Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Nov 2002
Comparative StudyBlood flow measurements in the ears of patients receiving cochlear implants.
We measured cochlear blood flow in 12 patients who received cochlear implants, using a laser-Doppler probe with an outer diameter of 0.8 mm. The subjects had congenital deafness, idiopathic progressive sensorineural hearing loss, Waardenburg's syndrome, narrow internal auditory canal, or sudden deafness. ⋯ Our results revealed that blood flow was maintained in all cochleas, although there was a probability of reduction in blood flow volume. We conclude that laser-Doppler flowmetry is both relatively safe and useful for measuring blood flow in the ears during cochlear implantation procedures.
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Ann Oto Rhinol Laryn · Sep 2002
Comparative StudyComparison of various methods of electromyographic monitoring of the recurrent laryngeal nerve in thyroid surgery.
In the present study, 3 types of electrodes for recurrent laryngeal nerve (RLN) monitoring are compared: 1) intralaryngeal surface electrodes attached to a conventional endotracheal tube, 2) monopolar needle electrodes placed on the vocal cords by direct laryngoscopy, and 3) bipolar needle electrodes inserted intraoperatively through the cricothyroid ligament. Data were collected from stimulation of 21 RLNs in 16 patients undergoing thyroid surgery. ⋯ The mean (+/-SD) amplitudes of the EMG potentials were 1.61 +/- 1.6 mV, 2.37 +/- 1.8 mV, and 0.35 +/- 0.4 mV for the monopolar endolaryngeal, bipolar transligament, and intralaryngeal surface electrodes, respectively. The advantages and disadvantages of each type of electrode are discussed.
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Ann Oto Rhinol Laryn · Mar 2002
Case ReportsMembranous tracheal rupture in children following minor blunt cervical trauma.
Injuries to the tracheobronchial tree are well-recognized sequelae of massive blunt or penetrating injuries of the neck or chest. They may also occur as a rare complication of endotracheal intubation. ⋯ Recognition and treatment of this problem requires a high index of suspicion for the lesion and timely investigations. Open repair of the trachea to secure a stable airway is recommended for this injury, unless the wound is small and the wound edges are well approximated.
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Ischemic injury of the tracheal mucosa in the endotracheally intubated patient is directly proportional to the tracheal tube cuff pressure. At a cuff pressure of 30 cm H2O, the tracheal mucosal blood flow becomes partially obstructed, and at a pressure of 45 cm H2O, the obstruction to the tracheal mucosal blood becomes total, leading to tracheal mucosal damage and subsequent complications. In our institute, we have developed a simple and very inexpensive method to gauge the cuff pressure. ⋯ At the same time, a check for leakage around the cuff was made by auscultation with a stethoscope above the sternal notch. Multiple comparisons between the repetitive intracuff pressure measurements revealed that there were no significant differences in the intracuff pressure values measured at the different times of surgery. These results indicate that there was an adequate venting of the excess intracuff pressure and also that there was no leakage around the cuff.
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Ann Oto Rhinol Laryn · Dec 2001
Geometric characterization of the laryngeal cartilage framework for the purpose of biomechanical modeling.
Some new anatomic data on the laryngeal cartilage framework have been obtained for the biomechanical modeling of the larynx. This study attempted to define and measure some biomechanically important morphometric features of the laryngeal framework, including both the human and the canine laryngeal frameworks, because the canine larynx has been frequently used as an animal model in gross morphology and in physiological experiments. ⋯ Linear and angular geometric measurements on the thyroid cartilage, the cricoid cartilage, and the arytenoid cartilage were made with a digital caliper and a protractor, respectively. The results are useful for constructing quantitative biomechanical models of vocal fold vibration and posturing (abduction and adduction), eg, continuum mechanical models and finite-element models of the vocal folds.