A modified American Optical (Model 100) CO2 laser was used to produce lesions in the tympanic membranes, ossicles, and cochlear capsules of guinea pigs. Even with the lowest available intensities and durations (0.4 watts, 50 msec), there was damage to the inner ear. Although laser surgery of the ear can avoid mechanical trauma and bleeding as well as increase accuracy, the use of commercial lasers in ear surgery should be avoided until a proven unit is available.
An ophthalmological slit lamp argon laser was used on 8 patients with multiple cutaneous and mucosal telangiectasis; 6 patients had telangiectatic lesions of various etiologies and 2 had hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease). Bleeding from trauma was the primary symptom with cosmesis as a secondary consideration. The telangiectatic lesions were photocoagulated using the argon laser with precise microscopic control. The optimum dose was determined by varying the spot diameter, beam power, shutter speed and number of applications until the lesions were visually ablated. All treatments were accomplished on an outpatient basis with no anesthesia or sedation and minimal reported patient discomfort. No lesions have recurred over a 12 month follow-up.
brainstem-evoked responses (ABR) to clicks were recorded in unanesthetized restrained cats before, during, and after systemic intravenous infusion of lidocaine hydrochloride. The drug was infused continuously at varying rates. Lidocaine's major effect on ABR was to lengthen latent periods to all waveform peaks in proportion with the infusion rate. The effect on latent periods was cumulative throughout the auditory brainstem, ie, all interpeak time intervals increased. Increases in ABR latencies were not due to reductions in effective stimulus intensity because lidocaine did not reduce ABR component amplitudes or increase thresholds. The effects of the drug were reversible. The data are consistent with the notion that lidocaine, directly or indirectly, works throughout the auditory brainstem to increase axonal and synaptic conduction times. (Arch Otolaryngol 1982;108:71-76) Lidocaine (2-[diethylaminol]-Ar-[2,6-dimethylphenyl] acetamide)
With the advent of the CO2 laser, the transendoscopic placement of stents and keels has become an important adjunct in the surgical treatment of laryngeal webs and stenosis. Fixation of stents, however, is often difficult and cumbersome. Here, we describe two relatively simple techniques of laryngeal stent construction, placement, and fixation.
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