The Laryngoscope
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Case Reports
Autoimmune thrombocytopenic purpura-like syndrome in a patient with head and neck cancer.
We report a case of presumed autoimmune thrombocytopenic purpura in a patient with squamous cell carcinoma of the neck. A review of the literature on the association of autoimmune thrombocytopenic purpura and solid tumors is presented. Autoimmune-like thrombocytopenia should be considered when patients with head and neck carcinoma present with an acute hemorrhage diathesis.
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A rare case of bilateral vocal cord paralysis after orotracheal intubation and inhalation anesthesia, in surgery not in relation to the neck, is presented. There was no obvious cause for the paralysis and possible etiological factors are discussed. Overextension of the neck during intubation is suspected of being the etiological agent causing stretching of both the vagus nerves. Normal laryngeal function returned after two months.
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Biography Historical Article
Pulmonary complications of tonsillectomy as originally described by Samuel J. Crowe, M.D.
The incidence of pulmonary complications of tonsillectomy is very low today in comparison to the early part of the 20th Century. Much of the credit belongs to Samuel Crowe and his colleagues who demonstrated that pulmonary complications could be prevented by the use of improved instrumentation and techniques which were based upon sound scientific principles. ⋯ Those that are available show incidence figures similar to those of Dr. Crowe.
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Continuing medical education is rapidly growing. During the four-year period between 1974-75 and 1978-79, the number of continuing medical education courses in otolaryngology increased 136%. ⋯ Although voluntary continuing medical education has proved to be satisfactory in maintaining a physician's competency in the past, the present trend is toward mandatory continuing medical education in order to ensure better health care for the public. Methods of obtaining continuing medical education are discussed and suggestions made as to how these could be improved.
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Intractable hiccups (singultus) is an uncommon disorder with various etiologies. The majority of reported studies of intractable hiccups has claimed ipsilateral spasm of the hemidiaphragm based solely on clinical or radiographic evidence. A case of intractable hiccups is presented. ⋯ Relief lasting for three to four week periods has been obtained by the intravenous administration of a specially prepared sterile solution of methylphenidate. The nerve pathways pertinent to hiccup are discussed. The etiology of intractable hiccups and the various treatment modalities are presented.