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

We collected data on postoperative nausea and vomiting from 3850 patients aged 11-91 years. Thirty-seven percent of the 3244 patients who received a general anaesthetic reported nausea and 23.2% vomited. Twenty percent of the 606 patients who received a local anaesthetic reported nausea and 11.4% vomited. Of the general anaesthetic patients reporting nausea, 72.2% were women, and the mean age was lower than for those who did not (p < 0.001). Similarly for vomiting, 74.0% were women and again the mean age was lower (p < 0.001). Of the local anaesthetic patients reporting nausea, 62.0% were women and the mean age was lower than for those who did not (p < 0.001). Similarly for vomiting, 68.1% were women and again the mean age was lower (p < 0.001). Anxiety before general, but not local, anaesthesia was associated with postoperative nausea (p < 0.001) but not vomiting. Patients from the gynaecological, orthopaedic, ENT and general surgical wards had higher incidences of postoperative nausea and vomiting. Linear visual analogue pain scores were higher in patients with postoperative nausea and vomiting in both general and local anaesthesia groups (p < 0.001).
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PMID:Studies in postoperative sequelae. Nausea and vomiting--still a problem. 831 Dec 15

A nasopharyngeal carcinoma was the first event in an otherwise symptom free HIV person. No reports of simultaneous nasopharyngeal carcinoma and HIV infection are known to us. A 46-year-homosexual man was admitted to the ENT department with a three week history of pain in the throat referred to the left ear. He was found to have an irregular tumour in the nasopharynx with a lymph node metastasis to the left side of the neck. The poor response to radiotherapy and the very aggressive progress after treatment raised suspicion of a co-existing disease process. The risk of sexually transmitted HIV was confirmed post mortem and could explain the rapid progression of the tumour. No anti-HIV treatment was given concurrently with radiotherapy.
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PMID:Nasopharyngeal carcinoma in an HIV-positive patient causing severe morbidity and early death. 849 52

The case of a man, 28, addressed to our ENT-Department complaining of pain and swelling of the left half of the face is presented. After X-Ray and tomographic study the diagnosis of an included tooth inside the maxillary sinus, accompanied by one cyst, is evidenced. In addition a canine tooth as well included on the floor of the nose and under the lower homonyme turbinate, is disclosed. Through sinusal approach, via Caldwell-Luc, are removed the lesions encountered. Then, the AA., attempt to classify the group of several cystic structures of maxillary sitting, aiming at unify the nomenclature of this pathology, and made a brief description of each type.
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PMID:[Cystic formations of the maxilla. Case report]. 857 31

There is little clinical data in the literature on the anaesthetic management of paediatric patients with Eisenmenger's syndrome undergoing non-cardiac surgery. This paper reviews our experiences with either such patients who underwent a total of 11 surgical procedures. Of the eight children, six had Down's syndrome and an atrio-ventricular septal defect, one had a ventricular septal defect and one an atrial septal defect. Nine of the eleven operations consisted of minor dental, plastic or ENT procedures, while one patient underwent two laparotomies. Premedication (trimeprazine/ meperidine combination or midazolam) was administered on three occasions. Induction of anaesthesia was achieved by either inhalation of halothane (2), or intravenously with thiopentone (6), ketamine (2) or propofol (1). Muscle relaxation and mechanical ventilation were employed only for both intra-abdominal procedures, otherwise patients were allowed to breathe spontaneously with, or without, manual assistance. Halothane (8), isoflurane (2) and enflurane (1) were all used for maintenance of anaesthesia. Non-invasive monitoring was applied intraoperatively for minor procedures, and arterial and central venous catheters inserted for the laparotomies. Postoperative analgesia for both these cases was provided by an epidural infusion of bupivacaine 0.125% and fentanyl 5 micrograms x ml(-1). A single im bolus of morphine was required following a dental clearance, otherwise pain relief for the rest of the cases was achieved by local anaesthetic infiltration and NSAIDS. With the exception of a single episode of bradycardia, induction, maintenance and recovery from anaesthesia were well tolerated in all cases. In conclusion, our experience suggests that despite theoretical risks, children with Eisenmenger's syndrome appear to tolerate a variety of anaesthetic techniques.
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PMID:The anaesthetic management of the child with Eisenmenger's syndrome. 870

