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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A safe closure of a dura lesion is necessary on account of the risk of potentially fatal (late) meningitis. 161 duraplasties of the frontal skull base carried out from 1979 to 1994 at the ENT-department Fulda were evaluated in a retrospective study in regard to etiology, operative techniques and results. Duraplasty of the rhinobasis was indicated in 70 cases of rhinobasal trauma, 47 cases after paranasal sinus surgery, 36 cases of tumors and 8 malformations. After an average follow-up time of 6 years the patients were interviewed for postoperative liquorrhea, sinusitis treated with antibiotics and meningitis. As an objective measure to verify the tight closure of the treated CSF-leaks a fluorescein test was performed in 50.9% 6 to 8 weeks after the operation. Duraplasty was successful in more than 96%. The approach and technique to perform a duraplasty have to be chosen individually considering size, location and etiology of the dural defect. In the majority of dural defects in the area of the frontal skull base reconstruction can be carried out now a days via an endonasal approach. By use of allogenic tissue, a mucosal flap from the surrounding area to cover the graft and fibrin clue good results were obtained.
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PMID:[Long-term follow-up of fronto-basal dura-plasty]. 941 33

Polymicrobial meningitis has become increasingly rare during recent decades. Historically, it has mainly been reported as being associated with disorders of the ENT-sphere. The treatment of these infections being optimized, polymicrobial meningitis nowadays is essentially a complication of gastrointestinal or gynaecological disorders and trauma. We present a case of polymicrobial meningitis following puncture of a unrecognized pre-sacral meningocele in a patient with Currarino syndrome and review of the relevant literature.
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PMID:Polymicrobial meningitis revealing an anterior sacral meningocele in a 23-year-old woman. 1084 Nov 2

Acute sinusitis is often a mild, self-limiting disease. However, in some cases, especially among children, sinusitis may become a severe, even life-threatening, disease. To examine the nature of complications of acute sinusitis, we studied the cases of children treated at the Helsinki University ENT Hospital, because of a complication caused by acute sinusitis from January 1997 to September 1998. There were 12 children (4 girls, 8 boys), whose ages ranged from 16 months to 16 years. One child had an epidural abscess, one got meningitis and cavernous sinus thrombosis, five had orbital cellulitis, one of whom lost her vision permanently in one eye, and five had preseptal cellulitis. All the children were treated with intravenous antibiotics and all, except the youngest, were treated with a direct sinus puncture. An operation (intranasal antrostomy, orbital drainage, functional endoscopic sinus surgery or adenoidectomy) was performed on six patients. In the majority of children, acute sinusitis is a mild self-limiting disease. However, severe complications still exist. When a complication of sinusitis is suspected, it is of utmost importance that the child be sent immediately to a hospital for proper diagnosis and treatment.
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PMID:Complications of acute sinusitis in children. 1090 7

In 1989-1998 ENT specialists of the Tashkent Institute of Postgraduate Medical Education treated 109 patients with otogenic intracranial complications. 13 (11.9%) of them had cerebellar abscess. Clinical symptoms of the abscesses were obscure or absent. Head ache was the leading symptom. Other hypertensive symptoms presented with nausea, (n = 2), vomiting (n = 5), bradycardia (n = 7). Changes on the fundus of the eye were not registered in 6 patients. Defective coordination of movements, scanning speech were observed in 11 and 3 patients, respectively. Large-swinging, mixed horizontal nystagmus was truncal, in 11 patients it was directed to the side of the abscess, in 2 patients--in both directions. Symptoms of the secondary meningitis arose in 12 patients. The patients underwent surgical cleaning of the middle ear and opening cerebellar abscess under drug therapy. One patient died of purulent ventriculitis (lethality 7.6%). It is inferred that cerebellar abscesses often run with mild symptoms. This creates diagnostic difficulties.
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PMID:[Otogenic cerebellar abscesses (in the light of 10-year observation materials at the ENT clinic at the Tashkent institute of continuing education of physicians)]. 1101 80

Shunt infections (SI) are a major concern in pediatric neurosurgery. Although SI occurs generally shortly after surgery, it can be very delayed in a number of cases. The incidence of late shunt infection (LSI) is not established, and the sources of contamination are poorly understood. We reviewed 1,793 pediatric cases from our database, with a mean follow-up of 9.12 years. We selected 40 cases of SI occurring more than one year after the previous shunt operation. These represented 12.7 % of SI, and the annual incidence of LSI was 0.28 % in our series. Peritonitis, generally due to appendicitis, was the cause of LSI in 11 cases. Hematogenous contamination was diagnosed in eight cases, because the germ was Haemophilus,Pneumococcus, or Listeria, or an ENT infection had preceded SI; the incidence of purulent meningitis was significantly higher in shunted patients than in the general population. LSI was due in seven cases to bowel perforation, and in four to direct inoculation, after abdominal surgery or traumatic exposure of the shunt. In the remaining 10 cases, no potential cause of infection was identified, and persistence of a germ since the previous shunt operation was suspected. SI represents a life-long threat after shunting, and may be unrelated to shunt surgery.
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PMID:Late shunt infection: incidence, pathogenesis, and therapeutic implications. 1236 84

Effects of viruses and bacterial associations are suggested to promote secondary purulent intracranial complications in ENT patients. Fundamental aspects of pathogenesis of viral neuroinfections and pathogenetic mechanisms of different conditions provoked by viral factors promoting bacterial complications are presented. Hemoculture, and cerebrospinal fluid in 24 patients with secondary purulent rhinogenic and otogenic meningitis were studied with polymerase chain reaction for enteroviruses, cytomegaloviruses, Epstein-Barr, herpes, zoster viruses. The viruses were present in the studied media in 29.4% samples.
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PMID:[Viral diseases as a predisposing factor of developing secondary oto- and rhinogenic bacterial meningitis]. 1635

