Evolution of endoscopic skull base surgery, current concepts, and future perspectives.

Endoscopic techniques have influenced almost all of the surgical specialties. From open procedures to minimally invasive approaches, the endoscope and its ability to reach areas within the human body has gained popularity among specialists, creating a revolution in some fields. Two of the fields in which endoscopes provided a true revolution are otolaryngology and neurosurgery. The authors discuss some important factors for the evolution of endoscopic skull base surgery and expanded endonasal approaches, highlighting historical landmarks but also addressing the current concepts, complications, and the future of this promising field for clinical research and surgical techniques and technology.

Láser en otorrinolaringología: [revisión] / Laser in otorhinolaryngology: [review]

Esta revisión bibliográfica analiza los diferentes tipos de láser usados en otorrinolaringología, destacando las propiedades de cada uno. Posteriormente describe las características de una sesión con anestesia y uso de láser y las patologías con indicaciones de cirugía láser. Estas se clasifican en cinco rubros. Patología laringotraqueal, patología faringobucal, patología sinusal, otología y dermatología cérvico facial. En la primera se analizan: lesiones fonoquirúrgico, papilomatosis laríngea, parálisis laríngeas, laringomalacia, angioma subglótico, estenosis y displasia laríngea, cáncer laríngeo. En patología faríngea y bucal se analiza su uso en atresia coanal, amígdalas palatinas linguales, roncopatías, divertículo de Zenker. En fosas nasales se describen los usos en cirugía endoscópica (FEELS). En patología otológica se analiza su uso en CAE y oído medio, para concluir con las lesiones cervicofaciales.

The effects of endoscopic sinus surgery on the nasal cycle as assessed by acoustic rhinometry.

Previous studies have demonstrated that acoustic rhinometry (AR) has a considerable utility in measuring nasal patency and in detecting the nasal cycle. This study was performed in 10 patients with chronic rhinosinusitis who were submitted to endoscopic sinus surgery. AR was used to determine minimum nasal cross-sectional area and volume as the indices of the nasal patency in all patients on the day before the surgery and 3 months postoperatively. We did not find any significant alteration when comparing the pattern of fluctuation, the periodicity, and the amplitude of the nasal cycle demonstrated by patients in the pre and postoperative periods, confirming that this surgery does not have any adverse effect on this physiologic cycle.

Semiologia otorrinolaringológica / Otorhinolaryngologic semiology

Nesta revisäo dirigida ao graduando em Medicina e ao médico näo especialista, apresentou-se os principais elementos semiológicos das fossas nasais, seios paranasais, laringe, faringe e ouvidos.

An education model for otitis media care field-tested in Latin America.

The World Health Organization has designated the teaching of otitis media management skills a "priority" status. Effective treatment of ear disease requires that the physician be both informationally educated as well as physically trained to use otoscopy. Little is known about how well this education can be provided in a short time and in a foreign country. To more objectively assess teaching effect, results of an education session for rural Mexican pediatric primary-care providers who were given an intensive otitis media lecture and otoscopy skills workshop in 1990 were evaluated. To test immediate cognitive impact, an anonymous written examination was given both before and after the teaching session. Average test scores after the educational sessions improved 24% (p < 0.001) over baseline scores before the sessions. To evaluate long-term impact on clinical practice, a follow-up telephone survey 2 years later was conducted. The use of an otoscope to diagnose otitis media had increased from 40% to 93% of respondents. We conclude that pediatric primary-care providers in rural Mexico possess a baseline level of knowledge about otitis media that can be significantly enhanced with one educational session. Further, this teaching effort produces an impact on practice pattern that lasts at least 2 years.

Infant botulism: considerations for airway management.

Infant botulism is a national problem with over 1000 confirmed cases in the United States since it was first recognized as a distinct clinical entity in 1976. The disease is characterized by a progressive, symmetrical descending paralysis of cranial nerves with eventual involvement of axial and trunk muscle innervation. Most infants progress to complete respiratory failure. An initial report in 1979 recommended early tracheotomy for avoidance of long-term intubation complications. However, over the past 10 years at St. Christopher's Hospital for Children, analysis of airway management in 11 patients with infant botulism revealed a median intubation time of 16 days. Following extubation, all patients progressed to complete respiratory recovery without adverse laryngotracheal sequelae. Otolaryngologists consulted for the airway management of infants with botulism should adopt a conservative approach with meticulous monitoring of endotracheal tube sizes and leak pressures. Tracheotomy is rarely required.

Cryomedicine: Argentina 1992

El uso del frio, fundamentalmente sobre la base de nitrógeno líquido y los instrumentos de aplicación en cirugía (en especial oncológica, O.R.L., dermatología, urología, proctología, ginecología) y otras áreas de la Medicina, son aquí considerados a lo largo de numerosos artículos breves. Contiene:criobiología y criopreservación, cirugía y criocirugía; Usos dermatológicos de la criocirugía; cosmiatría y aplicaciones de la criocirugía en las lesiones por papiloma virus

Post-surgical nasal cellulitis outbreak due to Mycobacterium chelonae.

An outbreak of post-rhinoplasty nasal cellulitis due to Mycobacterium chelonae in a secondary care centre is described. A case-control study demonstrated that the use of inadequately sterilized surgical equipment in the Otorhinolaryngology Department was a risk factor. The causal organism was cultured from the equipment, from the surface of the operating theatre lamp, adhesive tape and from two of the hospital's general water tanks. Introduction of effective instrument sterilization methods, monitored with biological controls, the use of new air filters and cleansing and disinfection of hospital water tanks, were sufficient to control the outbreak. The antimicrobial susceptibilities of the causal organism were consistently different from those previously reported in M. chelonae.