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1.
Arch Dis Child ; 103(11): 1076, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29472197
2.
Auris Nasus Larynx ; 45(2): 227-233, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28511890

RESUMO

OBJECTIVE: Many studies over the last decade showed favorable outcomes with intratympanic (IT) steroid treatment, alone as salvage treatment or in combination with conventional systemic therapy (ST). However, in severe to profound sensorineural hearing loss resistant to ST, the optimal infusion mode, the type and concentration of the solution, the preferable drug, its total amount, and the duration and fractionation of the treatment are still debated. Aim of the study was to investigate the feasibility and the outcomes of a direct and constant IT delivery of dexamethasone (DEX) by means of a new indwelling catheter. METHODS: A prospective case-control study in a tertiary referral university hospital. Ninety-nine subjects treated with ST only and 28 with additional IT DEX have been included in the study. A 4 Fr catheter inserted in a sub-annular fashion with a minimal postero-inferior tympanotomy through and endocanalar approach under local anesthesia. DEX 4mg/ml delivered daily, up to 7 days. Daily bone and air-conducted pure tone and speech audiometry were performed with a follow-up at 1, 3, 6 months after treatment. RESULTS: Twenty-one out of 28 patients (75%) refractory to ST gained on average 24.0dB±20.5dB HL after IT-DEX, compared to 35.4% (average 6.7dB±16.6dB HL) of those receiving only medical ST (p<0.001). No significant side effects were noted. CONCLUSION: In severe to profound sudden deafness refractory to conventional ST, the daily perfusion of 4mg/ml DEX through an intratympanic catheter is an easy, well accepted procedure that enables patients to receive a drug in the middle ear in a repeatable or sustained form, with minimal discomfort and a partial rescue (67.86%) and a speech recognition gain of 39%.


Assuntos
Dexametasona/administração & dosagem , Glucocorticoides/administração & dosagem , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/tratamento farmacológico , Adulto , Idoso , Estudos de Casos e Controles , Cateteres de Demora , Feminino , Humanos , Infusões Parenterais , Injeção Intratimpânica , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Índice de Gravidade de Doença
3.
Audiol Neurootol ; 22(4-5): 226-235, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29232662

RESUMO

Currently, there are no studies assessing everyday use of cochlear implant (CI) processors by recipients by means of objective tools. The Nucleus 6 sound processor features a data logging system capable of real-time recording of CI use in different acoustic environments and under various categories of loudness levels. In this study, we report data logged for the different scenes and different loudness levels of 1,366 CI patients, as recorded by SCAN. Monitoring device use in cochlear implant recipients of all ages provides important information about the listening conditions encountered in recipients' daily lives that may support counseling and assist in the further management of their device settings. The findings for this large cohort of active CI users confirm differences between age groups concerning device use and exposure to various noise environments, especially between the youngest and oldest age groups, while similar levels of loudness were observed.

4.
Int J Pediatr Otorhinolaryngol ; 88: 30-3, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27497382

RESUMO

OBJECTIVE: To evaluate the lateral semicircular canal high frequency vestibulo-oculomotor reflex (LSC HF VOR) in children with cochlear implant. METHODS: 16 children (10 females and 6 males, age range = 5-17 years) receiving a unilateral (n = 12) or a bilateral (n = 4) cochlear implant were included and compared to a control group of 20 age-matched normal-hearing (NH) children. Both implanted and NH children received a vestibular function test battery, including a Vestibulo-Ocular Reflex (VOR) gain assessment by means of a video-Head Impulse Test (vHIT), which represented the main outcome measure. In implanted subjects, vHIT was measured on both sides in the "CI-ON" and "CI-OFF" conditions. RESULTS: Overall, no significant LSC HF VOR gain difference was found between CI users and NH peers. In the unilaterally implanted group, the LSC HF VOR gain measured in the "CI-ON" condition was significantly higher than in the "CI-OFF" condition, both in the implanted and in the non-implanted ear. In the bilaterally implanted group there was no such a difference between the two conditions, on either side. CONCLUSION: This is the first study investigating the LSC HF VOR gain in children with unilateral and bilateral CI. The study demonstrates that the LSC HF VOR of bilaterally implanted children is comparable to normal hearing children.


