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

In accordance with the system of viral species, viral disorders of the oral mucosa may be classified with regard to their intensity of affection. There are but few viral infections exclusively affecting the oral mucosa like e.g. 1. Glossitis papulosa of Michelson, representing a special form of vaccinia inoculata, 2. Gingivo-stomatitis herpetica and 3. warts of the mucosa or condyloma-like papillomas of the oral mucosa including oral papillomatosis, that, itself shows morphological and clinical similarities to laryngeal papilloma. A second group of disorders mainly affecting the oral mucosa includes the "Aphthoid of Pospischill and Feyrter", Zahorsky's herpangina and other viral infections by the Coxsackie group, like vesicular stomatitis. The 3rd group represents viral infections of other organs in which affection of the oral mucosa is a prerogative, e.g. smallpox, varicella, foot-and-mouth disease and pharyngo-conjunctival fever. A 4th group includes those viral infections of the organs in which co-affection of oral mucosa occurs frequently or once in a while (at occasions). Here, we find eczema vaccinatum, herpes zoster, herpes simplex of the oral mucosa mostly on the hard palate, eczema herpeticatum, post-herpetic Erythema exsudativum multiforme, Mononucleosis infectiosa Pfeiffer, viral flu, German measles, parotitis epidemica, rubeola and ECHO-exanthema. A 5th and last group is made up by viral infections of other organs, in which affection of the oral mucosa hardly occurs at all. This group contains paravaccinal Ecthyma contagiosum, poliomyelitis, viral infection of the city of Marburg and some Arbovirus infections. Relatively few viral disorders never co-exist with lesions on the oral mucosa like e.g. Virus-hepatitis or some viral encephalitides. Groups 1 and 2, most important of all, are presented in detail regarding clinics, diagnostics, differential-diagnosis and therapy. The disorders within the other 3 groups are discussed only regarding their importance in the field of ENT-related symptoms of the oral mucosa. A number of pictures and tables completes important clinical details and give further hints to their differential-diagnosis.
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PMID:[Virus diseases of the mouth mucosa]. 83 Jan 6

Juvenile laryngeal papillomatosis is a rare and benign tumoral disease of childhood characterized by numerous relapses despite complete resection. The ENT treatment of choice is to vaporize the papillomas with a CO2 laser. Since the discovery of a viral etiology (Human Papilloma Virus), resection has been followed by medical attempts to control the disease by using various antiviral treatments. Among the latter, alfa interferon has proved effective during the first six months of treatment. In this article, we report on five cases of refractory juvenile laryngeal papillomatosis treated by excision (CO2 laser in four children, surgical resections in one child) and alpha-r IFN 1.5 x 10(5) U/kg daily. With this strategy, three of the five children are currently disease-free for periods ranging from 22 to 68 months. This series includes one remarkable observation of one child who responded only to double doses of alpha-r IFN, after initial failure at conventional doses. This therapeutic scheme reduced the frequency of relapses in a fourth child. In only one child the treatment did fail to modify the natural course of the disease. Side effects were tolerable and included anorexia (one case), palmar erythema (one case), a flu-like syndrome (two cases) and mild transient transaminase rise (three cases) not precluding further treatment. CO2-laser caused one laryngeal oedema and synechia of the anterior commisure of the vocal laryngeal cords in one other case.
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PMID:Combined CO2-laser and alfa recombinant interferon treatment in five children with juvenile laryngeal papillomatosis. 216 13

14 tumours in the ENT region were tested for the presence of human papillomaviruses (HPV) DNA. The dot-blot hybridization technique was used for HPV sequence detection. HPV DNA mixture of types 6b, 11, 16 and 18 served as a probe. The following five samples showed positive reaction: 3 carcinomas of the larynx, 1 carcinoma of the nasal cavity and 1 papilloma of the nasal cavity.
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PMID:[The presence of human papillomavirus deoxyribonucleic acid in tumors in the otorhinolaryngologic area]. 234 May 56

