Clinical otolaryngology and allied sciences
-
Clin Otolaryngol Allied Sci · Apr 1998
Randomized Controlled Trial Clinical TrialEfficacy of external fixation following nasal manipulation under local anaesthesia.
Nasal fractures are one of the commonest reasons for patients being referred to ENT departments, but few studies have been published about the management of this condition. In particular, the efficacy of external splintage following manipulation has not been assessed. This was a prospective randomized study, which examined the results of manipulation under local anaesthetic and the benefit to be gained from external fixation with Plaster of Paris (POP) following this procedure. ⋯ The mean deviation of the nasal bridge at presentation was 4.12 mm. Manipulation under local anaesthetic significantly improved the degree of deviation (mean 2.47 mm, P = 0.0011, 90% CI, 1-2 mm). Randomization of the patients, following manipulation, into POP/none-POP groups showed that external splintage of the nose appeared to be of little practical benefit.
-
The influence of age and gender on the pharyngeal pressure wave during swallowing was investigated in 73 healthy volunteers using a four-sensor manometry probe. The distal sensor was placed within the upper oesophageal sphincter (UOS) and three proximal sensors were located in the pharynx 2, 4 and 6 cm above the UOS. Twenty-nine variables describing the amplitude and timing of the swallow waveforms for a 5 ml water bolus were recorded from the pharynx and the UOS. Analysis of the results indicated that aging was associated with slowing of the swallow response in the pharynx, impaired opening of the UOS and a marked reduction in resting UOS tone.
-
The purpose of this study was to determine the incidence, degree and reversibility of hearing loss following spinal anaesthesia with bupivacaine and secondarily to see if there is a relationship between post-spinal headache and hearing loss. A prospective series of 35 patients admitted for elective Caesarean section under a standardized spinal anaesthetic was investigated. Otolaryngological examination and pure tone audiometry in the frequency range 250 Hz to 8 KHz were done on the day before surgery and on post-operative days 1 and 5. ⋯ This loss was either unilateral (3) or bilateral (2) and affected the low frequencies in all five patients. The demographic data for both groups (i.e. no change in hearing/sensorineural loss) was similar for age, weight, height, blood pressure change and level of sensory block. There was no association found with post-spinal headache.
-
Congestion of one side of the nose is accompanied by decongestion of the other side. This is called the nasal cycle. The nasal cycle does not seem to be present in all subjects and it has not been shown with rhinostereometry. ⋯ Measurements were made with rhinostereometry, a peak flow meter (PNIF) and by symptom scores. A nasal cycle was found in some subjects. There was no difference in total nasal mucosal swelling in the mornings and in the afternoons and no day-to-day variation in the total nasal mucosal swelling.
-
Clin Otolaryngol Allied Sci · Apr 1996
Comparative Study Clinical TrialLignocaine with adrenaline: is it as effective as cocaine in rhinological practice?
This double-blind study compares the effectiveness of two local anaesthetics with vasoconstrictive activity (10% cocaine and 4% lignocaine with adrenaline 1:1000) used in the nose. Anterior rhinomanometry was used to assess changes in nasal mucosal blood volume from a reduction in congestion of the nasal mucosa with a resulting reduction in nasal resistance. Nasendoscopy was then performed and the degree of subjective discomfort evaluated. ⋯ In all subjects, there was a significant reduction of nasal resistance after the administration of both drugs (P < 0.005). The anaesthetic effects of both agents were comparable with subjects reporting only a mild discomfort during nasendoscopy. We conclude from this study that 4% lignocaine with adrenaline (1:1000) solution is as effective as 10% cocaine.