Ann Oto Rhinol Laryn
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There is great interest in training surgeons in the technical aspects of their craft through simulation and laboratory-based exercises. However, there are as yet only a few objective tools to assess technical performance in a laboratory setting. This study assesses three potential objective assessment tools for a traditional otolaryngology laboratory exercise, temporal bone drilling. ⋯ This study validates EO, the GRS, and the TBC as measures of temporal bone drilling performance. Of these measures, the TBC correlates best with EO according to logistic regression and can be reliably used as an objective assessment of temporal bone drilling.
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Ann Oto Rhinol Laryn · Sep 2007
Multicenter Study Comparative StudyMonitoring tracheal tube cuff pressures in the intensive care unit: a comparison of digital palpation and manometry.
Tracheal tube cuff overinflation is a recognized risk factor for tracheal injury and stenosis. International studies report a 55% to 62% incidence of cuff overinflation among intensive care unit (ICU) patients. However, there are no data on tracheotomy tubes, and no recent data from ICUs in the United States. It is unknown whether routine cuff pressure measurement is beneficial. We sought to determine the incidence of cuff overinflation in the contemporary American ICU. ⋯ Despite increasing awareness among intensivists and respiratory therapists, the incidence of tracheal tube overinflation remains high, with both endotracheal and tracheotomy tubes. Our finding that the use of manometry to assess cuff pressures did not reduce the incidence of overinflation suggests that a more vigilant management protocol may be necessary.
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Ann Oto Rhinol Laryn · Aug 2007
Value of laryngeal electromyography in diagnosis of vocal fold immobility.
We sought to determine the value of laryngeal electromyography (LEMG) and evoked LEMG in the diagnosis of vocal fold immobility. ⋯ We conclude that LEMG and evoked LEMG behavior plays a crucial role in the diagnosis of vocal fold immobility. The decreased recruitment activities on LEMG and the decreased evoked LEMG signals with longer latency and lower amplitude reflect the severity of neuropathic laryngeal injury.
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Ann Oto Rhinol Laryn · Aug 2007
Randomized Controlled Trial Comparative StudyThermal welding versus cold dissection tonsillectomy: a prospective, randomized, single-blind study in adult patients.
We performed a single-blind, prospective, randomized, controlled clinical study to compare the rates of postoperative morbidity in adults undergoing thermal welding tonsillectomy versus cold dissection tonsillectomy. ⋯ Thermal welding tonsillectomy is a relatively safe and reliable method with significantly less postoperative morbidity than cold dissection tonsillectomy.
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The objectives of this study were to review perioperative bridging strategies for anticoagulated patients and to describe a novel bridging strategy for tonsillectomy in an anticoagulated patient that addresses both primary and secondary hemorrhage risks. ⋯ Tonsillectomy can be done relatively safely in an anticoagulated patient at high risk for thrombosis. The perioperative bridging strategy should account for its unique risk of primary and secondary postoperative hemorrhage. A proposed algorithm for managing these competing risks is presented.