RESUMO
OBJECTIVE: To obtain the main responsible organisms, its sensitivity and resistances to antibiotics in tonsillitis. MATERIAL AND METHODS: We have studied the post-surgical tonsils, carrying out a microbiologic study, its culture and sensitivity. RESULTS: The most frequent isolated organisms were Staphylococcus aureus (29.3%), followed by Streptococcus pyogenes (23.4%), and Haemophilus influenzae (12.1%). The highest resistances were for the S. aureus (penicillin 91%, erythromycin 18% and 5% to the rest of the beta-lactams), followed by H. influenzae (50% clarithromycin, 30% amoxyciIlin and 2% cephalosporins) and S. pyogenes (28% erytromycin, 10% clindamycin and 3% penicillin). CONCLUSIONS: We noticed the minimal resistance found to cephalosporins, and for this reason they appear to be the safest option, except in children under five years old, in which amoxicillin is still the first line treatment, because the causative agent is S. pyogenes, sensitive to that antibiotic.
Assuntos
Antibacterianos/uso terapêutico , Cefalosporinas/uso terapêutico , Farmacorresistência Bacteriana/fisiologia , Eritromicina/uso terapêutico , Tonsilite/tratamento farmacológico , Tonsilite/microbiologia , Adolescente , Adulto , Distribuição por Idade , Infecções Bacterianas/complicações , Infecções Bacterianas/tratamento farmacológico , Criança , Pré-Escolar , Farmacorresistência Fúngica , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Resistência às Penicilinas/fisiologia , Tonsilite/epidemiologiaRESUMO
Our aim was to know the clinical performance and management results of Functional Endoscopic Sinus Surgery (FESS) in Spanish hospitals. We sent a survey on the use and results of FESS to 160 Spanish public hospitals in June of 2002, obtaining a response rate of 69%. 82.9% of the interviewed hospitals carried out FESS and 17.1% of the remaining used the classic techniques of approaching the paranasal sinuses. The reported length of stay in hospital was 1.4 days for the FESS and 2.4 for the traditional surgery. The surgical time was 15 minutes shorter for the CENS, and the rate of recurrence was 16% less than for the classic surgery. As years of experience in the practice of the CENS go by, the surgical times tend to decrease, that didn't happen with the rate of recurrence. In conclusion, we consider that FESS seems to improve the analyzed clinical performance and assistential results.
Assuntos
Endoscopia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde , Doenças dos Seios Paranasais/cirurgia , Hospitais Públicos/normas , Hospitais Públicos/estatística & dados numéricos , Humanos , Tempo de Internação , Recidiva , Espanha , Inquéritos e QuestionáriosRESUMO
The purpose of this study is to find out more about the implementation of functional endoscopic sinus surgery (FESS) in our country. To do that, we designed a survey which was sent to 160 public hospitals (June 2002). We received the answers of 111 hospitals. 82.9% of hospitals and 58% of surgeons performed FESS, with some differences among autonomic regions. The percentage of surgeons who performed FESS was higher in small hospitals and their mean experience time was 6.2 years. We consider the implementation of endoscopic sinus surgery very high, this can reflect that there are evident advantages for those who specialists who use it.
Assuntos
Endoscopia/métodos , Otolaringologia/organização & administração , Doenças dos Seios Paranasais/cirurgia , Humanos , Pólipos Nasais/cirurgia , Sinusite/cirurgia , EspanhaRESUMO
A study of the objective evaluation of voice was made of 100 voices of healthy adults and 60 with disphonia (nodules and polyps). A laryngostroboscopy and an acoustic analysis was made to everyone. A sustained vowel "a" was carried out and digitalized with Dr. Speech Science software. These parameters were estimated: fundamental frequency (Fo, according to gender), Jitter, Shimmer and glottic noise (NNE, HNR, SNR). In the healthy group Fo was 139.72 in men and 267.33 in women, jitter 0.24 and shimmer 2.10. In disphonic patients (nodules) Fo was 126.96 in men and 240.72 in women, jitter 0.35 and shimmer 3.25. In disphonic patients (polyps) Fo was 119.75 in men and 218.26 in women, jitter 0.50 and shimmer 4.34. These difference were statistically significant. Glottic Noise in healthy group was: NNE -13.62, HNR 24.07 and SNR 24.49; in disphonic patients (nodules) was: NNE -10.65, HNR 25.21 and SNR 25.55; in disphonic patients (polyps) was: NNE -8.24, HNR 29.63 and SNR 28.22. Only the difference in the NNE was statistically significant. We highlight the importance of objective evaluation of voice disorders.
