Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Sep 2014
Intraoperatively diagnosed cerebellopontine angle facial nerve schwannoma: how to deal with it.
This study aimed to report our experience in the management of patients with intraoperatively diagnosed intracranial facial nerve schwannomas (FNSs) and propose a decision-making strategy. ⋯ Management of FNS diagnosed at surgery represents a significant clinical challenge. We considered total tumor resection with grafting when patients presented with preoperative facial nerve palsy (≥ grade III). Both subtotal and near-total tumor removal can be performed in patients with preoperative good facial function and/or large tumors with brainstem compression. Patients with small tumors who were selected for hearing preservation surgery can be considered for bony decompression. Fascicle preservation surgery may be an option when a clear cleavage plane between the tumor and the facial nerve is found.
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Ann Oto Rhinol Laryn · Jun 2014
Ketorolac after free tissue transfer: a comparative effectiveness study.
We sought to compare postoperative pain and complications in patients undergoing free tissue transfer for reconstruction of head and neck defects with and without ketorolac. ⋯ Ketorolac did not demonstrate a significant analgesic effect in this group of patients in terms of pain scores and opioid requirements. However, there also was no evidence to suggest a higher likelihood of bleeding complications. Ketorolac may be safely used as an anti-platelet agent, with narcotic requirements unchanged.
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Ann Oto Rhinol Laryn · Apr 2014
The effects of endoscopic sinus surgery on the postoperative outcomes of open rhinoplasty.
Several studies have advocated concurrent endoscopic sinus surgery and rhinoplasty. However, concerns about increased surgical risk, complications, and unsuccessful cosmetic outcomes following the concurrent procedures have been reported. The aim of this study was to investigate the overall safety of concurrent endoscopic sinus surgery and rhinoplasty and to specifically examine the effect of endoscopic sinus surgery on cosmetic outcomes. ⋯ Combined rhinoplasty and endoscopic sinus surgery achieves a similar aesthetic outcome to rhinoplasty only, with no significant increase in rates of revision or complication.
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Ann Oto Rhinol Laryn · Apr 2014
Risk factors for perioperative airway difficulty and evaluation of intubation approaches among patients with benign goiter.
The objective was to determine patient and gland characteristics associated with difficult intubation in patients undergoing thyroidectomy for goiter and to assess different methods of intubation in these patients. ⋯ Our results suggest that benign nodular goiter disease does not pose significant challenges to intubation in our patient cohort. The technique of intubation deviated from the initial plan several times in the FOI group, whereas LTOI was ultimately successful in every case. Our data suggest that the role of fiberoptic intubation for patients with large goiters should be further refined.
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Ann Oto Rhinol Laryn · Apr 2014
Airway management and endoscopic treatment of subglottic and tracheal stenosis: the laryngeal mask airway technique.
The objective is to present clinical outcomes of subglottic and tracheal stenosis treated by flexible bronchoscopic delivery of carbon dioxide (CO2) laser via laryngeal mask airway (LMA). ⋯ LMA is an effective way to manage ventilation while simultaneously allowing unencumbered flexible bronchoscopic access for laser surgery, balloon dilation, and mitomycin C application for airway stenosis. Long-term success in treating stenosis is achievable using this technique.