The incidence of HP infection in patients with LPRD in our study was 57%. Triple therapy showed a higher cure rate in patients with HPSA-positive test results.
Background:Tracheostomy is usually performed in patients with difficult weaning from mechanical ventilation or some catastrophic neurologic insult. Conventional tracheostomy involves dissection of the pretracheal tissues and insertion of the tracheostomy tube into the trachea under direct vision. Percutaneous dilatational tracheostomy is increasingly popular and has gained widespread acceptance in many intensive care unit and trauma centers.Aim:Aim of the study was to compare percutaneous dilatational tracheostomy versus conventional tracheostomy in intensive care patients.Patients and Methods:64 critically ill patients admitted to intensive care unit subjected to tracheostomy and randomly divided into two groups; percutaneous dilatational tracheostomy and conventional tracheostomy.Results:Mean duration of the procedure was similar between the two procedures while the mean size of tracheostomy tube was smaller in percutaneous technique. In addition, the Lowest SpO2 during procedure, PaCO2 after operation and intra-operative bleeding for both groups were nearly similar without any statistically difference. Postoperative infection after 7 days seen to be statistically lowered and the length of scar tend to be smaller among PDT patients.Conclusion:PDT technique is effective and safe as CST with low incidence of post operative complication.
Intact canal wall mastoidectomy techniques for cholesteatoma are often followed by a planned second look for residual disease and possible ossicular reconstruction. Endoscopic techniques may reduce morbidity but introduce new concerns. Twenty-five consecutive second-look procedures were performed from July 1994 to July 1996 utilizing endoscopes in 19 cases and avoiding or terminating their use in the others because of known difficult anatomy, inadequate exposure, or excessive bleeding. Thirteen cases were prospectively explored first through a planned exclusively endoscopic approach and then opened for a conventional second look in comparison. In one of the 13 cases, endoscopy was abandoned. There were no cases in which endoscopy yielded a false-negative result. Endoscopes underestimated the size of recurrence in one case. Our experience, indications, and precautions for endoscope-assisted second-stage tympanomastoidectomy are presented.
An experimental study was undertaken to investigate the use of a CO2 laser welding technique in myringoplasty. Albumin solder was used to fix a temporal fascia graft via an overlay transcanal approach. The results of the operative procedure were assessed by microscopic and histopathologic examination over an interval of 1, 2, 3 and 4 weeks postoperatively. Materials and Methods: Forty-eight adult guinea pigs were divided into two groups after permanent perforation of the tympanic membrane was created: laser-assisted myringoplasty group and surgical myringoplasty group. Laser beam power was 0.4 W, pulse duration 0.75 s, pulse interval 0.1 s and spot size 250 µm. Each experimental group was further subdivided into four subgroups of 6 animals each. Histological and microscopic findings of the tympanic membrane for both groups after 1, 2, 3, and 4 weeks were compared. Results: Microscopic examination of the tympanic membrane showed high success rate in the laser-assisted myringoplasty group compared to the control group. Histological evaluation for the tympanic membrane showed complete repair of the tympanic membrane in the laser-assisted myringoplasty group. Conclusion: Laser-assisted myringoplasty using CO2 might be a promising new method in surgical myringoplasty.
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