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

Tinnitus is a frequent symptom but a tinnitus that is rhythmic and synchronous with the patient's heartbeat is rare. The symptom "pulsating noise in the ear" may be due to various cause but most frequently, by glomus tumors, intracranial hypertension and atherosclerosis of the carotid arteries. Pulsatile tinnitus can often present a serious diagnostic problem. The diagnostic evaluation includes physical examination, audiologic assessment and imaging techniques (ultrasonic examination of cervical vessels, high-resolution computed tomography of the temporal bones, nuclear magnetic resonance, angiography of the carotid arteries and magnetic resonance angiography). Evaluation should be individualized but must include a thorough ENT work up. The evaluation of the patient includes otomicroscopy, palpation and auscultation of ears and cervical region and the head positioning test. The cause of pulsatile tinnitus may be even identified on otoscopic examination. Further investigations by other specialities (neurology, internal medicine, ophthalmology) may become necessary. Life-threatening causes such as arteriovenous shunts or carotid artery stenosis must be ruled out. Nevertheless, in several cases it will not be possible to determine the etiology of tinnitus. Finally, therapeutic options which occasionally can include surgical techniques or interventional radiology are discussed.
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PMID:[Pulsating tinnitus]. 1070 57

Between September 1996 and January 1999 we used polysomnography (PSG) to examine 473 patients (involving a total of 662 records). The diagnosis was a sleep-related breathing disorder in 256 patients, including sleep apnea syndrome (SAS) in 194 patients, sleep hypoxicemia in 18 and insomnia in the other four. The SAS consisted of three subtypes: central apnea (CA) in 56 patients, obstructive apnea (OA) in 124 and mixed apnea (MA) in eight. The ratio of central apnea was relatively higher than the national average. Among the 473 patients, the most common complication was heart disease (133 patients) while other complications included hypertension, and respiratory and cerebrovascular diseases. Concerning the therapy for these patients, continuous positive airway pressure therapy was the most commonly applied and was effective in each type of SAS (CA, OA, MA). Other therapies included prosthetic mandibular advancement, bilevel positive airway pressure, medication and ENT operations. In Koga Hospital, there are many patients with heart disease and/or respiratory disease. We examined those patients who presented with snoring and/or apnea using PSG. Among these patients, SAS was the most common sleep disorder. The relative ratio of CA was high and the average age was higher than those with OA.
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PMID:The Koga Hospital Center for studies on sleep: status report. 1118 86

We prospectively studied 279 patients with epistaxis referred to ENT specialist from emergency room in our hospital in one year. Masculine sex (62%), medium or old ages (median 56 year), and associated diseases (HBP 22.9%, anticoagulants or antiplatelet drugs 11.1%), were the most common. Predominant local etiologic factors were trauma (12.9%) and inflammation (14%). Epistaxis had been essential in 36.9%. The most frequent location in all ages was the anterior one, especially located in the Kiesselbach's area, although the incidence of the posterior epistaxis increases in characteristic way from fourth decade, affecting more to men. Most of epistaxis (> 99%) were treated successfully by conservative approach and only two patients required surgical or interventional therapy. Patients between 30-59 year and the posterior epistaxis was the most refractory to the treatment. Hospitalized patients were older than ambulatory ones and had more associated diseases. Their average hospital stay was 9.2 days.
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PMID:[Epistaxis: prospective study on emergency care at the hospital level]. 1127 Jan 4

Sleep-related breathing disorders in children are common. Nearly 10% of preschool-aged children snore, and 1% of 4- to 5-year-old children present with an obstructive sleep apnea syndrome (OSAS), mostly due to an adenotonsillar hyperplasia. OSAS in children differs markedly from adults concerning etiology, clinical symptoms, polysomnographic findings, and course of the disease. Therefore, results of adult sleep medicine cannot easily be applied to children. The disease may result in pulmonary or systemic hypertension, failure to thrive, and neurocognitive misbehavior. Up to now, there is no consensus concerning diagnosis and therapy. In this article, we summarize and discuss what is known so far about sleep-related breathing disorders in children, focussing on the OSAS as the most important diagnosis for the ENT specialist.
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PMID:[Sleep-associated respiratory disorders in childhood]. 1138 7

