Perioperative management of tonsilloadenoidectomy and circumcision of a patient with Bernard-Soulier syndrome: case report.

Bernard-Soulier syndrome is an autosomal recessive coagulopathy characterized by thrombocytopenia, prolonged bleeding time and large platelets. Because of the rarity of this disease, standard perioperative treatment protocols have not been developed and there are not enough available data for the management of surgical procedures. In this case, we successfully performed adenoidectomy and tonsillectomy and circumcision surgery concurrently under the preventive and intermittent transfusion of platelets. During hospitalization, no intraoperative or postoperative bleeding complications occurred.

Laser-induced microbial reduction in acute bacterial rhinosinusitis.

BACKGROUND: This study was designed to assess laser-induced manipulation on bacterial load and host in an animal model of acute bacterial rhinosinusitis (ABRS). An animal study using 12 rabbits followed an elaborated efficient in vitro model. ABRS was created by packing the nose with a sponge soaked in solution containing pathogenic microorganisms. Eight infected animals were randomly allocated to two separate groups, each being exposed to different laser therapies. Two healthy animals served as treatment controls, and one animal without ABRS and treatment was observed. METHODS: ABRS was confirmed histologically, radiologically, and bacteriologically. Two days after bacterial inoculation, packing was removed and nasal passages were treated by laser irradiation. Two laser modalities were tested. A near infrared (NIR) 940-nm diode laser with diffuser fiber tip was used in four rabbits. A photosensitizer (methylene blue 0.01 or 0.05%) and 635-nm laser combination was used in the second cohort. Nasal cultures were obtained before and after the laser treatments. Animals were killed 5-10 days after laser treatment and bacteriological/histological results were analyzed. RESULTS: An average 2 log reduction in bacterial colony counts was achieved with both laser methods compared with control. Histological studies showed tissue integrity preservation without significant damage to nasal mucosa. CONCLUSION: Significant bacterial reduction was achieved with both NIR laser and photograph activated therapies in an animal study of ABRS. This pilot study shows an innovative method of bacterial killing without host tissue damaging and may have potential future clinical application.

Three-dimensional computed tomography of a complete stylohyoid ossification with articulation.

The stylohyoid chain presents considerable anatomic variability. Three-dimensional (3D) CT is accepted as the method of choice for morphological assessment of the stylohyoid complex. We present volume-rendered, 3D multislice CT images of an unusual, incidental case of bilateral complete stylohyoid ossification with articulations.

Animal models of sinusitis: relevance to human disease.

Experimental animal models are necessary to assess the efficacy of both medical and surgical procedures. The researcher who wishes to confirm and publish his results must overcome controversies concerning the validity of his model and, therefore, needs guidelines for standardization. Various models are offered in the literature. In this article, the rabbit and murine models of experimental sinusitis and their relevance to human disease with anatomical, histopathologic, and microbiologic aspects are discussed.

Cephalic tetanus as a result of rooster pecking: an unusual case.

In this paper, a case of cephalic tetanus caused by rooster pecking to the face is presented. Cephalic tetanus is a rare type of tetanus defined by trismus and paralysis of 1 or more cranial nerves. On admission to hospital the patient had facial palsy and trismus. With proper medical management she recovered without any relapse.