BACKGROUND AND OBJECTIVES: Common complications after the operation of chronic otitis media are dizziness, postoperative nausea, and postoperative pain. Authors aimed to investigate whether the intravenous injection of dexamethasone during the operation of chronic otitis media can reduce these complications. SUBJECTS AND METHOD: With the approval of the institute's ethics committee, a total of 68 patients who had been diagnosed with chronic otitis media were included in the study. The patients in the dexamethasene group received 5mg of intravenous dexamethasone during canal wall-up mastoidectomy, and the patients in the placebo group received no additional injection except for Hartman solution. All patients requested to fill up the questionnaires about dizziness, postoperative pain, and postoperative nausea according to VAS (Visual analogue system) score at 3 hours, 6 hours and 24 hours after operation. RESULTS: No postoperative complications were found in both groups. There was significant improvement in dizziness and postoperative nausea 24 hours postoperatively in the dexamethasone group. But dexamethasone group failed to show significant difference regarding postoperative pain when compared with the placebo group. CONCLUSION: Intravenous dexamethasone injection during canal wall-up mastoidectomy appeared to have significant effects on reducing postoperative dizziness and postoperative nausea.
Dexamethasone* ; Dizziness* ; Ethics Committees ; Humans ; Injections, Intravenous ; Nausea* ; Otitis Media ; Pain, Postoperative ; Postoperative Complications ; Postoperative Nausea and Vomiting ; Surveys and Questionnaires

OBJECTIVES: This study was investigated the recovery characteristics of propofol-remifentanil and sevoflurane-remifentanil anesthesia for total thyroidectomy. METHODS: Eighty patients in ASA physical status 1 and 2 scheduled for total thyroidectomy were allocated randomly to either group P (n = 40) or group S (n = 40). Anesthesia was maintained with remifentanil effect site concentration (Ce) 1-3 ng/mL and propofol Ce 2-4 microg/mL in the group P, and was maintained with remifentanil Ce 1-3 ng/mL and sevoflurane 1.5-2% in the group S. Blood pressure, heart rate, and bispectral (BIS) index were measured during perioperative period. The times from discontinuance of anesthetic agent to eye opening, to extubation, and to stating name were measured. Postoperative complications were evaluated. RESULTS: There were no significant differences between group P and S on the blood pressure, heart rate, and recovery time. BIS index of group P showed lower than that of group S during operation (P < 0.05). The incidences of side effects were similar in the two groups, though the incidence of nausea was higher in the group S (P < 0.05). CONCLUSIONS: Propofol-remifentanil anesthesia was more advantageous than sevoflurane-remifentanil anesthesia for thyroidectomy in view of side effect incidences.
Anesthesia* ; Blood Pressure ; Heart Rate ; Humans ; Incidence ; Nausea ; Perioperative Period ; Postoperative Complications ; Propofol ; Thyroidectomy*

PURPOSE: The majority of nasal fractures have been treated by closed reduction. And they were manipulated under local anesthesia or general anesthesia. Under the local anesthesia, patients can feel the pain and fear, so general anesthesia through the endotracheal intubation became popularized recently to treat the nasal fracture. But it has still the drawbacks of postanesthetic complication. Therefore, under the mask ventilation anesthesia using oral airway, we tried to manipulate the nasal fracture. METHODS: From July 2007 to November 2007, we worked with fifty patients that were manipulated the nasal fracture. Fifty patients were divided into two groups, general anesthesia with the endotracheal intubation group(n=25) and the mask ventilation using oral airway group(n=25). We checked up the anesthesia time, postanesthetic complication, postoperative aesthetic & functional problem of nose in two groups. RESULTS: In total operation time and sore throat frequency among the postoperative anesthetic complications, there was statistically significant difference between the mask ventilation group and the endotracheal intubation group(p<0.05). But there was no difference statistically in nausea frequency(p>0.05). And no patients complained of postoperative nasal complication such as septal deviation, septal perforation, nasal obstruction and hump nose in two groups. CONCLUSION: Through the mask ventilation using oral airway, we could reach satisfactory results in the anesthetic time and postanesthetic complication.
Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Humans ; Intubation, Intratracheal ; Masks ; Nasal Bone ; Nasal Septal Perforation ; Nausea ; Nose ; Pharyngitis ; Postoperative Complications ; Ventilation

