Assuntos
Doenças em Gêmeos/genética , Perda Auditiva Bilateral/genética , Perda Auditiva Condutiva/genética , Perda Auditiva Neurossensorial/genética , Aqueduto Vestibular/anormalidades , Audiometria de Tons Puros , Criança , Pré-Escolar , Cóclea/diagnóstico por imagem , Dilatação Patológica , Doenças em Gêmeos/diagnóstico por imagem , Orelha Média/diagnóstico por imagem , Feminino , Perda Auditiva Bilateral/diagnóstico por imagem , Perda Auditiva Condutiva/diagnóstico por imagem , Perda Auditiva Neurossensorial/diagnóstico por imagem , Humanos , Masculino , Fenótipo , Síndrome , Tomografia Computadorizada por Raios X , Aqueduto Vestibular/diagnóstico por imagemRESUMO
We presented an unusual case of ophthalmic herpes zoster masquerading as orbital cellulitis, resulting in delay in appropriate treatment. A 65-year-old woman presented with left periorbital pain and swelling of a week duration. Examination revealed periorbital edema and inflammation but no proptosis. The erythema extended onto the brow. There was no change in visual acuity and cranial nerve function was normal. She was apyrexial and all other parameters were within normal limits. The patient was admitted with an initial diagnosis of sinusitis with orbital cellulitis/dacryocystitis and intravenous co-amoxiclav and a non-steroidal anti-inflammatory drug were administered. The following day, there was little change in her condition with the ocular movements being normal and vision remaining unaffected. She was apyrexial but the periorbital swelling persisted. Computed tomography of the sinuses did not show sinusitis or a periorbital collection. The third day after admission and 10 days after the initial appearance of pain, vesicles appeared on the left forehead, which enabled a diagnosis of herpes zoster of the ophthalmic branch of the trigeminal nerve. She was then treated with acyclovir with a good result.
Assuntos
Herpes Zoster/diagnóstico , Celulite Orbitária/diagnóstico , Nervo Trigêmeo , Aciclovir/uso terapêutico , Idoso , Antivirais/uso terapêutico , Diagnóstico Diferencial , Feminino , Herpes Zoster/tratamento farmacológico , Herpes Zoster/patologia , Humanos , Celulite Orbitária/tratamento farmacológico , Celulite Orbitária/patologiaRESUMO
OBJECTIVE: The aim of the present study was to evaluate the long-term success of endoscopic stapling as a primary procedure for the treatment of pharyngeal pouches. METHODS: This study is a retrospective case review of 25 patients with pharyngeal pouches treated by endoscopic stapling (23 stapled, 2 abandoned) over a 4-year period (1994 to 1998) at a University teaching hospital in the United Kingdom. Outcome measures used were relief of symptoms over a long-term follow-up of 2 to 5 years. RESULTS: Of the 25 patients analyzed, 12 patients (48%) have remained asymptomatic after their initial stapling. Eight patients (32%) were relieved of their symptoms after revision stapling. The overall long-term success rate for endoscopic stapling was 80% (20 of 25 patients) CONCLUSION: Reduced morbidity and few complications in the elderly make endoscopic stapling a favored primary technique of treating pharyngeal pouches. Open surgery is recommended only in healthy patients with very large pouches.
