Clinical otolaryngology and allied sciences
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Clin Otolaryngol Allied Sci · Feb 1988
Randomized Controlled Trial Clinical TrialOral tranexamic acid in the management of epistaxis.
This study evaluated oral tranexamic acid as an adjunct in controlling epistaxis and preventing or reducing recurrent epistaxis. Patients entered into the trial were randomized in double blind fashion to placebo or tranexamic acid 1 g, 3 times daily. Treatment continued for 10 days. ⋯ Of the 89 patients who completed the course of tablets, 25 (57%) in the placebo group and 21 (47%) in the treatment group had a rebleed. More patients in the placebo group had minor and moderate rebleeds, but the same number of patients in the placebo and treatment groups had severe rebleeds; this difference was not statistically significant. Oral tranexamic acid is, therefore, of no proven value as an adjunct in the treatment of epistaxis in patients requiring hospital admission.
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This study investigates postoperative hoarseness by comparing the patient's subjective assessment of change in voice following intubation with objective measures made using the laryngograph. Twenty-five patients admitted for routine surgery were assessed pre- and postoperatively. An Fx histogram was recorded on the laryngograph. ⋯ These measures can be recorded as the change in spread, standard deviation of the Fx histogram. The transient postoperative hoarseness following intubation is due to laryngeal damage. This damage has 2 mechanisms; in most cases it is due to direct mucosal trauma but in other cases a deeper muscular damage occurs.
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Clin Otolaryngol Allied Sci · Feb 1987
Case ReportsPeritonsillar abscess with parapharyngeal involvement: incidence and treatment.
In 2.3% of 217 patients with peritonsillar abscess, the clinical picture was atypical, with inflammatory swelling of the pharyngeal wall below and behind the tonsil, oedema of the epiglottis and a diffuse swelling on the side of the neck. The typical signs of peritonsillar abscess, i.e. trismus, a medially displaced tonsil and displacement of the uvula toward the opposite side, were either completely lacking or less pronounced than usual. The abscesses were all located in the peritonsillar space at the lower pole or behind the tonsil. To ensure rapid, uncomplicated recovery in such cases with parapharyngeal involvement, it is essential that abscess tonsillectomy under antibiotic cover with penicillin is not postponed.
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Cricoid pressure may be performed when a sharp object such as an animal bone is lodged in the post-cricoid oesophagus. This study was undertaken to determine what damage, if any, may be caused to the oesophagus. A sharp foreign body was inserted into the post-cricoid region of 15 cadavers. ⋯ In the remaining 10 cases, intubation with and without cricoid pressure was also performed. No significant damage was visible to the naked eye when the oesophagus was subsequently examined. Cricoid pressure does not seem to result in significant damage in this situation.