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 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The success of Uvulopalatopharyngoplasty (UPPP) for Obstructive Sleep Apnea (OSA) can be assessed by a variety of parameters including clinical evaluation and polysomnography (PSG). Patients are often reluctant to undergo post-operative testing and insurance companies are often unwilling to reimburse for expensive overnight sleep studies. Due to the reality of these medical and economical problems, can a clinician be confident of the success of UPPP based solely on clinical evaluation? Sixty patients underwent UPPP for the treatment of OSA from July 1987 through June 1992. Patients treated with tracheostomy or other methods were not included in this study. Fifty-three patients (88%) reported an improvement in their symptoms of snoring, daytime somnolence, morning headache and apnea. Twenty-one patients (35%) had post-operative PSG. Eighteen of 21 patients (85%) reported improvement in their symptoms. Eleven of 21 patients (57%) showed objective improvement in their sleep apnea. The objective findings of PSG do not correlate, in a significant number of patients, with subjective clinical improvement of patients treated with UPPP.
Ear Nose Throat J 1993 Jan
PMID:Uvulopalatopharyngoplasty for obstructive sleep apnea in adults: clinical correlation with polysomnographic results. 844 31

Massage and Acupression have a history of many years of use by the Vietnamese people in the treatment of diseases, and they can give wonderful therapeutic effects in painful syndromes and chronic diseases, etc. On the other hand, some methods of Chrono-Acupuncture based on chronobiological theory and the holistic concept of traditional medicine are studied and applied in clinical applications. This paper presents the therapy advice system based on Chrono-Massage and Acupression using the method of ZiWuLiuZhu called CHROMASSI. The system includes four major parts. Massage and Acupression Teaching: This part can provide the user with some background in Massage and Acupression theory such as the pathology of the meridians, the classification of points and their function, the therapeutic properties of points, the methods of Massage and Acupression (including Pression, Friction, Rubbing, Light Massage, Petrissage, Rolling and Rubbing, Percussion and Vibration), and the direction of the meridians circulation, displaying AcuPoints represented by color pictures of the 12 main meridians and 2 vessels. More than 330 popular AcuPoints are used in the system. Open AcuPoint Calculating: This module can help us to calculate open AcuPoints based on data about days, months, years and hours using the special method of ZiWuLiuZhu. The Points adopted by ZiWuLiuZhu are the Five Shu Points and Source Points including 66 points (all of them are located below the elbows and knees). The effectiveness of these points becomes particularly evident when they are needled or punctured at optimum time intervals. For example, at 9:00 a.m., September 22, 1994, the open Points by the ZiWuLiuZhu method will be the points K2 (Nhien Coc) and K10 (Am Coc). According to the chronotherapeutic method, first we have to pressure (or puncture) the above points in order to attain the sensation RDac KhiS (arrival of energy), then pressure the other treating points as in ordinary Massage and Acupression. Therapy Consultation: Knowledge of the system was provided by Prof. Nguyen Van Thang and Doctor Nguyen Nhu Oanh at the Vietnam National Institute of Oriental Medicine. CHROMASSI is able to advise on ways to treat about 153 diseases and symptoms in the following fields: Aches and Pains, Insomnia, Common Cold and Influenza, Sexual Disturbances, Medical Aesthetics in Face, Breast and Buttock, Hygiene, Cardio-Vascular Tract, Digestive Tract, Urinary Tract, Respiratory Tract, Genital Tract, Ear-Nose-Throat Tract, Nervous Tract. The system can provide information about Remarks, Acupoints formulas for treating by Massage and Acupression with colour pictures of meridians. Explanation: The CHROMASSI system can explain why the AcuPoints are used for treating diseases based on the theoretical bases of traditional Vietnamese medicine and on the meridians and collaterals system theory. The colour pictures representing the circulation of vital energy in the meridians are used for explanation. The CHROMASSI system was developed in TURBO-PROLOG and TURBO-PASCAL and can run on IBM PC/AT computers and compatibles. The system can be used for teaching and for clinics of Massage and Acupression combined with Chronotherapeutics. At present the system is used by some physicians for clinical applications. The first results indicate that, in 20 cases of generalized headache compared with the control group, the combining of chronoacupression using the ZiWuLiuZhu method and ordinary Massage and Acupression gave better effects than that obtained by either method alone.
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PMID:CHROMASSI: a therapy advice system based on chrono-massage and acupression using the method of ZiWuLiuZhu. 859 9

