Because Lemierre's syndrome is so rare, it is difficult to ascertain absolutely the need for either anticoagulation or long-term antibiotic therapy. At this time, the risks and benefits of providing either therapy must be weighed against the potential complications of incompletely treating septic thrombosis.
In a canine model of tonsillar wound healing, microdebrider intracapsular tonsillectomy produced significantly faster healing than electrocautery tonsillectomy in the early postoperative course. The "biologic dressing" theory of intracapsular tonsillectomy wound healing may account for observed differences in healing and suggests a mechanism for improved clinical outcomes.
We conducted a study to determine if the risk of airway compromise following tonsill ectomy with uvulopalatopharyn goplasty ju stifies the added cost and inconvenience of step-down monitoring in an intensive care unit. We perform ed a retrospective chart review of 130 patients with obstructive sleep apnea who had undergone isolated tonsillectomy with uvulopalatopharyngoplasty at our tertiary care center. The average length ofstay in the step-down unit was 18 hours. Wefound that only eight ofthese pati ents (6.2 %) had a postoperati ve desaturation level of less than 90%, includin g three of 12 patients (25 %) who had como rbid conditions. No patient had an adverse respirato ry event. We conclude that step-down monitoring in an intensive care unit is not neces sary, althou gh caution should be exercised in monitoring patients with comorbidities because they appear to be more pron e to desaturation. A comp lete lack of adverse respiratory events has not been reported in previous studies.
Schwannomas (neurilemmomas) are neurogenic tumors that arise from the Schwann cells of the neural sheath. They are most often benign and solitary. Extracranial schwannomas are rare, and can be mistaken for metastatic disease or other non-neurogenie tumors. Ancient schwannoma is a rare variant of schwannoma with a course typical of a slow-growing benign tumor. Histologically, it can be confused with a malignant mesenchymal tumor. An unusual case of an ancient schwannoma of the submandibular gland is reported. The clinical, histological and surgical aspects of this tumor are discussed, and the literature regarding this rare entity is reviewed.
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