Use of Spermatic Cord Block Systematically Identifies a Paraspinal Tumor as Source of Orchialgia.

Orchialgia is a common urologic complaint with a myriad of etiologies. Workup for orchialgia requires a broad differential diagnosis and a thorough understanding of relevant anatomy. We report the case of a 43-year-old man who presented to a urologist with right testicular pain.

Gender and thrombolysis therapy in stroke patients with incidence of dyslipidemia.

Background: When untreated, dyslipidemia is a higher risk factor for stroke and stroke-related mortality in men than in women. However, when dyslipidemia is treated the risk reduction is the same, but men benefited from mortality reduction more than women. Whether there is a gender difference in exclusion criteria for the use of recombinant tissue plasminogen activator (rtPA) or thrombolysis therapy in an acute ischemic stroke subpopulation with dyslipidemia is yet to be investigated.

[Quality Management in Medicine: What the Surgeon Needs to Know].

Quality management (QM) is a method used in the field of economics that was adopted late by the medical sector. The coincidence of quality management and what is referred to as economisation in medicine frequently leads to QM being - incorrectly - perceived as part of the economisation problem rather than as part of its solution. Quality assurance defines and observes key performance indicators for the achievement of quality objectives.

Cell phones in telehealth and otolaryngology.

The worldwide prevalence of mobile phones makes them a powerful platform for providing individualized health care delivered at the patient's convenience. They have the potential to extend the health care interaction from a brief office visit to a continuous monitoring via body sensors of either a specific healthcare parameter or with multiple sensors in wireless body area networks. Remote data collection by way of mobile phones in underserved areas allows for better management of public health and provides the opportunity for timely intervention.

Emerging technology in head and neck ultrasonography.

Increased use of ultrasonography of the head and neck by clinicians has resulted from more compact, higher resolution ultrasound machines that can be more readily used in the office setting. Palm-sized machines are already used for vascular access and bladder assessment. As the resolution of these machines becomes adequate for head and neck assessment, ultrasonography is likely to become a routine adjunct to the office physical examination.

Pneumosinus dilatans.

Pneumosinus dilatans refers to an abnormally large aerated sinus; two other characteristic features of this disease are that the bony walls of the sinus are of normal thickness and there is no evidence of erosion. Most cases occur in the frontal sinuses. We describe a new case of pneumosinus dilatans in a 21-year-old woman.

Radiofrequency excision versus monopolar electrosurgical excision for tonsillectomy.

Objective: We previously compared radiofrequency (Evac) tonsillotomy with monopolar electrosurgical (Bovie) tonsillectomy and showed significantly less pain with the Evac. Tonsillotomy leaves a cuff of tonsil behind, the significance of which is unknown. We hypothesize that Evac tonsillectomy also is less painful than Bovie tonsillectomy.

Radiofrequency ablation versus electrocautery in tonsillectomy.

Objectives: The objective of this study was to compare the safety, difficulty of removal, and postoperative pain profile of radiofrequency ablation versus standard electrocautery removal of tonsils.

Study Design And Setting: A prospective, blinded study was designed to remove 1 tonsil with each of the 2 methods. Time of operation, estimated blood loss, difficulty of operation, postoperative pain, rate of postoperative hemorrhage, and the patient's preferred technique were evaluated.

An analysis of 3599 midfacial and 1141 orbital blowout fractures among 4426 United States Army Soldiers, 1980-2000.

Objective: We sought to present the epidemiology associated with 3599 midfacial and 1141 orbital blowout fractures.

Study Design And Setting: We conducted a multicenter, 20-year retrospective analysis of hospitalization data on U.S.

Telehealth: voice therapy using telecommunications technology.

Telehealth offers the potential to meet the needs of underserved populations in remote regions. The purpose of this study was a proof-of-concept to determine whether voice therapy can be delivered effectively remotely. Treatment outcomes were evaluated for a vocal rehabilitation protocol delivered under 2 conditions: with the patient and clinician interacting within the same room (conventional group) and with the patient and clinician in separate rooms, interacting in real time via a hard-wired video camera and monitor (video teleconference group).

Rare tumors of the thyroid gland.

Although the vast majority of thyroid cancers are well-differentiated and carry an excellent prognosis, several rare tumors occasionally involve the thyroid gland and require unique treatment paradigms. Anaplastic carcinoma of the thyroid is an extremely aggressive neoplasm that is generally best managed with surgery followed by a multimodality regimen of radiotherapy and chemotherapy. Squamous cell carcinoma of the thyroid often mimics the clinical course of anaplastic carcinoma and is best treated with aggressive surgery followed by postoperative radiotherapy.

