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| A Hindu Tale The Jackal stood looking across the river where the crabs lay in the sun on the sand. "Oh," said the Jackal, "if I could only swim, how good those crabs would be! I wish I had a boat or a canoe!" Just then the Camel came ... Read more of The Jackal And The Camel at Children Stories.ca | Informational Privacy |
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Medical ArticlesTo Prevent DysenteryIn hot weather when bilious diseases prevail, use _Mercurius_... Telephones And Telephoning MOST men--and women--use more nervous force in speaki... Fomentation Some general remarks on this important treatment we give here.... Gastroscopy The stomach of any individual having a normal esophagus and n... Bronchitis This frequent and severe trouble results most usually from chi... Hearing We have had so much success in helping the deaf that we feel w... The Religion Of It THE religion of it is the whole of it. "All religion ... Pneumonia Its Cause and Prevention. The other great disease of the lung... What Effect Could Be Expected From A Warm Wet-sheet? The first impression of the wet-sheet is, as I stated before,... Nauheim Baths At Nauheim, under the direction of Dr. Theodore Schott, baths... Nursing Over Few vital processes are more remarkable than that by which foo... Anomalies Of The Esophagus Congenital esophagotracheal fistulae are the most frequent of... Bread Wheaten In some cases the bran in whole wheaten bread and Saltcoats bi... The Surgical Form Of The Deep Cervical And Facial Regions And The Relative Position Of The Principal Bloodvessels And Nerves While the human cervix is still extended in surgical position... Tempering Treatment Much, if not all, of the success in any case of treatment depe... Buttermilk Where we prescribe this, either for drinking or for external u... Vegetables Green And Fruit We would strongly recommend our readers to continually have th... Chest Pains See Angina Pectoris. ... Dropsy Use the A D current, moderate force. Give general tonic treat... Small Pox - Variola This disease begins with pain in the head and back, chilly se... |
Vocal ResultsCategory: INTRODUCTION OF THE BRONCHOSCOPE Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery A whispering voice can always be had as long as air can pass through the larynx, and this may be developed to a very loud penetrating stage whisper. If the arytenoid motility has been uninjured the repeated pulls on the scar tissue may draw out adventitious bands and develop a loud, useful, though perhaps rough and inflexible voice. Galvano-cauterization is the best method of treatment for chronic subglottic edema or hyperplasia such as is seen in children following diphtheria, when the stenosis produced prevents extubation or decannulation. The utmost caution should be used to avoid deep cauterizations; they are almost certain to set up perichondritis which will increase the stenosis. Some of the most difficult cases that have come to the author have been previously cauterized too deeply. Galvano-cautery puncture of tuberculous infiltrations of the larynx at times yields excellent results in cases with mild pulmonary lesions, and has quite replaced the use of the curette, lactic acid, and other caustics. The direct method of exposing the larynx renders the application of the cautery point easy and accurate. In severely stenosed tuberculous larynges a tracheotomy should first be done, for though the reaction is slight it might be sufficient to close a narrowed glottis. The technic is the usual one for laryngeal operations. Local anesthesia suffices. The larynx is exposed. The rheostat having been previously adjusted to heat the electrode to nearly white heat, the circuit is broken and the electrode introduced cold. When the point is in contact with the desired location the current is turned on and the point thrust in as deeply as desired. Usually it should penetrate until a firm resistance is felt; but care must be used not to damage the cricoarytenoid joint. The circuit is broken at the instant of withdrawal. Punctures should be made as nearly as possible perpendicular to the surface, so as to minimize the destruction of epithelium and thus lessen the reaction. A minute gray fibrous slough detaches itself in a few days. Cautery puncture should be repeated every two or three weeks, selecting a new location each time, until the desired result is obtained. Great caution, as mentioned above, must be used to avoid setting up perichondritis. Many cases of laryngeal tuberculosis will recover as quickly by silence and a general antituberculous regime. Radium, in form of capsules or of needles inserted in the tissues may be applied with great accuracy; but the author is strongly impressed with pyriform sinus applications by the Freer method. After-care of endolaryngeal operations includes careful cleansing of the teeth and mouth; and if the extrinsic area of the larynx is involved in the wound, sterile liquid food and water should be given for four days. The patient should be watched for complications by a special nurse who is familiar with the signs of laryngeal dyspnea (q.v.). Complications during endolaryngeal operations are rare. Dyspnea may require tracheotomy. Idiosyncrasy to cocain, or the sight or taste of blood may nauseate the patient and cause syncope. Serious hemorrhage could occur only in a hemophile. The careless handling of a bite block might damage a frail tool or dental fixture. Complications after endolaryngeal operations are unusual. Carelessness in asepsis has been known to cause cervical cellulitis. Emphysema of the neck has occurred. Edema of the larynx occasionally occurs, and might necessitate tracheotomy. Serious bleeding after operation is very rare except in bleeders. Hemorrhage within the larynx can be stopped by the introduction of a roll of gauze from above, tracheotomy having been previously performed. Morphin subcutaneously administered, has a constricting action on the vessels which renders it of value in controlling hemorrhage. Next: Introduction Of The Bronchoscope Previous: Endoscopic Operations For Laryngeal Stenosis
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