Assuntos
Implantes Cocleares , Teste do Impulso da Cabeça , Reflexo Vestíbulo-Ocular/fisiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Canais Semicirculares/fisiologia , Gravação em Vídeo
5.
Int J Pediatr Otorhinolaryngol ; 79(11): 1860-4, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26337560

RESUMO

OBJECTIVES: To evaluate the results of a newly introduced technique to our Department of endoscopic assisted transcanal myringoplasty applied in tympanic membrane perforation in children of any age and compare them to that of the previously standard microscopic assisted myringoplasty technique. METHODS: A retrospective study of myringoplasties performed between January 2005 and June 2014 in children suffering from chronic otitis media with perforation. In microscope-assisted cases, a transcanal approach was applied when the anterior tympanic annulus was completely visible through the ear speculum, and a postauricular approach was used in all other cases. A transcanal approach was used in all endoscopic-assisted cases. RESULTS: Between January 2005 and December 2010 and January 2011 and June 2014, 23 and 22 myringoplasties were performed by means of an operative microscope and an endoscope, respectively. Patient age varied from 5 to 16 years. Median duration of microscopic and endoscopic approaches was 90 min and 80 min (P=0.3), respectively. Hospital stay after surgery was significantly longer in the microscope group than the endoscope group (P<0.001). The intact graft success rate was 82.6% in microscopic and 90.9% in endoscopic approaches. Median postoperative air-bone gap of microscopic and endoscopic approaches was 6.2 dB and 6.6 dB, respectively (P=0.9). Neither intra- nor postoperative complications were observed. CONCLUSION: Endoscopic transcanal myringoplasty is an alternative surgical approach to traditional technique. This surgery is more conservative than microscopic approach and can be performed in all pediatric cases independently from age. Moreover, it offers comparable anatomical and functional results to the traditional surgery, and grants better comfort for the child.


Assuntos
Endoscopia/métodos , Miringoplastia/métodos , Otite Média/cirurgia , Perfuração da Membrana Timpânica/cirurgia , Membrana Timpânica/cirurgia , Timpanoplastia/métodos , Adolescente , Criança , Pré-Escolar , Doença Crônica , Feminino , Humanos , Tempo de Internação , Masculino , Complicações Pós-Operatórias/cirurgia , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento
6.
JAMA Otolaryngol Head Neck Surg ; 141(1): 34-9, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25375088

RESUMO

IMPORTANCE: Pars tensa retraction is a frequent condition in chronic otitis media, and there is a large diversity of opinions regarding its management. OBJECTIVE: To report the long-term results and prognostic factors of myringoplasty in pediatric patients with grade 5 pars tensa atelectasis. DESIGN, SETTING, AND PARTICIPANTS: This was an observational, retrospective case review, conducted at a referral university hospital, of children undergoing surgical intervention for dry tympanic disruption after a clinical history of tensa retraction with a transcanal or postauricular approach under general anesthesia. INTERVENTIONS: Underlay myringoplasty with temporalis fascia or tragal perichondrium by transcanal or postauricular approach under general anesthesia. MAIN OUTCOMES AND MEASURES: Anatomical results are reported with a minimum follow-up of 5 years analyzing perforation or retraction of the neotympanum. Age; sex; side, position, and size of the eardrum disruption; surgical approach; graft material; and presence of contralateral disease were correlated with anatomical failure. RESULTS: The population included 33 girls and 28 boys undergoing 65 interventions; the age varied from 4 to 16 years (mean [SD], 10 [3.2] years). An intact tympanic membrane was obtained in 58 cases (89.2%) with a follow-up varying from 5 to 14 years (mean follow-up, 9 years). None of the variables analyzed significantly predisposed patients to tympanic perforation after surgical repair. There were no new progressive retractions. CONCLUSIONS AND RELEVANCE: Tensa retraction resulting in a tympanic disruption can be cured by underlay myringoplasty with perichondrium or temporalis fascia with results similar to those of simple tympanic perforations without recurrent retraction even in the long-term period.