The aim of this study was to assess if differences in etiology and risk factors among 372 cases of bacterial meningitis acquired after surgery (PM) or in community (CBM) have impact on outcome of infected patients. Among 372 cases of bacterial meningitis within last 17 years from 10 major Slovak hospitals, 171 were PM and 201 CBM. Etiology, risk factors such as underlying disease, cancer, diabetes alcoholism, surgery, VLBW, ENT infections, trauma, sepsis were recorded and mortality, survival with sequellae, therapy failure were compared in both groups. Significant differences in etiology and risk factors between both groups were reported. Those after neurosurgery had more frequently Coagulase negative staphylococci (p<0.001), Enterobacteriaceae (p=0.01) and Acinetobacter baumannii (p=0.0008) isolated from CSF and vice versa Streptococcus pneumoniae (p<0.001), Neisseria meningitis (p<0.001) and Haemophillus influenza (p=0.0009) were more commonly isolated from CSF in CBM. Neurosurgery (p<0.001), sepsis (p=0.006), VLBW neonates (p=0.00002) and cancer (p=0.0007) were more common in PM and alcohol abuse (p<0.001) as well as otitis/sinusitis (p<0.001) and Roma ethnic group (p=0.001) in CAM. Initial treatment success was significantly more frequently observed among CAM (p<0.001) but cure after modification was more common in PM (p=0.002). Therefore outcome in both groups was similar (14.6% vs. 12.4%, p=NS).
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PMID:Comparison of postsurgical and community acquired bacterial meningitis--analysis of 372 cases within a nationwide survey. 1803 Feb 63

Within last 17 years we went through all charts of bacterial meningitis within our nationwide survey and among 372 cases we found 62 cases of MM, in 12 cases with meningococcal disease (with shock, petechial effusions or disseminated intravascular coagulation or digital gangrenes). MM was usually observed in young adults without any of investigated risk factors like neoplasia, ENT (ear, nose, throat) focuses, elderly age, sepsis, diabetes, alcoholism, trauma, neonatal VLBW etc. Trauma, diabetes mellitus, alcohol abuse and chronic sinusitis/otitis were significantly less frequently found as a risk factor for MM. Mortality was very low, only 4.8% and was lower than overall mortality in CBM (12.4%, NS). Also the proportion of neurologic sequellae (9.7%) and initial treatment failure (8.1%) were comparable or even lower. This positive outcome results are probably because all N. meningitis strains were susceptible to penicillin, chloramphenicol, cefotaxim, cotrimoxazol or ciprofloxacin. Other reason for low mortality was that most cases received oral antibiotic immediately, even before admission (50 of 62). 95.2% of cases survived, 90.3% without any transient neurological residual symptoms.
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PMID:Meningococcal meningitis is still the commonest neuroinfection in the community in tropics: overview of 62 cases. 1803 Feb 71

Meningitis associated with bacteremia is rare. Bacteremic form of meningitis occurred in 28 of 201 cases of community acquired meningitis (14%) in Slovakia within last 17 years. Bacteremic meningitis was associated with diabetes (21.4% vs. 7.5%, p=0.02) and with higher treatment failures (32.1% vs. 9.5%, p=0.01) and higher mortality (25% vs. 12.4%, NS). In univariate analysis comparing 28 cases of bacteremic community acquired bacterial meningitis (BCBM) to all CBM, no significant risk factor concerning underlying disease (cancer, ENT infection, alcohol abuses, trauma, splenectomy, etc.) or etiology was observed apart of diabetes mellitus, which was more common among bacteremic meningitis (21.4% vs. 7.5%, p=0.02). Mortality (25% vs. 12.4%, NS) insignificantly but therapy failure (32.1% vs. 9.5%, p=0.01) was significantly more frequently observed among meningitis with bacteremia. N. meningitis was the commonest causative agent (8 of 28 cases) followed by Str. pneumoniae (6), gram-negative bacteria (6), S. aureus (4) and H. influenzae (2).
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PMID:Bacteremic meningitis is associated with inferior outcome in comparison to community acquired meningitis without bacteremia. 1803 Feb 72

Despite modern achievements in diagnostics and treatment, invasive and non-invasive pneumococcal infections remain a topical public health problem. To a large extent, it is connected with the absence or inconsistence of evidence-based information on this kind of infection. In this paper, retrospective analysis of the incidence of pneumococcal infections was performed on the basis of medical records available today in every health institution; the peculiarities of their nosologic structure were revealed. Among invasive forms, pneumococcal pneumonias prevailed (50.06%); apparent hypodiagnostics of pneumococcal meningitis was noted (only 4.02%). Among non-invasive forms, acute otitis with various complications prevailed (47.5%), acute sinusitis was registered in 37.5% of cases, and other ENT diseases (sphenoiditis, frontitis, ethmoiditis, etc.) were registered in 15% of cases. The study found that the main risk factors in these patients had been different ENT diseases which the patients had suffered from during the previous three months before the actual illness. Thus, the necessity for the development and perfection of techniques of microbiological diagnostics and the development of epidemiological control methods on their basis are obvious.
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PMID:[Epidemiological analysis of the incidence of invasive and non-invasive pneumococcal infections in different population groups]. 1803 Jul 13


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