1/9. Otorhinolaryngological aspects of xeroderma pigmentosum.OBJECTIVE: to evaluate the probable presence of otorhinolaryngological pathology accompanied by head and neck region skin findings in patients with xeroderma pigmentosum. methods: a total of 19 patients with xeroderma pigmentosum were investigated for otorhinolaryngological findings. The patients gave their anamnesis and underwent physical examination, audiological tests and endoscopic examination. RESULTS: various malignancies developed in 14 patients on the sun-exposed areas of the head and neck region. Multiple malignancies were found in six of them. There was no other pathological condition secondary to this rare clinical entity. CONCLUSION: xeroderma pigmentosum causes skin lesions. Some otolaryngological findings such as rhinitis, sinusitis etc. were thought to be coincidental.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/9. Otorhinolaringologic manifestation of smith-magenis syndrome.smith-magenis syndrome (SMS) is a multiple congenital anomaly/mental retardation (MCA/MR) syndrome link to a contiguous-gene deletion syndrome, involving chromosome 1 7p 11.2,whose incidence is estimated to be 1:25,000 livebirth. SMS is characterised by a specific physical, behavioural and developmental pattern. The main clinical features consist of a broad flat midface with brachycefaly, broad nasal bridge, brachydactily, speech delay, hoarse deep voice and peripheral neuropathy. Behavioural abnormalities include hypermotility, self-mutilation and sleep disturbance. This report defines the otorhinolaryngological aspects of a new case of SMS, confirmed by cytogenetic-molecular analysis, in a 9 year old girl affected by chronic otitis media, deafness and sinusitis, who presented with typical clinical signs and symptoms.- - - - - - - - - - ranking = 0.07638207985264keywords = physical (Clic here for more details about this article) |
3/9. Sinonasal disease in patients with sarcoidosis.sarcoidosis is a chronic granulomatous disease of unclear etiology with a propensity to involve the lower respiratory tract, but may also involve the upper respiratory tract. Histologically, it is characterized by non-caseating granulomas of various organ systems. Although nasal and sinus involvement is uncommon, patients with sarcoidosis presenting with nasal and sinus complaints may have sinonasal sarcoidosis or simply rhinosinusitis. We reviewed the cases of six patients with pulmonary sarcoidosis who developed chronic sinonasal disease. All six patients had intranasal findings consistent with sinonasal sarcoidosis, but only four had histologic evidence of sinonasal sarcoidosis. These four patients continue to require extensive therapy including topical steroids, systemic steroids, intralesional steroid injections, and nasal irrigations. We conclude that patients with histologically proven sinonasal sarcoidosis present a significant therapeutic challenge because their symptoms and physical findings are often persistent despite aggressive medical and surgical therapy. Their recalcitrant sinonasal disease is thought to result from the destruction of cilia and mucus-producing glands by the granulomatous process.- - - - - - - - - - ranking = 0.07638207985264keywords = physical (Clic here for more details about this article) |
4/9. Complications of intranasal prescription narcotic abuse.The abuse of drugs via an intranasal route is an increasingly prevalent pattern of behavior. In the past year, a number of patients received care at our institution for complications resulting from the previously unreported phenomenon of intranasal prescription narcotic abuse. This report describes the clinical manifestations of this form of drug abuse in 5 patients. Their symptoms consisted of nasal and/or facial pain, nasal obstruction, and chronic foul-smelling drainage. Common physical findings were nasal septal perforation; erosion of the lateral nasal walls, nasopharynx, and soft palate; and mucopurulent exudate on affected nasal surfaces. In addition, 2 of the 5 patients had invasive fungal rhinosinusitis, which appears to be a complication unique to intranasal narcotic abuse.- - - - - - - - - - ranking = 0.07638207985264keywords = physical (Clic here for more details about this article) |
5/9. Liposomal amphotericin b treatment for rhinocerebral mucormycosis: how much is enough?Rhinocerebral mucormycosis is a potentially life-threatening disease, which affects mainly immunocompromised patients. Treatment options include reversing immunosuppression, surgery and systemic and local administration of anti-fungal medication. amphotericin b is the primary agent employed, but its use is often limited by frequent side effects. Complexing amphotericin b with lipid structures avoids most of the negative side effects, most importantly the dose-limiting nephrotoxicity. No consensus has been reached regarding the appropriate duration, rate of administration or total dose of treatment. We present a case of a patient suffering from Rhinocerebral mucormycosis treated by extensive surgery and Liposomal amphotericin b. He was treated for 29 days at a rate of 3 mg/kg/d and a total dose of 5.6 gram. The dose of Liposomal Aphotericin B used in previously published articles ranged from 1.5 mg/kg/d to 5 mg/kg/d. The response to treatment may be evaluated by physical examination, microbiological cultures, radiological and pathological studies. Taking into account the considerable cost of liposomal amphotericin b and other lipid complexed formulations, it is imperative to find out what is the appropriate treatment regime for Rhinocerebral and other mucormycosis infections.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
