RESUMEN
BACKGROUND: Bilateral vestibular dysfunction causes serious disabilities and handicaps. Patients with bilateral dysfunction often restrict their activities and tend to be unsocial. AIM: To compare the effects of vestibular rehabilitation on disability, balance, and postural stability in patients with unilateral and bilateral vestibular dysfunction. DESIGN: Retrospective study. SETTING: Outpatient rehabilitation center. POPULATION: Patients with unilateral (group 1, N.=42) and bilateral vestibular dysfunction (group 2, N.=19). METHODS: All patients were evaluated before and after eight weeks of customized vestibular rehabilitation for disability (Dizziness Handicap Inventory [DHI], Activities-specific Balance Confidence Scale [ABC]), dynamic balance (Timed Up and Go Test [TUG], Dynamic Gait Index [DGI]), and postural stability (static posturography). RESULTS: The differences between DHI, TUG, DGI, and falling index (as assessed by static posturography) scores before and after the exercise program were statistically significant in both groups (P<0.05). There were no significant intergroup differences in any of the parameters evaluated (P>0.05). CONCLUSION: In this study, vestibular rehabilitation was found to be equally effective in unilateral and bilateral vestibular dysfunction patients for improving disability, dynamic balance, and postural stability. CLINICAL REHABILITATION IMPACT: Patients with bilateral dysfunction, causing more disability and greater handicap may indeed regain their functions as in patients with unilateral vestibular dysfunction by receiving appropriate and adequate vestibular rehabilitation.
Asunto(s)
Actividades Cotidianas , Mareo/rehabilitación , Terapia por Ejercicio/métodos , Equilibrio Postural/fisiología , Trastornos de la Sensación/rehabilitación , Enfermedades Vestibulares/rehabilitación , Accidentes por Caídas/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Comorbilidad , Evaluación de la Discapacidad , Mareo/etiología , Femenino , Trastornos de la Audición , Humanos , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/epidemiología , Estudios Retrospectivos , Trastornos de la Sensación/etiología , Perfil de Impacto de Enfermedad , Turquía , Enfermedades Vestibulares/complicaciones , Pruebas de Función VestibularRESUMEN
OBJECTIVE: To analyse the expression of individual forms of cytochrome P450 (CYP) at the mRNA level in five homogenized oral buccal tissue samples from four individuals with or without oral malignancy. METHOD: Individual forms of CYPs were studied by reverse transcriptase-polymerase chain reaction (RT-PCR), using specific primers for CYPs 2B6, 2C, 2D6, 2E1, 3A3/4 and 3A5, and oral CYP expressions were compared with CYP expression in liver tissue. RESULTS: Consistent expression of CYPs 2C, 2E1 and 3A5 was observed in oral buccal tissue at mRNA level. CONCLUSIONS: These particular CYPs have possible roles in the protection of the body against orally ingested xenobiotics as well as influence the bioavailability of therapeutic compounds.
Asunto(s)
Sistema Enzimático del Citocromo P-450/biosíntesis , Mucosa Bucal/enzimología , Anciano , Sistema Enzimático del Citocromo P-450/genética , Perfilación de la Expresión Génica , Humanos , Isoenzimas/biosíntesis , Isoenzimas/genética , Hígado/enzimología , Persona de Mediana Edad , Especificidad de Órganos , ARN Mensajero/biosíntesis , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
We aimed to compare the effects of lidocaine and adrenaline with ibuprofen syrup (administered before adenotonsillectomy) on post-operative analgesia and initiation of oral feeding. One group of 20 children received 100 g/5 ml ibuprofen suspension (10 mg/kg) 1 h before anaesthesia; bleeding control was provided by pre-incisional administration of 1:200,000 adrenaline solution (10 ml). The same amount of 0.5% lidocaine solution plus 1:200,000 adrenaline was applied pre-incisionally in a similar manner in a second group of 20 children. No significant differences were observed between the two groups in terms of the duration of operation and anaesthesia, post-operative pain scores, paracetamol requirements, times to initiation of liquid and solid food intake, or adverse side-effects. We conclude that ibuprofen syrup applied pre-incisionally and local infiltration with lidocaine are equally effective for post-operative analgesia.
