage following laterally directed trauma to the thyroid cartilage. It may occur without additional cartilaginous or mucosal damage. ⋯ It may retain mobility and be exposed only on adduction, or it may lose mobility due to dislocation and be tipped into the laryngeal lumen. Prognosis for vocal cord mobility and voice production is good for the degloving injury alone, but poor if the arytenoid cartilage is also dislocated. Cases are discussed to illustrate the mechanism, treatment, and outcome of such injuries.
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Button batteries as foreign bodies are dangerous because of their ability to cause liquefaction necrosis on contact with moist tissue. We treated two patients with disk batteries in the ear and nose. Both patients had severe local reactions, necessitating prolonged treatment. Prompt identification and rapid removal of these foreign bodies is recommended.
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Acute infectious uvulitis is a rare condition. A case caused by Streptococcus pneumoniae occurred in a 56-year-old woman who also had coexisting epiglottitis. One other case of uvulitis reported in the literature has also been associated with acute epiglottitis. Because of potentially lethal complications, epiglottitis should be suspected in any patient who presents with acute painful swelling of the uvula.
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Aneurysms of the intrapetrous internal carotid artery are rarely encountered and can present difficult diagnostic problems. A review of the literature revealed 34 cases, and we now add a 35th. Presenting symptoms and signs are dependent on the direction of expansion of the aneurysm, with neurologic dysfunction typical of medial expansion, whereas lateral erosion often suggests a glomus tumor.
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Randomized Controlled Trial Comparative Study Clinical Trial
Alleviation of induced vertigo. Therapy with transdermal scopolamine and oral meclizine.
Twelve healthy subjects received seven-day treatments on a randomized, double-blind, crossover basis, of a transdermal scopolamine system, oral meclizine, and placebo, separated by one-week intervals. Just prior to each treatment, and on days 1 and 7 of each treatment, subjects received two warm (44 degrees C) caloric irrigations of each external auditory canal. Following each irrigation, subjects rated their vertigo symptoms. ⋯ Vertigo symptoms on day 1 of treatment were significantly less with transdermal scopolamine than oral meclizine or placebo and on day 7 were significantly less with both scopolamine and meclizine than the placebo. On day 1, meclizine did not reduce vertigo symptoms significantly when compared with the placebo. Drowsiness was greater with use of oral meclizine than transdermal scopolamine.