Assuntos
Miringoplastia , Membrana Timpânica/patologia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Prognóstico
7.
Laryngoscope ; 125(5): 1107-12, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25392970

RESUMO

OBJECTIVES/HYPOTHESIS: To assess sensory outcomes and quality of life (QoL) in two groups of patients with and without great auricular nerve (GAN) preservation during parotidectomy. STUDY DESIGN: Retrospective chart review. METHODS: The posterior branch of the GAN was preserved in 42 patients (group A) and sacrificed in 13 (group B). Tactile, heat, and cold sensitivities were investigated by dividing GAN territory into seven areas. Comparisons between operated (OS) and nonoperated sides (NS) within each group, and between the OS of the two groups were made. The QoL questionnaire was administered. RESULTS: In group A, normal tactile, heat, and cold sensitivities ranged from 16.7% to 66.7%, 11.9% to 73.8%, and 21.4% to 81%, respectively, in different OS areas. Significant differences between OS and NS were found, except for the preauricular superior area. In group B, normal tactile, heat, and cold sensitivities ranged from 0% to 61.5%, 0% to 53.8%, and 7.7% to 76.9%, respectively, in different OS areas. Significant differences between OS and NS were found except for the preauricular superior (tactile sensitivity), and preauricular superior and helix/concha areas (cold sensitivity). Comparing the OS tactile and thermic sensitivities between the two groups, only the lobule area showed differences. The preauricular inferior area was different only for heat. The QoL questionnaire showed different hypoesthesia extension between the two groups. All other items were comparable. CONCLUSIONS: Sensory deficits are commonly reported despite GAN preservation. Lobule and preauricular inferior areas showed differences in terms of tactile and thermic sensitivities, with better outcomes in group A. QoL seems tolerable despite GAN sacrifice. LEVEL OF EVIDENCE: 4


Assuntos
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Glândula Parótida/inervação , Glândula Parótida/cirurgia , Doenças das Glândulas Salivares/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Músculos do Pescoço/inervação , Qualidade de Vida , Estudos Retrospectivos , Limiar Sensorial , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
8.
Otolaryngol Head Neck Surg ; 148(4): 619-24, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23348873

RESUMO

OBJECTIVE: To identify the prevalence and risk factors of eustachian tube dysfunction after surgery for sinonasal cancer by observing the occurrence of middle ear effusion. STUDY DESIGN: Historical cohort study. SETTING: Academic university hospital. SUBJECTS AND METHODS: Clinical records of 112 patients surgically treated for sinonasal cancer over a 16-year period were evaluated. Initial bivariate analysis was followed by a multivariate logistic regression model. RESULTS: The best model included 2 variables: posterior extension of surgical resection (nasopharynx, soft palate, eustachian tube, pterygomaxillary fossa, parapharyngeal space) with an odds ratio of 5.662 (95% confidence interval [CI], 1.877-9.447) and postoperative radiotherapy with an odds ratio of 8.691 (95% CI, 4.187-13.194). CONCLUSION: Despite the limited number of patients, the study gives a prediction of middle ear effusion based on 2 well-defined factors: surgical resection of anatomic structures involved in tubal function and adjuvant radiotherapy.


Assuntos
Tuba Auditiva/lesões , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia , Otite Média com Derrame/etiologia , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Radioterapia Adjuvante/efeitos adversos , Idoso , Estudos de Coortes , Tuba Auditiva/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias dos Seios Paranasais/radioterapia , Neoplasias dos Seios Paranasais/cirurgia , Adulto Jovem
10.
Head Neck ; 32(6): 786-92, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19890908

RESUMO

BACKGROUND: The objective of this study was to assess angiogenesis and lymphangiogenesis patterns in advanced oral/oropharyngeal cancer by immunohistochemical techniques. METHODS: Forty-five patients with advanced oral/oropharyngeal cancer, treated by primary surgery between January 1996 and December 2005, were selected. All cases were followed for at least 24 months. Angiogenesis and lymphangiogenesis were evaluated with antibodies against CD31 and podoplanin, respectively. Survival outcomes were calculated by the Kaplan-Meier method, whereas univariate comparisons were obtained by log-rank, chi-square, and Mann-Whitney tests. RESULTS: Survival correlated with the area of peritumoral blood vessels (p = .02), whereas the number of intratumoral lymphatics (p = .02) correlated with the occurrence of nodal metastasis. The risk for distant metastasis correlated with the perimeter of intratumoral lymphatics (p = .02). CONCLUSIONS: Peritumoral angiogenesis presented different expression patterns between survivors and patients who died of disease. Intratumoral lymphangiogenesis was correlated with a higher risk of developing lymph node (LN) and distant metastasis.


