Pott's puffy tumor treated by endoscopic frontal sinusotomy.

Pott's puffy tumor is a serious extracranial complication of frontal sinusitis. The formation of this entity is facilitated by the close anatomic relationship between the paranasal sinuses and the frontal bone. Furthermore, the rich diploic venous drainage of the region enhances the spread of the infection. We report on successful functional endoscopic frontal sinusotomy in a series of four cases of Pott's puffy tumor following acute frontal sinusitis, between the years 1994 and 1997. We emphasize the advantages of this approach over the external approaches as follows: the technique treats the causative source of the disease, the morbidity is low, and it avoids facial cosmetic trauma and sequela.

Transnasal endoscopic management of choanal atresia.

Since 1755, when Roederer first described choanal atresia, more than 350 papers have been published dealing with the various aspects of this entity. Many surgical techniques have been used to treat the malformation, each with its advantages and disadvantages. Endoscopic transnasal repair of choanal atresia provides excellent visualization and enables accurate surgery to be performed on patients of all ages and even on newborn infants. Described are two newborn infants, one with bilateral choanal atresia and the other with bilateral choanal stenosis, successfully treated by endoscopic transnasal repair, with a 12 month follow-up. The technique of endoscopic choanal repair is described, emphasizing it as a highly successful, short and safe procedure with swift recovery and short hospitalization.

Functional endoscopic sinus surgery of orbital subperiosteal abscess in children.

Subperiosteal abscess of the orbit (SPA) should be considered an important part of the group of orbital complications following acute sinusitis. This situation requires early surgical intervention to avoid visual loss or ophthalmoplegia. Six cases of children with SPA of the orbit treated successfully by Functional Endoscopic Sinus Surgery (FESS) are reviewed. The importance of ophthalmological examination, nasal endoscopy and CT scan is emphasized concerning the management protocol. The major advantage of FESS is the avoidance of external ethmoidectomy with the resultant scar. FESS is demonstrated as a safe and convenient procedure with excellent post operative recovery of the patients.

Malignant external otitis versus acute external otitis.

Malignant External Otitis (MEO) and Acute External Otitis (AEO) are clinically very similar in their beginnings. It is important to differentiate between them very early. Bone scanning is the best diagnostic tool. Eight cases of AEO and MEO are herewith presented.

Superinduction of the human gene encoding immune interferon.

Mitogen-induced interferon-gamma (IFN-gamma) gene expression was analyzed in human tonsil cells by titration of IFN-gamma activity and by quantitation of IFN-gamma mRNA. Expression of the IFN-gamma gene can be superinduced extensively by two distinct methods: exposure to various inhibitors of translation, or to low doses of gamma-irradiation. gamma-Irradiated cells produce, after exposure to cycloheximide, up to 12-fold greater amounts of IFN-gamma activity. Within as little as 4 h after the addition of translation inhibitors, IFN-gamma mRNA levels rise 3- to 5-fold. Superinduction acts to increase the size of the wave of IFN-gamma mRNA. Primary transcription of the IFN-gamma gene does not increase in cells superinduced by cycloheximide, nor can superinduction be explained by stabilization of IFN-gamma mRNA sequences. These findings show that, during normal induction, a labile protein acts post-transcriptionally to repress the accumulation of mature IFN-gamma mRNA sequences. The superinductive effects of cycloheximide and gamma-irradiation on levels of IFN-gamma are additive, suggesting that they affect different aspects of IFN-gamma gene expression. Superinduction by gamma-irradiation also has a post-transcriptional basis and is consistent with the possibility that expression of the IFN-gamma gene is normally controlled by the action of suppressor T cells. Even though the genes for human IFN-gamma and for interleukin-2 are both superinducible, a striking difference in the regulation of expression of these lymphokine genes is observed. Superinduction of IFN-gamma mRNA is not due to superinduction of interleukin-2.

Waardenburg syndrome with associated multiple anomalies.

A 4 1/2-year-old girl presenting characteristics of Waardenburg's syndrome with associated multiple defects is described. The patient presents all the obvious signs of the syndrome with the exception of the white forelock (poliosis), but with additional anomalies like: syndactyly, absence of the fourth left toe, bilateral preauricular sinus and dacrocystitis. It is the second case of Waardenburg's syndrome reported by us during the last 20 years.

Synchronous bilateral oncocytoma of the parotid glands. A case report.

A case of synchronous bilateral oncocytoma arising in the parotid salivary gland is presented and the literature is reviewed. The oncocytoma forms a small group of neoplastic diseases in the parotid gland and synchronous bilateral tumors are relatively rare. According to the available literature this is the fourth case reported.