Most cleaning methods used in our trials appear to properly disinfect RNEs after in vitro inoculation with S aureus, S pneumoniae, and H influenzae. However, it appears that disinfectants may be less effective in cleaning rigid scopes experimentally inoculated with P aeruginosa. There is a paucity of published data regarding cross-contamination during rigid nasal endoscopy, and these results should guide future studies and to some extent practice to avoid iatrogenic spread of contamination.
Poster Presentations
P185
POSTERScareful outpatient workup, including CT/PET studies, failed to reveal a source. Of this group, a primary source was found in eight by tonsillectomy and directed biopsies. In the remaining 9, transoral laser resection of the ipsilateral base of tongue was performed, and a base of tongue source was found in 4. In all of these, no lesion was visualized or palpable, there were no procedure complications, patients returned to adequate PO intake immediately and operative time increased by forty minutes on average.
Conclusion:We conclude that transoral laser resection of the base of tongue in the workup of unknown primary HN cancers is safe, is well-tolerated, and provides valuable information for therapeutic planning as a supplement to other traditional diagnostic modalities, when no primary source has been previously identified.
While many of the basic tenants of upper lid blepharoplasty remain constant regardless of skin type, the thick-skinned eyelid patient requires special consideration. The brow may be naturally lower in the thick-skinned patient. These patients are more prone to having the brow pulled downward while attempting to remove redundant skin. There may also be more fat in the medial and central compartments. There may be fat in a lateral compartment overlying the lacrimal gland. Patient's expectations for a deep lid sulcus and complete excision of redundant skin may not be possible. They are more prone to an observable scar, a small dog ear at the lateral wound edge, and prolonged postoperative lid edema. Patients with lifelong upper lid fullness must get some input from significant others because their upper face aesthetic will change. In these patients, the eyelid surgery is not a rejuvenation, but a creation.
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