Acta oto-laryngologica
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Acta oto-laryngologica · Feb 2009
Are systemic prophylactic antibiotics indicated with anterior nasal packing for spontaneous epistaxis?
This pilot study did not show an advantage of the routine use of prophylactic antibiotics for spontaneous epistaxis treated by nasal packing. ⋯ We did not observe infection in any of the cases before or after removal of the anterior nasal pack. The bacterial growth profile of packed and non-packed sides of the nose did not differ significantly.
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Acta oto-laryngologica · Feb 2009
Delayed electrical stimulation and BDNF application following induced deafness in rats.
Under the condition of delayed intervention (30 days after deafening) following gentamicin+furosemide deafening in rats, we conclude that chronic intracochlear electrical stimulation (ES) and continuous intracochlear administration of brain-derived neurotrophic factor (BDNF) enhance spiral ganglion cell (SGC) body and peripheral process survival and improve auditory sensitivity. Moreover, the combination of ES and BDNF has a synergistic protective effect rather than an additive effect. Both SGC body and peripheral process influence the auditory sensitivity, and the latter appears to be more important. ⋯ In the AP group, EABR thresholds demonstrated a systematic and rapid increase throughout the treatment period after the deafening procedure and electrode implantation. However, in the other three treatment groups, EABR thresholds showed a slow increase at the beginning and then slow decrease. The thresholds of the BDNF and ES+AP groups were significantly less than those of the AP group from day 7 to 28 and those of the BDNF+ES group were significantly less than those of other three groups from day 21 to 28, indicating that BDNF infusion and chronic ES have a synergistic effect rather than an additive effect. In terms of SGC and peripheral process density, the difference between the treated and control ears of BDNF, ES+AP, and BDNF+ES groups was clearly significant. Analysis of the SGC/peripheral process density of the left cochlea across the treatment groups demonstrated that SGC/peripheral process density of the BDNF and ES+AP groups was significantly greater than that of the AP group and the density of the BDNF+ES group was significantly greater than that of the other three groups, indicating that BDNF infusion and chronic ES have a synergistic effect rather than an additive effect. Finally, a functional formula was developed relating the last EABR threshold and SGC density and process density.
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The endoscopic approaches developed for the treatment of the chordomas according to the different clival location provide the possibility for more complete tumor resection with maximal preservation of anatomic structures and reduction of the overall incidence of complications. ⋯ Seven gross total, four subtotal, and one partial resection were achieved after surgery. At 6 months to 3 years follow-up, eight patients were recurrence-free and two patients had unchanged residual tumor. One patient with recurrent chordoma underwent second surgery and subsequent intensity modulated radiation therapy (IMRT). The other patient with a recurrent chordoma died 1 year postoperation.
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Acta oto-laryngologica · Jan 2009
Metastasis to the submandibular gland in oral cavity squamous cell carcinomas: pathologic analysis.
This study demonstrates that the incidence of submandibular gland metastasis in oral cavity squamous cell carcinoma (SCC) is extremely rare and its involvement is through direct extension from a primary lesion. Therefore, if the primary lesion of the oral cavity carcinoma is not in close proximity and hence does not provide suspicion of direct extension, it may be safe to preserve the submandibular gland. ⋯ In all, 44 cases (21.9%) were found to show ipsilateral level I metastasis on pathologic examination. Only two cases (1%) had carcinoma involvement in the submandibular gland. Both these two cases had direct extension from a primary lesion (retromolar trigone and floor of mouth) and no submandibular glands showed pathologic evidence of isolated metastasis or local extension of metastatic lymph nodes.
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Acta oto-laryngologica · Jan 2009
Severe deep neck space infections and mediastinitis of odontogenic origin: clinical relevance and implications for diagnosis and treatment.
Early diagnosis and aggressive antimicrobial and surgical treatment are essential to successfully treat extensive cervico-mediastinal abscesses of odontogenic origin. Patient management should be performed by experienced clinicians well trained in managing possible complications. We recommend close clinical and radiological postoperative follow-up investigations with early surgical re-intervention if necessary. ⋯ The submandibular space was the most frequently encountered location of deep neck space infections. Mediastinitis was found in five patients. The most frequent causative bacteria were Streptococcus and Bacteroides species. All patients underwent intravenous antibiotic treatment and surgical therapy. Mediastinotomy was inevitable in five cases and thoracotomy in one case. All patients survived.