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To summarise the available literature related to wound healing post tonsillectomy, including the stages of healing, experimental models for assessing healing (in animals and humans) and the various factors that affect wound healing.
A search of the English literature was conducted using the Ovid Medline database, with the search terms ‘tonsillectomy’ or ‘tonsil’ and ‘wound healing’. Thirty-one articles that objectively assessed tonsillectomy wound healing were included for analysis.
The majority of assessments in humans investigating tonsillectomy wound healing involve serial direct clinical examinations of the oral cavity. Many patient and surgical factors have been shown to affect wound healing after tonsillectomy. There is some research to suggest that the administration of adjunctive treatment in the post-operative period may be beneficial to tonsillectomy wound healing.
Wound healing post tonsillectomy has been poorly researched. Having a better understanding of the process of wound healing would allow surgeons to potentially prevent, anticipate and manage complications from the surgery that arise as part of the healing process.
Subtotal petrosectomy combined with cochlear implantation is a procedure required in specific situations.
A retrospective review of all cases of subtotal petrosectomy in cochlear implant surgery over a five-year period was performed. The indications, complications and outcomes for this procedure are outlined.
Sixteen patients underwent cochlear implantation in combination with subtotal petrosectomy and blind sac closure of the external auditory meatus from 2008 to 2013. Seventy-five per cent of these were completed as a two-stage procedure and 25 per cent as a single-stage procedure. The most common indications for the procedure were chronic otitis media, previous radical cavity, and for surgical access in challenging anatomy or in drill-out procedures. Mastoids were obliterated with fat or musculoperiosteal flaps. The complication rate relating to blind sac closure was 6 per cent. Cochlear implants were successfully placed in all cases and there was no incidence of device failure.
For patients with chronic suppurative otitis media or existing mastoid cavities, subtotal petrosectomy with blind sac closure of the external auditory canal, closure of the eustachian tube, and cavity obliteration is an effective technique to facilitate safe cochlear implantation.
A Pott's puffy tumour is a subperiosteal abscess and osteomyelitis of the frontal bone secondary to frontal sinusitis. Intracranial complications are seen in approximately 40 per cent of cases and are potentially life-threatening; such complications have not previously been reported in pregnancy.
A 21-year-old woman at 35 weeks' gestation presented with a history of frontal headaches and swelling, periorbital oedema, pain and chemosis. Imaging confirmed Pott's puffy tumour with right-sided epidural empyema and periorbital cellulitis. A multidisciplinary team was involved in the patient's management. Intravenous antibiotics were commenced and initial percutaneous drainage through the frontal sinus skin was performed, followed by endoscopic sinus drainage. A caesarean section was performed 3 days later. Complete resolution of the sinus and intracranial collections was noted on imaging performed six weeks later.
This case highlights the challenges of managing rare intracranial complications of sinusitis in pregnancy, and the importance of multidisciplinary care.
In order to safely explore the medial wall of the attic, a working knowledge of the anatomy of the anterior supralabyrinthine air cell tract is required.
To clarify the surgically relevant anatomical relationships that comprise the anterior supralabyrinthine air cell tract.
Materials and methods:
Surgical dissection of 10 fresh cadaveric temporal bones was undertaken, including measurement of distances between the key anterior supralabyrinthine anatomical landmarks.
The following mean distances were calculated: the labyrinthine segment between the geniculate ganglion and the ampullated end of the superior semicircular canal, 2.33 mm (range 1.75–2.75); the tympanic segment between the anterior margin of the oval window niche and the geniculate ganglion, 3.58 mm (range 3.25–4); and from the tympanic segment adjacent to the anterior margin of the oval window niche to the labyrinthine segment adjacent to the superior semicircular canal, 3.48 mm (range 3–4.25).
The key anatomical landmarks of the anterior supralabyrinthine air cell tract define a distinct triangular segment of bone, knowledge of which is helpful in surgical dissection.
The GALLEX collaboration aims at the detection of solar neutrinos in a radiochemical experiment employing 30 tons of Gallium in form of concentrated aqueous Gallium-chloride solution. The detector is primarily sensitive to the otherwise inaccessible pp-neutrinos. Details of the experiment have been repeatedly described before [1-7]. Here we report the present status of implementation in the Laboratori Nazionali del Gran Sasso (Italy). So far, 12.2 tons of Gallium are at hand. The present status of development allows to start the first full scale run at the time when 30 tons of Gallium become available. This date is expected to be January, 1990.
The I—V characteristics of as—deposited antimony Schottky contacts on silicon were extremely sensitive to interface conditions. This led to unpredictable results for the unimplanted contacts. After Si* implantation the contacts displayed more uniform I—V characteristics. Implantation led to higher values for the ideality constant, the series resistance and for the saturation current. The ideality factor seems to decrease at the higher implantation doses (ϕ ≥ 5×1014 Sb+cn−2), while no clear dose dependence patterns were observed for the saturation current and series resistance after implantation.
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