Search

THERE are certain matters common in personal injury litigation wherein a plaintiff alleges physical and/or mental loss secondary to an injury. The medical expert for the plaintiff testifies that this [...]

Abstract The apnea-hypopnea index (AHI) is an important objective measure used in the diagnosis of sleep-disordered breathing. In affected patients, the AHI has been reported to vary across successive nights. [...]

Endoscopic surgery has supplanted external approaches. Does it deserve its central role in treating chronic, intractable sinusitis? Which of your patients are the most likely candidates? Sinusitis lasting longer than [...]

Injury patterns in alpine skiing have changed over time as ski, boot, binding, and slope-grooming technologies have evolved. We retrospectively examined injury patterns in alpine skiers over a 9-year period at the Mammoth and June mountains (California) ski area. A total of 24,340 injuries were reported for the 9 seasons studied, and total lift tickets sold numbered 9,201,486. The overall injury rate was 2.6 injuries per 1,000 skier days and increased slowly over the period studied. The knee was the most frequently injured area at 35% of all injuries. increasing trends (P < .05) were noted for the rates of lower extremity injuries (37%) and knee injuries (45%). A decreasing trend was noted for the rate of lacerations (31% decrease). Slight increases were noted in upper extremity and axial injury rates. Skiing injuries continue to be a worrisome recreational problem despite improvements in ski equipment and slope-grooming techniques. The increasing trend in lower extremity, particularly knee, injury rates highlights the need for continued skier education and equipment innovation. (Davidson TM, Laliotis AT: Alpine skiing injuries--A nine-year study. West J Med 1996; 164:310-314), The sport of alpine skiing has grown dramatically in the United States from an estimated 10,000 participants in 1935 to 14.5 million in 1987.[1] Injury rates and patterns have been [...]

Snowboarding is a rapidly growing winter sport. Its Unorthodox maneuvers and young participants raise many safety concerns. We examined injury patterns in recreational snowboarders, comparing these patterns with those found in alpine skiers. Snowboarding and skiing injury patterns differed significantly (P < .05) for the following categories: 49% of injured snowboarders were beginners versus 180% of skiers. Snowboarders were more likely to suffer wrist (19% versus 20%) and ankle (16% versus 6%) injuries, but less likely to sustain knee (17% versus 319%) or thumb (2% versus 4%) injuries than skiers. For snowboarders, wrist injuries were most common in beginners (30%), knee injuries in low intermediates (28%), ankle injuries in intermediates (17%), and shoulder or clavicle injuries in advanced snowboarders (14%). Most snowboarders (90%) wore soft-shelled boots, 73% of lower extremity injuries occurred to the lead-foot side, and 73% of wrist injuries occurred during backward falls; 67% of knee injuries occurred during forward falls. Of all injuries, 8% occurred while loading onto or unloading from a ski lift. The sport of snowboarding brings with it a different set of injuries from those seen in alpine skiing. The data focus attention on improvements such as wrist guards or splints, releasable front-foot bindings, and better instruction for beginner snowboarders to improve the safety of this sport. Finally, the data confirm that snowboarders and skiers may be safely combined on the same slopes., (Davidson TM, Laliotis AT: Snowboarding injuries--A four-year study with comparison with alpine ski injuries. West J Med 1996; 164:231-237) Despite initial concerns over safety and liability, snowboarding has grown into [...]

Obstructive sleep apnea (OSA) is often associated with reduced pharyngeal muscle tone and an anatomically narrowed pharyngeal airspace. We describe 2 cases of aberrant internal carotid arteries that were diagnosed during evaluations of patients with suspected OSA. It is possible that these anatomic anomalies contributed to airspace narrowing in these patients. These 2 cases represent an interesting presentation of sleep apnea, and they provide a reminder of the importance of clinically recognizing carotid artery aberrations in order to avoid arterial damage during routine oropharyngeal procedures., Introduction The internal carotid artery (ICA) usually follows a straight path from the bifurcation of the common carotid artery to the skull base. (1) An aberrant ICA is susceptible to [...]

The insurance industry has removed the joy from health care delivery with authorizations, documentation, guidelines for evaluation and treatment, diminished reimbursement, reimbursement delays, and denied payments. Physicians are now paid [...]

Abstract We conducted a survey of otolaryngologists at all Veterans Administration and Department of Defense hospitals in the United States to ascertain the nature and scope of their treatment of [...]

Judge: 'Has the jury reached a verdict?' Jury head: 'Yes, your honor.' Judge: 'What is the verdict?' Jury head: 'Guilty.' Judge: 'The court finds the defendant guilty of medical malpractice.' [...]

Abstract Sleep disordered breathing, including obstructive sleep apnea, is a common and morbid health problem. Traditionally, sleep disordered breathing is diagnosed by complex sleep studies. However, newer, easy-to-use, highly sensitive, [...]

Goals and objectives Otolaryngologists play an important role in the evaluation and treatment of patients with sleep disordered breathing, with special emphasis and expertise in obstructive sleep apnea, snoring, and [...]

Sleep disordered breathing (SDB) is a significant medical problem. By some estimates, it affects upwards of 20 to 30% of adult Americans. Otolaryngologists have a special interest and expertise in [...]