PURPOSE: Osteotome sinus floor elevation (OSFE) is an often-used technique of great utility in certain implant patients with resorbed posterior maxilla. Recently benign paroxysmal positional vertigo (BPPV) has been reported as an early postoperative complication following OSFE. Although OSFE-induced BPPV commonly resolves itself within a month without treatment, this complication can be a cause of trouble between the implant surgeon and patient. This report presents a case of BPPV following OSFE. METHODS: A 27-year-old man without any significant medical problems and missing his maxillary right first molar, was scheduled for OSFE and simultaneous implant placement. RESULTS: The patient suffered dizziness accompanied by nausea immediately after implant placement using OSFE. Following referral to the ear nose throat clinic, "right posterior canal BPPV" was diagnosed. Despite anti vertigo medication and a single episode of the Epley maneuver, the condition did not improve completely. The Epley maneuver was then applied 7 and 8 days later and the symptoms of BPPV disappeared. One year later, the patient remained symptom-free. CONCLUSIONS: Before sinus elevation with an osteotome, implant surgeons should screen out patients with a history of vertigo, to diminish the possibility of BPPV. Operators should be aware of BPPV symptoms. As the symptoms may be very incapacitating, immediate referral to an otorhinolaryngologist is recommended.
Adult ; Dizziness ; Ear ; Floors and Floorcoverings ; Humans ; Maxilla ; Maxillary Sinus ; Molar ; Nausea ; Nose ; Outpatients ; Pharynx ; Postoperative Complications ; Referral and Consultation ; Vertigo

PURPOSE: When patients underwent emergency surgery for suspected appendicitis, colon resection could be performed at the time of the initial operation. The aim of this study was to evaluate 42 cases underwent colectomy for suspected acute appendicitis. METHODS: A retrospective analysis of 42 patients underwent colectomy for suspected acute appendicitis was performed over the period from January 1997 to December 2003 at the department of surgery, Kangnam Sacred Heart hospital, Hallym university. RESULTS: The sex ratio were 1.2:1. The mean age was 37.7 years. Right lower quadrant pain was present in all patients. Nausea and vomiting occurred in 18 cases (42.8%). Preoperative fever was 11 cases (26.1%). Abdominal ultrasound was most commonly performed preoperatively. The operative findings showed cecal mass with pericecal abscess was 20 cases (47.5%) and cecal mass with inflammation, 11 cases (26.1%), etc. The pathologic findings showed cecal diverticular abscess was 18 cases (42.8%) and pericecal abscess, 9 cases (21.4%), periappendiceal abscess, 5 cases (11.9%), etc. Type of operation was ileocecectomy, 29 cases (69.04%), and right hemicolectomy, 12 cases (28.57%), and extended right hemicolectomy, 1 case. Postoperative complications developed in 12 cases (28.57%), but those were uneventful. CONCLUSIONS: When an unexpected and suspicious cecal mass was found at operation for suspected appendicitis, the resection of all clinically apparent disease including colectomy could be considered. So, the surgeon must be aware of the possibility of these condition and choose the appropriate treatment.
Abscess ; Appendicitis* ; Colectomy* ; Colon ; Emergencies ; Fever ; Heart ; Humans ; Inflammation ; Nausea ; Postoperative Complications ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Vomiting

Congenital anomalies of the pancreaticobiliary structure may go undetected until adulthood, and they can be the cause of unexplained jaundice, abdominal pain, nausea and vomiting. In addition to such associated disease, as cholangitis, gallstone, cholangiocarcinoma and pancreatitis, recognition of these variant anatomies is clinically important for planning surgery and for preventing inadvertent surgical injury. Although congenital abnormalities and variations of the biliary ducts are common, and variations in the drainage and course of the cystic duct are also frequently seen, variation of the cystic duct opening into the right hepatic duct is rare; further, it is important to avoid erroneous ligation of the hepatic duct during surgery. We report here on a case of aberrant cystic duct opening into the right hepatic duct along with acute pancreatitis.
Abdominal Pain ; Cholangiocarcinoma ; Cholangitis ; Congenital Abnormalities ; Cystic Duct* ; Drainage ; Gallstones ; Hepatic Duct, Common* ; Intraoperative Complications ; Jaundice ; Ligation ; Nausea ; Pancreatitis* ; Vomiting

Torsion of the gallbladder is a uncommon disease. Since Wendel reported the first case of torsion of the gallbladder in 1898, approximately 400 or more cases have been reported on. A mobile gallbladder with abnormal anatomical fixation to the liver is required for this torsion. Twisting of the mobile gallbladder on its pedicle creates occlusion of the blood supply or bile flow to the organ, and gangrene and necrosis finally occurs. Prompt surgery is required for this condition. Unless cholecystectomy is performed, this condition could cause severe postoperative complications or death to the patient. Torsion of the gallbladder has been known to occur frequently in thin, elderly females. Because of its medical rarity, diagnosis of torsion prior to operative exploration is extremely difficult and the diagnosis is generally maded by laparotomy. We report here on a case of torsion of the gallbladder. The patient was an 82 years old female who complained of severe epigastric pain, nausea, and vomiting. Ultrasonography and computed tomography were performed and these modalities demonstrated a distended gallbladder with wall thickening; the gallbladder didn't contain stones. Explorative laparotomy and cholecystectomy was then performed. We found that the necrotized gallbladder was twisted around its pedicle. We report here on a case of gallbladder torsion and we discuss the clinical features and diagnostic methods for this malady.
Aged ; Aged, 80 and over ; Bile ; Cholecystectomy ; Diagnosis ; Female ; Gallbladder* ; Gangrene ; Humans ; Laparotomy ; Liver ; Nausea ; Necrosis ; Postoperative Complications ; Ultrasonography ; Vomiting

