Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Aug 2013
Globus pharyngeus: effectiveness of treatment with proton pump inhibitors and gabapentin.
This study was performed to investigate the effectiveness of treatment of globus pharyngeus with proton pump inhibitors, gabapentin, or both. ⋯ A majority of patients with globus pharyngeus can be helped by treating reflux or neuralgia. A trial of gabapentin should be considered for patients who do not respond or only partially respond to reflux management.
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Ann Oto Rhinol Laryn · Jul 2013
Randomized Controlled Trial Comparative StudyComparison between dexmedetomidine and remifentanil for controlled hypotension and recovery in endoscopic sinus surgery.
We compared the efficacy of dexmedetomidine and remifentanil hydrochloride in intraoperative field conditions and recovery during endoscopic sinus surgery. ⋯ Although remifentanil and dexmedetomidine both enabled hypotensive anesthesia and good intraoperative fields for endoscopic sinus surgery, recovery was faster with remifentanil than with dexmedetomidine in the immediate postoperative period.
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Ann Oto Rhinol Laryn · Jul 2013
Review Case ReportsMalignant transformation of respiratory papillomatosis in a solid-organ transplant patient: case report and literature review.
We report the case of a 77-year-old non-smoker and non-drinker with a solid-organ transplant who had malignant transformation of respiratory papillomatosis 3 years after the initial diagnosis of this benign lesion. This is the first case reported in the literature of malignant transformation of respiratory papillomatosis in a solid-organ transplant patient. ⋯ There may be a higher rate of malignant transformation of respiratory papillomatosis in immunosuppressed patients, as this is a virus-associated disease. Closer observation, airway evaluation with laryngoscopy and tracheobronchoscopy, and interval biopsies of immunosuppressed patients with respiratory papillomatosis is recommended.
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Ann Oto Rhinol Laryn · Jun 2013
Case ReportsBalloon dilation complication during the treatment of subglottic stenosis: background of the FDA class 1 recall for the 18 x 40-mm Acclarent Inspira AIR balloon dilation system.
Balloon dilation for subglottic stenosis allows for a controlled radial expansion of the airway and is considered superior to older techniques of airway dilation. We report the case of a 39-year-old woman with idiopathic subglottic stenosis who had entrapment of an inflated balloon in her subglottis due to device failure while undergoing balloon dilation of the stenotic area. ⋯ This is the first report describing a dislodged inflated balloon in the subglottis as a complication of dilation for idiopathic subglottic stenosis. Awareness of this possibility, as well as preparedness with the proper instruments, is vital for prevention of a catastrophic emergency during an otherwise low-risk procedure.
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Although laryngotracheal stenosis is well described in the literature, the vast majority of cases are of stenosis at either the subglottic or glottic level. Supraglottic stenosis is an unusual subset of laryngotracheal stenosis that has distinctly different causes, symptoms, and treatment options. ⋯ Supraglottic stenosis is a rare condition that is often associated with external-beam radiation or autoimmune disorders. All of the patients in our series experienced some degree of symptomatic airway obstruction that required management. The majority also had coexisting dysphagia, often associated with pharyngeal or esophageal stricture. Despite the favorable response to endoscopic treatment, all patients eventually required additional procedures because of symptomatic recurrence of their stenosis. Although endoscopic surgical treatment with a carbon dioxide laser in the operating room setting is a viable option, office-based treatment with a pulsed KTP laser appears to be an effective and potentially safer alternative.