RESUMO
The history of necrotizing external otitis, its diagnosis and management are reviewed. A case history is presented of a patient who was diagnosed as having progressive necrotizing external otitis with facial paralysis. In spite of standard medical treatment and aggressive surgical management, the disease process continued with progressive involvement of Cranial nerves IX and X. The Pseudomonas aeruginosa bacteria developed an increased minimal inhibitory concentration (MIC) to carbenicillin and gentamicin by requiring near toxic blood levels to be effective. Investigational ticarcillin (alpha-carboxy-3-thienylmethylpenicillin) and tobramycin were used successfully in resolving the infection.
Assuntos
Antibacterianos/uso terapêutico , Otite Externa/tratamento farmacológico , Penicilinas/uso terapêutico , Infecções por Pseudomonas/tratamento farmacológico , Ticarcilina/uso terapêutico , Tobramicina/uso terapêutico , Carbenicilina/uso terapêutico , Nervos Cranianos , Quimioterapia Combinada , Orelha Externa/patologia , Gentamicinas/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Otite Externa/etiologia , Otite Externa/patologia , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/etiologiaRESUMO
This study of 25 cases of benign neoplastic involvement of the eighth nerve in man suggests: (1) Eighth nerve auditory dysfunction and minimal structural change in the internal auditory canal are the earliest reliable signs leading to tumor detection. (2) "Early" detection does not mean "small" tumor. (3) Schwannomas tend to grow more slowly in the elderly patient. (4) Compression and displacement of viable axons may be the primary pathophysiology of dysfunction.
Assuntos
Neoplasias dos Nervos Cranianos , Nervo Vestibulococlear , Adulto , Fatores Etários , Neoplasias dos Nervos Cranianos/diagnóstico , Neoplasias dos Nervos Cranianos/patologia , Neoplasias dos Nervos Cranianos/fisiopatologia , Neoplasias dos Nervos Cranianos/cirurgia , Hemangioma/patologia , Hemangioma/cirurgia , Humanos , Pessoa de Meia-Idade , Neurilemoma/patologia , Neurilemoma/cirurgia , Nervo Vestibulococlear/patologia , Nervo Vestibulococlear/fisiopatologiaRESUMO
The granular cell tumor is an uncommon lesion and, when arising in the head and neck, principally involves the tongue and larynx. A patient with a granular cell tumor of the floor of the mouth is reported. Management is usually accomplished by complete local excision, but longterm follow-up is mandatory. Distinguishing the epithelial (pseudo-epitheliomatous) hyperplasia from a well differentiated squamous cell carcinoma is critical to avoid unnecessary radical surgery. At present the lesion is considered to be a true neoplasm, likely of Schwann cell origin, and clinically benign.