Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialEffects of peritonsillar infiltration on post-tonsillectomy pain. A double-blind study.
The concept that local infiltration of the operative area with a local anesthetic when using general anesthesia could alleviate postoperative pain is well known. We tested this concept on 129 patients scheduled for elective tonsillectomy. The patients were investigated in a double-blind, randomized study, and the operation was carried out via the standard technique of infiltrating the peritonsillar area preoperatively. The results indicated that preincisional infiltration of the tonsils with bupivacaine hydrochloride markedly decreased the intensity of pain following tonsillectomy, well beyond the immediate postoperative period.
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Ann Oto Rhinol Laryn · May 1996
Case ReportsFragmented, distorted cricoid cartilage: an acquired abnormality.
This paper reports the identification of the fragmented, distorted cricoid cartilage. The laryngeal findings in four patients with this acquired abnormality are presented. The postmortem whole organ serial section of their larynges is described and illustrated with horizontal sections from the Laryngeal Development Laboratory in Chicago. The histopathologic sequence, pathogenesis, and clinical relevance are elucidated.
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Ann Oto Rhinol Laryn · Apr 1996
Review Case ReportsAtlanto-axial subluxation and cervical osteomyelitis: two unusual complications of adenoidectomy.
Grisel's syndrome (atlanto-axial subluxation) and cervical osteomyelitis are two unusual complications of adenoidectomy. We present two patients; one with atlanto-axial subluxation following uncomplicated tonsillectomy and adenoidectomy, and one with cervical osteomyelitis following uncomplicated adenoidectomy. Both patients presented with persistent postoperative neck pain. ⋯ Flexible nasopharyngoscopy and computed tomography of the cervical spine also aided in diagnosis and treatment planning. With early diagnosis and proper treatment, the prognosis is good. Neurologic sequelae were prevented in both of our patients.
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Ann Oto Rhinol Laryn · Apr 1996
ReviewSubglottic air pressure: a key component of swallowing efficiency.
The relationship between tracheostomy and swallowing dysfunction has been long recognized. Often this dysfunction is manifested by aspiration, for which a number of etiologic factors may be responsible. Disruption of glottic closure has been previously demonstrated in association with the presence of an indwelling tracheostomy tube. ⋯ Measurement of subglottic pressure through an indwelling tracheostomy tube during swallowing demonstrated pressure peaks occurring concomitant with swallowing and laryngeal elevation. This presentation will review the evidence supporting the role of subglottic pressure rise in swallowing efficiency. Current investigational activity will be reviewed, and new areas for study will be suggested.