Malignant otitis externa in upper Egypt: why do not all diabetics have malignant otitis externa?

Eighteen diabetic patients [7 men and 11 women, with an age ranged between 50 and 75 years] among 1730 cases of malignant otitis externa in the ENT Clinic at Assiut University Hospitals were studied and treated in this work. This group consisted of seven men and eleven women. Diabetes was long-standing in all patients and uncontrolled, except in one. Laboratory investigations in the form of high and low-density lipids, ESR, creatinine and blood sugar curves were done to all patients. Biopsy for histopathological examination was taken from the granulation tissues or aural polyp. Computerized tomography of the temporal bones and radioisotope bone scan using technetium 99 MDP was done to all patients in the Nuclear Medicine Unit in Assiut University Hospitals. The clinical features and presentation were summarized. The strategy of the diagnosis and treatment was discussed. The combination of antibiotic and drugs that improve microcirculation was found to be essential in treatment of malignant otitis externa. Liporegulation drugs are also valuable in controlling high levels of LDL. ESR is a useful tool to monitor patients with MOE during treatment and in the follow up

Spirometric lung function changes after total laryngectomy

In this study, repeated pulmonary function tests were studied in 20 patients with laryngeal carcinoma at 3 days before total laryngectomy, and 2 and 6 months after the operation, using a special extratracheal device in order to assess the effect of removal of the larynx on the pulmonary function and the possibility of management of treatable pulmonary function abnormalities. The present study aimed to determine if the newly designed extratracheal device used in the study enables and facilitates flow volume and resistance measurements performed with spirometric study. Also, the effect of bronchodilator for reversibility of airway obstruction in laryngectomized patients was studied. Finally, the compatibility of the data obtained from a questionnaire with the findings obtained from spirometric lung function was assessed. The results obtained in the present study revealed that in laryngectomized patients, expiratory lung functions were lower than the predicted values. Bronchodilator treatment was found to ameliorate some pulmonary function parameters in ten patients. The value of extratracheal device used was discussed

Endoscopy-guided balloon catheter dilatation of caustic oesophageal stricture in children

Between October 1997 and November 1998, 17 patients with symptomatic esophageal strictures underwent endoscopically and fluoroscopically guided balloon catheter dilatation. Their age range was between three and eight years with a mean age of 4.8 years. All the strictures were due to caustic ingestion, but the time of presentation after caustic ingestion varied until balloon catheter dilatation was applied. In sixteen patients, resolution or improvement of dysphagia was achieved with only one case needed surgery. There has been no patient morbidity or mortality after the procedure. It was concluded that balloon catheter dilatation under endoscopic and fluoroscopic guidance is a safe treatment of stricture. It should be considered the treatment of choice in the initial management of difficult esophageal narrowing and it appears to be safer than the more traditional methods of esophageal dilatation