Asunto(s)
Adenoidectomía/métodos , Anestésicos Locales/administración & dosificación , Ibuprofeno/farmacología , Lidocaína/farmacología , Dolor Postoperatorio/prevención & control , Tonsilectomía/métodos , Administración Oral , Analgesia , Analgésicos no Narcóticos/farmacología , Niño , Preescolar , Epinefrina/farmacología , Femenino , Humanos , Masculino , Dolor , Factores de TiempoRESUMEN
OBJECTIVE: The prospective study in 23 patients, who were undergone transseptal-transsphenoidal hypophysectomy, underlines the rhinologic aspects of this technique. MATERIALS AND METHODS: Preoperative and postoperative subjective complaints were compared, postoperative nasal respiratory functions were evaluated by means of electrohinomanometry. RESULTS: Nasal respiratory functions were preserved postoperatively in the patients with normal preoperative nasal anatomy (no statistical difference); while, in patients with obstructive deviation of the nasal septum, an improvement in nasal respiratory functions were noted as a result of simultaneously performed septoplasty (p < 0.01). CONCLUSION: Our results emphasize the importance of the collaboration of otorhinolaryngology and neurosurgery teams for the sake of postoperative nasal functions.
Asunto(s)
Hipofisectomía/instrumentación , Obstrucción Nasal/cirugía , Tabique Nasal/cirugía , Neoplasias Hipofisarias/cirugía , Rinomanometría/instrumentación , Seno Esfenoidal/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obstrucción Nasal/diagnóstico , Obstrucción Nasal/etiología , Neoplasias Hipofisarias/complicaciones , Cuidados Posoperatorios , Cuidados Preoperatorios , Estudios Prospectivos , Índice de Severidad de la EnfermedadRESUMEN
Eosinophilic bronchitis is a recently described condition in patients with chronic cough, sputum eosinophilia, normal spirometry and no evidence of bronchial hyperreactivity. The aim of the study was to assess the causes of chronic cough and to identify the prevalence of eosinophilic bronchitis as a cause of chronic cough. Thirty-six patients [mean age 45.4 +/- 14.3 years (range 16-69 years), M/F: 4/32] with an isolated chronic cough lasting for more than 4 weeks were recruited from the outpatient clinic. In all patients, after a full history and physical examination, blood eosinophil count, eosinophilic cationic protein (ECP), serum total and specific IgE levels were measured. Spirometry, methacholine provocation test, skin prick tests, ear, nose and throat examination, induction of sputum and esophageal pH testing were performed. The mean duration of cough was 31.3 +/- 52.3 months. Sputum eosinophilia greater than 3% was present in 12 (33.3%) patients and they were diagnosed as eosinophilic bronchitis. Their induced sputum had a mean eosinophil count of 8.3% and a mean ECP level of 98.5 mg x l(-1), which were higher than the others (P=0.003, both). The diagnosis of the remaining patients were postnasal drip syndrome in eight, gastroesophageal reflux disease in eight, post-infectious cough in two and cough-variant asthma in one patient. In conclusion, eosinophilic bronchitis is an important cause of chronic cough and should be considered in the assessment of patients before regarding them as having idiopathic chronic cough.
