ABSTRACT
No disponible
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Laryngostenosis/diagnosis , Larynx/abnormalities , Deglutition Disorders/etiology , Laryngoscopy , Laser Therapy/methods , Lasers, Gas/therapeutic useABSTRACT
OBJECTIVE: To evaluate vestibular function before and after cochlear implantation (CI) STUDY DESIGN: A prospective descriptive study. MATERIAL AND METHODS: Thirty consecutive patients with profound sensorineural hearing loss undergoing CI. Objective assessment of vestibular function was performed with the caloric test and video head impulse test (vHIT) in patients before and after CI. Dizziness Handicap Inventory (DHI) was used for subjective assessment before and after CI. RESULTS: Thirty patients received CI with 21 by round window approach and nine by anteroinferior cochleostomy. Vestibular results were categorized into four groups: no changes (20 patients), changes in the caloric test and vHIT (3 patients, all with DHI changes; P = 0.0001), changes in vHIT gain but not in caloric test (3 patients, all with DHI changes; P = 0.005), no changes in the caloric test and vHIT gain but only saccades appear (4 patients, all with DHI changes; P = 0.011). CONCLUSIONS: Although CI is a safe surgery with few major complications, it is a procedure that can produce dizziness. The vHIT reveals that 30% of patients demonstrate postoperative change in vestibular function. Therefore, when examining a CI patient with postoperative symptoms of dizziness, results of the vHIT test and gain as well as the presence of saccades, along with an increase DHI score, are parameters to consider in their evaluation. LEVEL OF EVIDENCE: 4.
Subject(s)
Hearing Loss, Sensorineural/rehabilitation , Vestibule, Labyrinth/physiopathology , Cochlear Implantation , Humans , Prospective Studies , Treatment Outcome , Vestibular Function TestsSubject(s)
Congenital Abnormalities/diagnosis , Congenital Abnormalities/surgery , Endoscopy/methods , Larynx/abnormalities , Laser Therapy/methods , Child, Preschool , Cough/etiology , Deglutition Disorders/etiology , Esophagus/abnormalities , Female , Fluoroscopy , Humans , Hypertelorism/diagnosis , Hypospadias/diagnosis , Infant , Larynx/surgery , Lasers, Gas/therapeutic use , Male , Pneumonia, Aspiration/etiology , Suture TechniquesABSTRACT
OBJECTIVE AND IMPORTANCE: The objective was to report the effectiveness of salvage treatment in soft tissue infection around cochlear implants with an absorbable gentamicin collagen sheet and a periosteum and skin rotation flaps. CLINICAL PRESENTATION: Three patients with cochlear implant and persistent surrounding soft tissue infection are included. All of them underwent antibiotic treatment prior to surgery without any response. INTERVENTION: In this study preoperative and postoperative audiograms were practiced. Surgical excision of infectious skin and a periosteum and skin rotation flaps were performed. The cochlear implant was refixed in the temporal bone and a gentamicin-impregnated collagen sheet was located covering the cochlear implant. CONCLUSION: headings In all patients with soft tissue infection around the cochlear implant, infection was completely resolved. It was not necessary to remove the device in any case. The use of an absorbable gentamicin-impregnated collagen sheet is not described for the management of soft tissue complications in pediatric cochlear implant patients. The local application of high concentrations of antibiotic administered by this sheet may be effective against resistant bacteria and, in conjunction with surgery, may resolve this type of complications.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Cochlear Implantation/adverse effects , Cochlear Implants , Gentamicins/administration & dosage , Soft Tissue Infections/drug therapy , Surgical Wound Infection/drug therapy , Child, Preschool , Collagen , Female , Haemophilus Infections/diagnosis , Haemophilus Infections/drug therapy , Haemophilus Infections/etiology , Haemophilus influenzae , Humans , Infant , Male , Methicillin-Resistant Staphylococcus aureus , Soft Tissue Infections/diagnosis , Soft Tissue Infections/etiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcal Infections/etiology , Surgical Flaps , Surgical Wound Infection/diagnosis , Surgical Wound Infection/etiologyABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Mediastinal Emphysema/complications , Subcutaneous Emphysema/complications , Neck Pain/etiology , Adrenal Cortex Hormones/therapeutic use , Histamine Antagonists/therapeutic useSubject(s)
Asthma/complications , Insect Bites and Stings/complications , Mediastinal Emphysema/etiology , Subcutaneous Emphysema/etiology , Adult , Animals , Critical Care , Deglutition Disorders/etiology , Dyspnea/etiology , Emergencies , Eye Injuries/complications , Eye Injuries/drug therapy , Histamine Antagonists/therapeutic use , Humans , Hypoxia/etiology , Hypoxia/therapy , Insect Bites and Stings/drug therapy , Mediastinal Emphysema/diagnostic imaging , Methylprednisolone/therapeutic use , Neck , Oxygen Inhalation Therapy , Subcutaneous Emphysema/diagnostic imaging , Thoracic Wall , Tomography, X-Ray ComputedABSTRACT
Paragangliomas are tumors that arise in the extraadrenal paraganglia and result from migration of neural crest cells during embryonic development. Based on their anatomical distribution, innervation and microscopic structure, these tumors can be classified into interrelated families: branchiomeric paraganglia (related to the branchial clefts and arches), intravagal, aortic-sympathetic and visceral-autonomic. Head and neck paragangliomas belong mainly to the first two of these families. The present article is divided into two parts. The first part reviews the embryological origin of these tumors. Special emphasis is placed on the process of neurulation or neural tube formation, neurosegmentation (with a summary of the mechanisms involved in the initial segmentation of the neural tube and of the hindbrain and spinal medulla), and the development of the sensory placodes and secondary inductions in the cranial region. Subsequently, the neural crest is analyzed, with special attention paid to the cranial neural crest. The embryonogenesis of paragangliomas is also described. The second part describes the topographical distribution of head and neck paragangliomas according to their localization: jugulotympanic, orbit, intercarotid, subclavian and laryngeal. The embryonogenesis and most important anatomical characteristics are described for each type.
