Arch Otolaryngol
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The orbital complications of paranasal sinus infection are well known to otolaryngologists. However, only a few articles have reported subperiosteal orbital hematoma as one of these complications. ⋯ A case of subperiosteal orbital hematoma secondary to ethmoidal sinusitis is presented. The relevant clinical characteristics, pathophysiology, and differential diagnosis of subperiosteal orbital hematoma, as well as treatment options, are reviewed and presented as they apply to cases associated with sinusitis.
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Acquired subglottic stenosis is a well-documented complication of endotracheal intubation in infants. In past years, many of these patients required a tracheotomy for a period of years prior to laryngotracheal reconstruction. The anterior cricoid split procedure was developed as a method of treatment for severe laryngeal stenosis in infants and young children without resorting to a tracheotomy. ⋯ This is contrasted with alternative means of cricoid decompression advocated by other surgeons. Our review supports the efficacy of this procedure when there is strict adherence to certain criteria prior to the performance of the operation. Specifically, this operation should be restricted to neonates or young infants whose pathology is limited to the glottis and subglottis or both, and in whom there is adequate pulmonary reserve.
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Rapid progression to blindness due to intraorbital hemorrhage following various forms of trauma requires immediate, aggressive intervention, with the potential to restore vision. Orbital decompression via either an external ethmoidectomy or transantral approach is described. The diagnosis, anatomy, and pathogenetic mechanisms relevant to these cases are reviewed.
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Case Reports
Rhinocerebral mucormycosis with cerebral extension successfully treated with adjunctive hyperbaric oxygen therapy.
Rhinocerebral mucormycosis is a devastating fungal disease with a high mortality rate. Extensive surgical débridement and amphotericin B are currently the mainstays of therapy. ⋯ Both patients showed marked clinical improvement with the addition of adjunctive hyperbaric oxygen therapy. Both patients remained free of their disease 21 months after hospital discharge.
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Forty-one patients undergoing surgery between 1977 and 1985 for malignant tumors of the paranasal sinuses abutting or eroding the orbital walls were studied for the need to remove the orbital contents. All patients had preliminary computed tomographic scans to delineate the extent of orbital invasion. All were treated with preoperative radiotherapy. ⋯ If invasion of the periorbita was extensive, an orbital exenteration was done. Only five of 41 patients required exenteration. Local recurrence of disease in the orbit has not occurred in these patients.