Chordomas are rare neoplasms of notochordal origin that arise along the vertebral axis. In the cervicofacial area, they show a marked proclivity for the sphenooccipital region. These slow-growing and infiltrating tumors are often discovered because of neglected symptoms related to the ENT field such as nasal obstruction, snoring, dyspnea or dysphagia in the case of anterior development, serous otitis media, cervical pain, or even palsy of the X, XI, or XII cranial nerves when the tumor develops toward the foramen jugulare or the foramen magnum. Prognosis is usually poor because of local malignancy, proximity to critical central nervous system structures, and volume of the tumor. Surgery is the preferred treatment for these extradural tumors, but most authors recommend postoperative irradiation because of surgical spillage or residual tumor. However, conventional irradiation is limited by the sensitivity of surrounding structures, which results in a poor rate of local control. We present 9 cases of histologically proven diagnosis of chordoma treated from 1984 to 1994 at our institution. Prognosis and therapeutic modalities are discussed. Therapeutic improvement might be brought the protontherapie, which ensures a better local control, and therefore may transform the prognosis of the disease.
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PMID:[Therapeutic management of craniocervical chordoma]. 876 68

Thyroid and non-thyroid inflammations are acute conditions accompanied by severe pain. It is impossible for general practitioners who have to refer patients to various outpatients department or specialised hospitals to distinguish between these conditions, even with the help of medical history, palpation and findings of laberatory investigations. Therefore, patients are often falsely referred to nuclear medicine or ENT outpatient departments. With the help of ultrasound a definite distinction between inflammatory conditions of the thyroid and other soft tissue inflammations of the neck can be established.
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PMID:Definite distinction between thyroidal inflammatory conditions and other soft tissue inflammations of the neck using ultrasound. 876 21

Two hundred and thirty-five consecutive Saudi patients aged between two and fifty-three years undergoing elective tympanoplasty (n = 32), septorhinoplasty (n = 68) or adenotonsillectomy (n = 135) were studied. They were randomized to receive either a total intravenous anaesthetic (10 ears, 23 noses, 44 throats) consisting of propofol for induction of anaesthesia followed by a propofol infusion, a combined intravenous-inhalational anaesthetic (11 ears, 22 noses, 46 throats) consisting of the above with isoflurane in oxygen-enriched air, or a balanced inhalational anaesthetic (11 ears, 23 noses, 45 throats) consisting of thiopentone for induction of anaesthesia and oxygen in nitrous oxide with isoflurane for maintenance. During tympanoplasty, all three anaesthetic techniques produced stable heart rates and arterial pressures. During septorhinoplasty, blood pressure rose in patients who received total intravenous anaesthesia, while combined and balanced techniques produced haemodynamic stability. During adenotonsillectomy, total intravenous anaesthesia produced a rise in both heart rate and blood pressure, the combined technique produced a rise in heart rate alone while balanced anaesthesia produced haemodynamic stability. Postoperatively, vomiting, pain scores and analgesic requirements were similar following all three types of anaesthetic within each surgical site subgroup. Our findings support the choice of balanced inhalational anaesthesia for all three types of ENT surgery and, where cost and facilities permit, total intravenous anaesthesia for tympanoplasty and combined intravenous-inhalational anaesthesia for septorhinoplasty.
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PMID:Comparison of total intravenous, balanced inhalational and combined intravenous-inhalational anaesthesia for tympanoplasty, septorhinoplasty and adenotonsillectomy. 878 57