Subject(s)
Head and Neck Neoplasms/embryology , Head and Neck Neoplasms/pathology , Paraganglioma/embryology , Paraganglioma/pathology , Head and Neck Neoplasms/blood supply , Humans , Paraganglioma/blood supplyABSTRACT
Los paragangliomas son neoplasmas procedentes de paraganglios extra adrenales que derivan de la migración de las células de la cresta neural durante el desarrollo embrionario. Según su distribución anatómica, su inervación y su estructura microscópica, pueden ser agrupados en familias interrelacionadas, diferenciándose paraganglios branquioméricos (relacionados con los arcos y hendiduras branquiales),intravagales, aórtico-simpáticos y autonómicos-viscerales. Los paragangliomas cervicocefálicos pertenecen principalmente a las 2 primeras de estas familias. El presente capítulo está divido en 2 partes. En la primera parte se hace una revisión sobre su origen embriológico, poniendo especial énfasis en el proceso de neurulación o formación del tubo neural; la neurosegmentación, resumiendo los mecanismos implicados en la segmentación inicial del tubo neural y la segmentación del rombencéfalo y la médula espinal, y la evolución de las placodas sensitivas e inducciones secundarias en la región craneal. Posteriormente, se analiza la cresta neural, con especial atención a la cresta neural craneal, para terminar con la embriogénesis de los paragangliomas. En la segunda parte se desarrolla la distribución topográfica de los paragangliomas cervicocefálicos, diferenciándolos conforme a su localización: yúgulo-timpánicos, orbitarios, intercarotídeos, subclavios y laríngeos. Cada tipo se asocia con su embriogénesis y con los detalles anatómicos más relevantes (AU)
Paragangliomas are tumors that arise in the extra adrenalparaganglia and result from migration of neural crest cells during embryonic development. Based on their anatomical distribution, innervation and microscopic structure, these tumors can be classified into interrelated families: branchiomeric paraganglia (related to the branchial clefts and arches), intravagal, aortic-sympathetic and visceral-autonomic. Head and neck paragangliomas belong mainly to the first two of these families. The present article is divided into two parts. The first part reviews the embryological origin of these tumors. Special emphasis is placed on the process of neurulation or neuraltube formation, neurosegmentation (with a summary of the mechanisms involved in the initial segmentation of the neuraltube and of the hindbrain and spinal medulla), and the development of the sensory placodes and secondary inductions in the cranial region. Subsequently, the neural crest is analyzed, with special attention paid to the cranial neuralcrest. The embryonogenesis of paragangliomas is also described. The second part describes the topographical distribution of head and neck paragangliomas according to their localization: jugulotympanic, orbit, intercarotid, subclavian and laryngeal. The embryonogenesis and most important anatomical characteristics are described for each type (AU)
Subject(s)
Humans , Head and Neck Neoplasms/embryology , Head and Neck Neoplasms/pathology , Paraganglioma/embryology , Paraganglioma/pathology , Head and Neck Neoplasms/blood supply , Paraganglioma/blood supplySubject(s)
Abscess/microbiology , Parotitis/microbiology , Salmonella Infections/diagnosis , Salmonella typhimurium/isolation & purification , Tomography, X-Ray Computed , Abscess/complications , Abscess/diagnostic imaging , Abscess/drug therapy , Abscess/surgery , Aged , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Drainage , Facial Paralysis/etiology , Gastroenteritis/etiology , Humans , Male , Parotitis/complications , Parotitis/diagnostic imaging , Parotitis/drug therapy , Parotitis/surgery , Salmonella Infections/complications , Salmonella Infections/drug therapy , Salmonella Infections/microbiology , Salmonella Infections/surgeryABSTRACT
No disponible
Subject(s)
Male , Aged , Humans , Abscess/microbiology , Parotid Diseases/microbiology , Salmonella enterica/pathogenicity , Parotid Gland/microbiologyABSTRACT
La sinusitis esfenoidal aguda aislada es una enfermedad inflamatoria poco común pero potencialmente peligrosa.Su diagnóstico se realiza raramente de forma inicial debido a la poca especificidad de su sintomatología, sin embargo, dada la gravedad de sus complicaciones, debe ser tenida en cuenta y considerarse como una urgencia terapéutica.El síntoma de presentación más común es una cefalea inespecífica, seguido de las alteraciones visuales y las parálisis de pares craneales. La TAC es actualmente el examen radiológico de elección. Su tratamiento es médico, asociado eventualmente a un drenaje quirúrgico por vía endoscópica.Se presenta un caso de sinusitis esfenoidal aguda aislada diagnosticada y tratada en nuestro servicio y realizamos una revisión de la bibliografía (AU)
