Assuntos
Neoplasias Parotídeas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/mortalidade , Carcinoma/patologia , Carcinoma/terapia , Feminino , Humanos , Lipossarcoma/patologia , Lipossarcoma/terapia , Linfoma não Hodgkin/mortalidade , Linfoma não Hodgkin/patologia , Linfoma não Hodgkin/terapia , Imageamento por Ressonância Magnética , Masculino , Melanoma/patologia , Melanoma/terapia , Pessoa de Meia-Idade , Neoplasias Parotídeas/mortalidade , Neoplasias Parotídeas/terapia , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Post-traumatic peri-lymphatic fistulas have been described following ear and temporal bone injury, particularly in the setting of temporal bone fractures. The symptoms and signs of perilymphatic fistulae (PLF) are very varied and frequently misleading. The diagnosis can be suspected on the bases of the clinical and the audiometrial findings. Indications for exploratory surgery in cases of trauma are vague and not well described. AIM: To assess the principal clinical and radiologic signs of PLF. METHOD: Study of 13 patients with different symptoms of posttraumatic peri-lymphatic fistulae. RESULTS: Ten patients had vertigo, and 2 presented otoliquorreha. Two patients had tympanic perforation. Nine patients presented neurosensorinal hearing loss and 5 were completely deaf. A CT Scann was realized in 12 cases and showed the fracture in 10 cases (91%) with a pneumolabyrinth in 4 cases. Medical and postural treatment was indicated for all the patients then a surgery was indicated in all of them in an average wait of 4 months realizing an ear exclusion in one case and a filling-up for 12 patients. Vertigo improved in 10 cases and the hearing loss in 2 cases. CONCLUSION: The diagnostic of perilymphatic fistulae is not easy. The trauma and the clinical signs can help but the confirmation is surgical. The indication of surgery and its timing are still discussed.
Assuntos
Fístula/etiologia , Fraturas Ósseas/complicações , Doenças do Labirinto/etiologia , Perilinfa , Osso Temporal/lesões , Doenças Vestibulares/etiologia , Estudos de Coortes , Orelha , Fístula/diagnóstico , Fraturas Ósseas/diagnóstico , Fraturas Ósseas/epidemiologia , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Doenças do Labirinto/complicações , Doenças do Labirinto/diagnóstico , Doenças do Labirinto/epidemiologia , Perilinfa/fisiologia , Estudos Retrospectivos , Perfuração da Membrana Timpânica/complicações , Perfuração da Membrana Timpânica/diagnóstico , Perfuração da Membrana Timpânica/epidemiologia , Perfuração da Membrana Timpânica/etiologia , Vertigem/diagnóstico , Vertigem/epidemiologia , Vertigem/etiologia , Doenças Vestibulares/complicações , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/epidemiologiaRESUMO
OBJECTIVE: To try to select the best treatment among synthetic anti-thyroid agents, surgery and radioiodine in the case of Graves' disease. METHOD: We present a retrospective study of therapeutic and progressive aspects of 300 cases of Graves' disease. RESULTS: At the time of the diagnosis, the patients' mean age was of 38.17 years. Female sex predominated (70.7%). Medical treatment was prescribed in 25.7% of cases. Agranulocytosis occurred in one patient who died from septic shock. Surgery was performed in 29.3% of patients and 41% were treated with radioactive iodine. After a mean follow-up of 53.7 months, a progression towards euthyroidism was noted in 60, 22.7 and 21.7% of patients treated respectively with antithyroid drugs, surgery and radioiodine. Hypothyroidism was noted in around 40% of cases, 57.8% of which were treated surgically. Recurrent hyperthyroidism is more frequent with antithyroid drugs. CONCLUSION: Medical treatment increases the risk of relapse. It is therefore preferable to apply radical treatments in order to obtain permanent remission from hyperthyroidism.
