The Journal of craniofacial surgery
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The aim of this prospective study was to evaluate and compare the epidemiology and pattern of maxillofacial injuries caused by stumbling and other kinds of falls. We evaluated all patients with facial injuries due to stumbling or falls who presented to Besat Hospital in Hamedan, Iran, during the 2.5-year study period and analyzed the acquired data. Of 2990 patients with facial injuries who were referred to Besat Hospital during the study period, 733 (24.5%) were injured by stumbling, and 246 (8.2%) were injured by falls. ⋯ The rate of associated injuries in falls was higher than stumbling accidents. We concluded that the incidence, age distribution, rate, and pattern of bone fractures and the frequency and type of associated injuries in stumbling accidents were significantly different from that of fall accidents. For a good program planning to prevent and manage facial injuries, we recommend separate evaluation of stumbling and fall accidents.
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Case Reports
Life-threatening complication of recurrent laryngeal nerve monitoring with EMG reinforced silicone ETT.
We present 2 cases with complication of herniation of a specially designed endotracheal tube (ETT) cuff used for laryngeal nerve monitoring during thyroid surgery. Abrupt and total blockage of ventilation has occurred at 35th and 40th minutes of general anesthesia. ⋯ In patients intubated with electromyographic reinforced ETT, any event suggesting sudden ventilation blockage should be managed initially by prompt deflation of the cuff. The cuff should be inflated at the minimal necessary volume, and operating room staff should pay maximum attention to the stability of endotracheal and breathing tubes.
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Chordoma is an uncommon tumor of bone that is believed to develop from remnants of the notochord. The chondroid variant of chordomas contains elements possessing both chordoma and cartilaginous tissues. ⋯ Here, we describe a patient with chondroid chordoma with skull base involvement who underwent an expanded endonasal endoscopic approach for complete resection. In conclusion, endonasal endoscopic approach should be kept in mind for the resection of carefully selected chondroid chordomas with skull base involvement because of its minimally invasive characteristics.
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Randomized Controlled Trial
Effect of rectal diclofenac and acetaminophen alone and in combination on postoperative pain after cleft palate repair in children.
Acetaminophen and diclofenac are prescribed as postoperative analgesic agents in children. However, the efficacy of their combination is not studied sufficiently. We compare the analgesic effects of acetaminophen, diclofenac, and their combination after cleft palate surgery. ⋯ Adverse effects were comparable among groups. Rectal acetaminophen plus diclofenac was found to be the most effective in pain control. However, both rectal acetaminophen and diclofenac were more effective than placebo, whereas diclofenac was more effective than acetaminophen.