摘要:

AbstractRetropharyngeal abscess appears in infancy and early childhood. Because of the advances in antibiotic therapy, the frequency of this disease has decreased considerably. If overlooked, however, the sequelae of retropharyngeal abscess can be disastrous.Of the typical signs and symptoms listed in presentation, the swelling of the posterior pharyngeal wall is referred to as an important diagnostic sign. This presentation will discuss the fallibility of this important sign in the evaluation of a retropharyngeal abscess in children. The size of the pediatric oral cavity and the presence of pooling secretions in the pharynx, due to retropharyngeal tissue swelling, make assessment of swelling of the posterior pharyngeal wall extremely difficult.Radiological assessment of retropharyngeal abscesses cannot differentiate between cellulitis and abscess formation. The presentation will discuss the radiological appearance of a retropharyngeal swelling and discuss the differentiation of abscess formation from cellulitis.The rationale for a therapeutic regime will be developed to validate the concept that with suggestive clinical signs, suggestive radiological diagnosis, and in spite of negative evidence of retropharyngeal swelling by oral examination, justification exists for an examination under anesthesia and incision and/or aspiration of the retropharyngeal abscess.

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00001

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00002

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractMycotic infections of the inner ear have only rarely been reported. In each reported case, involvement of the inner ear appeared to be secondary to overwhelming central nervous system disease. A review of specimens from the University of Minnesota temporal bone collection has identified three distinct routes of inner ear involvement by fungi suggesting the potential pathogenesis for this disease to be similar to that identified for bacterial labyrinthitis (tympanogenic, meningogenic, hematogenic).The first case, a 48‐year‐old white male with leukemia, died of mucor meningoencephalitis. Temporal bone study revealed Mucor sp. in the arterioles of the temporal bone as well as fungal involvement of the perilymphatic space secondary to round window invasion, oval window invasion, and invasion through the internal auditory canal. The second case was a 69‐year‐old white male, diabetic, who died of Klebsiella septicemia. Post mortem temporal bone study revealed a focus of Candida sp. in the vestibule under the stapedial footplate without apparent involvement of the internal auditory canal. Case 3 was a 16‐year‐old male with lymphosarcoma who died of septicemia and candida meningoencephalitis. Candida sp. could be seen in the scala tympani adjacent to Rosenthal's canals presumably secondary to spread from the central nervous system. The fourth case, that of a 28‐year‐old white female with systemic candidiasis, had sequential ante mortem audiograms demonstrating progressive bilateral sensorineural hearing loss. Post mortem histologic examination of the temporal bones identified candida involvement of the inner ear which appeared to be hematogenic in origin.These four cases demonstrate conclusive examples of inner ear involvement of fungal disease by the tympanogenic, meningogenic, and hem

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00003

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractHistiocytosis X encompasses three syndromes characterized by the idiopathic proliferation of histiocytes: eosinophilic granuloma, Hand‐Schuller‐Christian syndrome, and Letterer‐Siwe disease. At the Mayo Clinic between 1926 and 1978, 22 patients with histiocytosis X had involvement of the ear or temporal bone. These patients comprised 15% of all patients with histiocytosis X seen during that period. The ages at onset of the disease ranged from 2 months to 49 years. The most frequent otologic symptom was aural discharge (15 patients), followed in frequency by swelling in the temporal region (11 patients), vertigo (6 patients), and deafness (5 patients). Clinical findings included otitis media (13 patients), otitis externa with or without granulation tissue (10 patients), and osteolytic lesions of the temporal bone (9 patients). A high index of suspicion is required to recognize the otologic manifestations of histiocytosis X for two reasons: the systemic manifestations of the disease are often so dramatic that the ear findings are overlooked, and the otologic findings of histiocytosis X can mimic more common diseases, including simple otitis externa, aural polyps, acute mastoiditis, chronic otitis media, and metastatic le

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00004

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractIn the well pneumatized temporal bone, the temporal lobe of the brain is separated from the middle ear and mastoid process by a thin layer of bone known as the tegmen. Congenital defects, infection, and trauma can alter this structure in such a way that cerebral tissue herniates into the ear. This unusual condition may precipitate numerous otologic problems such as hearing loss, trapped squamous epithelium, and the potential for meningitis or encephalitis.The purpose of this paper is to define the problem as well as discuss the diagnosis and surgical management. The authors feel this should be a team effort, in many cases employing the assistance of a neurosurgeon, as the repair must often be intradural. Case histories and an extensive review of the literature are to be included.

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00005

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractTwo patients who had undergone radical mastoid surgery developed an isolated focus of cholesteatoma embedded in the sternomastoid muscle just below the mastoid tip. In one instance the etiology was felt to be iatrogenic implantation of squamous epithelium. In the second, unrecognized extension from the mastoid tip probably occurred.The purpose of this paper is to describe and discuss in detail the clinical and pathological features of these two cases.

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00006

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractThis report continues the evaluation of the use of a ventilation tube in the middle ear at the time of adenotonsillectomy. This series of 72 cases has been followed for 1 to 3 years. Each patient had bilaterally similar middle ear effusions. A myringotomy was performed in both ears. In one of the ears a ventilation tube was inserted, the other ear acting as a control.In 3 out of 4 of the patients in this study, adenotonsillectomy and evacuation of the middle ear fluid were sufficient to clear the middle ear indefinitely, and the use of the ventilation tube was redundant.

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00007

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractIn an effort to substantiate the efficacy of adenotonsillectomy in very young children, 108 procedures in one and two‐year‐old children were reviewed. After rigid preoperative criteria are met, a meticulous, conservative adenotonsillectomy is performed. A review of all hospital and office records shows the procedure can be safely and simply performed without significant complications. Seventy‐nine parents were questioned regarding postoperative problems and results. Of the parents, 96% were satisfied and would have the procedure done again if they had the chance. Eighty‐four referring physicians were polled and 87% thought the procedure solved the children's problem altogether or mostly. In conclusion, the results of this study show that, in carefully selected young children using expert anesthesia and atraumatic surgical technique, adenotonsillectomy under the age of three is a safe and gratifying pr

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00008

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractSix cases of heterotopic salivary gland tissue in the anterolateral neck are presented with a review of their clinical and histopathologic characteristics. Neoplastic transformation, fistulization, and isolated rests represent a spectrum of these uncommon lesions. The embryologic derivation of salivary tissue and close association with the branchial apparatus are discussed. The significance of salivary carcinoma presenting in the neck is reinterpreted in light of the embryogenesis of these heterotopias.

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00009

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractEndoscopic surgical operations of the larynx have many desirable features, including the conservative nature of these procedures, plus the ability to produce surgical changes predictable from the onset. For several years the direct lateralization of the vocal ligament after the removal of a preassessed amount of thyroarytenoid muscle appeared to be the simplest and most accurate surgical procedure. The resection of this wedge of muscle was easily performed with laryngeal microcautery. Posterior cicatricial webs can be easily removed with this instrument. Simple suturing techniques are also described, including the practicability of using padded buttons plus lead fishing sinkers to adjust the tension and secure these sutures on the surface of the neck. So far 16 patients have been rehabilitated using this technique, including 6 patients with posterior commissure webs. These anatomical techniques should be considered because of their obvious simplicity.

ISSN:0023-852X    

DOI:10.1288/00005537-197911000-00010

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY