BACKGROUND AND OBJECTIVES: Medial maxillectomy is commonly performed for benign and low-grade malignancies involving the lateral wall of the nose. The most frequent complications are cavity crusting, epicanthal scarring and epiphora. Silicone stent, tube fixation in lacrimal sac have been used for prophylaxis of epiphora. Authors studied for the incidence of epiphora and necessity for prophylatic procedure of epiphora in patients who underwent medial maxillectomy. MATERIALS AND METHOD: This study was performed on 26 patients treated with medial maxillectomy without additional procedure for management of epi-phora. The minimal duration of follow-up was 6 months. RESULTS: Twenty one patients were treated with medial maxillectomy only and five patients were treated with medial maxillectomy combined with irradiation. Incidence of epiphora was about 7% (2/26). All patients who complained of epiphora had inverted papilloma and underwent medial maxillectomy without irradiation. No patients treated with combination of medial maxillectomy and irradiation complained epiphora. CONCLUSION: It is not necessary to do routine prophylatic procedures for epiphora at the initial procedure.
Cicatrix ; Follow-Up Studies ; Humans ; Incidence ; Lacrimal Apparatus Diseases* ; Nose ; Papilloma, Inverted ; Silicones ; Stents

OBJECTIVE: Barbiturate coma therapy (BCT) is a useful method to control increased intracranial pressure (IICP) patients. However, the complications such as hypotension and hypokalemia have caused conditions that stopped BCT early. The complications of low dose BCT with Bispectral(TM) index (BIS) monitoring and those of high dose BCT without BIS monitoring have been compared to evaluate the efficacy of low dose BCT with BIS monitoring. METHODS: We analyzed 39 patients with high dose BCT group (21 patients) and low dose BCT group (18 patients). Because BIS value of 40-60 is general anesthesia score, we have adjusted the target dose of thiopental to maintain the BIS score of 40-60. Therefore, dose of thiopental was kept 1.3 to 2.6 mg/kg/hour during low dose BCT. However, high dose BCT consisted of 5 mg/kg/hour without BIS monitoing. RESULTS: The protocol of BCT was successful in 72.2% and 38.1% of low dose and high dose BCT groups, respectively. The complications such as QT prolongation, hypotension and cardiac arrest have caused conditions that stopped BCT early. Hypokalemia showed the highest incidence rate in complications of both BCT. The descent in potassium level were 0.63 +/- 0.26 in low dose group, and 1.31 +/- 0.48 in high dose group. The treatment durations were 4.89 +/- 1.68 days and 3.38 +/- 1.24 days in low dose BCT and high dose BCT, respectively. CONCLUSION: It was proved that low dose BCT showed less severe complications than high dose BCT. Low dose BCT with BIS monitoring provided enough duration of BCT possible to control ICP.
Anesthesia, General ; Barbiturates ; Coma ; Heart Arrest ; Humans ; Hypokalemia ; Hypotension ; Incidence ; Intracranial Hypertension ; Intracranial Pressure ; Potassium ; Thiopental