Subject(s)
Craniofacial Dysostosis/epidemiology , Hearing Loss, Conductive/epidemiology , Craniofacial Dysostosis/therapy , Embryonic and Fetal Development/physiology , Female , Head Protective Devices , Hearing/physiology , Humans , Infant , Pregnancy , Prenatal Exposure Delayed Effects , Risk Factors , Smoking/adverse effectsABSTRACT
OBJECTIVE/HYPOTHESIS: The combination of intravenous sedation and local infiltration anesthesia is routinely utilized in otologic surgery. Advantages over general anesthesia with endotracheal intubation include ease and speed of induction and emergence, safety, and decreased postoperative discomfort. Anatomic and physiological patient constraints may preclude the use of intravenous sedation and anesthetists inexperienced in this technique may find it difficult to achieve a consistent level of anesthesia appropriate for major otologic surgery. Administration of anesthesia using the laryngeal mask airway (LMA) has been proposed to offer many of the advantages of intravenous sedation with less risk of oversedation and obstructive apnea. STUDY DESIGN: A retrospective chart review. METHODS: A review of 100 consecutive adult and pediatric patients undergoing major otologic procedures in which the LMA was utilized. RESULTS: All laryngeal masks were introduced without a laryngoscope and successful placement was accomplished on the first attempt in 98%. Procedures were performed under spontaneous ventilation and in only one instance was surgery temporarily interrupted because of patient movement. No major complications occurred and no patients required endotracheal intubation. Only three patients complained of mild throat discomfort in the immediate postoperative period. CONCLUSIONS: The laryngeal mask airway is a safe and effective means of providing anesthesia during major otologic surgery.
Subject(s)
Laryngeal Masks , Otologic Surgical Procedures , Adolescent , Adult , Aged , Aged, 80 and over , Anesthesia, Inhalation , Child , Child, Preschool , Humans , Middle Aged , Retrospective StudiesABSTRACT
The application of a rapidly vascularized epithelial equivalent that inhibits wound contraction would have great potential in the prevention and repair of tracheal stenosis. An animal model was developed to simulate the effects of circumferential tracheal injury and an autologous epithelial equivalent was created from a fibroblast-collagen matrix and subsequently implanted in the traumatized site in an attempt to prevent stenosis. Postinjury physiologic and histologic evaluation revealed near-normal mucosal flow analysis in the treated sites and an area of less than 20% stenosis versus 95+% in controls. This study's findings indicate that tracheal stenosis can be limited by the use of an epithelial equivalent.
