ABSTRACT
AIM: To present the current treatment approach for oroantral fistula causing maxillary sinusitis. DESIGN: Case series. Four cases of oroantral fistula (diameters: 6, 9, 11 and 13 mm) due to chronic maxillary sinusitis were treated by excision of all diseased oroantral fistula tissue, followed by endoscopic creation of a large middle antrostomy and closure of the fistula using buccal flaps. A synthetic surgical glue and local alveolar bone were used. RESULTS: Patients were followed up for six months to three years; all were considered cured. CONCLUSION: Most surgeons use buccal or palatal flaps, combined with the Caldwell-Luc procedure, to treat chronic odontogenic sinusitis and to repair fistulae more than 5 mm in diameter. This study supports the hypothesis that an endoscopic technique could be successfully used in patients with oroantral fistula causing chronic maxillary sinusitis of dental origin, instead of the Caldwell-Luc procedure, at least in patients with a small to medium-sized oroantral fistula.
Subject(s)
Endoscopy/methods , Maxillary Sinusitis/complications , Oroantral Fistula/surgery , Tooth Extraction/adverse effects , Adult , Chronic Disease , Cyanoacrylates/therapeutic use , Debridement , Female , Humans , Male , Maxillary Sinusitis/diagnosis , Oroantral Fistula/diagnosis , Oroantral Fistula/etiology , Surgical FlapsABSTRACT
Angioedema due to use of angiotensin-converting enzyme inhibitors (ACEIs) is a rare side-effect but is seen more often because of the increase in the use of these drugs due to their effectiveness and good tolerance in the treatment of hypertension and congestive heart failure. Other types of angioedema, which should be included in the differential diagnosis, are the hereditary type, which results from deficiency of C1 esterase inhibitor and the allergic angioedema. Angioedema is a potentially life-threatening condition when it is located to the mucosal and submucosal layers of the upper airway. Some times an angioedema case can be very severe, resistant to the usual treatment and even rarely fatal. The last eight months, six patients with angioedema due to ACEIs (5 cases) or angiotensin II receptor blockers (1 case), were examined and hospitalized at our department. We describe the case of a 65 year old woman with severe migratory angioedema of the tongue, the floor of the mouth and the oropharynx, which was rather resistant to the usual treatment.
ABSTRACT
OBJECTIVE: Hearing loss can significantly impair patient's quality of life, affecting communicative behavior, emotional and social function. This study assesses the impact of hearing aids on the quality of life of patients in a rural area and its correlation with socio-economic factors. MATERIALS-METHODS: Thirty patients (18 male, 12 female), with bilateral sensorineural hearing loss of variable etiology, using hearing aid for at least five years, were enrolled in this study. Mean age of subjects was 74 years. This study used the Glasgow Benefit Inventory (GBI) to quantify the changes in quality of life. Patients were divided in above and below criterion group. The criterion used was the median of the air contraction threshold improvement. The binaural use and the type of hearing aids were recorded and correlated with the type of social security service of patients. RESULTS: Eighty per cent of patients reported significant benefit from the hearing aid use. The majority of patients (90%) used one hearing aid (mean GBI total score 35) and only 10% had binaural hearing aid (mean GBI total score 45). The majority of patients used analog hearing aid (56.5%) while 43.5% used digital hearing aid. Interestingly, it was found that patients did not attend appointments for hearing aids maintenance with a mean follow up of 2.5 years. CONCLUSION: This study demonstrates a trend of better quality of life for patients with bilateral hearing loss and binaural hearing aid use. The type of hearing aid is related to the funding from their social security service. Therefore more patients are using analog hearing aids, as they are less expensive than the digital hearing aids.
ABSTRACT
BACKGROUND: During the last years tracheoesophageal fistula has a well established role and in several units is now the principal means of speech rehabilitation following laryngectomy. The purpose of this study is to present the long term results after using the Provox voice prosthesis and to compare the phonetic results obtained with this means of speech rehabilitation with esophageal speech. PATIENTS, METHODS, AND RESULTS: During the last 7 years, 265 laryngectomy patients were trained in our Department in an effort to develop esophageal speech. One hundred and twelve of them developed comprehensive speech of various quality. In another group consisting of 35 patients, a Provox low-resistance, self-retaining prosthesis was fitted. Twenty-nine of them developed a very good voice. Ten patients of each group were tested in order to estimate the quality of voice of the two methods. Three measurements were obtained from each patient: the maximal intensity, the maximal phonation time, and the number of syllables with one breath. CONCLUSION: All the results confirmed the better quality of the tracheo-esophageal speech. The main two advantages of the prosthesis are the effortless speech due to the low resistance of the valve and the simple maintenance by the patient. The most important disadvantage is the cost and the need to occlude the stoma during phonation. Conclusively each method of speech rehabilitation should be selected individually according to the needs, desire, and abilities of every patient.
