Primary High-Grade Poorly Differentiated Angiosarcoma of an Intra-parotid Lymph Node.

Head and neck angiosarcoma is an infrequent malignant vascular tumor most commonly found in the skin and soft tissue of the head and neck. Most head and neck angiosarcomas are metastatic to cervical lymph nodes from other primitive location. We describe herein a case of primary high-grade poorly differentiated angiosarcoma arising in an intra-parotid lymph node, discuss the value of immunohistochemical stains for differential diagnosis, and review the literature concerning head and neck angiosarcoma.

Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study.

Background: Eustachian tube (ET) dysfunction plays an important role in the pathogenesis of acute otitis media (AOM). Unfortunately, there is a lack of knowledge about the exact role of the ET's bony support, the temporal bone, on occurrence of AOM. This study investigates whether severe suture restriction of the temporal bone is a risk factor for development of AOM in young children.

Do micropauses prevent surgeon's fatigue and loss of accuracy associated with prolonged surgery? An experimental prospective study.

Objective: This prospective experimental study evaluates the effectiveness of micropauses (MPs) to prevent muscular fatigue and its deleterious effect on surgeons during prolonged surgical procedures.

Background: Operating is a hazard for surgeon's health. Beyond acute injuries and blood-borne infections, back and neck pain is a poorly recognized factor causing chronic ailment in more than half the surgeons surveyed.

Otologic safety of manuka honey.

Objective: To investigate the possible ototoxic effects of a 50% concentration of manuka honey in a chinchilla animal model.

Study Design: A prospective, controlled animal study.

Setting: The Research Institute of the Montreal Children's Hospital, McGill University Health Centre.

Vocal cord adduction causing obstructive sleep apnea from vagal nerve stimulation: case report.

A recognized complication of vagal nerve stimulation is new or worsening sleep apnea. Its pathophysiology is not clearly understood. We report a patient with obstructive sleep apnea that was directly associated with vagal nerve stimulation causing recurring vocal cord adduction.

Radiation-induced xerostomia: is octreotide the solution?

Objective: In this study, we looked for evidence that octreotide, a drug used specifically in acromegaly and other digestive pathologies, can have a radioprotective effect on salivary glands. This effect has already been proven on the pituitary gland, which is why we postulated that octreotide could act the same way on rat parotid glands.

Method: A prospective randomized controlled study on animals was conducted.

Pain management after tonsillectomy: morphine is not enough.

Introduction: Tonsillectomy is usually done as day surgery, transferring to the parents most of the postoperative care. They often feel alone and incompetent in front of a child in pain. We developed a guide to help parents for both the evaluation and the management of postoperative pain.

Mechanisms of active laryngeal closure during noninvasive intermittent positive pressure ventilation in nonsedated lambs.

The present study stems from our recent demonstration (Moreau-Bussiere F, Samson N, St-Hilaire M, Reix P, Lafond JR, Nsegbe E, Praud JP. J Appl Physiol 102: 2149-2157, 2007) that a progressive increase in nasal intermittent positive pressure ventilation (nIPPV) leads to active glottal closure in nonsedated, newborn lambs. The aim of the study was to determine whether the mechanisms involved in this glottal narrowing during nIPPV originate from upper airway receptors and/or from bronchopulmonary receptors.

Obstructive sleep disordered breathing in children: beyond adenotonsillectomy.

Traditionally, adenotonsillectomy (AT) has long been the treatment of choice for obstructive sleep disordered breathing (SDB) in children. AT is usually considered a safe procedure, which cures 80% of children with SDB. Accumulated data have however challenged this overly simplistic view.

Origins of the inhibiting effects of nasal CPAP on nonnutritive swallowing in newborn lambs.

The present study investigated the mechanism by which continuous positive airway pressure (CPAP) suppresses nonnutritive swallowing (NNS) during quiet sleep (QS) in newborn lambs. Eighteen full-term lambs were chronically instrumented and evenly distributed into three separate groups to determine the extent to which modulation of NNS may be attributed to stimulation of upper airway and/or bronchopulmonary mechanoreceptors. Six lambs were tracheotomized, six other lambs underwent a two-step bilateral intrathoracic vagotomy, and the remaining six lambs underwent chronic laryngotracheal separation (isolated upper airway group).

