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1.
Heliyon ; 10(3): e25190, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38333844

RESUMEN

Background: Pulmonary infections by gram-negative organisms are important in cystic fibrosis (CF). Aminoglycosides (AG) are often part of the treatment regimen. However, they are a well-known cause of ototoxicity. Even minimal hearing impairment in children could have a future impact on functional well-being.We aimed to investigate the progression of sensorineural hearing loss (SNHL) over several years in pediatric CF patients, and to identify risk factors, such as the use of AG, including both intravenous (IV) and inhaled AG. Methods: Retrospective analyses of patient records from children and adolescents followed up at the CF clinic of the Antwerp University Hospital, Belgium, were performed. We collected data on age, sex, pure-tone audiometry, and the use of AG. Descriptive and binary logistic regression analyses, and if indicated generalized estimating equations (GEE) analyses were performed. Results: Forty pediatric patients were enrolled in the study taking part from 2013 to 2020. Pure-tone audiometry revealed an important rate of SNHL over several years, with a prevalence of 29 % for high-frequency SNHL (i.e. 8 kHz). Increasing age was identified as a significant risk factor for the development of SNHL at 8 kHz if 5 or more IV AG courses (p = 0.01) were reported or when IV AG were combined with inhaled AG (p = 0.002). Conclusions: Age combined with the use of IV AG (≥5 courses or in combination with inhaled AG) are predictive for developing high-frequency SNHL (i.e. 8 kHz). We suggest routine annual hearing screening (incl. high-frequency thresholds) in CF patients, starting from childhood.

2.
Rhinology ; 56(2): 106-110, 2018 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-29396959

RESUMEN

BACKGROUND: A possible complication of frontal sinus obliteration with fat is the formation of mucoceles. We studied the prevalence of mucoceles as well as and the need for revision surgery. METHODS: Retrospective case review of forty consecutive patients undergoing frontal sinus obliteration from September 1995 to February 2012 for chronic rhinosinusitis (26), frontal mucocele (12) or frontal osteoma (2) with an average follow up of 80 months (range 15-218). MRI of the paranasal sinuses was performed in all. Outcome measures included MRI signs of mucocele formation in the obliterated frontal sinus, revision surgery, symptom burden. RESULTS: Magnetic resonance imaging (MRI) showed potential postoperative frontal sinus mucoceles in 6/40 patients. In 3 patients (7.5%) a revision operation was performed, revealing mucoceles in two cases. A wait and scan-policy in the other 3 patients confirmed the presence of a mucocele in 1 of these patients. The majority of patients (33/40, 83%) was asymptomatic at the last follow up. CONCLUSION: The prevalence of mucoceles and revision rate in this series was 7.5% (3/40). MRI can improve detection rate and reduce / avoid unnecessary revision surgery after frontal sinus obliteration.


Asunto(s)
Seno Frontal , Imagen por Resonancia Magnética/métodos , Mucocele , Procedimientos Quirúrgicos Otorrinolaringológicos , Complicaciones Posoperatorias , Sinusitis/cirugía , Grasa Abdominal/trasplante , Enfermedad Crónica , Femenino , Seno Frontal/diagnóstico por imagen , Seno Frontal/patología , Seno Frontal/cirugía , Humanos , Masculino , Persona de Mediana Edad , Mucocele/diagnóstico , Mucocele/epidemiología , Mucocele/fisiopatología , Mucocele/cirugía , Países Bajos/epidemiología , Procedimientos Quirúrgicos Otorrinolaringológicos/efectos adversos , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/cirugía , Prevalencia , Reoperación/métodos , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Sinusitis/diagnóstico , Tomografía Computarizada por Rayos X/métodos
3.
Int J Pediatr Otorhinolaryngol ; 102: 56-60, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-29106876

RESUMEN

OBJECTIVES: The aim of this study was to review the clinical presentation and early signs and symptoms of otogenic intracranial complications (OIC) in children and adults. METHODS: retrospective chart review. The medical records of all children and adults admitted in our center with OIC during the period 2008-2017 were reviewed. Data concerning clinical presentation, treatment and outcomes were reviewed and analyzed. RESULTS: We included 47 patients with OIC: 21 children (range 1-13 years) and 26 adults (range 22-71 years). We included more patients with acute otitis media than with chronic otitis media (children 5% adults 19%, all with cholesteatoma). In children; the most common OIC was central cerebral venous thrombosis. In both children and adults; otogenic symptoms such as otalgia and otorrhea were present. Children presented more frequently with headache and nausea. Adults presented more frequently with decreased consciousness. Hearing loss was the most common long-term sequel. Three adults died. CONCLUSIONS: In our series, we found that OIC in children present as 'mimicking meningitis' (e.g. nausea and vomiting). Adults on the other hand have a clinical presentation 'mimicking stroke' (e.g. neurological deficits and decreased level of consciousness). In children, sinus thrombosis was observed more frequently than in adults. Despite the low mortality rate, death still occurs. Long -term sequelae most frequently include hearing loss in children as well as in adults.


Asunto(s)
Enfermedades del Sistema Nervioso Central/diagnóstico , Otitis Media/complicaciones , Adolescente , Adulto , Anciano , Enfermedades del Sistema Nervioso Central/etiología , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Otitis Media/diagnóstico , Estudios Retrospectivos
4.
Ned Tijdschr Geneeskd ; 161: D1342, 2017.
Artículo en Holandés | MEDLINE | ID: mdl-28745248

RESUMEN

Orbital cellulitis is a rare disease usually caused by sinusitis. Generally, the prognosis of both preseptal cellulitis and orbital cellulitis is favourable. Radiological distinction should be made between an orbital abscess and subperiosteal empyema. Theoretically, empyema is more accessible to antibiotics and, as it arises in a pre-existing anatomical space, it needs less aggressive treatment than an abscess. In contrast, the wall of an abscess created by the bacteria is scarcely permeable to antibiotics. Indications for surgical drainage should be based on clinical findings and not on Chandler's classification. Loss of vision, an unresponsive pupil or a densely packed orbit are indications for immediate surgical drainage. Drainage of an orbital abscess may speed up recovery.


Asunto(s)
Celulitis Orbitaria/diagnóstico , Enfermedades Orbitales/diagnóstico , Absceso/complicaciones , Absceso/diagnóstico , Adolescente , Antibacterianos/uso terapéutico , Preescolar , Drenaje/métodos , Humanos , Masculino , Persona de Mediana Edad , Celulitis Orbitaria/etiología , Enfermedades Orbitales/etiología , Estudios Retrospectivos , Sinusitis/complicaciones , Sinusitis/diagnóstico , Tomografía Computarizada por Rayos X
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