Assuntos
Linfangiogênese/fisiologia , Glicoproteínas de Membrana/metabolismo , Neoplasias Bucais/metabolismo , Neovascularização Patológica/fisiopatologia , Neoplasias Orofaríngeas/metabolismo , Molécula-1 de Adesão Celular Endotelial a Plaquetas/metabolismo , Adulto , Idoso , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Neoplasias Orofaríngeas/mortalidade , Neoplasias Orofaríngeas/patologia , Prognóstico
11.
Head Neck ; 32(8): 977-83, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19902535

RESUMO

BACKGROUND: Transoral CO(2) laser surgery has been accepted as a valuable therapeutic option for glottic cancer. METHODS: This was a retrospective analysis of 595 patients. Five-year overall and disease-specific survivals, local control with laser, locoregional, regional control, and organ preservation rates were calculated. The impact of different variables was calculated by univariate analysis. RESULTS: Overall, disease-specific and disease-free survivals, local control with laser, locoregional, regional control, and organ preservation rates were 87.5%, 99%, 81.3%, 92.7%, 98.9%, 98.2%, and 97.1%, respectively. Univariate analysis showed a significant impact of pT category on local control with laser, organ preservation, locoregional and regional control, of endoscopic re-treatment for positive deep surgical margins on local control with laser and organ preservation, and recurrence after endoscopic re-treatment on local control with laser and organ preservation. CONCLUSION: This series confirms the good oncologic outcomes of endoscopic laser surgery for T(is), T(1), and selected T(2) and T(3) glottic tumors.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Endoscopia , Glote , Neoplasias Laríngeas/cirurgia , Laringectomia , Lasers de Gás/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Itália , Neoplasias Laríngeas/mortalidade , Neoplasias Laríngeas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
13.
Eur Arch Otorhinolaryngol ; 265(4): 447-52, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17960409

RESUMO

The aim of this study was to investigate the management and prognostic determinants of recurrent pleomorphic adenoma (RPA). A retrospective analysis was performed to examine the clinical features, the prevalence of surgical complications, and new recurrences of RPA. Tumor recurrence rate was estimated by the Kaplan-Meier method, and the prognostic value of some of the variables was tested by univariate analysis using the log rank test. The study focused on 33 patients, 18 female (54.5%) and 15 male (45.5%), aged 12-71 years (median 41). A total or extended total parotidectomy was performed in 16 cases (48.5%), a superficial parotidectomy in 10 cases (30.3%), and a local excision in 7 cases (21.2%). In ten patients (30.3%), a branch or the trunk of the facial nerve was deliberately sacrificed. Major complications included one unexpected definitive paralysis of the marginal mandibular branch of the facial nerve and 14 cases of Frey syndrome. Follow-up varied from 2 to 25 years (median 10.5 years), and there were 11 new recurrences (33.3%) within a period varying from 1 to 16 years (median 6 years). The estimated tumor recurrence rates were 14.1+/-6.6% at 5 years, 31.4+/-9.4% at 10 years, 43.0+/-10.8% at 15 years, and 57.2+/-14.8% at 20 years. Presence of a multinodular lesion and the type of intervention performed were significantly associated with a higher probability of recurrence. RPAs are prone to new recurrences, especially when multinodular and treated with a local excision. Surgical treatment should include facial nerve resection in selected cases. Follow-up for the patient's lifetime is warranted.


Assuntos
Adenoma Pleomorfo , Recidiva Local de Neoplasia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Neoplasias Parotídeas , Adenoma Pleomorfo/diagnóstico , Adenoma Pleomorfo/epidemiologia , Adenoma Pleomorfo/cirurgia , Adolescente , Adulto , Idoso , Criança , Feminino , Seguimentos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Morbidade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Parotídeas/diagnóstico , Neoplasias Parotídeas/epidemiologia , Neoplasias Parotídeas/cirurgia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Fatores de Tempo
14.
Eur Arch Otorhinolaryngol ; 264(10): 1179-84, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17534640

