The Laryngoscope
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Comparative Study
Anatomical and computed tomographic analysis of the transcochlear and endoscopic transclival approaches to the petroclival region.
Advances in the field of skull base surgery aim to maximize anatomical exposure while minimizing patient morbidity. The petroclival region of the skull base presents numerous challenges for surgical access due to the complex anatomy. The transcochlear approach to the region provides adequate access; however, the resection involved sacrifices hearing and results in at least a grade 3 facial palsy. An endoscopic endonasal approach could potentially avoid negative patient outcomes while providing a desirable surgical window in a select patient population. ⋯ Endoscopic access to the petroclival region is a feasible approach. It potentially avoids hearing loss, facial nerve manipulation, and cosmetic damage.
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Free tissue transfer has success rates greater than 95%. Approximately 10% will require reexploration for vascular compromise. Return to the operating room within 48 hours yields the highest rate of successful salvage. Our aim was to determine whether an implantable Doppler used for intraoperative/postoperative monitoring would 1) alter the pattern of detecting flap failure and 2) alter the overall incidence of flap survival. ⋯ Intraoperative Doppler's increase the detection of immediate/incipient vascular problems. Patients requiring revision in the operating room require revision more often in the postoperative period (P = .03) and are less likely to have successful salvage and a lower flap survival rate (P = .05).
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Our objectives were to study effects of orally administered resveratrol (RV) against cisplatin (CDDP) ototoxicity in different doses and to investigate ultrastructural changes in the cochlea and brainstem. ⋯ Our results implied that there were noticeable differences between different oral RV doses used for cisplatin ototoxicity. Especially in higher doses, RV was observed to enhance cisplatin ototoxicity.