Ann Oto Rhinol Laryn
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Congenital cholesteatoma of the ear is a capricious and challenging problem for the otologist. We present 21 cases managed at the Mayo Clinic from 1961 to 1983. ⋯ Disease was located in the middle ear or in the middle ear and mastoid, except in one patient who had cholesteatoma extending into the petrous apex. Surgical management depended on the extent of the lesion, and recurrences were unusual, suggesting that congenital cholesteatoma may not be as aggressive as acquired cholesteatoma.
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Ann Oto Rhinol Laryn · Sep 1984
Case ReportsComplications associated with a narrow bore nasogastric tube.
The use of a new narrow bore nasogastric feeding tube with stylet has resulted in two cases of misplacement with traumatic laceration of the visceral pleura. Diagnoses were made by chest x-ray film, one case immediately and the other 24 hours later. In both cases, the narrow bore tube was inserted asymptomatically by a graduate physician. Detailed case reports of both patients are presented, those patients at risk for abnormal placement of this nasogastric tube are discussed, and new guidelines for safer use are proposed.
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The unusual complex of physiological problems associated with rupture of the tracheobronchial tree complicating blunt chest trauma is discussed. The mechanics of injury leading to rupture are abrupt compression of the chest with consequent fixation of the cervical trachea where it enters the mediastinum, separation of the lungs, and fracture of the bronchus over the vertebral bodies. Treatment by aspiration thoracentesis, tracheotomy, and thoracotomy with primary repair as well as expectant therapy are discussed. Two cases, one treated expectantly and one treated by thoracotomy, both with complete recovery, are presented.
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The requirements of anesthesia for laryngoscopy and microlaryngeal surgery must be compatible with maximum safety and minimum patient discomfort. Some techniques require the use of an endotracheal tube while some do not. ⋯ In general, for pediatric endoscopy we prefer spontaneous respiration with inhalational anesthesia supplemented by topical lignocaine (lidocaine), and in adults, a relaxant technique with controlled jet ventilation supplemented by topical lignocaine. A new pediatric microlaryngoscope and a new tube for jet ventilation in older children and adults are described.
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Ann Oto Rhinol Laryn · Jul 1984
Historical ArticleTracheotomy versus intubation. A 19th century controversy.
The early history of tracheotomy and intubation is reviewed. Both techniques evolved to their modern formats during the 19th century stimulated by the need to treat diphtheria epidemics. Development of technical aspects of tracheotomy during the first half of the 19th century, and of endotracheal and endolaryngeal intubation in the latter part, are reviewed.