Asunto(s)
Bronquitis/complicaciones , Tos/etiología , Eosinofilia Pulmonar/complicaciones , Adolescente , Adulto , Anciano , Algoritmos , Líquido del Lavado Bronquioalveolar/citología , Enfermedad Crónica , Femenino , Volumen Espiratorio Forzado/fisiología , Humanos , Concentración de Iones de Hidrógeno , Leucocitos , Masculino , Manometría , Persona de Mediana Edad , Esputo/citología , Capacidad Vital/fisiologíaRESUMEN
The pituitary fossa, sphenoid rostrum, sphenoid sinus, nasopharynx, pterygopalatine fossa and clivus are the components of the central compartment of the middle cranial base. It is a surgical challenge to gain access to this region. This fact has led to the development of a number of surgical procedures reported in the literature. However, none of these techniques can provide a wide and direct exposure to the middle cranial fossa without morbidity on its own. In this report, nasomaxillary osteotomy is described as a satisfactory alternative to reach the middle cranial fossa. With the nasomaxillary osteotomy technique, a wide access can be obtained to the central compartment of the skull base, caudally till the inferior clivus and upper cervical vertebrae (C1, C2). Since bilateral, internal carotid arteries are in sight laterally, the technique provides a secure resection of tumors with marked lateral extensions. Repositioning the translocated bone segment, surrounding the apertura piriformis, results in satisfactory cosmesis postoperatively. The technique is discussed on the basis of eight cases with the histopathological diagnosis of squamous cell carcinoma (1 case), olfactory neuroblastoma (2 cases), chordoma (2 cases) and juvenile nasopharyngeal angiofibroma (3 cases). No vascular complication has been encountered. One chordoma patient died of the disease in the follow-up period. All other cases, including one squamous cell carcinoma patient, are alive and disease-free without cosmetic deformity. In conclusion, nasomaxillary osteotomy provides a wide and direct exposure to the central compartment of the skull base in a relatively short period of time, securing the vascular and neural structures. Besides, it offers the advantage that it can be combined with other techniques in extensive tumors, while cosmesis and nasal functions are preserved.
Asunto(s)
Osteotomía/métodos , Procedimientos Quirúrgicos Otorrinolaringológicos , Neoplasias de la Base del Cráneo/cirugía , Adolescente , Adulto , Anciano , Angiofibroma/cirugía , Carcinoma de Células Escamosas/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Nasofaríngeas/cirugíaRESUMEN
A family affected with oculopharygeal muscular dystrophy (OPMD) is reported. This is an uncommon progressive myopathy. The proband presented for evaluation of secretory otitis media with effusion, as a result of tubal dysfunction. CT examination of the father revealed prominent muscular atrophy, and widespread fatty degeneration of the psoas, paraspinal, gluteal and femoral muscles.
Asunto(s)
Distrofias Musculares/diagnóstico por imagen , Distrofias Musculares/patología , Tomografía Computarizada por Rayos X , Adulto , Anciano , Humanos , Persona de Mediana Edad , Distrofias Musculares/genética , Otitis Media con Derrame/diagnóstico por imagenRESUMEN
A considerable number of articles on foreign-body ingestion and inhalation have been reported in the literature. Of these, nasopharyngeal foreign bodies are rare. Unless they cause total obstruction, symptoms typically appear late. Foreign bodies, especially metal ones, can lodge in soft tissue, and their removal can be rather complicated. In this article, we describe the case of a 4-year-old girl who had had a gold ring lodged in her nasopharynx. The history led us to determine that the ring had been there since the child was 3 months old. A flexible fiberoptic nasopharyngeal examination revealed that the ring was embedded in the nasal surface of the soft palate and was enclosed by a thin layer of mucosal membrane. With the patient under general anesthesia, we were able to remove the foreign body with a 0 degree endoscope.
Asunto(s)
Cuerpos Extraños/diagnóstico , Metales , Nasofaringe/patología , Preescolar , Endoscopía/métodos , Femenino , Cuerpos Extraños/cirugía , Humanos , Nasofaringe/cirugíaRESUMEN
Branchial cysts in the parapharyngeal space are rare. Until now, only 23 such cases have been reported in the literature. In this article, we report a new case in a 65-year-old man. Information gained from the clinical examination, fiberoscopy, and computed tomography revealed that the cyst was obstructing the oropharynx and filling the parapharyngeal and retropharyngeal spaces on the right. The mass was excised via a transcervical approach without any complications. We also review the literature on this condition.