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. 1207 37

Numerous internal diseases can express themselves in the form of ENT manifestations. Epistaxis is one of the most common emergencies seen by the ENT specialist. Possible underlying systemic etiologies may be hypertension, systemic anticoagulation or even rare entities such as hereditary hemorrhagic telangiectasia. Internal-medical conditions underlying hoarseness are usually injuries to the recurrent nerve with lesions of the thyroid gland and mediastinum being prominent. Modern electrophysiological techniques permit early prognostication of the chances of healing a vocal cord paresis. A number of surgical procedures for improving vocal problems in the treatment of irreversible paresis are available. Unclear cervical swellings prompt a wide range of possible differential diagnoses that differ dramatically in terms of both treatment and outcome. For this reason, a rational, interdisciplinary diagnostic work-up is essential. In light of the risk of delaying the diagnosis and worsening the outcome, uncritical primary sampling of such tissue must be avoided.
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PMID:[Hereditary telangiectasia, recurrent laryngeal nerve paralysis, tumor in the neck area. When you need the expertise of an ENT specialist]. 1238 Mar 36

Economies in National Health Systems forces ENT surgeons to review their indications for outpatient tonsillectomy. Therefore, it is important to preoperatively identify special risk groups who frequently have extensive posttonsillectomy bleeding with the need of a blood transfusion. Aim of this study was to estimate the incidence for posttonsillectomy bleeding related blood transfusion, to identify risk factors associated with the need for blood transfusion and to release guidelines for posttonsillectomy bleeding of high risk patients. A retrospective study was done on the medical history of 1720 patients who underwent tonsillectomy for chronic tonsillitis between 1982-1993 in the ENT Department at the University of Kiel. The average transfusion rate was 0.52%. End Stage Renal Disease and hypertension combined with a preoperatively decreased Hb and Hct were the risk factors identified leading to a transfusion. These patients should not get a tonsillectomy as an outpatient procedure. The Hb, Hct, PT, PTT, blood type and crossmatch should be drawn and assessed prior to tonsillectomy. We recommend immediate treatment of secondary hemorrhage in those high risk patients under general anesthesia to avoid severe complications.
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PMID:Incidence and clinical background of posttonsillectomy bleeding related blood transfusion over 12 years. 1573 24

We report an extremely rare case of metastasic renal cell carcinoma to the temporal bone which presented initially as a jugulotympanic paraganglioma. The clinical and radiological appearances were misleading.Investigations of concomitant high blood pressure revealed a tumour of the right kidney. Biopsy of the mastoid mass was histologically compatible with a metastasis from a clear cell renal carcinoma. The patient underwent a radical nephrectomy and local external radiotherapy to the head. He also received adjuvant treatment with interferon-_ and interleukin 2. The clinical presentation, the radiological and histological features, the patterns of spread, the treatment options and the prognosis of these tumours are discussed. A review of the literature confirms the extremely unusual occurrence of this localisation.
B-ENT 2005
PMID:Metastatic renal cell carcinoma to the temporal bone: case report. 1599 75

New Information on Chronic Rhinosinusitis and Polyposis Nasi Chronic inflammation of the paranasal sinuses is more common than inflammatory or degenerative diseases of the joints or arterial hypertension. The pathogenesis of chronic rhinosinusitis has still not been completely worked out. It is known that in particular the administration of antibiotics is incapable of healing the condition. Once the diagnosis has been established by an ENT specialist, topical or systemic steroids may be helpful. In most cases, however, it is necessary to combine these substances with surgical treatment. For this purpose, endoscopic sinus surgery is an approach that is capable of providing good long-term results.
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PMID:[New information on chronic rhinosinusitis and polyposis nasi]. 1624 78

Pediatric migraine differs from adult migraine especially in regards to duration, localisation and quality of pain. A detailed description of the symptoms with a normal neurological examination allows in most cases to rule out secondary headaches without other exams. Many different medications are used for symptomatic or prophylactic treatment with success. Symptomatic headaches should be suspected if there is any abnormality in history or neurological exam. Headaches due to arterial hypertension, ENT problems or maxillofacial causes should not be forgotten. Intracranial hypertension should be excluded especially in children with ventriculo-peritoneal shunt, since shunt dysfunction can be fatal. Post traumatic headache can be impressive but have a good prognosis.
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PMID:[Migraine and symptomatic headache in children]. 1840 4


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