The Laryngoscope
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Randomized Controlled Trial
Pain treatment and recovery after endoscopic sinus surgery.
Early recovery and pain management after endoscopic sinus surgery (ESS) are largely unexplored regardless of the large number of ESSs performed by otorhinolaryngologists. In the present study, we evaluated whether scheduled administration of acetaminophen (paracetamol) for pain management after ESS would allow faster recovery to normal daily activities compared with acetaminophen administered on an as needed basis. ⋯ The present study suggests that patients recover in 9 to 10 days after ESS when provided with appropriate pain management. Our data indicate that by prescribing scheduled acetaminophen, postoperative pain after ESS can be controlled effectively without the need for opioid analgesics.
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Randomized Controlled Trial
Cold dissection versus coblation-assisted adenotonsillectomy in children.
To compare intraoperative efficiency and postoperative recovery between cold dissection adenotonsillectomy (CDA) and coblation-assisted adenotonsillectomy (CAA). ⋯ CAA offers better operative speed and intraoperative hemostasis as compared with CDA. However, CAA does not result in poorer postoperative pain scores or recoveries despite these intraoperative advantages.
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Randomized Controlled Trial Comparative Study
Using a virtual reality temporal bone simulator to assess otolaryngology trainees.
The objective of this study is to determine the feasibility of computerized evaluation of resident performance using hand motion analysis on a virtual reality temporal bone (VR TB) simulator. We hypothesized that both computerized analysis and expert ratings would discriminate the performance of novices from experienced trainees. We also hypothesized that performance on the virtual reality temporal bone simulator (VR TB) would differentiate based on previous drilling experience. ⋯ Performance, as measured by hand motion analysis on the VR TB simulator, reflects trainees' previous drilling experience. This study suggests that otolaryngology trainees could accomplish initial temporal bone training on a VR TB simulator, which can provide feedback to the trainee, and may reduce the need for constant faculty supervision and evaluation.
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Randomized Controlled Trial Multicenter Study
Reactivation of herpes simplex virus type 1 and varicella-zoster virus and therapeutic effects of combination therapy with prednisolone and valacyclovir in patients with Bell's palsy.
To determine whether reactivation of herpes simplex virus (HSV) type 1 or varicella-zoster virus (VZV) is the main cause of Bell's palsy and whether antiviral drugs bring about recovery from Bell's palsy. ⋯ Reactivation of HSV-1 or VZV was observed in 34% of the patients with Bell's palsy. The effect of combination therapy with prednisolone and valacyclovir on recovery was not significantly higher than that with prednisolone alone.
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Randomized Controlled Trial
Effectiveness of amitriptyline versus cough suppressants in the treatment of chronic cough resulting from postviral vagal neuropathy.
The objective of this prospective, randomized, controlled study (N = 28) was to evaluate the effectiveness of amitriptyline versus cough suppressants in the treatment of chronic cough resulting from postviral vagal neuropathy. ⋯ Chronic cough can have a profound impact on the psychosocial function of patients. The most common causes of a persisting cough in the absence of infection or chronic smoking are laryngopharyngeal reflux, asthma, particularly the cough variant, allergy, rhinosinusitis, bronchitis, and medications, in particular angiotensin-converting enzyme inhibitors. Currently, there are few effective treatments for cough with an acceptable therapeutic ratio and more selective drugs with a more favorable side effect profile are needed. This is this first prospective, randomized, controlled study comparing the effectiveness of amitriptyline versus codeine/guaifenesin for select cases of chronic cough resulting from suspected postviral vagal neuropathy.