RESUMO
The one-day surgery is not a new concept, but has become more frequent during the last years. Medical, psychosocial and especially economical reasons are the basis of this evolution. These different reasons having been analyzed, this evolution is illustrated by a personal experience and statistical data of the last ten years. Advantages and possible complications of the ambulatory surgery in our specialty are then discussed.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Otorrinolaringopatias/cirurgia , Adolescente , Adulto , Procedimentos Cirúrgicos Ambulatórios/economia , Bélgica , Criança , Controle de Custos , Humanos , Procedimentos Cirúrgicos Menores , Centros Cirúrgicos/organização & administraçãoRESUMO
A case of laryngeal stridor in an adult patient is presented and the diagnose of syndrome of Shy-Drager is proposed. This syndrome is the result of a degeneration of the central nervous system. Some autonomic functions are involved in this process. The leading symptoms are an orthostatic hypotension, parkinson-like symptoms and laryngeal stridor. The last symptom results from a neurogenic paralysis of both posterior crico-arytenoideus muscles. A depletion of neurotransmitters in the central nervous system would be the cause of the syndrome. The treatment is symptomatic. Concerning the laryngeal stridor, tracheotomy, eventually followed by a crico-arytenoidopexy, is the only treatment which can be proposed.
Assuntos
Obstrução das Vias Respiratórias/etiologia , Sons Respiratórios , Síndrome de Shy-Drager/complicações , Paralisia das Pregas Vocais/etiologia , Idoso , Feminino , Humanos , Nervo Laríngeo RecorrenteRESUMO
The clinical electrocochleography essentially allows the registration of the global action potential of the acoustic nerve. The use of acoustic stimulations with alternating polarity eliminates the cochlear microphonics. In severe deafness, where no action potential can be registered, even not with maximal acoustic impulses, it can be interesting to register the microphonic potentials. This can be done by using acoustic stimulations with the same polarity. If some microphonic potentials can be registered by this technique, one can assume that the ciliated cells are -- at least partially -- unaffected and that the cause of the deafmess in neurogenic. This test thus allows a primary differentiation between sensory and neural deafness. Some clinical cases illustrate this phenomenon.
Assuntos
Potenciais de Ação , Cóclea/fisiopatologia , Surdez/diagnóstico , Nervo Vestibulococlear/fisiopatologia , HumanosRESUMO
Thirty Ménière patients were treated with betahistine hydrochlorid for an average period of 17 months. The majority of them had been resistent to every previous treatment. The results of this new treatment were very gratifying with respect to the attacks of vertigo and the accompanying neuro-vegetative symptoms. The tinnitus aurium proved to be resistent, whereas the auditory acuity was significantly improved in 7 patients. Early treatment with this product at the first signs of Ménière's disease is very likely to hold up the progressive degradation of auditory acuity, during the further spontaneous evolution of the disease.
Assuntos
beta-Histina/uso terapêutico , Doença de Meniere/tratamento farmacológico , Piridinas/uso terapêutico , Avaliação de Medicamentos , Transtornos da Audição/tratamento farmacológico , Humanos , Zumbido/tratamento farmacológicoRESUMO
A case of synechia laryngis of the vocal cords is presented. Etiology and treatment of this pathological condition are reviewed. For the present case the synechia seems to have been caused by an acute recurring laryngitis. A teflon oval sectionned tube is placed in the anterior commissure and anchored through the prelaryngeal skin, until epithelisation has occurred. This method is compared with other similar techniques.