By John B. Morin
ISBN-10: 0915795884
ISBN-13: 9780915795888
Read or Download Sea Lords (Sealords) of Gondor: Pelargir and Lebennin (MERP Middle Earth Role Playing #3400) PDF
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Additional info for Sea Lords (Sealords) of Gondor: Pelargir and Lebennin (MERP Middle Earth Role Playing #3400)
Example text
When used in chronic otitis media surgery, the laser permits noncontact ossicular work and soft-tissue ablation with almost no bleeding. Fig. 05 s). To date there have been no detailed studies on laser use in chronic ear surgery. Thedinger [95] reported on the use of 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 36 Lasers in Otology 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 the KTP laser in 103 cases of chronic otitis media following tympanoplasty and mastoidectomy.
If conservative therapy is ineffective or if rapid hearing improvement is desired, a laser myringotomy is done using the same parameters as in the treatment of SOM (see above). If effusion is not definitely present, the laser should be used at a reduced power setting. Barotrauma Barotrauma results from a rapid change in ambient pressure in the presence of eustachian tube dysfunction. It can occur during flying, diving, or rapid altitude changes in the mountains when acutely painful positive pressure, or rarely negative pressure, develops in the middle ear causing a bulging or retraction of the tympanic membrane.
Defocusing the laser beam to create a larger myringotomy reduces the power density at the target in proportion to the square of the radius of the irradiated area. The power setting must be increased considerably to achieve effective power density. Defocusing the beam to a 2-mm spot size would require a power setting of approximately 60 W to achieve the effective power density indicated above. Moreover, the laser beam profile becomes imprecise when the beam is defocused, also resulting in less effective perforation.
Sea Lords (Sealords) of Gondor: Pelargir and Lebennin (MERP Middle Earth Role Playing #3400) by John B. Morin
by George
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