Endoscopic surgery for early glottic carcinoma

Early glottic carcinoma, specifically stage I or II, can be treated with endoscopic excision, radiation therapy, or open partial laryngectomy. Over the past two decades, this topic has received intensive interest, and controversies have often focused on techniques and outcomes comparing the use of endoscopic excision versus radiation therapy. This article will discuss philosophy, techniques, and outcomes of resection using the endoscopic approach to early glottic carcinoma. Optimization through appropriate instrumentation, staging, and technical details are critical to postoperative oncologic and vocal outcomes. The reader must remember that over 90% of T1 lesions and approximately 75% of T2 lesions are curable, and therefore adherence to the principles described below is important to achieve these outcomes.     

Self-Warming Lidocaine/Tetracaine Patch Effectively and Safely Induces Local Anesthesia during Minor Dermatologic Procedures

BACKGROUND Dermatologic procedures often cause some degree of pain. A self-warming patch containing lidocaine and tetracaine (L/T) was developed to provide topical local anesthesia prior to painful procedures.
OBJECTIVES To evaluate the safety and efficacy of a self-warming L/T patch to provide anesthesia in adult patients undergoing minor dermatologic procedures.
METHODS An active or placebo study drug was placed on adults 30 minutes prior to minor dermatologic surgical procedures in a prospectively randomized, double-blinded manner. Subcutaneous lidocaine injection was available during the procedure as a rescue medication if requested by the subject. Immediately following the procedure, the subjects, the investigator, and an independent observer rated pain intensity and adverse events were recorded.
RESULTS Patient-reported pain intensity was significantly lower in the L/T patch group (   p < .001  ). Investigators and an independent observer rated the pain in the L/T patch group to be less than in the placebo patch group (   p = .004  and   p < .001  , respectively). Forty-nine percent of patients in the placebo group required rescue subcutaneous lidocaine compared with 22% in the L/T patch study group (   p = .008  ). One patient in the L/T patch group reported a transient moderate burning sensation.
CONCLUSION The self-warming L/T patch was effective in providing clinically useful local anesthesia for minor dermatologic procedures in adult patients.
ZARS, INC., PROVIDED SUPPORT VIA A SPONSORED RESEARCH GRANT TO THE UNIVERSITY OF MIAMI.