Ear, nose, & throat journal
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Randomized Controlled Trial Comparative Study
Vibration Versus Ice to Reduce Cosmetic Botulinum Toxin Injection Pain-A Randomized Controlled Trial.
Botulinum toxin is the most commonly performed facial cosmetic procedure and pain at the injection site is a frequent patient concern. While various topical interventions have been described for analgesia, there have not been any studies comparing different techniques. We compared the use of a vibratory stimulus, ice pack application, and no intervention on injection site pain for cosmetic botulinum toxin injection. ⋯ Further, pain scale scores did not differ significantly between medial and lateral injections nor did patients have a reduction in pain on either side of the forehead regardless of which method was used. While there may be a role for topical interventions to improve injection site analgesia, we maintain that consistently proper technique plays a greater role in improving patient tolerance. Future studies will continue to investigate the role of topical anesthesia in cosmetic facial injections and address patient-specific factors contributing to discomfort.
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Randomized Controlled Trial Comparative Study
Comparative study of intranasal septal splints and nasal packs in patients undergoing nasal septal surgery.
We conducted a prospective, comparative, interventional study to evaluate the role of intranasal septal splints and to compare the results of this type of support with those of conventional nasal packing. Our study population was made up of 60 patients, aged 18 to 50 years, who had undergone septoplasty for the treatment of a symptomatic deviation of the nasal septum at our tertiary care referral hospital. These patients were randomly divided into two groups according to the type of nasal support they would receive: 30 patients (25 men and 5 women, mean age: 23.3 yr) received bilateral intranasal septal splints and the other 30 (26 men and 4 women, mean age: 22.4 yr) underwent anterior nasal packing. ⋯ At the 6-week follow-up, only 2 patients (6.7%) in the splint group exhibited a residual deformity, compared with 8 patients (26.7%) in the packing group (p = 0.038). Finally, no patient in the splint group had an intranasal adhesion at follow-up, while 4 (13.3%) in the packing group did (p < 0.05). We conclude that intranasal septal splints result in less postoperative pain without increasing postoperative complications, and thus they can be used as an effective alternative to nasal packing after septoplasty.
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Randomized Controlled Trial
Efficacy of gabapentin on subjective idiopathic tinnitus: a randomized, double-blind, placebo-controlled trial.
Tinnitus can cause extreme morbidity. Despite many attempts to find a treatment for idiopathic cases, they remain difficult to manage. Because nerve injury is one of the suspected etiologies of tinnitus and because gabapentin has been found to be effective in treating nerve injuries, some authors have attempted to determine if gabapentin has a role in treating tinnitus. ⋯ At study's end, we found no significant differences between the gabapentin and control groups in mean decreases in TSI value and loudness score (p=0.85 and p=0.12, respectively). However, we did find that patients with hypertension, diabetes, and/or dyslipidemia showed a better response to gabapentin than did those with tinnitus alone (p=0.01). We conclude that although there was no statistically significant difference between gabapentin and placebo in treating isolated tinnitus or tinnitus overall, patients with concomitant hypertension, diabetes, and/or dyslipidemia may benefit from gabapentin.
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Randomized Controlled Trial Multicenter Study
Effects of chlorhexidine/benzydamine mouth spray on pain and quality of life in acute viral pharyngitis: a prospective, randomized, double-blind, placebo-controlled, multicenter study.
We conducted a prospective, randomized, double-blind, placebo-controlled, multicenter study to assess the efficacy of chlorhexidine gluconate/benzydamine HCl mouth spray for reducing pain and improving quality of life in patients with acute viral pharyngitis. Prior to treatment, patients rated the intensity of their pain on a visual analog scale and evaluated their quality of life on the 36-Item Short-Form Health Survey. Patients were then randomized to receive either paracetamol (acetaminophen) plus chlorhexidine/benzydamine or paracetamol plus placebo for 7 days. ⋯ A comparison of self-evaluations revealed that the active treatment group reported less pain on both day 3 (p < 0.001) and day 7 (p = 0.002). Likewise, the chlorhexidine/benzydamine group reported a significantly better quality of life on day 7 (p < 0.001). Chlorhexidine/benzydamine was well tolerated, and no serious adverse events were observed.
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Randomized Controlled Trial Multicenter Study Comparative Study
Is a head bandage useful after otoplasty? A quasi-randomized controlled study of complications and patient satisfaction.
We conducted a prospective, quasi-randomized, controlled study to evaluate the incidence of postoperative complications and the degree of long-term patient satisfaction associated with the use or nonuse of a head bandage following otoplasty (pinnaplasty). Our study population was made up of 84 consecutively presenting patients who had undergone bilateral otoplasty (either an antihelical or conchaplasty procedure) for the correction of prominent ears under general anesthesia from January 2000 through March 2005. Patients ranged in age from 5 to 56 years (median: 13); 69 patients (82%) were aged 19 years and younger. ⋯ Two independent variables were found to influence long-term patient satisfaction only: the presence/absence of any complication and the individual surgeon who performed the procedure. There was no correlation between individual surgeons and complications. We conclude that the use of a head bandage is not necessary or advantageous following otoplasty for the correction of prominent ears, particularly in patients who have undergone cartilage plication.