RESUMO
BACKGROUND AND OBJECTIVES: The traditional adenoidectomy using adenotome and adenoid curette could not guarantee a clear operative field due to bleeding. Also the traditional transoral adenoidectomy was not always effective in the complete removal of adenoid tissues obstructing the choana and surrounding the eustachian tube. This study was performed to evaluate the effectiveness of using the electric suction coagulator for adenoidectomy. MATERIALS AND METHOD: This study was completed by 60 patients who underwent adenoidectomy or adenoidectomy with ventilation tube insertion. For adenoidectomy, 30 cases were performed using the variable sized suction coagulator via nasal cavity and the other 30 were performed using the adenotome and adenoid curette with oral approach. The amount of intraoperative bleeding and the duration of surgery were recorded. A preoperative and a at least one-month post operative nasal endoscopic photograph and lateral skull radiograph were obtained. RESULTS: Intraoperative bleeding amount was less and less time was needed in suction coagulator method (p<0.05). There was no statistical difference in the postoperative endoscopic grade, adenoid nasopharyngeal ratio, and the shortest nasopharyngeal diameter between two groups. The postoperative improvement of subjective symptoms was not different. CONCLUSION: Adenoidectomy using transnasal suction coagulator is an effective method for complete removal of adenoid with the advantages of excellent visualization and complete hemostasis. Especially, the authors think that this method is useful for the removal of superior part of adenoid and peritubal adenoid tissue.
Assuntos
Humanos , Adenoidectomia , Tonsila Faríngea , Eletrocoagulação , Tuba Auditiva , Hemorragia , Hemostasia , Cavidade Nasal , Crânio , Sucção , VentilaçãoRESUMO
BACKGROUND AND OBJECTIVES: The etiology of Idiopathic sudden sensorineural hearing loss (ISSHL) is uncertain, but viral infection and disturbance of blood circulation in the inner ear are suspected as the causes of the disease, and a stellate ganglion block (SGB) and antiviral agent (Acyclovir) have been used in its treatment. The purpose of this study was to find out the effect of SGB and antiviral agent in the treatment of ISSHL and to find out appropriate patients to evaluate the therapeutic effect. MATERIALS AND METHODS: We reviewed the records of 193 patients (202 ears) who were admitted to the Presbyterian Medical Center from January 1994 to August 2000. Fifty-eight ears were treated with acyclovir and sixty nine ears were treated with SGB and seventy five ears were treated as a control group. RESULTS: The therapeutic result of SGB was better than that of control group and acyclovir had more effect on the subgroups when the initial hearing loss was 41dB~70dB. In the patients with initial hearing level worse than 71dB, the recovery rates were constant regardless of the group. And the patients who were treated after 8 days from the onset had analogic recovery rate to each remedy. CONCLUSION: The patients with the initial hearing level of worse than 71dB and who visited the clinic within 7days of the onset were found to be appropriate candidates for the evaluation of therapeutic effects of ISSHL and SGB. SGB was recommended for the treatment of ISSHL and antiviral agents for patients between the hearing levels of 410dB-70dB.
Assuntos
Humanos , Aciclovir , Antivirais , Circulação Sanguínea , Orelha , Orelha Interna , Audição , Perda Auditiva , Perda Auditiva Neurossensorial , Protestantismo , Gânglio EstreladoRESUMO
BACKGROUND AND OBJECTIVES: Vestibular compensation is a process of behavioral recovery following unilateral labyrinthectomy (ULX). The neural plasticity in vestibular compensation was assessed by observing changes of behavioral response and c-Fos expression following contralateral labyrinthectomy (second labyrinthectomy) in ULX rats. MATERIAL AND METHODS: Contrala-teral labyrinthectomy was performed 2 weeks after ULX in Sprague-Dawley rats, each weighing 250-300 gm. Changes of spontaneous nystagmus, head tilt, and c-Fos expression in the medial vestibular nucleus (MVN) and nucleus prepositus hypoglossi (PrH) were measured. RESULT: In ULX, spontaneous nystagmus with the slow phase directed to the lesion side was 3.5+/-0.5 beats/sec and head tilt deviated to the lesion side was 71+/-16 degrees just after ULX. Spontaneous nystagmus disappeared within 72 hours, but head tilt was maintained at 28+/-8 degrees until 2 weeks after ULX. The number of c-Fos proteins 2 hours after ULX was 81+/-25 and 212+/-63 in MVN of the lesion side and the intact side, respectively. And PrH showed 136+/-37 in the lesion side and 94+/-19 in the intact side, which was opposite of MVN in spatial expression of c-Fos. In second labyrinthectomy, direction of spontaneous nystagmus and head tilt was opposite to the first ULX and their decrement was faster. c-Fos was expressed more in the MVN of the first labyrinthectomized side than in the second one and PrH showed the opposite pattern to MVN, which was opposite to the first ULX in spatial expression. CONCLUSION: These results suggest that recovery of vestibuloocular reflex in vestibular compensation is accomplished by restoration of neuronal activity in the central nervous system including MVN and PrH.
Assuntos
Animais , Ratos , Sistema Nervoso Central , Compensação e Reparação , Cabeça , Neurônios , Plásticos , Proteínas Proto-Oncogênicas c-fos , Ratos Sprague-Dawley , Reflexo Vestíbulo-Ocular , Núcleos VestibularesRESUMO
No abstract available.
RESUMO
No abstract available.