Ionized field ablation subtotal tonsillectomy may offer an alternative to traditional subcapsular tonsillar surgery with a decreased incidence of postoperative complications. Further study is necessary to establish the complication rate of this technique.
The types of temporal bone fractures, longitudinal and transverse, are reviewed. All cases of bilateral temporal bone fractures at Parkland Memorial Hospital in Dallas over a 10‐year period from 1968 to 1978 are reviewed and discussed by the authors. One hundred sixty patients with the diagnosis of base of skull fractures were studied. Fifty‐nine of these were temporal bone fractures and 17 of the 59 were bilateral. Of all the base of skull fractures, 10% were bilateral temporal bone fractures and 29% of all temporal bone fractures were bilateral. For each case the method of injury, the extent of damage to hearing and facial nerve function, presence of CSF otorrhea, X‐ray findings, and additional complications are summarized and the results discussed. The operative findings of facial nerve decompressions are carefully reviewed. The authors' method of caring for temporal bone fractures is presented.
We reviewed 564 tympanoplasties operated upon over an eight year period at the Otologic Medical Group in which tragal cartilage was used to re-establish the sound pressure transfer mechanism. Eighty-six percent of the cases were revisions, and half of these were planned second stage procedures. In the majority of cases the stapes crural arch was missing. The conductive deficit in these cases was reduced to 20 db or less in 67% and 10 db or less in 40%. The commonest single cause of failure was a short prosthesis. There were no instances of cartilage resorption. Extrusion occurred in one case. Tragal cartilage has been more satisfactory than ossicular tissue in many situations. Recently we have been using plastic prosthesis (TORP and PORP) in combination with tragal cartilage and believe that the results will be even better.
Hemophilus influenzae type B (30 cases), untyped (two cases), and type A (one case), and H parainfluenzae (one case) were recovered in blood cultures from 44 cultures of 53 children with acute epiglottitis. These patients were managed by observation, tracheotomy, or intubation, with intubation being the most satisfactory. Both ampicillin and chloramphenicol have been employed recently because of the emergence of ampicillin resistance, which was 18.7% of all cases in 1977.
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