6/9. The relationship between periodontitis and the maxillary sinus.This article presents a short review of the literature describing the relationship of periodontal disease and the maxillary sinus. This is followed by two case reports which demonstrate a close physical relationship between molar roots and the sinus and suggest that a sinusitis may develop from the extension of periodontal disease into the maxillary sinus. Further investigation of this hypothesis is necessary.- - - - - - - - - - ranking = 0.07638207985264keywords = physical (Clic here for more details about this article) |
7/9. frontal sinusitis and its intracranial complications.Although there has been a significant decrease in the incidence of frontal sinus disease since the advent of antibiotics, frontal sinus infection still occurs and may follow a clinical course not unlike that seen during the preantibiotic era. Secondarily to cranial and intracranial invasion the following complications may occur: osteomyelitis, cavernous sinus thrombosis, meningitis, extradural, subdural and cerebral abscess. The proximity of the frontal sinus to both the dura and the marrow of the frontal bone, as well as a rich communicating venous system, lends support to the facility of intracranial extension. Classically, frontal sinusitis presents with headache or pain usually following an upper respiratory infection. Purulent nasal discharge may be noted on physical examination. Roentgenographic studies will show opacification or an air-fluid level within the sinus. We present 4 cases of intracranial complications of frontal sinusitis seen in male adolescents. It is our contention that this disease bears a notable preponderance in males; a postulation that appears to be substantiated in the literature. Frequently even the classic signs and symptoms of frontal sinusitis may be undetected, which indicates that certainly the more subtle presentation of this disease may escape diagnosis during the course of examination. The use of CT scanning has proved an invaluable tool in the diagnosis of both frontal sinusitis and intracranial involvement. The importance of its incorporation into the diagnostic workup of the patient with frontal sinus disease cannot be overemphasized. We advocate aggressive medical and surgical management for all adolescents presenting with frontal sinusitis in an attempt to avoid possible intracranial complications.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
8/9. Invasive fungal sinusitis in the immunocompromised pediatric patient.Invasive fungal sinusitis in the pediatric population appears to be a relatively rare entity. An increasing incidence has been noted in accordance with the widespread use of antibiotics, steroids, antineoplastic drugs and radiation therapy. Three illustrative cases are described which outline the initial presenting symptoms, findings on physical examination, computed tomography (CT), intraoperative findings, and histopathologic findings. A review of the literature is presented and a treatment protocol is proposed once a diagnosis is made. Early suspicion and diagnosis are the most important prerequisites for successful treatment which consists of control of the underlying disease, surgical debridement, and systemic antifungal therapy. Cooperation between the otolaryngologist, pediatric specialists, and pathologists are key to the survival of children with invasive fungal sinusitis. survival in this series was dependent upon return of an immune competent state.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
9/9. Acute sinusitis in adults. Difficult to diagnose, essential to treat.Acute sinusitis is difficult to diagnose. diagnosis depends on obtaining a complete history and physical examination in addition to use of radiographic diagnostic aids and, if necessary, sinus aspiration. Once the diagnosis is made, empirical treatment with antibiotic agents and adjunctive measures should be started. Because most acute sinus infections are caused by H influenzae and S pneumoniae, the preferred antibiotic for treatment is amoxicillin or TMP-SMZ. Timely and appropriate therapy prevents complications. Symptoms persisting after completion of an appropriate course of treatment are an indication for referral to an otolaryngologist.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |