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

We present what to the best of our knowledge is the first reported case of an orbital abscess as a result of acute rhinosinusitis caused by obstruction of the middle meatus secondary to the impaction of a nasal foreign body in a child. The patient, a 5-year-old Hispanic boy, had presented with left periorbital edema, eye pain, rhinorrhea, headache, and a fever. The presence of a nasal foreign body had been suggested by a finding of a low-density signal in the left anterior nasal cavity and middle meatus on computed tomography. Endoscopic drainage of the abscess through the involved sinuses revealed that the foreign body was a wad of cotton. The cotton was removed, and the patient recovered uneventfully.
Ear Nose Throat J 2010 Feb
PMID:Nasal foreign body as the cause of a subperiosteal orbital abscess in a child. 2015 63

Aneurysms of the petrous portion of the internal carotid artery (ICA) are rare. Their etiology is usually congenital, traumatic, or mycotic. Depending on the size and location of the aneurysm, the direction of its growth, and the specific adjacent structures involved, patients may or may not present with signs and symptoms. When signs and symptoms do manifest, they may include headaches, epistaxis, a vascular retrotympanic mass with hemotympanum and/or otorrhagia, pulsatile tinnitus, hearing loss, vertigo, and Horner syndrome or Raeder paratrigeminal neuralgia. We describe the imaging aspects of the case of a 27-year-old man who presented with a 5-day history of unilateral symptoms secondary to a lesion located in the area of the right foramen lacerum. The lesion proved to be an aneurysm of the petrous portion of the ICA. We discuss the anatomic, imaging, and otologic aspects of ICA aneurysms in this location.
Ear Nose Throat J 2010 Jul
PMID:Aneurysm of the petrous portion of the internal carotid artery at the foramen lacerum: anatomic, imaging, and otologic findings. 2062 87

The purpose of the study was to determine the associations between dust, endotoxins and bacterial exposure, and health effects in sewage workers. Exposure of 19 workers handling dry sludge and 25 other sewage workers was measured. Controls were office workers from compost and sewage plants. Spirometry, acoustic rhinometry and nitric oxide in exhaled air were performed before and after exposure were measured. CRP was measured in blood samples. It was found that workers handling dry sludge were exposed to higher levels of dust and endotoxins than other workers and reported more airway and systemic symptoms than controls. Compared to controls, FEV(1)/FVC was 0.12 lower in workers handling dry sludge and 0.05 lower in other sewage workers. Nose irritation, cough and headache were more prevalent in workers handling dry sludge (ORs 2.3-23), and together with unusual tiredness associated with endotoxins and/or dust, ORs 2.9-34 for-10-fold increases in exposure. Cross-shift decreases of nasal dimensions were larger in workers handling dry sludge than controls and were associated with dust and endotoxin exposure. It was concluded that workers handling dry sludge were higher exposed to endotoxins and dust than other sewage workers and also reported more respiratory and systemic symptoms. Exposure-response relationships were found for nasal dimensions, nose irritation and systemic symptoms.
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PMID:Exposure, symptoms and airway inflammation among sewage workers. 2118 69

Skull base osteomyelitis is a life-threatening condition that sometimes arises as a sequela of otitis media and mastoiditis. We present a retrospective analysis of the clinical course of 3 patients with skull base osteomyelitis that originated in the middle ear or mastoid. All 3 patients were elderly diabetic men who presented with headache. We review the clinical features, radiologic findings, and culture results in all 3 cases, and we describe the treatment regimens that led to a successful response in all 3 patients.
Ear Nose Throat J 2011 Mar
PMID:Skull base osteomyelitis originating in the middle ear or mastoid: a review of 3 cases. 2141 42

A 25-year-old male patient presented to our Ear, Nose and Throat clinic with a history of nausea, vomiting, headache, vertigo and weight loss of 5 kg over the preceding 3 months. An enlarged cervical lymph node was detected at clinical examination. Lymph node biopsy showed nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL, nodular paragranuloma). Because of the neurological symptoms a cerebral MRI scan was performed and revealed an intense perivascular, bilateral, contrast-medium enhancing lesion of the temporal lobes suggestive of cerebral vasculitis. Cerebrospinal fluid analysis showed an increased number of mononuclear cells, but there was no indication for neurotropic viral or bacterial infections. EEG revealed a left temporal epileptic focus, and anti-epileptic therapy was initiated. NLPHL was treated with 2 cycles of ABVD chemotherapy and 20 Gy involved-field radiotherapy. Steroid therapy (prednisone 100 mg q.d.) for the presumed paraneoplastic neurological manifestation was started 1 week before chemotherapy and led to the rapid disappearance of complaints. Because of renewed onset of nausea and vertigo after 3 weeks of treatment with ABVD chemotherapy and 4 weeks of treatment with steroids, a follow-up brain MRI and EEG were performed and demonstrated complete disappearance of the 'vasculitic' changes without additional pathologic findings. Five months after therapy, the patient is without neurological symptoms and a PET-CT showed a complete remission. This case is a unique example of paraneoplastic central nervous system (CNS) involvement in a patient with newly diagnosed NLPHL. We present a review of the literature on paraneoplastic CNS symptoms in Hodgkin's lymphoma.
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PMID:Hodgkin's Lymphoma and Paraneoplastic Phenomena in the Central Nervous System: A Case Report and Review of the Literature. 2147 99