Assuntos
Doenças da Boca/fisiopatologia , Neoplasias Bucais/fisiopatologia , Pólipos/fisiopatologia , Distúrbios da Voz/fisiopatologia , Qualidade da Voz , Adulto , Feminino , Humanos , Masculino , Doenças da Boca/complicações , Doenças da Boca/patologia , Neoplasias Bucais/complicações , Neoplasias Bucais/patologia , Pólipos/complicações , Pólipos/patologia , Prevalência , Distúrbios da Voz/epidemiologia , Distúrbios da Voz/etiologiaRESUMO
Extramedullary solitary plasmacytoma is a rare plasmatic cell tumor occurring in the head and neck. We report the case of a patient with a mass that arose from the sphenoidal base, extended toward the right paranasal sinuses, and invaded the orbit. The clinical characteristics, diagnostic criteria, and therapeutic problems are discussed and reviewed in the literature, with special attention to an alternative therapeutic approach, midfacial degloving.
Assuntos
Neoplasias Orbitárias , Neoplasias dos Seios Paranasais , Plasmocitoma , Neoplasias Cranianas , Osso Esfenoide , Procedimentos Cirúrgicos Operatórios/métodos , Adulto , Feminino , Humanos , Invasividade Neoplásica , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/patologia , Neoplasias Orbitárias/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/cirurgia , Plasmocitoma/diagnóstico por imagem , Plasmocitoma/patologia , Plasmocitoma/cirurgia , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias Cranianas/patologia , Neoplasias Cranianas/cirurgia , Osso Esfenoide/diagnóstico por imagem , Osso Esfenoide/patologia , Osso Esfenoide/cirurgia , Tomografia Computadorizada por Raios XRESUMO
UNLABELLED: Cerebrospinal fluid (SCF) rhinorrea results from a breakdown of the dura and supporting structures of the skull base. Trauma is responsible for 81 to 90 percent of the cases of SCF rhinorrea, and it occurs in approximately 2 percent of all head injuries. This is a retrospective review of 5 patients who underwent endoscopic treatment of CSF rhinorrea during 1997 in our hospital. The aetiology of leaks was: iatrogenic in two cases (by transphenoidal hypophysectomies), traumatic in two cases (by head injuries) and spontaneous in one (nasal encephalocele). CONCLUSION: we recommend endoscopic approach as the first line in managing CSF rhinorrea because it avoids an external incision, requires less cumbersome instrumentation and in our hands in the safest and most successful. Furthermore, we prefer the autogenous mocuperiosteum of the inferior turbinate glued over the fistula offers several advantages: it is readily available in sufficient size for the closure of most defects, only minor surgery for graft harvesting is necessary and, the texture of the mucoperiostium permits a good secure seal.
Assuntos
Rinorreia de Líquido Cefalorraquidiano/cirurgia , Doenças Nasais/cirurgia , Fístula do Sistema Respiratório/cirurgia , Rinorreia de Líquido Cefalorraquidiano/etiologia , Endoscopia , Humanos , Doenças Nasais/complicações , Fístula do Sistema Respiratório/complicações , Estudos RetrospectivosRESUMO
The rate of occurrence of neoplasma arising from the parapharyngeal space is scarce, about 0.5 percent of neck and face tumors. In the paper is reported our 10-year experience on its clinical diagnosis and therapeutical management as well. We have found 13 percent (3/23) malignancies and 87 percent (20/30) benign growth. 35 percent were paragangliomas and 22 percent represent salivary tumors. Diagnostic procedures, ways of approach and surgical complications are considered.
Assuntos
Neoplasias Faríngeas/patologia , Faringe/patologia , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Faríngeas/diagnóstico , Neoplasias Faríngeas/cirurgia , Faringe/cirurgia , Complicações Pós-Operatórias , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/cirurgia , Glândulas Salivares/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The aim of the present study was to assess the clinical and bacteriological efficacy of ciprofloxacin in the treatment of chronic otitis media. Ciprofloxacin was randomly administered for ten days to two groups of patients. Group A was given 500 mg. orally twice a day. Group B received drops of ciprofloxacin in saline solution locally twice a day. We obtained a favorable clinical and bacteriological response. Bacteriological response observed in group B was statistically higher than that of group A (p < 0.01). Results obtained in this study suggest that ciprofloxacin locally administered is very effective in the treatment of chronic otitis media.
Assuntos
Ciprofloxacina/administração & dosagem , Otite Média/tratamento farmacológico , Administração Oral , Administração Tópica , Adolescente , Adulto , Idoso , Bactérias/isolamento & purificação , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média/microbiologiaRESUMO
Sarcomas constitute less than one percent of laryngeal neoplasms. Fibrosarcomas are by far the most commonly reported mesenchymal tumors of the larynx. We report two cases of fibrosarcoma of the larynx and discuss clinical aspects, diagnosis and treatment.
Assuntos
Fibrossarcoma , Neoplasias Laríngeas , Idoso , Fibrossarcoma/diagnóstico , Fibrossarcoma/cirurgia , Humanos , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-IdadeRESUMO
The authors made an audiological screening of the entire population of the Valle de los Pedroches entering primary education in 1992. The auditory levels of the children were measured and abnormalities were detected. In a total of 440 children, 43 hypoacusic cases were found. The type of hypoacusis was predominanthy conductive (95.4%), serous otitis media, being the most common cause of hypoacusis in infancy. We deduce that screening is useful for detecting this medical problem.
