The Canadian Institutes of Health Research response to antimicrobial resistance.

Antimicrobial resistance (AMR) has been a research priority for the Canadian Institutes of Health Research (CIHR), Institute of Infection and Immunity (III) since its inception, and a number of strategic research initiatives have been launched to address this global health problem by promoting and supporting research related to mechanisms and processes that impact the emergence and spread of resistance among individuals and within the environment. Here we will present research initiatives on AMR led by CIHR-III, which include national programs as well as international partnerships with the United Kingdom and the European Union, in addition to interesting outcomes of these initiatives.

Meningitis after cochlear implantation in Mondini malformation.

Although the potential for CSF leakage and subsequent meningitis after cochlear implantation in the malformed cochlea has been recognized, this complication has not been previously reported. We report a case of CSF otorhinorrhea and meningitis after minor head trauma developing 2 years after cochlear implantation in a child with Mondini malformation. Leakage of CSF was identified from the cochleostomy around the electrode of the implant, and this leak was sealed with a temporalis fascia and muscle plug. Although this complication appears to be rare, care must be taken to seal the cochleostomy in children with inner ear malformations at the initial surgery, and any episode of meningitis after surgery must be thoroughly investigated to rule out CSF leakage from the labyrinth.

Endoscopic vs external drainage of orbital subperiosteal abscess.

Periorbital cellulitis is frequently limited to the preseptal region. However, there may be associated postseptal inflammation and orbital subperiosteal abscess (SPA). Surgical management of orbital SPA includes open drainage through an external ethmoidectomy approach, although recently the use of endoscopic techniques has been reported. This study was undertaken to evaluate postseptal cellulitis and orbital SPA in patients with periorbital cellulitis and to assess the safety and effectiveness of endoscopic management of orbital SPA. From 1989 through 1994, 158 patients were admitted with a diagnosis of periorbital cellulitis. Nineteen of these patients were diagnosed with postseptal orbital inflammation, and 14 underwent surgical drainage via an external approach, an endoscopic approach, or a combination of both. Issues addressed include (1) the role of sinus disease as the cause of periorbital cellulitis; (2) the role of computed tomographic scanning; (3) the effectiveness of aggressive medical therapy; and (4) the results of endoscopic drainage of orbital SPA compared with the external approach.

Endoscopic surgery of the frontal sinus.

Endoscopic intranasal frontal sinusotomy represents a relatively new technique for approaching disease in the frontal sinus. As with all "new" techniques, it has not withstood the scrutiny of time. It does represent, however, a significant alternative to external obliterative procedures for the frontal sinus. The frontal sinus can be visualized with office nasal endoscopy, and the difficult evaluation of the obliterated cavity can be avoided. With an in-depth understanding of frontal sinus anatomy and the application of advanced endoscopic techniques, the frontal sinus surgeon may achieve satisfying results while producing minimal morbidity.

Aneurysmal bone cyst of the zygomatic arch.

BACKGROUND: Aneurysmal bone cysts are rare vascular lesions that are most commonly found in the long bones. They are rare in the head and neck. Only two prior cases of aneurysmal bone cysts of the zygoma have been reported in the world literature. RESULTS: We report a case of aneurysmal bone cyst arising in the zygomatic arch with intracranial extension treated with selective arterial embolization and complete excision via an intratemporal fossa approach. This is the first such case reported in the head and neck surgery literature. CONCLUSIONS: Selected cases of aneurysmal bone cyst may be safely treated with selective arterial embolization and complete resection.

Nonlinear mechanical behaviour of the basilar membrane in the basal turn of the guinea pig cochlea.

A capacitance probe is used to measure the vibrational displacement of the basilar membrane in the basal turn of the guinea pig. Nonlinear behaviour is exhibited in the region of the mechanical cut-off frequency similar to that previously described only for the squirrel monkey. The degree of nonlinearity appears to be directly correlated with the single unit threshold as reflected in the N1 action potential. Loss of neural sensitivity indicates loss of nonlinear behaviour in the mechanics which is undetectable shortly after death.