ABSTRACT
Drill-generated noise during chronic ear surgery, as well as surgical trauma, has been incriminated as a cause of sensorineural hearing loss in the operated ear. The contralateral ear is subjected to the drill noise but is spared the surgical trauma. Sixty-two patients who had undergone different mastoid operations served as the basis for this study. The average drilling time during surgery was 45 minutes. Sound pressure levels did not exceed 84 dB in the operated ear and 82 dB in the contralateral ear. Though some sensorineural hearing loss was found in the operated ear in fourteen patients, no changes in hearing were found in the contralateral ear. It is suggested that there is no damage exclusively due to the drill noise during mastoid surgery.
Subject(s)
Hearing Loss, Noise-Induced/epidemiology , Mastoid/surgery , Hearing Tests , Humans , Postoperative Complications , Risk , Surgical InstrumentsABSTRACT
General anesthesia is not considered as a potential cause of hearing loss. However, three patients who sustained sensorineural hearing loss due to labyrinthine membrane rupture following general anesthesia with nitrous oxide have come to the authors' attention. These cases are presented and the mechanism causing labyrinthine membrane rupture is discussed.
Subject(s)
Anesthesia, General , Cochlea/injuries , Nitrous Oxide , Oval Window, Ear/injuries , Round Window, Ear/injuries , Vestibule, Labyrinth/injuries , Adult , Audiometry, Pure-Tone , Deafness/etiology , Female , Hearing Loss, Sensorineural/etiology , Humans , Male , Middle Aged , Postoperative Complications/etiology , Rupture, SpontaneousABSTRACT
The results of early repair of traumatic perforations of the tympanic membrane by alignment and approximation of the fragmented drum and paper patching of the defect are described in 14 children. The procedure was performed under light general anaesthesia, using Ketalar (ketamine hydrochloride) in a minimal dosage. In all cases except one, healing following patching was complete and uneventful. The disadvantage of general anaesthesia is outweighed by the prompt and uncomplicated healing, and a higher percentage of defect closure, compared with untreated cases in other reports.
Subject(s)
Myringoplasty/methods , Tympanic Membrane/injuries , Audiometry, Pure-Tone , Child , Child, Preschool , Hearing Loss, Conductive/diagnosis , Hearing Loss, Conductive/etiology , Humans , InfantABSTRACT
A series is presented of 100 patients who underwent direct laryngoscopy under general anaesthesia. Our preferred technique of ventilation is jet insufflation by an injector attached to the blade of the laryngoscope, as it provides the surgeon with a quiet and completely exposed larynx. In nine cases, chest expansion was assessed as inadequate by the anaesthetist. These patients were obese with a short neck, and/or stiff-necked; thus, insertion of the laryngoscope was difficult and a good seal between it and the larynx could not be achieved. Arterial blood gas values in six of these patients demonstrated marked hypoventilation. To improve ventilation in these patients an alternative technique of insufflation through a nasotracheal catheter was used. Arterial blood gas values indicated that this method resolved the problem of hypoventilation. Although the catheter somewhat limits the view of the endolarynx, the improved ventilation outweighs the drawbacks of this technique. It is suggested that for the obese and/or stiff-necked patient, a nasotracheal catheter be used electively for ventilation.
Subject(s)
Laryngoscopes , Respiration, Artificial/instrumentation , Adolescent , Adult , Aged , Carbon Dioxide/blood , Female , Humans , Hydrogen-Ion Concentration , Intubation, Intratracheal , Male , Middle Aged , Oxygen/bloodABSTRACT
The complication of retraction and lateralization of the graft after a tympanoplasty operation is described, and the underlying mechanism discussed. This complication occurs mainly when using the overlay procedure and causes a severe conductive hearing loss. A surgical technique for correcting this problem is described. It consists of removing all of the former graft, positioning the new graft medial to the eardrum remnants and covering the denuded ear canal bone with split-thickness skin graft. The results of 7 cases successfully treated by the technique described are presented.
Subject(s)
Tympanic Membrane/surgery , Tympanoplasty/adverse effects , Hearing Loss, Conductive/etiology , Hearing Loss, Conductive/surgery , Humans , MethodsABSTRACT
This article describes a prospective study of the effectiveness of prophylactic antibiotic treatment in preventing infection following mastoid surgery. Seventy-two patients who underwent surgery for chronic middle ear disease served as the basis for this study. Bacteriologic findings from middle ear discharge, showing aerobic and anaerobic bacteria, are reported. The patients were randomly classified into two groups, one undergoing surgery with preventive antibiotic treatment with clindamycin and gentamycin and the other undergoing surgery without antibiotic therapy. The early postoperative inflammatory complications are presented. No significant differences were found in the incidence of these complications between the two groups. In view of the results, the effectiveness of preventive antibiotic treatment in mastoid surgery is questioned.
Subject(s)
Clindamycin/therapeutic use , Gentamicins/therapeutic use , Mastoid/surgery , Postoperative Complications/prevention & control , Adolescent , Adult , Aged , Child , Ear Diseases/surgery , Female , Humans , Male , Middle Aged , Prospective Studies , Random AllocationABSTRACT
A rare case of emergency parotidectomy in a boy of 12, necessitated by a sudden, rapid and marked increase in size of a parotid hemangioma is describe. The literature dealing with parotid hemangiomas in adults is reviewed; the number of cases reported is small. The histological differences and the natural history of parotid hemangioma in adults and in infants are described. The therapeutic approach is discussed.