The described treatment of CT diastema widening by trained personnel is an effective and safe treatment, but repeated treatments are often necessary, especially with secondary diastemata.
Objective: Myringotomy and tube placement in children and sometimes in adults has traditionally required general anesthesia. Risks of general anesthesia and costs of even outpatient surgery have led to a search for alternatives. This study demonstrates the safety and effectiveness of nitrous oxide conscious sedation as a supplement to local anesthesia for myringotomy and tube placement in children and adults.Methods: Nitrous oxide was used as conscious sedation for 595 cases of myringotomy and tube placement in children and 789 cases of myringotomy and tube placement in adults. These cases were retrospectively reviewed.Results: Nitrous oxide was effective as an agent for conscious sedation in conjunction with local anesthesia for office myringotomy and tube placement. There were no significant complications in 1384 cases.Conclusion: Nitrous oxide conscious sedation used as a supplement to local anesthesia is effective and safe as a method of office myringotomy and tube placement.
Corpus callosum haematoma is a rare feature in subarachnoid haemorrhage (SAH), which may result from aneurysms of the anterior communicating artery (ACoA) or pericallosal artery (PCA). In 348 patients with aneurysmal SAH, bleeding from ACoA aneurysms in 88 cases produced no abnormality on CT in 7. Blood in the cistern of the lamina terminalis was the most frequent abnormality (76/88); haematomas of the septum pellucidum, confined to patients with ACoA aneurysms, were seen in 26 (30%). Rupture of PCA aneurysms in 12 patients gave rise to blood in the pericallosal cistern, anterior interhemispheric fissure and cistern of the lamina terminalis in 11. There was no blood in the septum pellucidum or the ventricular system in any case, but haematomas in the corpus callosum occurred in 8 (67%). In all of these, blood extended into the anterodorsal aspect of the callosum and spread posteriorly along its dorsal border. An identical, supracallosal pattern was seen in 2 patients (2.5%) with ACoA aneurysms, in whom haemorrhage was more extensive, with a large frontal lobe haematoma extending up from the cistern of the lamina terminalis in 1 and a haematoma of the septum pellucidum, with intraventricular extension in the other. In 8 patients (9%) with ACoA aneurysms a corpus callosum haematoma appeared to result from passage of blood up through the cistern of the lamina terminalis into the septum pellucidum and thence into the ventral aspect of the anterior corpus callosum; blood was present within the cistern, the septum and the ventricles.
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