Scopoderm transdermal therapeutic system (TTS) is a form of application permitting programmed release of scopolamine through the skin into the bloodstream. Scopoderm TTS is indicated for prevention of nausea and vomiting associated with motion sickness. The most common side effect associated with its use is dryness of the mouth. We have been using Scopoderm TTS for reducing salivary flow in patients with sialorrhea or with difficulties in swallowing normal amounts of salivary secretions. Good results were achieved with minimal discomfort from adverse effects. We recommend the use of Scopoderm TTS in selected cases of sialorrhea and drooling, preoperatively and postoperatively in patients undergoing surgery of oral, laryngeal, and pharyngeal lesions.
A rare cose of an 8½ year old boy with a stage III well differentiated squamous cell carcinoma of the larynx, which responded to chemotherapy and irradiation, is reported. It is the 56th cose in children up to 15 years of age and the 20th case in children 10 years old or younger reported since 1868. Carcinoma of the larynx in children has similar clinicopathological features to those of adult laryngeal carcinoma, but markedly differs as concerning sex incidence ratio. The main differential diagnosis is juvenile papillomatosis and the principal risk factor is previous cervical irradiation. Delayed diagnosis is frequent since clinical manifestations might be attributed to the normal laryngeal maturation process or to a common respiratory infection. Treatment is problematic, for special effort must be made to preserve laryngeal anatomy and function and to avoid complications. Prognosis of childhood laryngeal cancer is unclear since the reported survival rates are not tumor stage related.
Human amnion is a readily available allograft with low antigenicity, high antimicrobial potential, and the ability to foster cpithelialization. We have used human amniotic membrane in our department for replacing nasal mucosa in Rendu‐Osler‐Weber disease, as tympanic membrane grafts, and for covering head and neck sites after flap necrosis. Our experience shows moderate success for management of severe epistaxis and excellent results in covering surfaces after flap necrosis. Use of amnion in eardrum perforations was unsuccessful and was discontinued. Properties of human amniotic membrane are listed and its application in the otolaryngologic practice is reviewed.
The incidence of subclinical central diabetic neuropathy is unclear due to difficulty in detecting latent alterations of central neural transmission process. The aim of this study was to evaluate a central neuroconductive mechanism in diabetics by brainstem auditory evoked responses (BAER). We found increased latencies of peaks I, III, V in diabetics as compared to control subjects. These BAER abnormalities were demonstrated in 62 per cent of insulin-controlled diabetics and in 33 per cent o patients treated by diet, or peroral drugs. No alterations in brainstem responses were observed in patients with latent diabetes. We did not find any correlation between the BAER abnormalities and the duration of the disease, the blood glucose level or the level of control of the diabetes.
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