The Journal of otolaryngology
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Osteomas are the most commonly encountered neoplasms of the frontal sinus. Extension of these lesions through the posterior table can result in life-threatening complications. We present the case of a 70-year-old man with yellow nail syndrome who complained of persistent rhinorrhea and the sensation of "sloshing" when moving his head. ⋯ The resulting dural defect was resurfaced using a flap of pericranium to facilitate anterior cranialization. The features of this interesting case are discussed as an illustration of the potential complications of frontal sinus osteomas. The literature is reviewed regarding management of these lesions and their complications.
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Comparative Study
Ototoxicity of carboplatin: comparing animal and clinical models at the Hospital for Sick Children.
Carboplatin was introduced to the paediatric population as an alternative chemotherapeutic agent in the management of various malignant neoplasms, including sarcomas of the head and neck, in the hope that it would have fewer side effects than pre-existing agents. While many investigators have considered the ototoxicity of this drug only incidentally, others have presumed it to be of negligible importance. ⋯ This complication occurred as early as after the first dose and was generally progressively worse with subsequent doses. Consequently, we recommend careful audiologic monitoring of children receiving this agent.
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This is a case-control study of over 500 cases of tonsillectomy and adenotonsillectomy performed at the Montreal Children's Hospital over a 10-month period. Demographics of patient population and selection criteria for out-patient procedure are presented. The hot (cautery) and cold (knife) dissection techniques are compared. ⋯ The recognition of aerodigestive tract complications necessitating re-admission or emergency room management cannot be over emphasized. Recent history of upper airway infection (UAI) was noted to be associated with postoperative aerodigestive tract complications. The triad of UAI, knife dissection technique and increased intraoperative bleeding was found to be associated clinically and statistically with primary postoperative hemorrhage.
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Morbidly obese patients who manifest upper airway obstruction or pulmonary insufficiency may require tracheostomy to ensure patency or provide ventilatory support, respectively. In this patient population the girth of the neck region may preclude use of currently available manufactured standardized tracheostomy tubes. Reported herein is the fabrication of a tracheal cannula with bisociation of an uncuffed endotracheal tube and the "swivel neck plate" of a tracheostomy tube, to provide a secure and comfortable single lumen tracheal prosthesis to accommodate such a patient's unique anatomy. The technique is applicable to other clinical scenarios if standard marketed tracheostomy tubes do not suffice.
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Acquired (secondary) cholesteatomas of the middle ear and mastoid are usually a complication of chronic otomastoiditis and are often accompanied by infection from the outset, and their contents show evidence of some inflammatory reaction. Congenital (primary) cholesteatomas of the temporal bone are due to epithelial rest of embryonal origin. There are many sites of occurrence of congenital cholesteatomas (epidermoids) within the temporal bone: (1) middle ear, (2) mastoid, (3) middle ear and mastoid, (4) petrous bone, (5) the squama, and (6) within the tympanic membrane. ⋯ In this paper, we stress the role of magnetic resonance imaging (MRI) and computed tomography (CT) in the evaluation of acquired and congenital cholesteatomas of the temporal bone. It is our opinion that CT remains the study of choice for cholesteatomas of the middle ear cleft. MRI is superior to CT for the evaluations of infected cholesteatomas, petrous apex, and CPA cholesteatomas, as well as for the majority evaluation of cholesteatomatous involvement of the facial nerve, membranous labyrinth, and intracranial structures.