Increasing popularity of the retrosigmoid approach would have one believe this is the preferred posteriorfossa approach for a vestibular nerve section. The authors take issue with this. The antesigmoid posterior lateral retrolabyrinthine approach is a gentle craniotomy, easily performed and with low morbidity. A review of 70 consecutive cases revealed no procedural alteration because of surgical exposure, an absence of meningitis, no VIIth nerve weakness, minimal headache, average hospital stay of five days, and only one patient with a significant CSF leak. Hyperventilation anesthesia, patience during delicate VIIIth nerve exposure, incorporation of abdominal fat into dural closure sutures and prophylactic antibiotics have made this operation easy for the patient...and the surgeon. Don't abandon it!
Ear Nose Throat J 1996 Feb
PMID:To abandon or not abandon: antesigmoid craniotomy with retrolabyrinthine vestibular nerve section. 871 20

This study reviews the records of 21 patients with isolated sphenoid sinus disease who were treated by rigid endoscopic sphenoidotomy at the Nose and Sinus Unit, Department of Otolaryngology of Beilinson Medical Center, Israel. Diagnosis was made on the basis of history, rigid nasal endoscopy and computed tomography (CT) scan. The most frequent symptom was headache; no instances of 'pathognomonic' headache were found. Sphenoidotomy was performed through the area of the natural ostium. The pathological finding was infection in 11 patients, cyst in four patients, polyps in three patients, mucocoele in two, and inverted papilloma in one patient. Surgical results were very good. Endoscopic sphenoidotomy proved to be safe, with minimal blood loss, reduced operating time, decreased morbidity, and short post-operative hospitalization.
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PMID:Isolated sphenoid sinus changes--history, CT and endoscopic finding. 894 95

Magnetic resonance angiography is an established radiologic technique which is rapidly becoming useful in imaging the head and neck. Currently, this imaging modality is important in the diagnosis of sigmoid sinus thrombosis caused by otologic disease. Since the introduction of antibiotic therapy, the percentage of deaths attributed to intracranial complications from otitic disease has decreased from 2.5 to approximately 0.25% of documented deaths. Also, the incidence of sinus thrombosis within this group has decreased, but it is still a serious and potentially lethal condition. Sinus thrombosis is suspected clinically when mastoid disease progresses, with picket fence fever pattern, chills, headaches and signs of papilledema. Definitive diagnosis is necessary before surgical treatment. The Queckenstedt test is unreliable, computed tomography is better suited for demonstrating thrombosis of the sagittal sinus rather than the sigmoid sinus, and conventional angiography (although it provides excellent visualization) has the hazard of ionizing radiation and requires vessel puncture and the use of intraarterial contrast agents. We present two cases of thrombosis of the sigmoid sinus as an intracranial otologic complication which were diagnosed definitively with magnetic resonance imaging and magnetic resonance angiography. The combination of magnetic resonance imaging, which showed the thrombosis displaying abnormal signal intensity, and magnetic resonance angiography, which demonstrated the absence of flow in the sinus, was an ideal diagnostic tool. For both patients, treatment consisted of mastoidectomy, sigmoid sinus decompression and antibiotics.
Ear Nose Throat J 1997 Jul
PMID:Use of magnetic resonance imaging and magnetic resonance angiography in diagnosis of sigmoid sinus thrombosis. 924 35

Recently, leukotrienes have been implicated in the mediation of bronchoconstriction and inflammatory changes in asthma. Leukotriene levels have also been shown to be elevated in patients with asthma as well as in those with sinonasal polyposis and sinusitis. The leukotriene synthesis inhibitor zileuton and the leukotriene receptor antagonist zafirlukast have been shown to produce subjective and objective improvements in patients with mild to moderate asthma. Given these findings, we evaluated the efficacy of these two medications in controlling sinonasal polyposis and their associated symptoms. We treated 40 patients diagnosed with sinonasal polyposis and sinusitis with either zileuton or zafirlukast. No other change was made in their standard therapy. Outcome measures included subjective interviews and questionnaire responses, as well as office endoscopic examinations and chart reviews. At study's end, 36 patients were available for evaluation. Twenty-six had taken zafirlukast, five had taken zileuton, and five others had switched from zafirlukast to zileuton. Overall, 26 patients (72%) experienced subjective improvement in their symptomatology after starting their medication. Statistically significant improvement was noted with respect to headache, facial pain and pressure, ear discomfort, dentalgia, purulent nasal discharge, postnasal drip, nasal congestion and obstruction, olfaction, and fever. An objective alleviation, or at least stabilization, of sinonasal polyposis was seen in 50% of the patients. Four patients (11%) discontinued their medication because of side effects. We conclude that antileukotrienes might play a significant role in controlling polyposis and symptoms secondary to sinonasal disease, and they might be a viable alternative to long-term oral steroid therapy and repeated surgical debridement.
Ear Nose Throat J 2000 Jan
PMID:Acute effects of antileukotrienes on sinonasal polyposis and sinusitis. 1066 87

