Aspiration of nasal secretions into the lungs in patients with acute sinonasal infections.

OBJECTIVES: To compare the amounts of nasal secretions aspirated into the lower airway by patients with acute sinonasal infection with that aspirated by healthy adults during sleep. STUDY DESIGN: Sixteen patients who had received a diagnosis of acute sinonasal infections by accurate history, anterior rhinoscopic examination, and radiological assessment and 13 healthy volunteers, aged 14 to 45 years. METHODS: A 10-mCi dose of technetium 99m-labeled macroaggregated albumin (Tc-99m MAA) with a concentration of 1 mCi/mL was prepared at midnight, just before sleep. Each subject was administered two puffs of this spray. At 8 AM the next morning transmission and emission views of the thorax were taken with a gamma camera. RESULTS: No significant difference between the two groups was observed in the amounts of nasal secretions aspirated into the lungs. CONCLUSIONS: The amount of nasal secretions aspirated does not increase during acute sinonasal infection. However, by irritating the mucosa of the lower respiratory tracts, bacteria, toxins, and inflammatory products existing in purulent secretions may play a major role in the pathophysiology of asthma and sinusitis.

Effects of topical otic preparations on hearing in chronic otitis media.

Most of the topical otic preparations have been shown to cause ototoxicity. In this study ciprofloxacin hydrochloride, a relatively new topical agent, and gentamicin sulfate were studied in two groups of 20 patients with chronic otitis media. Patients were randomly selected to receive either ciprofloxacin (200 microg/ml) or gentamicin sulfate (5 mg/ml) locally, five drops three times a day for 10 days. Clinical response was seen in 20 of 20 patients in the ciprofloxacin group compared with 6 of 20 patients in the gentamicin group. Audiometric evaluation revealed no significant ototoxic effect in either group. In fact, hearing thresholds were slightly better than pretreatment levels in both groups.

Treatment of chronic ear disease. Topical ciprofloxacin vs topical gentamicin.

OBJECTIVE: To determine and compare the therapeutic efficiency of ciprofloxacin hydrochloride and gentamicin sulfate in the treatment of chronic ear disease. DESIGN: Prospective randomized study. SETTING: Academic tertiary medical center. PATIENTS: Consecutive referred sample of 44 patients with chronic suppurative otitis media randomized into two groups. INTERVENTIONS: Ciprofloxacin hydrochloride (200 mg/mL) was administered to the first group (composed of 24 patients), while the second group (composed of 20 patients) received gentamicin sulfate (5 mg/mL) locally, five drops three times a day for 10 days. RESULTS: In the ciprofloxacin group, 21 (88%) of the 24 patients with suppurative chronic otitis media were cured. On the other hand, only six (30%) of the patients in the gentamicin group were cured. The rest of the patients showed no clinical or bacteriological improvement. CONCLUSIONS: To our knowledge, this is the first study to compare the efficiency of two topical otic preparations in the treatment of chronic ear disease. The results show that topical ciprofloxacin preparation is more efficacious and efficient than topical gentamicin for the treatment of chronic otitis media in the acute stage.