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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

(1) Apart from acute laryngitis in children, the use of steroids in acute ENT infections is not supported by clinical data. (2) A single dose of steroids (oral or intramuscular dexamethasone, 0.6 mg/kg) has only moderate efficacy in children with acute laryngitis, but it can hasten symptom relief. Available clinical data fail to show whether steroid therapy reduces the frequency of severe respiratory complications in this setting, or if it is helpful in minor cases. (3) There are no published data justifying the use of steroids as adjuvant treatment in other acute ENT infections, such as non allergic rhinitis, sinusitis, pharyngitis, tonsillitis and otitis. Two randomised trials have shown an analgesic effect of steroids in pharyngitis, but there are no published comparisons with standard analgesics such as paracetamol. (4) Severe complications appear to be rare with single-dose and short-term steroid therapy (for less than a week). However, there is a potential risk of rare but severe complications of chickenpox, and avascular necrosis of the femoral head. (5) Routine use of steroids for recurrent ENT infections has the same risks as long-term steroid therapy.
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PMID:Steroid therapy of acute ENT infections: rarely indicated. 1193 78

The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million deaths. In the UK, paediatric cases are clustered around population centres where there are high concentrations of infected immigrant adults, and to a lesser extent, areas where IV drug abuse is common. The highest incidence remains in London and the southeast. With the national redistribution of immigrant and refugee families, any doctor in any specialty may expect to be involved with children who are HIV positive, or have clinical AIDS. The majority of children are infected vertically, i.e. infection of the infant from an infected mother in the pre-, peri-, or post-natal periods. Rates of transmission vary from 15-20% in the developed countries. Children with HIV infection may have their primary presentation to ENT doctors, who should have appropriate thresholds for suspecting the diagnosis. The most common presenting features include persistent generalised lymphadenopathy, hepatosplenomegaly, chronic/recurrent diarrhoea, poor growth, and fever. Fifteen to twenty percent of untreated children will present with an AIDS-defining illness by 12 months, typically with Pneumocystis pneumonia at approximately 3-4 months of age. Seventy percent of perinatally infected children will exhibit some signs or symptoms by 12 months Without treatment, the median age to progression to AIDS is approximately 6 years, and 25-30% will have died by this age. The median age of death is approximately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality. Infections may be due to unusual pathogens such as Pseudomonas, 'typical' and atypical Mycobacteria, Candida, Aspergillus, etc. Fungal infections of the sinuses (inc. Aspergillus and Rhizopus spp.) may be particularly devastating, with rapid spread to involve bone and the central nervous system. Another classical presentation, which may present to ENT doctors, is that of bilateral parotid enlargement, especially in children who are 'slow progressors', many of whom also have Lymphoid Interstitial Pneumonitis (LIP). A major attitudinal change has occurred due to advances in 3 main areas: (i) the multidisciplinary management of the infected mother (inc. counselling, antenatal screening, elective caesarean section, advising against breast feeding, etc.), (ii) the prevention of vertical transmission, using anti-retroviral therapy to the infected mother during pregnancy, and to the potentially infected infant in the first weeks of life, and (iii) major advances due to the advent of highly active anti-retroviral treatment. With effective use of these measures, transmission rates may be reduced to <2%. None of the measures though, affect a cure, and it will still be many years before the development of effective vaccines. ENT doctors may be referred children already known to be HIV-positive. Knowing how to talk to infected children (and their parents) is full of potential pitfalls, and requires careful forethought. Many infection-control policies have required considerable rethinking due to the AIDS epidemic. This has especially been the case with respect to needle-stick injuries, post-exposure prophylaxis, sterilization and re-use of equipment, and safe approaches to surgery.
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PMID:HIV infection in children--impact upon ENT doctors. 1466 74

Tonsillectomy and adenoidectomy are probably the commonest surgeries performed in the ENT field as well as the most controversial ones. There are very few consensus documents available for these two surgeries. In 1997 a document written by the two mentioned Societies was published, in order to update such document regarding tonsillectomy and adenoidectomy procedures we have met this year representatives from both scientific societies and a new document has been elaborated. We describe the diagnostic criteria of pharyngo-tonsillitis and adenoiditis as well as of obstructive sleep apnoea syndrome, with the aim of a better comprehension of these processes when a decision needs to be made regarding surgery. Indications and contraindications of tonsillectomy and adenoidectomy are here described.
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PMID:[Indications for tonsillectomy and adenoidectomy: consensus document by the Spanish Society of ORL and the Spanish Society of Pediatrics]. 1655 Aug 58

Berger's disease, so called IgA nephropathy, is a mesangioproliferative glomerulonephritis characterized by recurrent episodes of gross hematuria in relation with ENT infections like tonsillitis. We report a clinical case which presented that association and make a review of the literature about the possible advantages of tonsillectomy on the evolutive course and prognosis of the nephropathy.
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PMID:[Relationship between repeating tonsillitis and Berger's disease. Report of A case and review of the literature]. 1656 97

Tularemia is a rare zoonosis occuring in many clinical forms, including ulceral, glandular, oropharyngeal, pneumonic, and septic form. ENT specialists seeing their patients in ambulatory and emergency settings are most likely to encounter oropharyngeal and glandular form. Tularemia became widely discussed clinical entity in recent years due to its potential to being used as a biological weapon in acts of terrorism. Authors present a case of a 75 yrs old woman treated for atypical tonsillitis with suppurative cervical lymphadenitis. As infection with typical pathogens was ruled out and no improvement with antibiotics was observed, further evaluation was initiated. Malignancies and tuberculosis were excluded. Final diagnosis was established based on a serological test. Epidemiology, clinical manifestations, diagnostic procedures and treatment of tularemia, as well as diagnostic pitfalls are briefly discussed.
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PMID:[Glandular tularemia--case report]. 1735 77

