European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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This is a report of four patients who inhaled leeches. They presented with severe attacks of inspiratory stridor, difficulty in breathing and spitting blood. ⋯ Laryngoscopy was performed with local anaesthesia in two of the cases and general anaesthesia was used in the other two. The leeches were removed with forceps.
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The pathophysiology, differential diagnosis, and currently available management of barotrauma affecting the ears and sinuses after scuba diving are reviewed, along with medical standards for resuming scuba diving after barotrauma has resolved.
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Manifest fungal infection of the middle ear, fungal mastoiditis, is a very rare entity, which is almost exclusively seen in immunocompromised patients. The authors present a case of fungal mastoiditis in a 52-year-old woman without immunocompromise. The patient presented with acutely progressing symptoms of hearing loss and dysequilibrium. ⋯ Her hearing recovered following the surgery, which revealed massive granulations and proliferation of fungi but no cholesteatoma in the mastoid cavity. Fungal infection of the middle ear is rare, but can cause serious complications. The possibility should be considered even in immunocompetent patients.
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Eur Arch Otorhinolaryngol · Jan 2001
Effect of bolus consistency on swallowing--does altering consistency help?
The influence of food bolus consistency on the pharyngeal wave during swallowing was investigated using a four-sensor manometry probe in 22 healthy volunteers. Pharyngeal pressures were recorded for 5 ml boluses of water, pudding and buttered bread via a manometry probe placed transnasally. The distal sensor was sited within the upper oesophageal sphincter (UOS); the three proximal sensors were then located 2, 4 and 6 cm above the UOS. ⋯ In the UOS, increased bolus viscosity was associated with a larger pressure nadir (sub-atmospheric pressure) on opening and intra bolus pressure during transit. Bolus consistency also influenced the coordination of the swallow response with delayed pharyngeal clearance. The putative relevance of these findings to dietary modification for patients with neurological and neuromuscular dysphagia is discussed.
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Eur Arch Otorhinolaryngol · Jan 1999
Clinical Trial Controlled Clinical TrialTreatment of sudden sensorineural hearing loss with a continuous epidural block.
The efficacy of a continuous epidural block was evaluated in the treatment of 20 patients with sudden sensorineural hearing loss (SNHL). Ten patients were treated with continuous cervicothoracic epidural block (group A) and the other 10 were treated with stellate ganglion block (group B). ⋯ In the epidural block group 70% achieved substantial hearing improvement, while this occurred in only 30% of patients undergoing stellate ganglion block. These findings suggest that continuous epidural block can be effective in the treatment of sudden SNHL.