RESUMO

Treatment of glottic cancer by CO(2) laser endoscopic cordectomies can be associated with poor vocal outcome when the excision is extended beyond the superficial part of the thyro-arytenoid muscle. Different phonosugical techniques have been described in order to improve postoperative vocal outcome in patients undergoing this type of surgery. We herein present a new device for augmentation of residual vocal cord by video-endoscopic assisted primary intracordal autologous fat injection (PIAFI) performed at the end of transmuscular cordectomy. Twenty-four patients underwent transmuscular cordectomy and PIAFI for Tis and T1a glottic cancer. Eight cc of abdominal fat were obtained during the endoscopic procedure and processed. Infusion of intact parcels of fat tissue was performed to maximally reduce its resorption. PIAFI was performed in the residual vocal cord obtaining its immediate medialization, using a new device that permitted modulated (0.5 cc per click) injection. Fourteen patients were submitted to postoperative voice evaluation including subjective, perceptual, and objective assessment. The results were compared with those of 24 patients treated by transmuscular (Type III) cordectomy without subsequent PIAFI. No complications were observed as a result of PIAFI and the procedure did not significantly prolong overall surgical time. All patients were discharged the day after surgery. Comparison of vocal outcomes according to the Mann-Whitney and Wilcoxon tests showed a positive trend for patients submitted to PIAFI in terms of subjective and objective analysis. By contrast, a statistically significant improvement was reached in terms of perceptual analysis when comparing patients treated by Type III cordectomy alone with those submitted to this kind of procedure followed by PIAFI.


Assuntos
Tecido Adiposo/transplante , Endoscopia/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Cirurgia Vídeoassistida/instrumentação , Prega Vocal/cirurgia , Adulto , Feminino , Humanos , Injeções Intramusculares , Masculino , Microcirurgia/instrumentação , Pessoa de Meia-Idade
15.
Eur Arch Otorhinolaryngol ; 264(10): 1185-90, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17534641

RESUMO

Major glottic incompetence is often encountered after total (Type IV) and extended (Type V) cordectomies and is responsible for poor vocal outcome. Even though the vast majority of patients do not complain of significant limitations in daily life, a selected number of them eventually require some sort of phonosurgical treatment in order to improve voice quality. Different techniques have been described in the literature to ameliorate long-term vocal outcome. The aim of the present report was to retrospectively describe our experience in this challenging clinical scenario. Between April 1999 and March 2005, 24 patients previously treated by Type IV-V endoscopic cordectomies for T1 and T2 glottic cancer presented unsatisfactory vocal outcome in spite of intensive speech therapy and therefore underwent some form of phonosurgical treatment at our Department after at least 12 months without evidence of local-regional recurrence. Patients were treated by medialization thyroplasty with a Montgomery System Implant (two cases), Gore-Tex strips (16 cases), medialization thyroplasty with Gore-Tex associated with anterior commissure laryngoplasty (three cases), and augmentation with Vox Implant injection (three cases). Nineteen patients had comprehensive evaluation by videolaryngoscopic examination and subjective, perceptual, and objective voice analysis both in the pre-phonosurgical treatment period and after at least 12 months. Comparison of pre- and postoperative videolaryngoscopic findings revealed improved glottic closure in 74% of patients. Comparison between the pre- and postoperative subjective, perceptual, and objective voice analysis by the Wilcoxon matched-pair test showed a statistically significant improvement from a Voice Handicap Index mean value of 46 (preoperative) to 21 (postoperative); an improvement for each parameter of the GRBAS scale with statistically significant differences for G, B, A, and S, while R showed only an improving trend; and statistically significant improvement in the mean values of Jitter, Shimmer, Noise to Harmonic Ratio, and Maximum Phonation Time. In conclusion, the different delayed phonosurgical procedures herein used demonstrate the possibility to improve vocal outcomes after total and extended cordectomies in selected and highly motivated patients that have not achieved satisfactory performance after prolonged and intensive speech therapy.


Assuntos
Endoscopia/métodos , Glote/fisiopatologia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Complicações Pós-Operatórias/fisiopatologia , Prega Vocal/cirurgia , Adulto , Idoso , Feminino , Glote/patologia , Glote/cirurgia , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Laringectomia , Laringe/patologia , Laringe/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos
16.
Otol Neurotol ; 27(7): 937-44, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17006344

