ABSTRACT
This study reports on patients with severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) presenting with sudden sensorineural hearing loss (SSNHL) during the coronavirus disease 2019 (COVID-19) pandemic. The study included four adult patients who presented with the complaint of unilateral SSNHL after testing positive for SARS-CoV-2 by RT-PCR from January to April 2022. Of the four patients, only one young adult recovered his hearing following a combination of oral and intratympanic steroid therapy. It is a challenge to confirm evidence of association between COVID-19 and SSNHL. Nevertheless, the early screening and diagnosis for SSNHL following COVID-19 enables prompt treatment with steroids, which offers the best chance of hearing recovery.
ABSTRACT
Caudal septal deviation is an important cause of nasal obstruction and is a major cause of nasal septal surgery. Although reinforcing and straightening the deviated nasal septum with bone fragment or cartilage is known to be quite effective, such procedure is complicated and time-consuming as it consists of three steps; ‘separation,’ ‘correction,’ and ‘reposition and fixation.’ In this article, we introduce a new technique that can reliably position the caudal septum along the midline and simplify the surgical process into two steps: ‘separation’ and ‘correction and fixation.’
ABSTRACT
BACKGROUND: The effects of a muscle relaxant may differ in elderly compared with young adult patients for a variety of the pharmacokinetic and pharmacodynamic reasons. Atracurium is eliminated by nonorgan dependent pathway, Hofmann elimination and ester hydrolysis. So there are some arguments for age-related differences. The purpose of this study was to compare the differences of the onset and duration of atracurium in young and elderly. METHODS: Eighteen young adults (21-54 yr) and 18 elderly (>65 yr) patients anesthetized with nitrous oxide and enflurane. Atracurium (0.5 mg/kg) was given and then intubation was performed after T1 response was blocked more than 80%. Neuromuscular relaxation was measured by the first twitch of train-of-four (T1) response at the adductor pollicis after supramaximal stimulation of ulnar nerve at 2Hz every 12 sec. The onset (disappearance of T1) and duration of 5, 25, 50, 75% recovery time of T1 and recovery index (time for 25-75% recovery of T1) were recorded. RESULTS: Onset of block was not significantly different between the young and elderly. Recovery time of 5, 25, 50, 75% and recovery index were not prolonged in elderly compared with young adults. CONCLUSIONS: There were no significant differences between young and elderly adults in onest time, recovery time of 5, 25, 50, 75% and recovery index when atracurium is used in a single bolus dose. The results suggest that atracurium in elderly patients has similar onset and action duration compared with younger patients.