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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A sudden hearing loss (SHL) research clinic to which 30 members of an ENT Society refer patients, accumulates information about incidence, prognosis, recovery patterns, and treatment of SHL. The diagnostic protocol includes laboratory, audiometric, and radiologic studies; patients are followed for a minimum of 10 months. Among 76 patients seen in 1973, the diagnosis of idiopathic SHL was retained in 52; more specific diagnoses were established in 24. The incidence of SHL in the general population is estimated at 10.7 cases per 100,000. Although the therapeutic protocol was individualized, all patients with idiopathic SHL were advised to restrict dietary sodium, to discontinue use of stimulants, and were given instructions regarding activity. Twenty-six patients received prednisone. Results indicate that prednisone may have a beneficial effect when administered before the 10th day of SHL. Increasing age, hypertension, diabetes, and severe vertigo were found to be poor prognostic indicators. Outcome was significantly better in patients seen early in the course of their illness than in those seen later. Possible etiologic factors include vascular dysfunction and inflammatory response. Further studies of controlled series are needed to establish standards for diagnosis of SHL and its recovery pattern.
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PMID:Seventy-six cases of presumed sudden hearing loss occurring in 1973: prognosis and incidence. 85 Apr 55

Acquired sixth nerve palsies in infants and children that occur without fever primarily suggest a tumor or intracranial hypertension. In a few instances, the cause is benign and spontaneous recovery occurs although relapses are occasionally seen. We report seven episodes of benign sixth nerve palsy in four children aged 5 1/2 months to 8 1/2 years. An ENT infection was the precipitating factor in four of these seven episodes. Recovery consistently occurred within 4 days to 6 weeks. None of the children had residual oculomotor impairment. The various etiologic hypotheses put forward in the literature are discussed. No study provides a pathophysiologic explanation for these transient palsies.
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PMID:[Benign paralysis of the 6th cranial nerve in children]. 219 74

The diagnosis of obstructive sleep apnea is frequently made by taking a meticulous history coupled with a high index of suspicion. Snoring and hypersomnolence are clinical features common to individuals with sleep apnea. Since snoring is said to be a "disease of listeners," it is not uncommon that bed partners reported an increased incidence of depression and marital displeasure. It is for this reason that the spouse or bed partner should be interviewed, since the patient may not be aware of any sleeping problems. Physicians should also be alert to complaints of excessive daytime somnolence, because studies have shown that patients with obstructive sleep apnea are at increased risk for automobile crashes. It has been estimated that approx 58,000 motor vehicle accidents involving people with sleep apnea will occur in the US each yr. By proper diagnosis and treatment, the physician is in a unique position to prevent at least some of the automobile accidents that result from falling asleep while driving. Polysomnography is the only definitive way to obtain a diagnosis of sleep apnea. This allows the physician not only to diagnosis the disorder, but also helps in the evaluation of the severity of the syndrome and selection of therapy. An ENT evaluation is also important in ruling out anatomic disorders that can cause upper airway obstruction. Certain factors, such as alcohol and sedative ingestion, may aggravate the condition in a person predisposed to sleep apnea, and subtle changes, such as unexplained hypertension, polycythemia, and cor pulmonale, should lead one to investigate the possibility of sleep apnea as the etiology.
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PMID:Diagnosis of obstructive sleep apnea. 229 95

CSF fistulas are a major complication of head injury but also occur spontaneously or symptomatically in connection with tumours of the skull base, empty sella syndrome, ethmoidal encephalomyelocele, intracranial hypertension or postoperatively in connection with operations on skull base tumours or ENT operations. Their main risk is the possibility of meningitis. The main clinical symptom is CSF leakage from the nose, but meningitis may be the first manifestation. Isotope cisternography and metrizamide CT cisternography are the most important methods for precise localization, sometimes also for verification of a suspected fistula. Most traumatic CSF fistulas of the frontal and ethmoidal region have to be treated operatively. The method of choice is the transfrontal approach and the closure of the fistula opening using a pedicled pericranial flap or fascia lata graft. Most sphenoidal fistulas have to be treated by packing the sphenoidal sinus with muscle. The treatment methods of the rare spontaneous and symptomatic CSF fistulas are also described. The results of operative treatment are satisfactory. About 6% recurrences, which as a rule can be cured by reoperation, and a mortality rate of about 1-3% seem to be an acceptable price for prevention of an otherwise unavoidable and oftenly deadly meningitis. Future efforts are necessary to improve the operative technique in order to reduce the incidence of anosmia. Our descriptions and advice are based not only on literature reports but also on our own experiences with a combined material of 237 cases operated on for rhinorrhea.
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PMID:Traumatic, spontaneous and postoperative CSF rhinorrhea. 653 67

Seventy-eight workers, drawn from a population of 1502 presumably healthy working men who were interviewed about sleep habits and sleep disorders, underwent polygraphic recordings for at least 1 night. A significant association was found between the complaint of excessive daytime sleepiness and the incidence of sleep apnea. Workers with more than 10 apneas per hour of sleep complained significantly more about loud snoring, hypermotility in sleep, and frequent headaches. They had significantly more ENT findings and hypertension.
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PMID:Incidence of sleep apnea in a presumably healthy working population: a significant relationship with excessive daytime sleepiness. 666 93

