RESUMO
BACKGROUND AND OBJECTIVES: The purpose of this study was to provide possible causes and post-treatment prognosis of delayed facial nerve palsy (DFP) following middle ear and mastoid surgery. SUBJECTS AND METHOD: The medical records of 3787 cases of middle ear and mastoid surgery from June, 1980 to August, 2003 were retrospectively reviewed. Nine cases developed ipsilateral facial nerve palsy after 72 hours of surgery. Their age ranged from 20 to 67 years (the mean of 40 years old and the male: female ratio of 1:1.25). For the review of the chart, we checked preoperative middle ear and mastoid state, intraoperative findings, clinical features of development and recovery of facial nerve palsy. To evaluate the degree and the possibility of recovery of facial nerve palsy, the House-Blackman grading system was used and electrophysiologic studies (Maximal stimulation test, Nerve excitability test and Nerve conduction velocity test) were performed. The steroid and vasodilator drugs were prescribed for the treatment. RESULTS: All of the nine patients had preoperative diagnosis of chronic otitis media and five of them also had cholesteatoma. Radical mastoidectomy was done in two cases, open cavity techniques in two cases and closed cavity techniques in five cases. There were postoperative wound infections in five cases. Facial palsy was developed between 5th and 16th postoperative day (mean 9th day) and the initial House-Blackman grade was II or III. The time for complete recovery ranged from 1 month to 6 months, with the fastest recovery time being 9 days after DFP. CONCLUSION: DFP following middle ear and mastoid surgery is an unpredictable complication. Postoperative wound infection may have been related to it and should be regarded as a risk factor of DFP.
Assuntos
Adulto , Feminino , Humanos , Masculino , Colesteatoma , Diagnóstico , Orelha Média , Nervo Facial , Paralisia Facial , Isoflurofato , Processo Mastoide , Prontuários Médicos , Condução Nervosa , Otite Média , Paralisia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica , Vasodilatadores , Infecção dos FerimentosRESUMO
BACKGROUND AND OBJECTIVES: Cisplatin (CP), an antitumor agent widely used in the treatment of head and neck cancers, has side effects such as ototoxicity and nephrotoxicity. These side effects are closely related to oxidative stress. In the present study, we attempted to suppress CP-induced ototoxicity in rats by administering melatonin, an antioxidant. MATERIALS AND METHOD: Male Sprague-Dawley rats were divided into different groups and were treated as follows: 1) saline control, 2) CP (16 mg/kg, i.p.), 3) CP plus melatonin (10 mg/kg, i.p.). The rats were sacrificed at the 6th day after CP treatment. RESULTS: CP-treated rats showed increase in cochlear malondialdehyde, hydrogen peroxide, glutathione peroxidase and glutathione reductase levels, and the decrease in cochlear superoxide dismutase (SOD) and catalase levels. CP-treated rats showed markedly decreased in the number of stereocilia on the inner hair cells and mildly decreased in the number of outer hair cells in organ of Corti under the light and scanning electron microscopic examination. Light and electron microscopic findings, and cochlear hydrogen peroxide, malondialdehyde, SOD, catalase, glutathione peroxidase and glutathione reductase levels were restored in the rats injected with CP plus melatonin than those with CP alone. CONCLUSION: These results suggest that melatonin suppresses CP-induced ototoxicity via the suppression of the increased production of reactive oxygen species.
Assuntos
Animais , Humanos , Masculino , Ratos , Catalase , Cisplatino , Glutationa Peroxidase , Glutationa Redutase , Cabelo , Cabeça , Peróxido de Hidrogênio , Malondialdeído , Melatonina , Pescoço , Órgão Espiral , Estresse Oxidativo , Ratos Sprague-Dawley , Espécies Reativas de Oxigênio , Estereocílios , Superóxido DismutaseRESUMO
BACKGROUND AND OBJECTIVES: Epistaxis is often regarded as trivial disease, but it may cause serious situation and requires hospital admission. With the advent of nasal endoscopy, localizing the precise location of nasal bleeding is possible in most cases and enables direct treatment rather than simple nasal packing. We analyzed the epistaxis patients who require hospital admission during recent 10 years. MATERIALS AND METHODS: One hundred and one patients who required hospital admission from January 1990 to December 1999 due to intractable or recurrent epistaxis were included in this study. Records of the hospital admission were reviewed and analyzed retrospectively. RESULTS: Male patients were predominant (72.1%) and the highest age distribution was in the 50's. Intervals between the initial attack of epistaxis and medical attention was 2-5 days (60.4%). The mean duration of hospital stay was 5-10 days (49.5%). The precise localization of bleeding point was possible in 98 cases (81.6%), whereas some sites of bleeding revealed Little's area (35.0%) and nasal turbinates (28.3%). The most frequent preexisting structural abnormality and systemic illness were nasal septal deviation and hypertension. In hypertension patients, the predominant age distribution was in the 60's (28.6%), and there was no difference in the bleeding frequency and the mode of management. CONCLUSION: We analyzed the epistaxis patients who required hospitalization. Nasal endoscopy enabled precise localization of the epistaxis and prompt focused management rather than conservative management.
Assuntos
Humanos , Masculino , Distribuição por Idade , Endoscopia , Epistaxe , Hemorragia , Hospitalização , Hipertensão , Tempo de Internação , Estudos Retrospectivos , Conchas NasaisRESUMO
Epistaxis is a common otolaryngologic emergency. Posterior epitaxis is more frequent in the elderly and associates with hypertension and arteriosclerosis. This is apt to be more vigorous in volume, is more difficult to identify the active bleeding point, and is more troublesome to contol. A number of different treatments are used to control the posterior epistaxis. Some of these are deep anterior packing, posterior packing, nasal balloon tamponade, arterial ligation, arterial embolization and posterior endoscopic cautery. Recently we directly photocoagulated the bleeding points in 7 cases of posterior epistaxis using endoscope and KTP/532 laser. The epistaxis was controlled in all cases without any significant complication.
Assuntos
Idoso , Humanos , Arteriosclerose , Oclusão com Balão , Cauterização , Emergências , Endoscópios , Epistaxe , Hemorragia , Hipertensão , Ligadura , FotocoagulaçãoRESUMO
No abstract available.
Assuntos
Nervo Facial , Herpes Zoster da Orelha Externa , Herpes Zoster , ParalisiaRESUMO
No abstract available.
RESUMO
No abstract available.