Many patients who present with otalgia have a normal otological examination, and a distant source of pain must be considered. The ear receives an extensive sensory innervation arising from six nerve roots. Many other structures in the head, neck and thorax share a common neuronal pathway with the ear, and these tissues represent the possible sites of disease in the cases of referred otalgia. Consequently, the differential diagnosis is extensive and varied. Making an accurate diagnosis relies on an understanding of the complex distribution of nerve fibres and a structured approach to patient assessment. This article aims to classify the aetiology of referred otalgia and to outline current treatments for these conditions. The origins of referred otalgia may be as remote as the cranial cavity and thorax; however, dental disease, tonsillitis, temporomandibular joint disorders and cervical spine pathology represent the most frequent causes. Ear pain may also be the first sign of a head and neck malignancy. Patients complaining of otalgia, with risk factors for an aerodigestive neoplasm, and a normal ENT examination require an urgent otolaryngological opinion.
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PMID:Referred otalgia: a structured approach to diagnosis and treatment. 1750 63

First branchial cleft anomalies are uncommon, and only sporadic case reports are published in the literature. They account for 1% to 8% of all the branchial abnormalities. The often variable presentation and tract siting of first arch fistulae have led to misdiagnosis. The misdiagnosis results in inappropriate/ineffective treatment and recurrence of the sinus tract. We present a 19-year-old woman who presented to the ENT outpatient department with episodic discharge from a long-standing fistula anterior to the left sternomastoid muscle. This was associated with repeated episodes of ipsilateral tonsillitis. In relation to the history and because of the position of the fistula, a diagnosis of second branchial arch fistula was made. An attempt at excision was unfortunately followed by early recurrence of discharge. At review following the procedure, a defect of the left tympanic membrane in the form of a fibrous band was noted, and a revised diagnosis of first branchial arch sinus was made. Wide surgical excision of the tract with partial parotidectomy was performed. An uneventful postoperative course followed, with no recurrence of symptoms after 24 months of review. We discuss the case, the diagnostic pathway, and the wide local excision technique used for removal of branchial fistulae.
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PMID:First branchial arch fistula: diagnostic dilemma and improvised surgical management. 2103 11

The indication for tonsil surgery is tonsillitis or obstructive symptoms due to tonsillar hypertrophy, associated with morbidity affecting health related quality of life (HRQL). Surgery performed is either tonsillectomy (TE) or partial intra capsular tonsillectomy/tonsillotomy (TT). TT is associated with fewer postoperative complications and rapid recovery, but with risk for regrowth of tonsillar tissue and return of sleep disordered breathing (SDB) or infections. The aim of this study was to investigate the long-term effects of TT and TE in young adults relating to HRQL and well-being as consequence of obstructive symptoms or ENT-infections after 6 years versus effect after 1 year. Young adults with symptoms of tonsillar hyperplasia were randomized to TE (44) or TT (32). Patients were assessed prior to surgery and 1 and 6 years postoperatively. Short Form 36 and the EuroQul Visual Analog Scale evaluated HRQL. Questionnaire was used to explore well-being, obstruction symptoms and infections. Patient BMI was calculated. Six years after surgery, 91 % of young adults (TE39/TT29) reported persisting benefits in well-being, reduced obstructive problems and fewer infections. Some patients in both groups reported a slight increase in snoring compared to 1 year after surgery, but still less than before surgery. Obesity was more frequent among those snoring. Both TT and TE in young adults yielded HRQL improvements and reduction in symptoms defining SDB persisting through 6 years postsurgery. Results indicated that both surgical methods were equally effective. Findings favor choice of TT due to lesser postoperative morbidity.
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PMID:Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up. 2242 21

The objective of the present study was to estimate the efficacy of laripront intended for the treatment of inflammatory diseases of the laryngopharynx in the children. Available for the observation were 50 patients aged between 4 and 14 years suffering from the following ENT pathologies: adenoiditis, lacunar tonsillitis, acute laryngitis, chronic tonsillitis, oropharyngeal candidiasis, chronic hypertrophic pharyngitis, atrophic pharyngolaryngitis after the chemical burn of the mouse cavity and laryngopharynx or in the case of gastroesophageal reflux disease. All the patients enjoyed the positive outcome of the treatment that was especially efficacions in the patients with acute pathologies. No adverse effects of the treatment were documented.
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PMID:[The application of laripront in the pediatric otorhinolaryngological practice]. 2325 May 35

The analysis of the prevalence of mycoses based on the literature data and original observations gives evidence of the increase in the relative frequency of mycotic lesions in the overall ENT morbidity. The occurrence of otomycosis among otitides of different etiology is estimated at 25% and that of pharyngomycosis in the patients presenting with chronic pharygitis and tonsillitis up to 28%. The mycotic lesions in the larynx are diagnosed in almost 15% of the patients with chronic laryngitis. Chronic inflammation of intranasal cavity and paranasal sinuses is associated with mycosis in 7% of the patients. The factors that promote the development of mycotic lesions are considered and specific clinical manifestations described with special reference to their localization and taxonomical identification of the fungi. The optimal approaches to the diagnostics and treatment of ENT mycosis are discussed. The strategies of local and general antimycotic therapy are proposed with the use of modern antimycotic agents taking into account peculiarities of the clinical course of the disease, indications and contraindications for their application.
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PMID:[The modern approach to diagnostics and treatment of mycotic lesions in ear, nose, and throat]. 2326 56


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