Clinical otolaryngology and allied sciences
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Clin Otolaryngol Allied Sci · Dec 2002
Randomized Controlled Trial Clinical TrialThe use of topical nasal anaesthesia before flexible nasendoscopy: a double-blind, randomized controlled trial comparing cophenylcaine with placebo.
The objective was to evaluate the necessity to use topical nasal anaesthesia before flexible nasendoscopy and to compare its use with placebo. The study was carried out using a double-blind randomized controlled trial, with three treatment arms, at the out-patient department at Raigmore Hospital, Inverness. The participants were 90 patients attending the otolaryngology out-patient department who required flexible nasendoscopy as part of their assessment. ⋯ Overall unpleasantness scores were 2.0 for cophenylcaine, 1.9 for no spray and 2.4 for placebo. On a visual analogue scale of 0-10, none of these mean main outcome measures reached levels of significance. It was concluded that the use of cophenylcaine spray before flexible nasendoscopy does not give significant advantages over the use of no nasal preparation.
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Clin Otolaryngol Allied Sci · Oct 2002
Randomized Controlled Trial Clinical TrialDexamethasone reduces pain after tonsillectomy in adults.
The aim of this study was to assess the effect of a course of dexamethasone on postoperative pain and morbidity after adult tonsillectomy. We report the results of a double-blind, randomized, placebo-controlled trial of 200 adult patients undergoing elective tonsillectomy. Patients were randomized to three groups: one group received the non-steroidal anti-inflammatory drug piroxicam for 8 days postoperatively, one group received dexamethasone for the same period and the third group received both drugs. ⋯ This difference was statistically significant (P < 0.05) on all days except the day of surgery and the second postoperative day. Patients treated with piroxicam alone had significantly higher analgesic requirements than in either of the other groups. Dexamethasone given in this regime reduces postoperative pain and analgesic requirements after adult tonsillectomy.
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Clin Otolaryngol Allied Sci · Apr 2001
Randomized Controlled Trial Multicenter Study Clinical TrialRisk factors for persistence of bilateral otitis media with effusion.
Otitis media with effusion (OME) is a common, episodic condition in childhood. The subset that has persistent bilateral OME is important to identify so that their management can be targeted. Most guidelines suggest a watchful-waiting period before a decision is made on the appropriateness of surgical intervention. ⋯ In this age group, parental report of duration of OME, history of acute otitis media, parental smoking and pars tensa retractions were not significant factors for persistence. These risk factors in combination can increase the odds ratio of persistence more than sixfold. However, the proportion persisting is insufficient to bypass a period of watchful waiting, except perhaps in extreme combinations which apply to less than 7% of the cohort.
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Clin Otolaryngol Allied Sci · Sep 1999
Randomized Controlled Trial Comparative Study Clinical TrialManipulation of the fractured nose: a comparison of local infiltration anaesthesia and topical local anaesthesia.
Reduction of simple nasal fractures under local anaesthetic is now an accepted practice. The anaesthetic is usually administered using an external percutaneous approach, coupled with topical intranasal cocaine. Topical local anaesthetic with intranasal cocaine is an alternative method. ⋯ However, patients in group A perceived the procedure as significantly more painful than the patients of groups B and C. Despite the increased procedure time, we recommend topical anaesthesia as the method of choice to reduce simple nasal fractures in the outpatient department. It offers a similar outcome, whilst being significantly less painful than external infiltration.
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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.