Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Sep 2014
Preventing cuff rupture during tracheostomy: importance of endotracheal tube positioning.
The objective of our study is to describe the technique of distal endotracheal tube (ETT) positioning for avoiding cuff rupture and validate the technique in a virtual tracheostomy model. ⋯ Distal ETT positioning during tracheostomy should be considered for avoiding inadvertent ETT cuff rupture.
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Deconditioning and frailty may contribute to dysphagia and aspiration. Early identification of patients at risk of aspiration is important. Aspiration prevention would lead to reduced morbidity and health care costs. We therefore wondered whether objective measurements of frailty could help identify patients at risk for dysphagia and aspiration. ⋯ Nonambulatory status is a predictor of aspiration and should be included in risk assessments for dysphagia. The relationship between frailty and dysphagia deserves further investigation. Frailty assessments may help identify those at risk for complications of dysphagia.
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Ann Oto Rhinol Laryn · Sep 2014
Intraoperatively diagnosed cerebellopontine angle facial nerve schwannoma: how to deal with it.
This study aimed to report our experience in the management of patients with intraoperatively diagnosed intracranial facial nerve schwannomas (FNSs) and propose a decision-making strategy. ⋯ Management of FNS diagnosed at surgery represents a significant clinical challenge. We considered total tumor resection with grafting when patients presented with preoperative facial nerve palsy (≥ grade III). Both subtotal and near-total tumor removal can be performed in patients with preoperative good facial function and/or large tumors with brainstem compression. Patients with small tumors who were selected for hearing preservation surgery can be considered for bony decompression. Fascicle preservation surgery may be an option when a clear cleavage plane between the tumor and the facial nerve is found.