Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Apr 1993
Review Case ReportsLymphoma of the sphenoid sinus presenting as an expansile mass.
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Ann Oto Rhinol Laryn · Apr 1993
Comparative StudyComparison of functional endoscopic sinus surgery under local and general anesthesia.
We present a retrospective comparison of intravenous sedation and general anesthesia techniques employed at New York University-Bellevue Medical Center for functional endoscopic sinus surgery. Some authors have stressed the use of local anesthesia with intravenous sedation in order to avoid complications and reduce blood loss. We have reviewed 232 patients who underwent 401 consecutive ethmoidectomies and maxillary antrostomies. ⋯ The rate of operative complications for local anesthesia was 8.7% per patient, with a 1.6% rate of major complications per side. General anesthesia carried an overall complication rate of 2.4% per patient, with no major complications. General anesthesia is a relatively safe and viable option for endoscopic sinus surgery that in selected cases may be preferable to local anesthesia.
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Ann Oto Rhinol Laryn · Nov 1992
Comparative StudyContinuous positive airway pressure as a promoter of laryngospasm during halothane anesthesia.
Twenty mongrel dogs were anesthetized with halothane 2.0%, 1.25%, 0.94%, and 0.63% in oxygen. Thyroarytenoid (TA) and posterior cricoarytenoid (PCA) electromyography (EMG) tracings were recorded with the animal at rest, following mechanical irritation of the glottis, and during 20 mm Hg continuous positive airway pressure (CPAP) following either airway occlusion or hyperventilation. Adductor laryngospasm was defined as continuous tonic TA EMG activity, silent PCA EMG, and vocal cord adduction. ⋯ The incidence of adductor laryngospasm following mechanical irritation was 30% to 50%. The combined incidence of laryngospasm during application of CPAP following airway occlusion or hyperventilation was 25% to 50%, and differed from the incidence of irritation-induced adductor laryngospasm by 5% or less at the same anesthetic level. Continuous positive airway pressure appears to be a stimulant of laryngeal muscle spasm comparable to mechanical irritation of the glottis.
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Ann Oto Rhinol Laryn · Oct 1992
Review Case ReportsJunctional epidermolysis bullosa of the larynx. Report of a case and literature review.
Epidermolysis bullosa (EB) is a group of rare inherited disorders in which minor trauma causes blister formation in the skin and mucosa, including the esophagus. Morbidity varies with the type of disease and ranges from occasional trivial skin blisters to death in infancy. Laryngeal involvement presenting as hoarseness and respiratory distress has been reported in nine patients, five of whom had junctional EB. We present the sixth case of junctional EB with laryngeal involvement, and offer guidelines for otolaryngologists and anesthesiologists caring for these fragile patients.