The Journal of otolaryngology
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Mucormycosis is a fatal infection of the immunocompromised individual. It is unusual to affect healthy individuals. We report eight such cases of infection caused by this emerging fungal pathogen in healthy patients. Of the eight cases, three were infected with Apophysomyces elegans, again an unusual pathogen causing mucormycosis. ⋯ Mucormycosis must be considered in the differential diagnosis of any severe acute headache, sinusitis, or orbital cellulites, not only in immunocompromised patients but also in the absence of any underlying disease. Successful treatment requires tissue débridement and injection of amphotericin B.
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To describe our experience concerning sudden sensorineural hearing loss (SSNHL) in a large single-institution series of SSNHL patients and to discuss the results. ⋯ Mostly, SSNHL results in idiopathic disease. At present, diagnostic and therapeutic efforts appear to be inadequate to improve the prognosis of SSNHL. Further studies are needed to obtain better knowledge about the etiopathogenesis of SSNHL so that new therapeutic strategies can be considered in the treatment of this challenging ear disease.
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To determine the prevalence of obstructive sleep apnea (OSA) in patients with cancer of the oral cavity and oropharynx scheduled for primary surgical resection. To correlate the presence of OSA and the occurrence of postoperative morbidities in this patient population. ⋯ These findings point to a strong association between OSA and malignancies of the oral cavity and oropharynx. This relationship was independent of the size of the primary malignancy in this patient population with tumours ranging from 1 to 7 cm (p = not significant). When comparing the two groups (AHI < 20 and AHI > or = 20), there was a tendency for the group with OSA to have an increase in postoperative morbidities. Further research is warranted to further evaluate the postoperative morbidities and mortalities associated with OSA in this patient population and to determine the potential roles for preoperative treatment with continuous positive airway pressure and tracheotomy.
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Sixty-two patients requiring tracheotomy from 1998 to 2002 were followed for a mean length of 223.3 days. Outcomes were measured based on indications for ventilatory support, age, sex, length of intensive care unit (ICU) and hospital stay, and overall status at discharge. ⋯ Information should assist families, intensivists, and physicians involved in the care of such critically ill patients. Ethical questions that arise in the care of these patients are addressed.