Comparative study of acetaminophen-morphine versus rofecoxib-morphine for post-tonsillectomy pain control.

Introduction: Although we routinely use morphine at our institution, moderate to severe pain often persists for several days after tonsillectomy. Nonsteroidal anti-inflammatory drugs could offer significant relief. Unfortunately, concerns about increased risk of bleeding limit their use.

Non-nutritive swallowing and respiration coordination among states of alertness in adult sheep.

Swallowing is a powerful inhibitor of respiration. Its coordination with respiration is therefore crucial to avoid aspiration and apnea. The aim of this study was to determine the coordination between non-nutritive swallowing (NNS) and phases of the respiratory cycle, including the assessment of the effect of states of alertness in adult sheep.

First myringotomy with insertion of a modified Goode T-Tube: changing the perforation paradigm.

Background: Goode T-Tubes (Medtronic Xomed, Inc) have a bad reputation because of their residual tympanic perforation rate. However, these long-term tubes are mostly used in patients with chronic middle ear problems. On the other hand, "safer," short-term tubes may need to be reinserted in up to 20% of children.

Cognitive skills analysis, kinesiology, and mental imagery in the acquisition of surgical skills.

Goal: Isolate and evaluate the impact of mental imagery on the acquisition of an emergency surgical technique.

Method: We studied 44 first-year medical students performing a cricothyrotomy on a mannequin to determine the impact of teaching using mental imagery (MI) and/or kinesiology (KG) compared to the standard Advandec Trauma Life Support (ATLS) approach. Students were randomly assigned to one of three groups: MI and KG, KG alone or control (ATLS).

Effects of C fiber blockade on cardiorespiratory responses to laryngeal stimulation in concious lambs.

The primary aim of the study was to explore cardiorespiratory reflexes originating from laryngeal C fiber endings in the neonatal period. Seventeen lambs were instrumented for recording glottal adductor and diaphragm EMG, heart rate, systemic arterial pressure and respiratory movements. C fiber blockade was induced in eight lambs by 30 mg/kg capsaicin, the remaining nine lambs serving as controls.

Quality of life following surgical treatment of oculopharyngeal syndrome.

Oculopharyngeal syndrome is a hereditary disease mostly affecting French Canadians. Cricopharyngeal myotomy and blepharoplasty are commonly performed on these patients. We reviewed the files of 20 patients who underwent these procedures between June 1986 and June 1999.

The larynx and neonatal apneas.

Objective: We sought to review the current literature on the role of the larynx in neonatal apneas.

Study Design: We conducted a literature search and analysis of the published and other available information on the topic.

Results: Publications on this topic in otolaryngology journals are rare, although more basic sciences-oriented journals have published interesting results from animal studies during the past 20 years.

Active upper airway closure during induced central apneas in lambs is complete at the laryngeal level only.

We tested the hypotheses that active upper airway closure during induced central apneas in nonsedated lambs 1). is complete and occurs at the laryngeal level and 2). is not due to stimulation of the superior laryngeal nerves (SLN).

Type III tympanoplasties: the Sherbrooke experience.

Objectives: To review short- and longer-term results of type III tympanoplasties as performed by the senior author and to compare these results with those reported in the literature.

Method: Retrospective review of 96 type III tympanoplasties, with and without mastoidectomy, performed between April 1996 and August 2000.

Results: At a mean of 384 days postoperatively, 57.

Active glottal closure during central apneas limits oxygen desaturation in premature lambs.

Our laboratory previously reported that active glottal closure was present in 90% of spontaneous central apneas in premature lambs while maintaining a high-apneic lung volume (Renolleau S, Letourneau P, Niyonsenga T, and Praud JP. Am J Respir Crit Care Med 159: 1396-1404, 1999.) The present study aimed at testing whether this mechanism limits postapnea oxygen desaturation.