Telemedicine in otolaryngology.

More research is needed in otolaryngology telemedicine, but it would be a mistake to stop at only determining if telemedicine is as good as an in-person exam. The digital image recorded in a telemedicine encounter can be manipulated to increase diagnostic information not currently available. Radiologists currently take a chest radiograph in which a chest mass or the tip of an nasogastric tube is difficult to visualize, and by inverting the gray scale or viewing other digital manipulations of that image, the mass or tube tip becomes obvious.

Telemedicine: teleproctored endoscopic sinus surgery.

Objective/hypothesis: Teleproctored surgery projects a surgeon's expertise to remote locations. The objective of the present study was to evaluate the safety and feasibility of this technique as compared with the current standard of care.

Study Design: Prospective.

5196 mandible fractures among 4381 active duty army soldiers, 1980 to 1998.

Objective: We present the frequencies of various types of mandibular fractures along with associated mechanisms and injuries.

Methods: Retrospective analysis of 5196 mandible fractures in 4381 patients extracted from the Total Army Injury and Health Outcomes Database (TAIHOD), a comprehensive database developed by the U.S.

Waldenstrom's macroglobulinemia and sensorineural hearing loss.

Waldenstrom's macroglobulinemia, (WM) first described in 1944, is an uncommon disease caused by the abnormal production of immunoglobulin M monoclonal macroglobulin. Presenting signs and symptoms most frequently include fatigue or generalized weakness; tendency to bleed from mucosal surfaces; characteristic retinal lesions, including dilated and tortuous retinal veins, retinal hemorrhages, and exudates; lymphadenopathy; hepatosplenomegaly; sensory motor peripheral neuropathy; worsening normochromic anemia; increased sedimentation rate; and extremely high serum viscosity. Hearing loss is an unusual presenting symptom of WM; only 6 cases are reported in literature.

Incidence of carcinoma in incidental tonsil asymmetry.

Objective: To determine the incidence of malignancy in patients with incidentally discovered unilateral tonsillar enlargement with an otherwise normal physical examination.

Study Design: A retrospective review of our institution's experience with unilateral tonsillar enlargement.

Results: During a five-year period, 570 patients underwent tonsillectomy at our institution.

Acanthamoeba sinusitis with subsequent dissemination in an AIDS patient.

Otolaryngologists can play an important role in the care of patients with acquired immunodeficiency syndrome (AIDS) and/or human immunodeficiency virus infection. We present the case of an AIDS patient who was hospitalized for dehydration and who was soon found to have sinusitis and subsequent disseminated infection caused by Acanthamoeba. To treat the Acanthamoeba infection, the patient was started on oral itraconazole and intravenous metronidazole; i.

Effect of pentoxifylline on the healing of guinea pig tympanic membrane.

Although most tympanic membrane perforations heal spontaneously, persistent perforations frequently require treatment by otolaryngologists. Initial management strategies include keeping the ear dry, ensuring aural hygiene, and using topical antibiotics. For persistent perforations, paper patching or myringoplasty may be required.

Corticosteroid treatment for idiopathic facial nerve paralysis: a meta-analysis.

Objective: A meta-analysis was designed to evaluate facial recovery in patients with complete idiopathic facial nerve paralysis (IFNP) by comparing outcomes of those treated with corticosteroid therapy with outcomes of those treated with placebo or no treatment.

Study Design: Meta-analysis of prospective trials evaluating corticosteroid therapy for idiopathic facial nerve paralysis.

Methods: A protocol was followed outlining methods for trial selection, data extraction, and statistical analysis.

Saline irrigation in the prevention of otorrhea after tympanostomy tube placement.

Objectives: Comparison of intraoperative saline irrigation to otic drops in the prevention of postoperative otorrhea in children with middle ear effusion undergoing bilateral myringotomy with ventilation tubes.

Study Design: This study was designed as a blinded, controlled, prospectively randomized trial.

Methods: Study children were randomly assigned to receive either otic drops for 3 days postoperatively or saline irrigation of the middle ear space at the time of myringotomy.

Management of lateral sinus thrombosis.

Objectives: Review the clinical signs and symptoms, management, bacteriology and outcomes of patients treated for lateral sinus thrombosis.

Study Design: A retrospective review of six patients, treated from 1993 through 1998, with an intraoperatively confirmed diagnosis of lateral sinus thrombosis.

Methods: All charts from 1993 through 1998 coded for sinus thrombosis, meningitis, brain abscess, otitic hydrocephalus, subdural abscess, and mastoidectomy were reviewed.