ABSTRACT
A retrospective evaluation of glass ionomer cement (GIC) in middle ear surgery with emphasis on short- and long-term safety was conducted at the tertiary referral center. GIC was applied between 1995 and 2006 in 444 patients in otologic surgery. Technical aspects, safety, benefits and complications due to GIC were analysed until 2011 (follow-up 5-16 years; mean 10 years). GIC was applied in stapes surgery (228 primary, 92 revisions), cochlear implants (108) and implantable hearing aids (7), ossiculoplasty (7), for coverage of opened mastoid air cells towards the external ear canal (1) and inner ear fistula closure (1). GIC turned out to be very handy in stapes surgery for optimal prosthesis fixation at the incus (260) and on the malleus handle (60) without complications. Results suggest that GIC may diminish the danger of incus necrosis in primary stapedotomy. In cochlear implants and implantable hearing aids, GIC was used for casing alone (74), casing and electrode fixation (27) and electrode alone fixation (14). Inflammatory reactions were observed in five cases (4.3%), mostly after trauma. Broken cement fragments appeared to promote foreign body rejection. In seven cases an incudo-stapedial gap was repaired with GIC with excellent hearing gain; in three cases (43%) revision surgery was needed due to cement breakage. In one case, GIC was applied for a watertight coverage of opened mastoid cells, and in the other for fistula closure of the lateral semi-circular canal over cartilage, covered with bone pathé; follow-up was uneventful. Targeted use of GIC in middle ear surgery rarely poses problems. GIC cannot be used in neuro-otosurgery in contact with cerebrospinal fluid because of possible aluminium encephalopathy.
Subject(s)
Forecasting , Glass Ionomer Cements , Hearing Loss, Conductive/surgery , Hearing/physiology , Incus/surgery , Malleus/surgery , Microsurgery/methods , Stapes Surgery/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Hearing Loss, Conductive/physiopathology , Humans , Male , Middle Aged , Reoperation , Retrospective Studies , Young AdultABSTRACT
Nasopharyngeal carcinoma (NPC) is strongly associated with Epstein-Barr virus (EBV) infection. To assess whether EBV DNA detection by polymerase chain reaction (PCR) or presence of specific serum antibody to viral capsid antigen (VCA) was a better marker for screening NPC, nasopharyngeal tissues and blood samples from 58 NPC patients and 24 non-NPC patients (23 with laryngotracheal stenosis and 1 with chronic tonsillitis) were tested for the presence of EBV DNA and serum specific VCA antibodies, respectively. EBV DNA was detected in 56 (96.5%) of NPC patients and 15 (62.5%) of non-NPC controls, with predominantly EBV type A in both groups. On the other hand, specific VCA IgA antibody was detected in the majority of NPC patients: 52 (89.7%) while only 4 (16.7%) were detected in non-NPC controls. Therefore, specific VCA IgA antibody may serve as a better marker for screening NPC than EBV DNA detected by PCR.
Subject(s)
Antigens, Viral/immunology , Capsid Proteins , Epstein-Barr Virus Infections/diagnosis , Immunoglobulin A/blood , Nasopharyngeal Neoplasms/diagnosis , Polymerase Chain Reaction , Antibodies, Viral/blood , Antigens, Viral/genetics , Biomarkers , DNA, Viral/analysis , Humans , Mass Screening/methods , Nasopharyngeal Neoplasms/virology , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
Nasopharyngeal tuberculosis used to be a common disease in the upper aerodigestive system. Before 1920, 1.4 and 6.5 per cent of all adenoids and tonsils removed from asymptomatic patients were infected by tuberculosis. After the introduction of antituberculous chemotherapy and BCG vaccination, this disease was considered uncommon and sporadic cases were reported in the medical literature. Recently, tuberculosis has begun to increase again due to the high global HIV-infected rate and antituberculous drug resistance among these people. To describe and highlight the clinical features of this condition, fifteen Thai patients (7 males and 8 females) from the Department of Otolaryngology, Siriraj Hospital, Bangkok, Thailand were reviewed. Cervical lymphadenopathy was the most common presenting symptom in our series (93.34%), 11 of them were classified as primary nasopharyngeal tuberculosis and most had abnormal nasopharyngeal findings by mirror examination except 2 cases. Although all had histopathological confirmation of nasopharyngeal tuberculosis, sometimes problems occur in the diagnosis between this disease and nasopharyngeal carcinoma, which are also common among Oriental people in many of their clinical similarities. Therefore routine nasopharyngeal biopsy is considered justified and diagnostic.
Subject(s)
Nasopharyngeal Diseases/diagnosis , Nasopharyngeal Neoplasms/pathology , Tuberculosis/diagnosis , Adolescent , Adult , Aged , Antitubercular Agents/therapeutic use , Biopsy, Needle , Child , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Male , Middle Aged , Nasopharyngeal Diseases/drug therapy , Nasopharyngeal Neoplasms/diagnosis , Prognosis , Thailand , Tuberculosis/drug therapyABSTRACT
Primary laryngeal cryptococcosis was reported in a 42-year-old man with AIDS. The patient also had pulmonary tuberculosis and hydropneumothorax as a complication. Serological tests and/or cultures from blood, CSF, urine and pleural fluid were all negative for cryptococcus. He was successfully treated with oral fluconazole for 8 weeks to clear the infection and remained clear in the follow-up period 9 months after treatment.