ABSTRACT
Advances in technology and otomicrosurgery have dramatically changed the management of temporal bone fractures. Based upon our experiences and a review of the literature, the following recommendations are made: The complete temporal bone surgeon should have access to a late-generation CT scanner and have a good working relationship with a neuroradiologist. The surgeon should be capable of repairing the facial nerve within the internal acoustic meatus, by both middle fossa and translabyrinthine approaches. It is advantageous to follow the progress of cochlear implantation. One should be knowledgeable about the electrophysiologic diagnosis of facial paralysis and know when to be conservative in facial palsy secondary to head trauma.
Subject(s)
Skull Fractures/surgery , Temporal Bone/injuries , Adolescent , Adult , Cerebrospinal Fluid Otorrhea/etiology , Cerebrospinal Fluid Rhinorrhea/etiology , Child , Deafness/etiology , Facial Paralysis/etiology , Female , Humans , Male , Middle Aged , Skull Fractures/classification , Skull Fractures/complications , Temporal Bone/surgery , Vertigo/etiologyABSTRACT
Two prostheses for voice rehabilitation after laryngectomy were compared. A comparison was also made to evaluate the interchangeability of the two prostheses (Panje button and Blom-Singer duckbill) when only a single tracheoesophageal fistula was made. Fourteen laryngectomized patients were included in the study. Factors taken into account were voice quality, intelligibility, surgical technique, ease of insertion of the prostheses, patient preference, and care of each device. It was concluded that the Panje button in a Blom-Singer fistula offered better results when voice quality was compared. Patient selectivity is a factor important to the high success rate reported for voice restoration when either prosthesis is used. The development and success of these new prostheses is highlighted in a brief review of the literature.