Archives of otolaryngology--head & neck surgery
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Arch. Otolaryngol. Head Neck Surg. · Feb 2011
Navigated surgery at the lateral skull base and registration and preoperative imagery: experimental results.
To assess factors that affect the accuracy of navigated surgery at the human lateral skull base, including the choice of registration procedures and preoperative computed tomography (CT) section thickness, and to compare target registration error, a measure of clinical application accuracy, with root mean square, an accuracy variable provided by several surgical navigation systems. ⋯ High-resolution CT images, 0.5 mm, of the petrous bone and a pair-point registration using loci on the patient and registration superstructures worked best under experimental conditions. Only target registration error was found to provide reliable information on accuracy intraoperatively. In line with the literature, these data prove that root mean square bears little relevance for clinical application accuracy.
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Arch. Otolaryngol. Head Neck Surg. · Jan 2011
Comparative StudyAutomated cuff pressure modulation: a novel device to reduce endotracheal tube injury.
To assess whether dynamically modulating endotracheal tube (ETT) cuff pressure, by decreasing it during each ventilatory cycle instead of maintaining a constant level, would reduce the extent of intubation-related laryngotracheal injury. ⋯ This novel device reduces the risk of subglottic and tracheal injury by modulating ETT cuff pressure in synchronization with the ventilatory cycle. This finding could have far-reaching implications for reducing the risk of airway injury in patients undergoing long-term intubation. Further clinical study of this device is warranted.
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Arch. Otolaryngol. Head Neck Surg. · Jan 2011
Randomized Controlled Trial Comparative StudyUse of laryngeal mask airway in pediatric adenotonsillectomy.
To compare the use of flexible laryngeal mask airway (LMA) and endotracheal tube (ETT) in pediatric adenotonsillectomy. ⋯ An LMA is an efficient alternative to ETT in pediatric adenotonsillectomy. When comparing LMA and ETT, there is no difference in rates of laryngospasm. Time to extubation is significantly shorter in patients using LMA. Before adopting the routine use of LMA in pediatric adenotonsillectomy, further study is needed to address visualization and kinking issues associated with this device.
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Arch. Otolaryngol. Head Neck Surg. · Nov 2010
Transoral robotic surgery for advanced oropharyngeal carcinoma.
To determine the oncologic and functional outcomes in patients undergoing primary transoral robotic surgery followed by adjuvant therapy as indicated with a minimum of 18-month follow-up for advanced oropharyngeal carcinoma. ⋯ This novel transoral robotic surgery treatment regimen offers disease control, survival, and safety commensurate with standard treatments and an unexpected beneficial outcome of gastrostomy dependency rates that are markedly lower than those reported with standard nonsurgical therapies.