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

This paper discusses the personal criteria followed in indicating tonsillectomy and/or adenotonsillectomy in treating a group of 150 children between the ages of 2 and 12 in the ENT Department of the Crobu Hospital of Iglesias where a follow-up was carried out from May 1989 to March 1991. The study analyzes when and under what conditions these surgical procedures are indicated in young patients without recurrent tonsillitis but with obstructive sleep apnea (OSA). The utility of traditional laboratory investigations (such as surface pharyngeal swabbing) in indicating surgical therapy is also evaluated. In concluding, the Authors affirm that recurrent tonsillitis no longer controllable with medical therapy is still the most frequent indication for surgery. In fact, 64% of the children studied belonged to either class TR or ITR in which recurring infection was the primary indication factor. However, respiratory obstruction has recently emerged as a increasingly important factor in indicating tonsillectomy and/or adenotonsillectomy. In fact, 54 children (35.9%) of the 150 studied belonged to class IT or OSA in which tonsillar and/or adeno-tonsillar hypertrophy with obstruction of various degrees was the determining factor in indicating surgical treatment. It appears that in the near future with fewer tonsillectomies being indicated in the case of recurrent tonsillitis, a progressive increase in the number of indications of surgical treatment in cases of obstruction may be expected. The Authors stress, however, the importance of identifying OSA patients because of the cardiorespiratory risks they may encounter during surgery (intubation difficulty found by the anaesthesiologist, tendency towards laryngeal spasms and pharyngeal obstruction in the post-operatory period).
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PMID:[Tonsillectomy in childhood: personal considerations]. 181 87

Isolated disease of sphenoid sinus is rare, representing 2-3% of all paranasal sinus lesions. Usually it is inflammatory in origin; very rarely it is due to neoplasm. Isolated sphenoid sinus diseases are difficult to diagnose and to treat because either the symptoms are very vague or they present to us very late as a result of disease complications. Here we are presenting a case of isolated sphenoid fungal sinusitis. A 40 year female came to our ENT outpatient department with complaints of intermittent headache for past 3 months. She was treated for similar complaints by a general practitioner with antibiotics and analgesics before three months. She was referred to an ophthalmologist and neurologist as the headache did not subside. Since there was no abnormality in ophthalmological examination, the neurologist suggested a MRI which showed opacification of the sphenoid sinus. Hence she was referred to an ENT specialist. ENT Clinical examination was normal. Urgent CT scan along with MRI was ordered which revealed complete opacification of the sphenoid sinus. There was no air fluid level, no hyper dense foci suggestive of fungal elements. There was no bony erosion. A provisional diagnosis of Chronic Sphenoid sinusitis was made and planned for endoscopic sphenoidotomy under general anesthesia. Sphenoid sinus was opened and fungal debri was seen inside, which was sent for culture. Sphenoid ostium was widened. Post operatively patient was completely relieved of headache. Patient was started on Tab.Itraconazole 200mg/day for 6 weeks, since the culture was suggestive of aspergillosis. Owing to the non specific presentation and the vague symptomology of the disease there may be considerable delay in diagnosing and treating the patient. Hence imaging studies like CT and MRI is necessary when the disease is suspected for prompt diagnosis.
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PMID:Isolated Sphenoid Sinusitis. 3176 40