Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Mar 2006
Randomized Controlled TrialPreoperative administration of rofecoxib versus ketoprofen for pain relief after tonsillectomy.
We evaluated the analgesic efficacy and the opioid-sparing effect of oral rofecoxib compared with intramuscular (IM) ketoprofen in tonsillectomy. ⋯ Oral premedication with rofecoxib seems to be more effective than use of ketoprofen in decreasing postoperative pain and the need for opioid rescue medication after elective tonsillectomy. Both drugs seem to be relatively safe as far as postoperative bleeding is concerned.
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Our intent was to review the clinical signs, computed tomography (CT) scans, treatment, and outcome of parapharyngeal space infections (PPIs), and to define 2 types of infections of the parapharyngeal space (PPS) according to the location of the infectious process. ⋯ The term "parapharyngeal abscess" was assigned long before the CT scan era, and was based on physical examination and plain film radiology. In essence, the entity PPS "abscess" or "infection" is composed of 2 different disorders. Infection located in the posterior part of the PPS with no invasion into the parapharyngeal fat and with no extension into other cervical spaces except the adjacent retropharyngeal space may be termed posterior parapharyngeal infection or parapharyngeal lymphadenitis. This is a relatively benign condition, and nonsurgical treatment should be considered. Infection involving the parapharyngeal fat may be termed parapharyngeal abscess or deep neck abscess. Diffusion into the mediastinum and other severe complications are frequent. Urgent surgical drainage is therefore mandatory.
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We investigated the long-term outcome of pediatric tracheostomy to identify predictive factors of early decannulation. ⋯ Tracheostomy indication and patient diagnosis are significant variables that predict early decannulation in pediatric patients in whom tracheostomy is required. Other variables were not shown to be significant independent predictors.
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Ann Oto Rhinol Laryn · Oct 2005
Relationship of snoring and sleepiness as presenting symptoms in a sleep clinic population.
Sleepiness has traditionally been considered medically the cardinal symptom of obstructive sleep apnea syndrome. Snoring is perceived as a social or cosmetic complaint. Without independent medical morbidity, snoring identification and treatment is not a major focus in sleep medicine. We speculate that snoring is a major independent symptom. To evaluate how patients rated snoring symptom severity, we compared the relative significance of a sleep clinic population's presenting symptoms of snoring and sleepiness. ⋯ The presenting symptoms of snoring are larger in magnitude, importance, and severity than those of sleepiness in a broad population of patients with sleep disorders and sleep-disordered breathing irrespective of severity of sleep apnea or sleepiness. Symptoms of major significance are clinically relevant to identifying, diagnosing, and treating patients. Failure of medical providers to appreciate the impact of snoring on this population may affect attempts to identify, diagnose, and treat patients with sleep-disordered breathing.
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Ann Oto Rhinol Laryn · Aug 2005
Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis.
We performed a prospective study to assess respiratory function and voice quality before and after laser microsurgical bilateral posterior cordectomy performed for chronic airway obstruction in patients with bilateral vocal fold paralysis. ⋯ A bilateral approach for laser microsurgical posterior cordectomy combines excellent airway improvement and satisfactory voice preservation. In bilateral vocal fold paralysis, pretreatment and posttreatment clinical data should be evaluated by objective measures.