Burkholderia gladioli sinonasal infection.

INTRODUCTION: Burkholderia gladioli are non-fermenting, Gram-negative, rod-shaped aerobic bacteria that were first identified as a plant pathogen. Most of the B. gladioli infections reported in the literature have involved immunocompromised adults and newborn infants. B. gladioli in humans is often associated with a poor prognosis. CASE REPORT: We describe the first case of sinonasal infection due to B. gladioli and Staphylococcus aureus in an immunocompetent patient who had recently travelled to the Congo. DISCUSSION: As in the few other reported cases involving immunocompetent patients, the appropriate approach to this multidrug-resistant B. gladioli infection was a combination of surgery and antibiotics chosen in the light of an antibiogram.

[The treatment of choanal atresia]. / Trattamento dell'atresia coanale.

Choanal atresia occurs in approximately 1 out of every 8000 live births. In about 60% of these cases it is unilateral and is often associated with other major craniofacial anomalies or visceral malformations such as the so-called CHARGE syndrome (i.e. Choloboma, Heart defects, choanal Atresia, Retarded growth and development, Genital anomaly, and Ear defect with deafness) first described by Pagon in 1981. In newborns the clinical manifestations of choanal atresia consist of respiratory distress strictly related to the entity of nasal obstruction. Total bilateral congenial choanal atresia must, therefore, be considered a surgical emergency since nasal obstruction impedes the suction mechanism and hence normal feeding in the newborn. For this reason, prompt surgery is mandatory. The surgical approach employed in choanal atresia consists of both the trans-nasal and trans-palatal approaches. Between 1985 and 1997 31 patients with choanal atresia were treated in our department (16 males, 15 females; age range 2 days-5.5 years; mean 11.4 months). In 25 cases (80.6%) the malformation was bilateral. Associated anomalies were seen in 8 patients (25.8% of cases). All of these patients were treated using the trans-nasal approach, under general anesthesia, and endoscopic control. In 27 cases a trocar was employed to perforate the bony atresia and a stent was then positioned. Three patients underwent contact-laser resection of the stenosis without requiring any further stent and without any complications. None of these patients developed total recurrences, although after varying amounts of time, in 8 of the 27 patients operated using the trocar (29.6% of cases) a partial reduction of the airway occurred, the substenosis requiring dilatation with progressive Hegar dilators. In the remaining cases contact-laser therapy was associated with dilation. Three of the patients were treated by laser-therapy alone and none developed a recurrence. One patient dropped out of the follow-up for other serious malformations.

Compensation mechanisms after acute peripheral disorders of the labyrinth as a function of age.

Nowadays opinions on the complexity of the central vestibular compensation mechanisms are still divergent, but it is correct to believe that biochemical and morphological changes appearing in various sites of the central nervous system during aging have a negative reflection on the integrity of such a process. The present paper is a clinical-descriptive study on 26 patients affected with a sudden loss of the vestibular function, examined at the ENT Department at the University of Padua, from 1981 to 1983. The study's results are reported, and several problems connected to the interference of the aging process on the mechanism of vestibular compensation are examined.

Epidemiological considerations in sudden hearing loss: a study of 183 cases.

We have studied certain epidemiological problems not often encountered in the literature, involving patients with sudden hearing loss. We performed a retrospective cross-sectional study on 183 patients at the University of Padova and found that: age at the onset of the hearing loss incurred is closely associated with the presence of concomitant diseases; partial or total recovery of hearing is strongly predicated by the variables of age at onset and the interval between onset of hearing loss and the beginning of treatment given. We have also used polar-coordinate diagrams to show that cases of sudden hearing loss tend to be cyclic and are more prevalent in the central months of each season.