RESUMO

OBJECTIVE: To discuss the clinical aspects and management of internal jugular vein thrombosis associated with acute otitis media. STUDY DESIGN: Case reports and review of the literature. SETTING: University hospital, tertiary referral center. PATIENT: The authors describe two cases of internal jugular vein thrombosis, without sigmoid sinus thrombosis, secondary to acute otomastoiditis. INTERVENTION: Jugular vein thrombosis was diagnosed in both cases by observation of filling defects of the involved jugular bulb on contrast-enhanced computed tomography and confirmed by conventional magnetic resonance and magnetic resonance venography. RESULTS: Both patients recovered after recanalization of the vessel concomitant to anticoagulation and antibiotic treatment associated with a simple mastoidectomy. CONCLUSION: Internal jugular vein thrombosis may be a complication of acute otitis media, without involvement of the sigmoid sinus and with a starting point in the jugular bulb. Anticoagulation associated with antibiotic therapy can be considered a safe and effective treatment. Surgery should only be performed to eliminate the source of infection from the middle ear and mastoid.


Assuntos
Veias Jugulares/patologia , Mastoidite/complicações , Otite Média/complicações , Trombose/etiologia , Doença Aguda , Amoxicilina/uso terapêutico , Ampicilina/uso terapêutico , Antibacterianos/uso terapêutico , Anticoagulantes/uso terapêutico , Criança , Pré-Escolar , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Masculino , Mastoidite/diagnóstico , Mastoidite/tratamento farmacológico , Otite Média/diagnóstico , Otite Média/tratamento farmacológico , Flebografia , Sulbactam/uso terapêutico , Trombose/diagnóstico , Trombose/tratamento farmacológico , Tomografia Computadorizada por Raios X
17.
Int J Audiol ; 44(10): 593-8, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16315450

RESUMO

The aim of the present study was to investigate the consequences of chronic otitis media on inner ear function. Retrospective analysis of conventional pure-tone audiometry tests was carried out on 344 patients who were scheduled for surgical treatment of unilateral chronic otitis media without other risk factors for sensorineural hearing loss. Bone conduction thresholds of diseased ears were compared with those of contralateral, non-diseased ears. Selected clinical features were assessed among diseased ears to examine possible influences on inner ear function. Mean bone conduction threshold differences varied from 0.6 dB at 0.5 kHz to 3.7 dB at 4 kHz. These differences augmented with increasing duration of middle ear disease. Impaired hearing by bone conduction thresholds of diseased ears correlated with increased age at every frequency and with an interruption of the ossicular chain only at higher frequencies. The severity of sensorineural hearing loss correlated with longer duration of middle ear disease. Thus, surgical treatment of dry and apparently stable tympanic membrane perforation is warranted.


Assuntos
Limiar Auditivo , Condução Óssea , Perda Auditiva Neurossensorial/etiologia , Otite Média/complicações , Adulto , Fatores Etários , Idoso , Audiometria de Tons Puros , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Otite Média/cirurgia , Análise de Regressão , Estudos Retrospectivos , Índice de Gravidade de Doença
18.
Otol Neurotol ; 24(6): 843-9, 2003 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-14600461

RESUMO

OBJECTIVE: To discuss the clinical aspects and management of nontuberculous mycobacteriosis of the temporal bone. STUDY DESIGN: Case report and review of the literature. SETTING: University hospital, tertiary referral center. PATIENT, INTERVENTION, AND RESULTS: The authors describe an uncommon case of nontuberculous mycobacteriosis of the temporal bone in an immunosuppressed 62-year-old woman with facial nerve paralysis caused by disease complication. The case was cured with radical tympanomastoidectomy and prolonged multiple antibiotic therapy. CONCLUSIONS: Nontuberculous mycobacteriosis should be suspected in immunosuppressed patients with intractable middle ear granulations. Cultural and histologic examinations are the mainstay for diagnosis. Long-standing multiantibiotic therapy together with aggressive surgery should be considered as appropriate management.


Assuntos
Antibacterianos/uso terapêutico , Paralisia Facial/microbiologia , Infecções por Micobactéria não Tuberculosa , Micobactérias não Tuberculosas/patogenicidade , Procedimentos Cirúrgicos Otológicos , Osso Temporal/microbiologia , Nervo Facial/patologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Pessoa de Meia-Idade , Infecções por Micobactéria não Tuberculosa/complicações , Infecções por Micobactéria não Tuberculosa/diagnóstico , Infecções por Micobactéria não Tuberculosa/microbiologia , Infecções por Micobactéria não Tuberculosa/terapia , Otite Média/microbiologia , Osso Temporal/patologia
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