American journal of otolaryngology
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From November 2008 to October 2010, 565 military personnel sustained blast injury in Southernmost Thailand and 99 personnel, affected by multiple injuries, were transferred to Phramongkutklao Hospital. No data on the effect of blast injury to the ears among Thai military personnel have been reported. This study aims 1) to determine the prevalence of Sensorineural Hearing Loss (SNHL) and otologic manifestations from primary blast injury among military personnel, in Pattani, Yala and Narathiwat Provinces, and 2) to evaluate the impact of explosive devices and distance from explosion on SNHL under various conditions. ⋯ Correlation among all three incident areas and two factors: impact of explosive devices and distance from explosion are risk factors of SNHL without significance.
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Unintentional mechanical manipulation anywhere in the distribution of the trigeminal nerve might activate a reflexive bradycardia. Neurosurgeons need to bear in mind detrimental consequences on cardiac function. A female patient (53 years) underwent a computer-assisted (CAS), paranasal sinus operation performed under general anesthesia. ⋯ During neurosurgical procedures, the incidence of the reflex varies between 10 and 18%. To the best of our knowledge, we report for the first time on a direct stimulation of the ethmoidal nerve with instruments (CAS probe) during paranasal surgery. Although normally cardioprotective, exaggeration of the diving reflex can be detrimental and has been implicated in cardiorespiratory disorders, including sudden death and the sudden infant death syndrome.
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We report a case of near-complete remodeling of the anterior table of the frontal sinus after treatment for an erosive Pott's Puffy Tumor. A 61-year-old male presented with progressive swelling of his left forehead. ⋯ Frontal trephination with marsupialization of the mucocele was performed, and at 8 month follow-up, the patient had no visible defect and only minimally palpable bony defect. The anterior table had remodeled with no additional intervention resulting in a cosmetic outcome imperceptible from the patient's baseline.
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The use of radiation therapy has largely widespread and becomes in many centers the preference modality of treatment for symptomatic patients who are old, medically unfit for surgical therapy, those who refuse surgery and in some recurrent or residual growing tumors. The risk of radiotherapy failure in the treatment of vestibular schwannoma might be underestimated in the literature. The purpose of this study is to show the Gruppo Otologico experience with salvage surgery to better understand the surgical outcomes and difficulties in treating vestibular schwannoma after failed radiotherapy. ⋯ Complete surgical resection of VS is more difficult after radiotherapy with relatively poor facial nerve outcomes and nearly impossible hearing preservation. Patients who receive radiation therapy for the treatment of vestibular schwannoma should be made aware of its potential complications and risk of failure, especially in young patients and NF2 cases.
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Pneumomediastinum and subcutaneous emphysema are rare presentations of an airway foreign body. Only a handful of other cases have been reported in the English literature. We present a case of a 2 year old female who presented with wheezing and a dry cough. ⋯ A chest tube was placed, and the patient was successfully extubated the following day. When faced with a pediatric patient presenting with subcutaneous emphysema or pneumomediastinum of unknown origin, the pediatrician and otolaryngologist should consider the possibility of an airway foreign body. Management involves emergent airway evaluation in the operating room, removal of the foreign body, placement of a chest tube if pneumomediastinum is present, and supportive care with reflux medications and intravenous steroids.