PURPOSE: 'White-eye blowout' fracture is often occur in young patients and defined as blow out fracture with little or no clinical sign of soft tissue trauma such as edema, ecchymosis, but with marked motility restrictions in vertical gaze. In this conditions, immediate operation is essential. We reported the clinical investigation study of these cases about clinical symptoms and radiologic findings and introduce our experiences about immediate operations in 'white-eye blowout' fractures. METHODS: From January 2008 to December 2009, nine pediatric patients who were diagnosed as pure white-eye blowout fractures were involved this study. Patients with other facial bone fractures or with poor general medical condition were excluded. In all cases, we performed immediate operation within 48 hours. RESULTS: All patients had diplopia, vertical gaze restriction or systemic symptoms. Six patients had nausea, vomiting and syncope caused by oculocardiac reflex. In all patients, preoperative symptoms were improved after immediate operation. There were no postoperative complications such as infection, hematoma or wound dehiscence. CONCLUSION: When we meet the young patients with history of periocular trauma, with little or no soft tissue trauma signs, but with marked vertical gaze restriction or general symptoms caused by oculocardiac reflex, we should immediately examine by facial bone computed tomography and refer the patient to ophthalmologist for ophthalmic evaluations. If patient is diagnosed as orbital floor fracture with entrapped muscle or soft tissue, the earlier surgical reduction get better clinical outcomes.
Diplopia ; Ecchymosis ; Edema ; Facial Bones ; Floors and Floorcoverings ; Hematoma ; Humans ; Muscles ; Nausea ; Orbit ; Postoperative Complications ; Reflex, Oculocardiac ; Syncope ; Vomiting

BACKGROUND: Propofol is an intravenous anesthetic characterized by rapid induction and prompt recovery. Recently, its is used widely in clinical practice, especially when early discharge is advisable. We conducted this study for the evaluation of the effects of propofol as a sole intravenous anesthetic on the operation with minimal pain such as TUL(transurethral lithotripsy). METHODS: Patients were recruited for ASA class 1 and 2 from those who received TUL operation. Propofol was administered 2 mg/kg for induction and continuously infused at the rate of 1.2~1.4 mg/kg/hr after the loss of consciousness. With the stabilization of the vital signs, we reduced the dose of propofol to 1.0~1.2 mg/kg/hr. We checked the patients' movement, vital signs, recovery time and monitored the appearance of the symtoms such as nausea, vomiting postoperatively. RESULTS: 1) The average time of operation was 15+/-12 minutes. 2) The average recovery time was 15+/-9 minutes(range 2~30 min). 3) Blood pressure and peripheral oxygen saturation(SpO2) were declined during anesthesia, but SpO2 was normalized in the recovery room. 4) No significant complications were observed. 5) Mild movement of the patient was noticed in the begining of operation, but it did not affect the surgical procedure. CONCLUSIONS: Propofol was effective as a sole intravenous anesthetic to minimize postoperative complications such as nauea, vomiting for TUL with minimal pain.
Anesthesia ; Anesthetics, Intravenous* ; Blood Pressure ; Humans ; Lithotripsy* ; Nausea ; Oxygen ; Postoperative Complications ; Propofol* ; Recovery Room ; Unconsciousness ; Vital Signs ; Vomiting

In order to analyze clinical presentations and surgical outcome, we studied eleven cases of cerebellar hemangioblastomas from among a series of 421 intracranial tumors treated over a period of seven years. The proportion of male patients was 2.7 times that of females and the age peak appeared between 30 and 50 years(mean age: 37.7 years old). The common clinical presentations were headache(73%), dizziness(55%), unilateral cerebellar dysfunction(45%), and nausea or vomiting(36%). In our series there were two cases of cranial nerve palsy associated with von Hippel-Lindau(VHL) disease. Polycythemia that normalized postoperatively appeared in two of eleven cases. Radiologic studies showed nine cystic tumors, six in the cerebellar hemisphere and three in the cerebellar vermis, and three solid tumors extended into the brain stem. After aspiration of the cyst, careful removal of the mural nodule gave good results in more than 70% of patients. Because the tumor extended into the brain stem, however, three solid lesions were resected subtotally. Postoperative complications developed in four patients, and in three of these, the lesion extended into the brain stem. In conclusion, major clinical features were due to increased intracranial pressure, and varying expression of cerebellar and cranial nerve deficits was characteristic. To determine the resectability of lesions and to minimize surgical morbidity, extremely careful clinical and neuroradiological observation is essential.
Brain Stem ; Cerebellum ; Cranial Nerve Diseases ; Cranial Nerves ; Female ; Headache ; Hemangioblastoma* ; Humans ; Intracranial Pressure ; Male ; Nausea ; Polycythemia ; Postoperative Complications