The problem of diagnosis and treatment of precanceroses and carcinome of the larynx is still one of the foremost interests of ENT specialists. In 1973 to 1982 82 patients with precanceroses of the larynx and 174 patients with carcinoma of the larynx were detected and treated. In the treatment of precanceroses of the larynx the laryngomicro-surgical procedure proved useful. In the third stage of Reinke's oedema a satisfactory functional effect was achieved in 100%, in solitary papilloma and papillomatosis in 88%, in leukoplakia and pachyderma in 76% and in chronic hyperplastic in 67%. Least relapses were recorded in the third stage of Reinke's oedema (0%) and in chronic hyperplastic laryngitis (23%). In the treatment of carcinoma of the larynx combined surgical and radiation therapy is preferable and was used in 55.4% patients; in 36.9% patients only irradiation was used and in 7.7% patients only surgical treatment. Within the framework of surgical and combined treatment 52.8% patients were subjected to laryngectomy and 47.2% to various types of partial resections of the larynx. By combined treatment five-year survival was achieved in 67.5% patients; in stage I and II of carcinoma in as many as 87.5% and in stage III and IV only in 47.5%. In patients after actinotherapy five-year survival was attained only in 45% of the patients, and in those with a supraglottic localization of the tumour only in 30%.
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PMID:[Treatment of precanceroses and carcinoma of the larynx]. 235 Aug 8

Juvenile laryngeal papilloma is the most common childhood neoplasm of the larynx. It is most often multiple and is characterized by a strong tendency to recur. Seventy-eight children with primary juvenile laryngeal papillomatosis (JLP) were treated at the ENT Department of the Zagreb University School of Medicine in the last 20 years and in the last 6 years interferon has been introduced into the therapy. Causes of the recurrence and the resistance to the therapy have been investigated. It has been shown that the administration of interferon has a certain effect on the tumor growth, but it has no effect against tumor recurrence. In patients with a severe clinical course the epithelial atypia of basal layer of papilloma and the increased enzymatic activity have been found.
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PMID:[Juvenile papillomatosis of the larynx]. 263

The current state of electronmicroscopy in research and clinical applications in otorhinolaryngology is reviewed. The recognition of cytoarchitectonic relationships by means of transmission electronmicroscopy, tracer studies and freeze fracture technique provides functionally interesting findings on the sensory epithelium and the permeability barriers of the inner ear. Knowledge of the fine structure of the animal and human ear also facilitates the understanding of the pathomechanism of the inner ear. Experimental and clinical findings of seromucotympanon are also described, as well as the morphology of normal and diseased respiratory mucosa. A viral origin for laryngeal papilloma is clearly confirmed. New findings in the pathohistology of otosclerosis are described. Finally, the use of electronmicroscopy in the diagnosis of ENT tumours is considered. The demonstration of pathognomonic cell organelles is useful not only in the diagnosis of rare tumours, e.g. esthesioneuroblastoma or carcinoid. The epithelial origin of anaplastic tumours can also be shown or excluded. Electronmicroscopy also offers important clues in the case of neck metastases from an unknown primary tumour.
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PMID:[The importance of electron microscopy in research and clinical otorhinolaryngology]. 355 89

Nasal polypectomy is a common ENT operation. Cerebrospinal fluid (CSF) rhinorrhoea and pneumocephalus are rare complications. We present a patient who developed both these complications after biopsy of nasal polyps which subsequently proved to be an inverted papilloma. He had a defect in the ethmoid roof, which was repaired. Whilst endoscopic repair of CSF leak is increasing in popularity, in this patient because of his pathology and difficulty of access a more traditional lateral rhinotomy approach was made with a successful outcome. An overview of the management of these complications is presented.
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PMID:The management of massive pneumocephalus and cerebrospinal fluid rhinorrhoea as a consequence of biopsy in a patient with inverted papilloma. 977 99