Asunto(s)
Branquioma/diagnóstico , Branquioma/cirugía , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/cirugía , Anciano , Biopsia con Aguja , Estudios de Seguimiento , Humanos , Laringoscopía , Masculino , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Intradural tumours affecting the clivus may be divided into three categories depending the area primarily involved by tumour. The second area extends from the spheno-occipital synchondrosis to the level of the jugular foramina. This area is best approached through the petrosal approach and suited for patients with serviceable hearing on the side of the lesion. 35 cases having skull base lesions were operated by the Skull Base Surgery Group of Ege University Medical Faculty between October 1993 and December 1997. 8 out of 35 cases having the intradural tumours affecting the petroclival and anterior cerebellopontine region, the petrosal presigmoid approach was performed in 4 patients. As hearing was absent in another 4 patients, the translabyrinthine route was coupled a the petrosal craniotomy (transtemporal approach). The aim of this article is to highlight the definitions, indications, hints and pitfalls of the approach from the otoneurological point of view.
Asunto(s)
Neoplasias Encefálicas/cirugía , Glioma/cirugía , Meduloblastoma/cirugía , Neoplasias Meníngeas/cirugía , Meningioma/cirugía , Plasmacitoma/cirugía , Neoplasias de la Base del Cráneo/cirugía , Adolescente , Adulto , Anciano , Tronco Encefálico/cirugía , Neoplasias Cerebelosas/cirugía , Craneotomía , Sordera/complicaciones , Duramadre/cirugía , Nervio Facial/fisiología , Femenino , Audición , Humanos , Masculino , Persona de Mediana Edad , Nervio Vestibulococlear/fisiologíaRESUMEN
Though TNM staging is the most popular clinical system for defining the prognosis of Head and Neck Squamous Cell Carcinoma (HNSCC), different clinical trials of the tumours with the same TNM stage have caused doubts about this system. Extra Capsular Spread (ECS) in a metastatic lymph node is one of the recently defined prognostic factors in HNSCC. The hypothesis of this study was to assess the relationship between the primary tumour of laryngeal and oral cavity squamous cell carcinoma and the metastatic lymph nodes with and without ECS. The argyrophillic Nucleolar Organiser Regions (AgNOR) count was used as an index of the grade of malignancy of the neoplastic tissue. As a result, significantly higher AgNOR counts were obtained in the metastatic lymph nodes with ECS than in the primary tumours, while the lowest AgNOR counts were found in the metastatic lymph nodes without ECS. However, when primary tumours of the metastatic lymph nodes with ECS and the primary tumours of the metastatic lymph nodes without ECS were compared, no significant difference was found.
Asunto(s)
Carcinoma de Células Escamosas/secundario , Neoplasias Laríngeas/patología , Ganglios Linfáticos/patología , Neoplasias de la Boca/patología , Tinción con Nitrato de Plata , Carcinoma de Células Escamosas/ultraestructura , Humanos , Neoplasias Laríngeas/ultraestructura , Ganglios Linfáticos/ultraestructura , Metástasis Linfática , Neoplasias de la Boca/ultraestructura , Estadificación de Neoplasias/métodos , Región Organizadora del Nucléolo , Valor Predictivo de las Pruebas , Estudios RetrospectivosRESUMEN
A case of metastatic papillary carcinoma to the mandible is presented. Though relatively rare, metastatic tumours of the mandible should be included in the differential diagnosis of the tumours in the parotid region. For the primary site; being in the cervicofacial region, the thyroid gland must be considered by the head and neck surgeon.
Asunto(s)
Carcinoma Papilar/diagnóstico por imagen , Carcinoma Papilar/patología , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/secundario , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/patología , Carcinoma Papilar/cirugía , Femenino , Humanos , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Neoplasias Primarias Secundarias , Neoplasias de la Tiroides/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Fungal infections of the paranasal sinuses are in four clinical forms. Beside the acute fulminating form, chronic invasive form, allergic fungal sinusitis and fungus ball. Fungus ball is mostly encountered in only one paranasal sinus of an otherwise healthy person. Ten fungus balls of the paranasal sinuses are presented with their management and results.