We describe the case of a 37-year-old woman who presented with a complaint of recurrent headaches since childhood. Clinical examination revealed the presence of a reddish-bluish mass in the inferior half of the tympanic membrane in her right ear. Source and three-dimensional time-of-flight magnetic resonance angiography (MRA) detected a protruded right internal carotid artery (ICA) in the hypotympanum. The vertical segment of the ICA was absent, and the artery was narrowed and lateralized and had a "reverse 7" shape. Meanwhile, a persistent stapedial artery (PSA) was seen originating in the petrous portion of the ICA to form a middle meningeal artery. The A1 segment of the right anterior cerebral artery was hypoplastic. Based on these findings and on follow-up findings on computed tomography, the patient was diagnosed with a concomitant aberrant ICA and PSA. No intervention was undertaken. We review the management of this rare finding, and we discuss the role of MRA in its diagnosis.
Ear Nose Throat J 2011 May
PMID:A case of a coexisting aberrant internal carotid artery and persistent stapedial artery: the role of MR angiography in the diagnosis. 2156 75

A retrospective study was undertaken to review the clinical presentation, evaluation, management, and outcome of otogenic lateral sinus thrombosis (LST) in children. All pediatric patients with LST seen in our department between 1999 and 2007 were included; there were 9 cases involving 6 boys and 3 girls whose ages ranged from 8 to 12 years. They had all been treated with antibiotics elsewhere prior to admission, and the duration of symptoms before admission ranged from 5 to 18 days. The most common presenting symptoms were ear discharge, headache, otalgia, and fever. Radiologic evaluation included computed tomography and magnetic resonance imaging. All patients underwent radical mastoidectomy with incision of the lateral sinus and removal of its content. There were no deaths. Pseudomonas and Proteus spp were the most commonly identified organisms. Otogenic LST still poses a serious threat that warrants immediate attention and care. It is often associated with other intracranial complications, such as cerebellar abscess. Computed tomography and magnetic resonance imaging play an important role in the management of this disease. Early and aggressive surgical intervention of this otogenic complication can potentially minimize mortality.
Ear Nose Throat J 2011 Jun
PMID:Lateral sinus thrombosis in children: a review. 2167 59

The present study examined the clinico-pathological profile of sinonasal masses in patients attending an Ear Nose Throat clinic of a rural tertiary care hospital of western Maharashtra in India, between May 2007 to June 2009. During the study period, 112 patients presented with sinonasal masses (male 68, female 44; age group 8-70 years). Nasal polyploid masses were non-neoplastic in 80 (71.4%) subjects, and neoplastic in 32 (28.6%) cases. Nasal obstruction was the most common (97.3%) presenting complaint, followed by rhinorrhoea (49.1%), hyposmia (31.25%), intermittent epistaxis (17.9%), headache (16.9%), facial swelling (11.6%) and eye-related symptoms (10.7%). The most common site of origin of polyploid masses was the middle meatus (54.4%) followed by the lateral wall of the nasal cavity (16.1%) and superior meatus (10.7%). Unilateral nasal masses was present in 47.7% patients, while the remaining patients had bilateral nasal masses. Allergic (62.5%) and inflammatory (25%) polyps were the most common non-neoplastic mass. Haemangioma (47.3%) and inverted papilloma (36.8%) were most common benign neoplastic mass; 92.3% of all malignant masses were squamous cell carcinoma. Surgery was the major mode of treatment. It included Caldwell-Luc operation (7.1%), polypectomy (17.8%), excision of mass (25.0%) and functional endoscopic sinus surgery (44.6%). Malignancies were treated with radiotherapy.
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PMID:Clinico-pathological profile of sinonasal masses: a study from a tertiary care hospital of India. 2232 48

A concha bullosa is a common anatomic variant that represents an aerated turbinate, usually the middle turbinate. It is usually asymptomatic. When extensively pneumatized, a large concha bullosa may cause significant problems, including headache, nasal obstruction, and blockage of sinus drainage. We report a case of a large concha bullosa mucopyocele that manifested as recurring migraine headaches. It was successfully treated with surgical excision. We also review the available literature.
Ear Nose Throat J 2012 May
PMID:A concha bullosa mucopyocele manifesting as migraine headaches: a case report and literature review. 2261 62

Septic cavernous sinus thrombosis is a rare and potentially life-threatening complication of infections involving the paranasal sinuses or the middle one-third of the face. We report a challenging case of cavernous sinus thrombosis to familiarize otolaryngologists with its clinical features, diagnosis, and management. The patient was a 45-year-old diabetic woman whose signs and symptoms mimicked those of complicated fungal sinusitis. She presented with fever, nausea without vomiting, frontal headache, bilateral ptosis and swelling, double vision, a partial loss of visual acuity in the left eye, and restricted lateral ocular movements. Her Snellen visual acuity had been reduced to 8/10 on the right and 6/10 on the left. Radiologic investigation revealed cavernous sinus extension of sphenoid sinusitis and a fungus-ball appearance in the sphenoid sinus. On the second day of her admission, the patient's vision was further reduced to 6/10 on the right and 2/10 on the left. She then underwent urgent bilateral anterior and posterior ethmoidectomy and sphenoidectomy. At postoperative follow-up, her vision had stabilized at 10/10 bilaterally. At 2 months after discharge, she exhibited no evidence of abducens nerve palsy, and her ocular function had returned to normal. The diagnosis of cavernous sinus thrombosis requires a high index of suspicion and confirmation by imaging. The favorable outcome in our case was attributable to early diagnosis, prompt initiation of appropriate intravenous antibiotic therapy, and surgical drainage by the skillful surgical team.
Ear Nose Throat J 2012 Jul
PMID:Staphylococcus aureus cavernous sinus thrombosis mimicking complicated fungal sinusitis. 2282 43


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