HNO
-
Several screening methods for the prediction of a difficult endotracheal intubation such as the test by Patil or the Mallampati-Score have been described. The incidence of difficult microlaryngoscopic procedures and the prognostic value of those screening tests for their prediction has not been investigated. ⋯ Therefore an impossible indirect laryngoscopy can be regarded as a warning sign for a difficult microlaryngoscopic procedure. Summation-scores like the Arné Multivariate Risk Index or the use of check lists (Benumof) may improve the predictive value of preoperative screening.
-
The role of sensitive parts of the cervical plexus for the development of neuropathic pain is not yet clear. Our study investigated the correlation between shoulder pain and cervical plexus damage after different types of neck dissection (ND). ⋯ Our investigations showed that the superficial cervical plexus function is assessable by cutaneous sensitivity tests. The minor occipital nerve seemed to be less affected. Fewer pain symptoms in cases with preserved cervical plexus could be demonstrated. We can conclude that preservation of the superficial cervical plexus is important to diminish postoperative shoulder pain.
-
Case Reports Comparative Study
[Pyoderma gangraenosum. Case report and comparison with necrotizing fasciitis].
The differential diagnosis of patients with ulcerative trachelophyma repeatedly causes difficulties. Particularly in view of the possibly fatal outcome, early differentiation between two clinical pictures is very important. Necrotizing fasciitis is often misdiagnosed or the diagnosis is delayed with a mortality rate of approximately 25-40%. ⋯ Pyoderma gangrenosum develops following an initial lesion with pustules and bullae in an ulceration with slight bleeding. Therapy consists of i.v. glucocorticoids (60-200 mg prednisolone/day) administered as early as possible. In complete contrast to the therapy for necrotizing fasciitis, surgical intervention should be strictly avoided in cases of pyoderma gangrenosum.