Assuntos
Otopatias/terapia , Otorreia de Líquido Cefalorraquidiano/diagnóstico , Otorreia de Líquido Cefalorraquidiano/etiologia , Otorreia de Líquido Cefalorraquidiano/terapia , Colesteatoma da Orelha Média/diagnóstico , Colesteatoma da Orelha Média/etiologia , Colesteatoma da Orelha Média/terapia , Otopatias/diagnóstico , Otopatias/etiologia , Feminino , Humanos , Masculino , Ventilação da Orelha Média/efeitos adversos , Otite/diagnóstico , Otite/etiologia , Otite/terapiaRESUMO
Rhinoliths are calcareous concretions that are formed by the deposition of salts on an intranasal foreign body over a number of years. We describe a rare case of rhinolithiasis, whereby a small foreign body has been lodged in a man's nasal cavity for over 80 years. He presented to the ear, nose and throat clinic with a sore throat and an incidental finding of a rhinolith was made which was confirmed by x-ray. This was managed conservatively.
Assuntos
Cálculos/diagnóstico , Corpos Estranhos/diagnóstico , Cavidade Nasal , Doenças Nasais/diagnóstico , Nariz , Idoso de 80 Anos ou mais , Calcinose/diagnóstico , Diagnóstico Diferencial , Endoscopia , Humanos , MasculinoRESUMO
Difficult access can make identification of a cerebrospinal fluid leak from the lateral wall of the sphenoid sinus very difficult, especially in a well-pneumatized sinus. Access to the sphenoid sinus has become easier with the advancement of minimally invasive endoscopic technology. In this article we describe our approach to a cerebrospinal fluid leak originating from this location, which has not been described previously in the literature.
Assuntos
Rinorreia de Líquido Cefalorraquidiano/cirurgia , Endoscopia/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Seio Esfenoidal/cirurgia , Idoso , Rinorreia de Líquido Cefalorraquidiano/diagnóstico , Fascia Lata/transplante , Feminino , Adesivo Tecidual de Fibrina , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Cartilagens Nasais/transplante , Seio Esfenoidal/patologia , Adesivos Teciduais , Tomografia Computadorizada por Raios X , Conchas Nasais/transplanteRESUMO
OBJECTIVE: The incidence of COM without cholesteatoma in Australian aboriginals is quoted as being between 25 and 47%. The incidence of cholesteatomatous OM is very low in comparison (between 1 and 3%). A comprehensive literature search found no studies offering an explanation for the large discrepancy between these two types of OM. We offer a theory to account for the disproportionate rates of the two types of OM together with an observational study on aboriginals with COM to substantiate our argument. METHOD/RESULTS: The crux of our hypothesis centres on the anatomy of the posterior attic. We found that in a study of 40 aboriginal patients undergoing tympanoplasty with audiometric evidence of an intact ossicular chain that, after posterior tympanomeatal flap elevation, no part of the incudostapedial assembly was visible in 95% of cases denoting its location behind the posterior attic wall. CONCLUSION: We hypothesise that in aboriginal ears the resulting 'crowding' of the posterior attic by the incudostapedial assembly results in narrowing of the epitympanic space which compromises atticoantral drainage, thus leading to mucosal COM, however supporting the posterior-superior segment of the tympanic membrane, impeding the formation of a retraction pocket, and cholesteatoma formation migrating into the mastoid antrum.