摘要:

AbstractFrom a group of 60 patients with histologically‐proven Wegener's granulomatosis managed at the National Institute of Allergy and Infectious Disease, approximately 45% were found to have disease that involved the ears. The majority of these patients had either recurrent or persistent serous otitis, resulting from eustachian tube dysfunction as a consequence of nasopharyngeal inflammations. Other pathologies included suppurative otitis, cholesteatoma, facial nerve paralyses, temporal bone grnnulomata, and sensory hearing losses. The presentation and management of these changes and their relationships to underlying disease are described in selected case reports, and a general philosophy of patient management is presente

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00001

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe authors review 1,939 chronic ear surgeries in which 1,556 underwent some form of tympanic membrane grafting. The overall take rate was 93%. There was no selection of cases with regard to presence of infection, cholesteatoma, polyps, or granulation tissue at the time of surgery. There appeared to be no difference in the take rate based upon age of the patient, presence of infection, or cholesteatoma. Autogenous and homograft fascia performed well and there was no significant difference in take rate. Complications were minimal and were related more to the disease process than the grafting techniqueper se.In addition to reviewing the long‐term follow‐up of the original technique the authors present a method of dealing with tympanic membrane retraction pockets. Called a cartilage tympanoplasty this procedure incorporates a large piece of full thickness tragal cartilage with attached perichondrium into the substance of the tympanic membrane.With 2 years follow‐up at this writing, this procedure has markedly reduced postoperative retraction pockets and recurrent choleste

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00002

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractWe reviewed the records of 22 patients with orbital cellulitis to determine the value of high resolution computerized tomography (HRCT) and standardized ultrasound (US) in their management, In 13 patients, they demonstrated abscess formation and accurately defined its location and extent. The appearance of an abscess did not necessarily mandate immediate surgery. Three patients responded promptly to intensive antibiotic therapy and resolved despite a presumptive diagnosis of orbital abscess. The remaining 10 patients required surgical intervention and abscess formation was confirmed.In patients presenting with good visual acuity and some globe motion we recommended instituting intensive intravenous antibiotic therapy for 36 hours with close monitoring of visual acuity, avoiding surgery unless some impairment of vision is noted. The decision regarding surgery is then made on the time honored basis of response to therapy. Surgery is not necessary in those patients exhibiting prompt significant improvement in local inflammatory signs.

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00003

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractOptimal management of patients with orbital cellulitis depends on how accurately the disease is classified and on the appropriateness with which antibiotics and surgery are used to treat the disease. Therapy must be adjusted on the basis of the extent of the disease. In order to determine the balance of treatment modalities which is most beneficial for certain disease presentations, we reviewed a series of 303 patients with orbital cellulitis. The anatomical and bacteriological etiology of the disease was determined in each case on the basis of the examination, visual acuity, results of sinus radiography, results of culture, ultrasonography, and computerized tomography. To avoid the 5% complication rate that occurred in this series, an evaluation and treatment protocol is recommended.

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00004

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractIn this review of 526 intrnnasal ethmoidectomy procedures, there was a complication rate of 2.5% with no blindness, meningitis, or deaths. The rationale for associated concurrent procedures is presented. The use of an absorbable hemostntic sinus sponge and an easily removable Telfa® nasal packing made possible just a two‐night hospital stay in over 90% of these patien

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00005

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractAt Emory, six cases of lateral sinus thrombosis (LST) were seen over the last ten years — two children and four adults.The picture and bacteriology of LST have changed with the advent of antibiotics as has the usefulness of various diagnostic tests. Less is it a disease of children in association with acute otitis media. More often it is seen in the adult patient after a long history of chronic ear disease. Fever and mastoid and neck tenderness are still universal signs of the affliction. However, rarely patients do present with progressive anemia, emaciation and evidence of septic emboli. Since antibiotics are commonly used during the prodromal ear infection, cultures are often negative. If they do identify an organism, it is usually a mixed flora rather thanbeta hemolytic streptococcus. Spinal fluid results are variable and seldom is there evidence of increased spinal fluid pressure. Arteriography, venography, and digital subtraction venography are the most reliable tests to prove and delimit the thrombus.Early management involves high dose broad spectrum, intravenous antibiotics including chloramphenicol. Surgical intervention involves a mastoidectomy, exposure of the sinus, incision and drainage, but not necessarily removal of the thrombus. Internal jugular vein ligation should be reserved for those cases in which septicemia and embolization do not respond to initial surgery and intravenous antibiotic

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00006

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractTwenty‐eight children with sensorineural hearing loss resulting from viral (17) or infectious (11) agents were analyzed according to the degree and stability of the loss and the age at identification. Early identification and determination of etiology is enhanced when a viral screen is performed in the nursery, and of questionable value when viral studies are done later. Eighty percent of the children who sustained a permanent loss as a result of meningitis had severe‐profound losses. Serial hearing testing should be done every 6 months for these children who are at risk for progression or fluctuations in their hearing l

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00007

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractPhycomycosis is the preferred terminology to define a fungal disease which may be devastating and fatal. It is caused by a nonseptate hyphae, class phycomycetes and genus (Rhizopus, Mucor, Absidia). Phycomycosis in man is usually associated with debilitating diseases such as: diabetes mellitus, leukemia and immunosuppressive conditions. The cephalic phycomycosis has two forms:1. rhinoorbital cerebral which may be fatal, and2. rhino‐parnnasal sinuses form which usually has a benign clinical course.From 1943 to 1967, only 45 cases of the cephalic form were described with a mortality rate of 50%. Since then several series have been added to the literature with improved survival, probably due to the addition of amphotericin B to the therapy. Even with modern therapy, the mortality rate is still about 30%. Modern technology C.T. scan is very helpful to establish orbital and intracranial extension. When intracranial involvement is present, the prognosis is dismal. Our series of 8 patients is reporte

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00008

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractChronic rhinocerebral mucormycosis, as distinct from the acute fulminating form, has been previously unreported in the otolaryngology literature. We have observed two cases of chronic rhinocerebral mycormycosis with osteomyelitis and bony sequestration at 8 months and 2 years after apparent control of initial infection. In addition to the accepted management of early diagnosis, surgical debridement, an appropriate medical therapy, patients who have been successfully treated for acute and fulminating mucormycosis need long‐term, close follow‐up with further debridement should any chronic infection become evid

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00009

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractAspergillosis is becoming an increasingly recognized pathogen in the sinonasal tract. The courses of two patients, one seemingly healthy and one with a terminal malignancy, are reviewed. These patients illustrate the clinical course, difficulties in diagnosis, and management of patients with aspergillosis of the sinonasal tract.Aspergillusis a common endogenous contaminant of the upper respiratory tract; however, bacterial sinusitis may trigger its growth and proliferation.Aspergillus fumigatusis the most common species implicated in paranasal sinus disease in the United States. The maxillary antrum is the most commonly involved site in the paranasal sinuses. Originally, aspergillosis was described in healthy patients, but it has become increasingly recognized in the immunocompromised and the chronically debilitated. Paranasal sinusAspergillusinfections are classified as non‐invasive, invasive and fulminant. The treatment is primarily surgical. Antifungal chemotherapeutic agents are used in the treatment of central nervous system involvement and in the fulminant form of the diseas

ISSN:0023-852X    

DOI:10.1288/00005537-198207000-00010

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY