Carl W. Moeller

Combinatorial treatments enhance recovery following facial nerve crush.

To investigate the effects of various combinatorial treatments, consisting of a tapering dose of prednisone (P), a brief period of nerve electrical stimulation (ES), and systemic testosterone propionate (TP) on improving functional recovery following an intratemporal facial nerve crush injury.

Prevention and Management of Complications in Sphenoidotomy

Endoscopic sphenoidotomy is a common surgical procedure that often accompanies routine sinus surgery. Safe completion of a sphenoidotomy depends on a thorough understanding of the surrounding anatomy, reviewing preoperative imaging, and maintaining intraoperative orientation. Intraoperative complications include local hemorrhage, catastrophic hemorrhage caused by internal carotid injury, optic nerve injury, and CSF leak. Postoperative complications tend to be less severe and include postoperative stenosis and mucocele formation. Regarding surgery of the sphenoid sinuses, the best management of complications truly is prevention, making pre- and intraoperative vigilance vital to a successful outcome.

The safety and efficacy of intravenous ketorolac in patients undergoing primary endoscopic sinus surgery: A randomized, double-blinded clinical trial

Ketorolac (KT) is an intravenous (IV) nonsteroidal anti‐inflammatory drug (NSAID) for acute, moderate pain. KT is safe, but may be linked to increased risk of post‐tonsillectomy hemorrhage. The safety and efficacy of KT following primary endoscopic sinus surgery (ESS) is unknown.

Sinonasal evaluation preceding hematopoietic transplantation

Objective. To determine the efficacy of sinonasal evaluation preceding hematopoietic cell transplant (HCT) and to correlate pretransplant findings with subsequent risk of post-HCT complications based on radiographic, endoscopic, and microbiologic findings. Study Design. Case series with chart review. Setting. Academic tertiary care center. Subjects and Methods. Seventy-one patients underwent pre-HCT sinonasal evaluation. Pre-HCT imaging and endoscopic exams were evaluated via standardized scales. Middle meatus culture results were also recorded. Pre-HCT intervention was noted, as was any post-HCT evaluation and intervention. Results. Seventy-one patients underwent pre-HCT evaluation. Sixty-five percent of patients were asymptomatic at the time of evaluation. On computed tomography (CT) imaging, the average Lund-Mackay score was 2.2 ± 3.7. Mean endoscopic grading score was 0.6 ± 1.6. The majority of cultures grew commensal organisms only. Four of 71 patients (6%) had evidence of chronic rhinosinusitis pre-HCT; 3 patients underwent endoscopic sinus surgery, and 1 patient was treated medically. None developed rhinosinusitis following HCT. Four different patients were evaluated for sinonasal symptoms post-HCT. Two were diagnosed with acute rhinosinusitis: 1 was treated medically, and 1 was treated surgically. No patient developed invasive fungal sinusitis. Conclusions. All patients who required pre-HCT medical or surgical intervention had symptoms of rhinosinusitis and positive endoscopy and/or CT imaging. Two patients who developed acute rhinosinusitis post-HCT had no evidence of rhinosinusitis during pre-HCT evaluation. Evaluation and studies are costly, time-consuming, and not found to be predictive in this study.

Facial motor nuclei cell loss with intratemporal facial nerve crush injuries in rats

Injuries of cranial nerves that are distal to but near the motor nucleus might result in retrograde motoneuron cell death. The hypothesis of this article is that an intratemporal crush injury of the facial nerve in rats can cause facial motor nuclei cell death.

Late Complication of Thoracic Endovascular Stent–Grafting

Thoracic endovascular aortic repair (TEVAR) has become increasingly popular for the treatment of descending thoracic aortic aneurysms. Despite their proven efficacy and safety, several complications can occur with TEVAR. We report a case of a 76-year-old woman with a late-term complication after TEVAR related to recurrent thyroid cancer and carotid-subclavian revascularization.

P132: Collagen Tube Augmentation of Facial Nerve Repair

OBJECTIVES: Evaluate patients with complaints of dizziness/vertigo through the active cephalic auto-rotation, comparing symptoms with alterations found. METHODS: A group of 1,281 patients with dizziness underwent the horizontal active cephalic auto-rotation test with fixed target, as a part of otoneurological evaluation to verify the alterations that showed up. RESULTS: Ages ranged from 3 to 93 years with an average of 49,6 years; there were 946 (73.8%) females and 335 (26.2%) males. The vertigo complaint was reported by 896 (69.9%) patients and dizziness by 385 (30.1%). The frequency answering rate to cephalic auto-rotation test ranged from 1.5 to 7.5Hz with an average of 3.5Hz. The active cephalic autorotation test was normal in 937 (73.1%) and abnormal in 344 (26.9%) patients. The most frequent alterations were those having to do with the gain (increase–reduction) isolated or associated to alterations of phase and symmetry in 241 (19%) patients. The increase of gain isolated was verified in 92 (7.2%) patients. CONCLUSIONS: There was no relation between alterations in the active cephalic auto-rotation test and the complaints of dizziness and vertigo.