The present study comprises 43 patients with sinonasal papillomas operated on between 1990 and 1997 at the ENT Department, University Hospital of Zurich. Histology showed 5 cases of exophytic papilloma (EP) (12%), 34 cases of inverted papilloma (IP) (79%) including 4 cases of associated carcinoma (9%), and 4 cases of columnar cell papilloma (CCP) (9%). Recurrence developed in 6 of 41 patients (2 EP, 4 IP) (15%). HPV was detected in 4 of 37 specimens (11%) both by in situ hybridization (ISH) and polymerase chain reaction (PCR). HPV-11 was found in 3 lesions (2 EP, 1 IP), whereas HPV-6b was detected only in one lesion (1 EP). Altogether 3 of 5 EP (60%), one of 29 IP (3%) and one of 6 recurrent papillomas (1 EP) (17%) tested positive for HPV. Our findings suggest a possible role for HPV in the pathogenesis of exophytic papilloma. As no correlation was found with associated malignancy and recurrence of disease, screening for HPV seems not to be useful as a prognostic parameter.
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PMID:[Significance of human papillomaviruses (HPV) in sinonasal papillomas]. 1078 89

There is still some skepticism about endoscopic endonasal resection of inverted papillomas. We conducted a long-term retrospective study and examined 104 patients (82 male, 22 female) with inverted papilloma who were operated at the ENT-Department of the University of Erlangen between 1974 and 1997. The endoscopic approach was chosen in each case, either alone or in combination with external approaches. In 64.4% (67 cases), tumors of all T-classes were resected by endoscopic approach alone (T1:17.9%, T2:23.9%, T3:41.8%, T4:16.4%). For the rest of the patients an additional transoral and transfacial approach was necessary due to difficult tumor localization (T2:24.3%, T3:29.7%, T4:45.9%). The mean age of the patients was 55 years. The recurrence rate after primary endoscopic endonasal sinus surgery was 22.4% (15/67) and after combined endoscopic and external surgery 16.2% (6/37). Second salvage surgery after endoscopic sinus surgery was performed again endonasally in 46% (7/15) and externally in 53.3% (8/15). The recurrence rate after the endonasal approach was now 57.1% (4/7) and 50% (4/8) after external surgery. Third salvage surgery was performed again endoscopically in four cases and externally in four cases. The recurrence rate in both groups was 50% each, so that up to six operations, either endoscopically or externally, were necessary for complete tumor resection. The longest period for a tumor recurrence was 3.4 years after endoscopic sinus surgery and 9 years after combined endoscopic and external surgery. A tumor recurrence after endoscopic endonasal sinus surgery that could not be managed endoscopically again occurred in 12%. Tumor localization is the limiting factor for endoscopic endonasal sinus surgery of inverted papilloma. However, in 64.4% of cases, endoscopic endonasal sinus surgery alone was performed successfully without any loss of one patient. Long-term follow-up is necessary since the recurrence of tumor can happen after a long time. Endoscopic endonasal sinus surgery of inverted papilloma is safe and should be preferred due to its minimal invasive character.
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PMID:[Inverted papilloma of the nose and paranasal sinuses. Long-term outcome of endoscopic endonasal resection]. 1099 67

Surgical excision of papillomas remains the mainstay of the management of laryngeal papillomatosis, as causal therapy is not yet available. Eighty-nine patients -32 with juvenile papillomatosis (JP) and 57 with adult papillomas (AP)-- underwent endolaryngeal microsurgery (EM) in our department during the last 15 years. The ENT-department in Kaunas serves most of the patients with laryngeal papilloma among the 3.85 million inhabitants of Lithuania. Therapeutic outcome was assessed as both the recurrence rate and the length of time between recurrences of papillomas in the follow-up period lasting at least 2 years. The recurrence rate was 71.9% (23 patients) in the JP group and 22.8% (13 patients) in the AP group. The interval between recurrences of papillomas ranged from 1 month to 10 years (mean 1.9 years) in the JP group and from 6 months to 9 years (mean 3.2 years) in the AP group. The number of EMs per patient ranged from 1 to 18 (mean 3.2) in the JP group and from 1 to 5 (mean 1.35) in the AP group. EM is a minimally invasive and safe technique which provides accurate removal of papillomas, although recurrence is often unavoidable. Prognosis for the disease therefore remains rather unpredictable.
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PMID:The course of laryngeal papillomatosis treated by endolaryngeal microsurgery. 1113 77


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