We performed a randomized double-blind controlled study in community medical practice comparing lysine acetylsalicylate (LAS) and paracetamol (PAR). Both drugs were given at the same dose (1 g, thrice daily) during two days; from the third to the seventh day, the patients could freely take the same drug if necessary. The analgesic effect of drugs was measured by two means: an analog scale of pain during day 1 & 2 and the count of drugs units taken during days 3 to 7. The side effects were reported. We included 473 patients (167 men, 306 women) by means of a group of 54 general practitioners. 470 patients were stratified according to the site of pain: head (n = 113), joints (n = 80), back (n = 193), thorax (n = 11), teeth (n = 48), ENT (n = 25). The pain was either acute (73%) or chronic (27%) and scored an average +/- SD of 76 +/- 12 mm on an analog visual scale from 0 to 100 mm. Response was defined as a decrease of at least 50% of the pain score. Before intake of active drugs, all patients were given placebo. Only 14% responded. Under LAS or PAR, although the difference is not statistically significant, the number of responders was slightly higher with LAS than with PAR. Moreover, the study yields some interesting differences. During day 1 and day 2, the patients of the LAS group had less pain than those of the PAR group. This difference became statistically significant at D2 H12 (p < 0.05). LAS was significantly more effective than PAR in patients with back pain (p < 0.01), and there was a trend in favor of LAS in dental and ENT pain, and for intense pain. PAR never yielded better response levels than LAS. Among the placebo-unresponsive patients, the amount of drug taken from day 3 to day 7 was significantly lower in the LAS group than in the PAR group (p < 0.05). The side effects were comparable in both groups. According to the investigators' point of view both drugs were similarly well accepted by the patients (89.3% in LAS group, 94% in PAR group). The fact that LAS seems more effective than PAR in some kinds of pain is to bring near to the anti-inflammatory action of LAS and to its better bioavailability.
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PMID:[Comparative trial of lysine acetylsalicylate and paracetamol on pain in daily medical practice]. 895 56

The results of a national audit of sinus surgery are presented. Forty-six consultant ENT surgeons reported on over 2500 sinus procedures. There has been an exponential rise in the number of surgeons in England and Wales performing functional endoscopic sinus surgery (FESS) in recent years. Sixty-five per cent of surgeons in our study used the FESS technique and 81% had formal or other training. Outpatient sinus endoscopy and CT scans have become more routine pre-operative investigations, whilst the use of plain films has waned. There was a wide variation in the numbers of FESS procedures performed by individual surgeons in the 6-month period (between 5 and 85). The overall complication rate was 0.75% for conventional surgery and 1.41% for functional surgery but no major complications were recorded. The primary symptom of blockage was most successfully treated by both conventional and functional surgery (70% and 84% asymptomatic or improved at 6 months). Pain was relieved in 75% of functional procedures and 47% of conventional procedures and discharge relieved in 76% of FESS procedures and 47% of conventional procedures.
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PMID:A national audit of sinus surgery. Results of the Royal College of Surgeons of England comparative audit of ENT surgery. 916 Sep 29

In a prospective observational study carried out by 1 homoeopathic and 4 conventional ENT practitioners, the 2 methods of treating acute pediatric otitis media were compared. Group A received treatment with homoeopathic single remedies (Aconitum napellus, Apis mellifica, Belladonna, Capsicum, Chamomilla, Kalium bichromicum, Lachesis, Lycopodium, Mercurius solubilis, Okoubaka, Pulsatilla, Silicea), whereas group B received nasal drops, antibiotics, secretolytics and/or antipyretics. The main outcome measures were duration of pain, duration of fever, and the number of recurrences after 1 year, whereby alpha < 0.05 was taken as significance level. The secondary measures were improvement after 3 hours, results of audiometry and tympanometry, and necessity for additional therapy. These parameters were only considered descriptively. The study involved 103 children in group A and 28 children in group B, aged between 6 months and 11 years in both groups. For duration of pain, the median was 2 days in group A and 3 days in group B. For duration of therapy, the median was 4 days in group A and 10 days in group B: this is due to the fact that antibiotics are usually administered over a period of 8-10 days, whereas homoeopathics can be discontinued at an earlier stage once healing has started. Of the children treated, 70.7% were free of recurrence within a year in group A and 29.3% were found to have a maximum of 3 recurrences. In group B, 56.5% were free of recurrence, and 43.5% had a maximum of 6 recurrences. Out of the 103 children in group A, 5 subsequently received antibiotics, though homoeopathic treatment was carried through to the healing stage in the remaining 98. No permanent sequels were observed in either group.
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PMID:The homoeopathic treatment of otitis media in children--comparisons with conventional therapy. 924 43


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