The Journal of otolaryngology
-
Acute epiglottitis in adults is usually treated by close observation or tracheostomy. In the last decade, this therapeutic attitude has been challenged by the impressive results obtained by nasotracheal intubation in the treatment of pediatric cases. ⋯ Three conditions have to be met before safe nasotracheal intubation can be considered: interested anesthesiological service, supportive otolaryngological assistance, and dependable nursing care. The case of a young woman treated by close observation proceeding to nasotracheal intubation, as the sole way to secure the airway is presented.
-
The temporal bones from a two year old drowning victim are compared with those of a 13 month old strangulation victim. Tympanomastoid hemorrhage and submucosal edema and petechiae with moderate vascular congestion were characteristic in drowning. Marked congestion with edema but no sign of hemorrhage was found in strangulation. It is concluded that respiratory effort against a closed glottis is not solely responsible for the tympanomastoid hemorrhage known to occur frequently as a result of drowning.
-
Hemangiomas are the most common benign tumor of childhood occurring in the head and neck. The vast majority of these lesions are noted in the neonatal period and are a frequent cause for parental concern. ⋯ A review of the literature is presented with anatomic descriptions, classification, and discussion of treatment modalities. Special emphasis is placed on the diagnosis and treatment of the often life-threatening subglottic hemangioma.
-
Head and neck cancer patients who develop incurable recurrent tumors present the surgical team with unique problems dissimilar to patients with cancer of other areas. When the structures of the head and neck are violated by tumor, the dying process is slow, lingering, and painful; and the anatomic areas involved tend to be visible, difficult to shield from those in attendance, and of course, are very obvious to the patient. ⋯ Our approach includes the palliative use of surgery, radiotherapy, and chemotherapy, and the participation of members of a palliative team by which therapeutic decisions and timing can be individualized for each patient. This system of palliation offers significant advantages to the patient and to the surgeon, and is a new concept applicable to head and neck cancer patients for whom previously little could be offered.