[Phlegmons of the neck: our experience with 7 cases]. / Flemmoni del collo: nostra esperienza su 7 casi clinici.

Phlegmons of the neck originate from infectious diseases of head and neck. Odontogeneous inflammation of the oral cavity is most frquently primary lesion, followed by sinusitis, otitis, as well as radiation therapy and surgical procedures. Phlegmons of head and neck can drain into the spaces among the muscles, aponevrosis, organs inside the neck like sublingual space, lateral pharyngeal space, retro-pharyngeal space or pre-vertebral space. We hereby report our experience with 7 patients treated from 2001 to 2005.

Early diagnosis of endolymphatic hydrops with distortion. Product otoacoustic emissions.

The present investigation was specifically designed to evaluate the ability of the glycerol test combined with pure-tone audiometry, distortion-product otoacoustic emissions (DPOAEs) to diagnose endolymphatic hydrops early and to identify patients who may evolve toward Meniere's disease. This investigation consisted of 43 consecutive patients with daily episodes of tinnitus with duration exceeding few hours or with continuous tinnitus who received no treatment. These were the unique symptoms reported by the patients. Each patient underwent glycerol testing measured with conventional pure tone audiometry and with distortion product otoacoustic emissions (DPOAEs). For the traditional pure-tone glycerol test a hearing improvement of at least 10 dB, at the lower two or three frequencies (125,250 and 500 Hz) was judged as positive result. For the DPOAEs glycerol testing, a smaller positive difference (5 dB) for at least three frequencies was interpreted as a significant fluctuation. Twenty four patients showed negative glycerol test both with pure tone audiometry and DPOAEs. In 7 cases the improvement was concurrently observed. In 9 patients post-glycerol changes appeared only in the DPOAEs outcomes. Finally the remaining three patients had two different patterns. Two had different ameliorations of the DPOAEs and pure-audiometry on the left and right sides respectively, and in the last one only post-glycerol, audiograms recovered. The present study re-confirms the potentiality of DPOAEs associated with glycerol test in diagnosing endolymphatic hydrops precociously. The possibility of these patients degenerating into Meniere's disease should not be underestimated.

Diagnóstico precoz del hydrops endolinfático con emisiones otoacústicas con productos de distorsión / Early diagnosis of endolymphatic hydrops with distortion-product otoacoustic emissions

La presente investigación fue diseñada específicamente para evaluar la eficacia del test del glicerol combinado con audiometría tonal y las emisiones otoacústicas con productos de distorsión (DPOAEs) para diagnosticar precozmente el hydrops endolidnfático e identificar los pacientes que pueden evolucionar hacia la enfermedad de Ménière. Esta investigación se basa en 43 pacientes con episodios diarios de acúfenos con duración superior a varias horas o con acúfenos continuos. Estos eran los únicos síntomas referidos por los pacientes. Cada paciente se sometió al test del glicerol medido con audiometría tonal convencional y con productos de distorsión. Para el tradicional tono puro test del glicerol una mejoría de por lo menos 10 dB en dos o tres frecuencias graves (125,250 y 500 Hz) fue juzgada como un resultado positivo. Para la DPOAEs test del glicerol una diferencia positiva menor (5dB) para al menos 3 frecuencias fue interpretado como una fluctuación significativa. Veinticuatro pacientes presentaron un test del glicerol negativo en ambas pruebas tono puro y DPOAEs. Finalmente los 3 pacientes restantes presentaron patrones diferentes. Dos tuvieron mejorías en las DPOAEs y en la audiometría tonal del lado izquierdo y derecho respectivamente y el último sólo mejoró el audiograma postglicerol. El presente estudio reconfirma la potencialidad de las DPOAEs asociadas al test de glicerol en el diagnóstico precoz del hydrops endolinfático. La posibilidad de que éstos pacientes degeneren hacia una enfermedad de Ménière no debe ser subestimada (AU)

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Health care of the future.

Michigan Health & Hospitals magazine asked two member CEOs to answer the question what will health care delivery look like in the future? Judeth Javorek looked 50 years ahead, while Anthony Tersigni explored the near future. Following are their responses.