Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Jan 2003
Comparative StudyTopical nasal anesthesia and laryngopharyngeal sensory testing: a prospective, double-blind crossover study.
Laryngopharyngeal sensory discrimination testing (LPSDT) has become a popular means of detecting sensory deficits in patients with voice and/or swallowing complaints. During this procedure, transnasal fiberoptic laryngoscopy (TFL) using a specialized fiberoptic scope is performed in order to deliver discrete pulses of air to the laryngopharyngeal mucosa. Historically, topical anesthesia has been applied to the nasal mucosa to lessen discomfort during TFL. ⋯ The sensory scores for oxymetazoline and cocaine were 3.4 and 3.5 mm Hg, respectively. When compared to saline solution and oxymetazoline independently, sensory testing of the laryngopharynx during which the nose was anesthetized with cocaine resulted in similar thresholds for eliciting the laryngeal adductor reflex (p = .40 and p = .85). We conclude that topical anesthesia can be applied to the nasal cavity during LPSDT without altering laryngeal sensation.
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Ann Oto Rhinol Laryn · Jan 2003
Comparative StudySimple technique for tracheocutaneous fistula closure in the pediatric population.
To review our experience with cauterization of persistent tracheocutaneous fistulas in children, we performed a retrospective review of patients who underwent cauterization of tracheocutaneous fistulas by the senior author (O. E. B.) from 1986 to 2001 in an academic, tertiary care children's hospital. ⋯ This patient was the only one admitted after the operation, for a pulmonary infiltrate. No other patients required airway support in the immediate postoperative period. Cauterization of tracheocutaneous fistulas in children is a relatively simple, effective, and safe technique.
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Ann Oto Rhinol Laryn · Jan 2003
Comparative StudyPost-tonsillectomy and -adenoidectomy hemorrhage in nonselected patients.
This retrospective study was undertaken to evaluate the incidence of hemorrhage in nonselected patients requiring surgical treatment after adenoidectomy (group 1; 7,785 patients) or tonsillectomy with or without adenoidectomy (group 2; 6,794 patients). Postoperative bleeding from the tonsillar fossae occurred in 200 patients (2.94%). Primary hemorrhage (< 24 hours) clearly prevailed in groups 1 (86%) and 2 (78%). ⋯ The latest bleeding occurred 6 days (adenoidectomy) and 18 days (tonsillectomy) after surgery. Hemorrhage following both procedures is a rare complication predominantly occurring several hours after surgery and in nonselected patients. Male gender, age over 70 years, infectious mononucleosis, and a history of recurrent tonsillitis were found to be risk factors for posttonsillectomy hemorrhage.