Idiopathic IgA nephropathy of Berger's disease is characterized by prominent and diffuse IgA deposits in the mesangium. In many countries, it is the most common type of primary chronic glomerulonephritis. Typically, it is revealed by recurrent episodes of gross hematuria in association with ENT infection, but it can progress insidiously with microscopic hematuria and proteinuria. Serum IgA levels are increased in about 50% of cases. IgA nephropathy is not a minor condition: 20% of patients develop end-stage chronic renal failure 10 years after diagnosis and 50% after 20 years. IgA nephropathy can recur in a transplanted kidney suggesting that this disease is a systemic disorder although it has a remarkable tropism for the kidney. Even though many points remain to be elucidated, its pathogenesis appears to be linked to a genetic factor responsible for a lymphocyte dysfunction and an acquired environmental factor such as penetration of an antigen via the mucosa which may give rise to an excessive and inappropriate IgA immune response with the deposition of IgA in the mesangium and the development of progressive renal alterations. No treatment has been shown to be effective but tonsillectomy advised in case of a recurrent tonsillar focal infection is most often accompanied by a decrease in the incidence of gross hematuria. Corticosteroid therapy can be of benefit in cases involving a nephrotic syndrome associated with minimal glomerular lesions. In all cases, control of possible hypertension is of value in slowing the progression of this disease.
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PMID:[Mesangial IgA deposits nephropathy]. 793 58

Obstructive sleep apnoea syndrome is due to pharyngeal obstruction of inspiratory airflow with preservation of thoraco-abdominal respiratory movements. This disease has been described for about thirty years, but is now the subject of growing interest. According to the increasingly abundant literature on this subject, OSAS is associated with essentially cardiovascular morbidity and mortality (systemic hypertension, pulmonary hypertension, heart failure, coronary heart disease, arrhythmias, cerebral vascular accidents and sudden death). The pathophysiology of its underlying mechanisms and its complications is complex and multifactorial. The diagnosis of this syndrome should be suspected on clinical interview (snoring, excessive daytime drowsiness, and apnoea during sleep) and is confirmed by polysomnography. Nasal continuous positive pressure with elimination of aggravating factors is the reference treatment in 1994. The diagnosis and management of this syndrome requires a multidisciplinary approach with collaboration between general practitioners, neurologists, maxillofacial/ENT surgeons, cardiologists and respiratory physicians.
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PMID:[Obstructive sleep apnea syndrome and cardiovascular diseases]. 874 61

541 workers with long-term history of occupational contact with antibiotics and chemicals were examined by a dermatologist, ENT specialist, neuropathologist, surgeon, ophthalmologist. Many workers complained of occasional skin eruption, rhinitis, skin itching, sneezing, cough, Quincke's edema. Allergic examination revealed the presence of allergic symptoms (allergic dermatitis, itch, vasomotor rhinitis, chronic eczema, obstructive bronchitis, bronchial asthma, Quincke's edema, acute and chronic conjunctivitis) in 98 examinees. Somatic affections are represented by hypertension, chronic hepatitis, ulcer.
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PMID:[The effect of antibiotics on the body of those working in their manufacture]. 877

The prevalence of sleep-disordered breathing (SDB) was evaluated in a male population sample of Lorraine (university staff), with a protocol including a self-completed standardized questionnaire, anthropometry (including neck, waist and hip circumferences) and non-invasive ear, nose, and throat examination. Among 357 subjects present in the institution at the moment of the survey, 334 (93.6%) accepted to participate, and 300 (84%) returned the questionnaires. The anthropometric results corresponded to the French normative values according to gender and age. We chose a value of 32 as limit of the body mass index (BMI) between weight excess and obesity; this limit was exceeded by 7.2% of the subjects. The mean age of the sample was 44.8 (SD 10.1) years; the waist-to-hip ratio was of 0.907 +/- 0.053. The ENT examination found a high prevalence of nasal septum deviations (52.6%), of soft palate (25.2%), and uvula (42%) abnormalities; 32.1% of the subjects had experienced amygdalectomy. The non-responses to the questionnaire were infrequent (less than 2%), except for the questions regarding a history of hypertension (2.6%), weight fluctuations the last 5 years (7.6%), and the number of years in school (12%). The questionnaire included, for each question, the optional answer "don't know"; this answer was chosen for the questions concerning the duration of snoring (37.1%), stopping breathing during sleep (12.7%) and the parental history of narcolepsy (18.7 and 20.7%) and sleep apnoea (33.7 and 36.4%). 5.7% of the subjects declared sleep apnoeas at least once per week: 16.1% had unrefreshing sleep; 10.6% admitted to excessive daytime sleepiness; 41.9% were habitual snorers. These results indicate a prevalence of SDB in our sample which is comparable to the figures obtained in other European studies. Further analysis of our data will indicate if, besides weight excess and its troncular distribution, cigarette smoking and respiratory symptoms, the "minor" ENT abnormalities play a role in the pathogenesis of SDB.
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PMID:[An epidemiologic study of sleep-disordered breathing in the male population of Lorraine: preliminary results]. 977 16

Optimal methods of endotracheal anesthesia using non-opiate drugs of four classes (clofelin, transamine, contrykal, ketanes) have been fundamentally grounded developed and tried in extensive and traumatic operations for ENT malignant and vascular tumors as well as inflammation in patients of high anesthesiological operative risk. The drugs were used in 174 patients including 13 children. 87.9% of the patients had concomitant diseases: blood hypertension, coronary heart disease, chronic nonspecific pulmonary diseases, bronchial asthma, asthmatic bronchitis, diabetes mellitus, anemia. Adequate stable anesthesia was achieved in reduced dosage of conventional anesthesiological agents.
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PMID:[Use of nonopiate agents for anesthesia in ENT patients at high surgical-anesthesiological risk]. 1008 93


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