Isolated cases of spontaneous cerebrospinal fluid (CSF) leakage with and without middle ear encephalocele have been reported. These leaks are usually accompanied by episodes of recurrent meningitis, hearing loss, or chronic headache. In this article, we report seven new cases of spontaneous CSF leakage. Six of these patients had conductive hearing loss and serous otitis media, and three had recurrent meningitis. Prior to a definitive diagnosis, six patients had received myringotomy tubes, which produced profuse clear otorrhea. Three patients had positive beta-2 transferrin assays. Computed tomography and magnetic resonance imaging confirmed a defect in the temporal bone tegmen. A combined transmastoid and middle fossa surgical approach with a three-layer closure was used to repair the tegmen defect. All patients had a lumbar drain placed prior to surgery. In addition to describing the seven new cases, we review the history of CSF leakage and discuss diagnostic methods, surgical findings, and our recommendations for management.
Ear Nose Throat J 2000 May
PMID:Spontaneous cerebrospinal fluid leakage and middle ear encephalocele in seven patients. 1083 3

We describe the case of a woman who had complained of worsening headache during the previous year. Analysis of computed tomography imaging and biopsy led to a diagnosis of fibrous dysplasia of the skull. A symptomatic frontal bone lesion was removed, and the resulting defect was repaired with hydroxyapatite cement. Hydroxyapatite cement has several advantages over hydroxyapatite ceramic blocks and granules, and it is particularly well suited for calvarial reconstruction.
Ear Nose Throat J 2001 Jan
PMID:Hydroxyapatite cranioplasty in fibrous dysplasia of the skull. 1120 16

Common nasal complaints are managed by both the otolaryngologist and the primary care physician. We describe the cases of two patients with nasal obstruction who were referred to us for evaluation--one with severe headache and the other with profuse epistaxis. Their histories prior to referral included long-term, common rhinologic complaints of low-grade headache and mild epistaxis. Neither patient had been referred to us until their symptoms had become severe. Our examination revealed that both patients had rare paranasal sinus pathology. One patient had a fibroxanthoma of the frontal sinus, and the other had extramedullary hematopoiesis of the maxillary sinus. Fibroxanthoma of the frontal sinus is rare, and extramedullary hematopoiesis of the maxillary sinus has not been previously reported. These two unique cases serve as a reminder that long-term common rhinologic complaints can occasionally be a sign of life-threatening pathology and require a full evaluation by an otolaryngologist.
Ear Nose Throat J 2001 Oct
PMID:Unusual paranasal sinus tumors in two patients with common nasal complaints. 1160 70

We undertook a study to assess whether patients who had both spontaneous vertigo and headache would respond to treatment for endolymphatic hydrops rather than treatment for migraine. We also attempted to discover if there were any individual characteristics that might predict which patients with an equivocal history and symptoms would be more likely to have either of the two conditions as opposed to the other. All patients were initially treated for endolymphatic hydrops with sodium restriction and increased water intake. Response to treatment was assessed by three tools: the Dizziness Handicap Inventory, a symptom severity scale, and a disability scale. Patients who did not respond to treatment for endolymphatic hydrops were switched to treatment for migraine. At the first follow-up period, 23 patients were available for analysis by telephone survey. According to data obtained by the three assessment tools, 14 patients (60.9%) improved after initial therapy and six (26.1%) improved following subsequent migraine treatment; the remaining three patients (13.0%) did not comply with their initial treatment regimen, and they showed no improvement. Although no statistically significant conclusions can be drawn because of the small sample size, there were trends to suggest that certain demographic, clinical, and objective-testing characteristics might predict which patients are likely to have one of these two conditions as opposed to the other. We conclude that a stepwise approach to treatment, beginning with therapy for endolymphatic hydrops, is an appropriate strategy. Also, the fact that no improvement was seen among the three patients who did not comply suggests that improvement is indeed the result of treatment rather than simply a function of the passage of time.
Ear Nose Throat J 2001 Dec
PMID:Spontaneous vertigo and headache: endolymphatic hydrops or migraine? 1177 22


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