Assuntos
Orelha Média/fisiopatologia , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/fisiopatologia , Testes de Impedância Acústica , Otorreia de Líquido Cefalorraquidiano/diagnóstico , Criança , Feminino , Perda Auditiva Condutiva/epidemiologia , Humanos , Masculino , Otite Média com Derrame/epidemiologia , Otite Média com Derrame/fisiopatologia , Prevalência , Fatores Sexuais , Espanha/epidemiologiaRESUMO
We analyzed the DNA nuclear content and cellular cycle distribution of the healthy laryngeal tissues without any laryngeal disease (healthy) and that of from patients afflicted with laryngeal epidermoid carcinoma (healthy/Ca). We have carried out studies on fresh samples, unfixed samples, and analysing them immediately after their extraction in the flow cytometer, using human peripheral blood lymphocytes as control of the ploidy in each case. In the study effected, we did not find any differences in the DNA content of the healthy laryngeal tissues and those macroscopically healthy from patients with epidermoid carcinoma of the larynx. However, the laryngeal tissues show a significantly higher DNA content than the human peripheral blood lymphocytes used as check.
Assuntos
DNA/química , Citometria de Fluxo , Laringe/fisiologia , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/patologia , Técnicas de Cultura , Feminino , Humanos , Laringe/química , Laringe/patologia , Linfócitos/química , MasculinoRESUMO
We present a case of intracranial Tuberculoma of the cerebellopontine angle and discuss the problems to set up the preoperative etiological diagnosis. Finally we make a review of the literature of the subject.
Assuntos
Encefalopatias/diagnóstico , Ângulo Cerebelopontino/diagnóstico por imagem , Tuberculoma/diagnóstico , Encefalopatias/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Tuberculoma/diagnóstico por imagemRESUMO
We carried out a clinical study on the manifestations of various connective tissue pathologies of the head and neck. The need to suspect the presence of these pathological entities from non-specific ENT symptoms and performing early diagnoses of cochleovestibular diseases on the basis of a clinical and examination protocol is emphasized.
Assuntos
Doenças do Colágeno/complicações , Otorrinolaringopatias/etiologia , Adulto , Idoso , Artrite Reumatoide/complicações , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Masculino , Pessoa de Meia-Idade , Doença Mista do Tecido Conjuntivo/complicações , Policondrite Recidivante/complicações , Escleroderma Sistêmico , Síndrome de Sjogren/complicaçõesRESUMO
A patient with Sarcoidosis presented with hoarseness in the course of the disease, caused by mediastinal adenopathies compressing the left recurrent laryngeal nerve. Vocal cord paralysis is an unusual complication of sarcoidosis. We have found in the consulted worldwide bibliography on the subject only four cases of sarcoidosis with mediastinal enlarged lymph nodes causing compression of the left recurrent nerve and subsequently vocal paralysis.
Assuntos
Nervos Laríngeos , Síndromes de Compressão Nervosa/complicações , Sarcoidose/complicações , Paralisia das Pregas Vocais/etiologia , Humanos , Doenças Linfáticas/complicações , Masculino , Mediastino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/etiologiaRESUMO
Idiopathic brain herniation into the middle ear and the mastoid process is an infrequent condition. There are only 29 cases reported in the world literature covering the last 40 years. The paper inform on one of those cases, a man, of spontaneous encephalocele and deals with the pathogenesis, the clinical features and the suitable surgical approach.
Assuntos
Orelha Média , Encefalocele , Encefalocele/diagnóstico por imagem , Encefalocele/cirurgia , Humanos , Masculino , Processo Mastoide/cirurgia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
We present a case of rhinocerebral mucormycosis in a 47 years old woman without diabetic or immunodepression past. The diagnosis was confirmed through a histological study of the material obtained after surgery. The treatment with amphotericin B and radical surgery showed ineffective. The patient died two weeks after entrance. We make an evaluation of the etiopathological, clinical and therapeutic aspects and also a revision of the relevant literature.
Assuntos
Sinusite Etmoidal/diagnóstico , Mucormicose/diagnóstico , Anfotericina B/administração & dosagem , Terapia Combinada , Seio Etmoidal/diagnóstico por imagem , Seio Etmoidal/patologia , Seio Etmoidal/cirurgia , Sinusite Etmoidal/patologia , Sinusite Etmoidal/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Mucormicose/patologia , Mucormicose/terapia , Tomografia Computadorizada por Raios XRESUMO
The AA. present a review of the expansive processes of the cerebellopontine angle (CPA) diagnosed at their Department, during the six last years. Emphasis is made upon the clinic findings gained through neuro-otological explorations and imaging, both helpful for preoperative diagnosis of the nature of the tumor.