RESUMEN
HYPOTHESIS: The goals of this study were to identify the effects of hypercholesterolemia on the cochlea and to find out where the pathologic changes first occur. BACKGROUND: Some authors have stated that hypercholesterolemia alone does not produce auditory dysfunction. Others propose that auditory dysfunction is caused by glycogen accumulation and other alterations on cochlear ultrastructure. METHODS: Twenty guinea pigs were classified as a control group fed with a normal diet, and a cholesterol group of 24 animals was given a diet composed of 1 g cholesterol per day for 4 months. The hearing acuity of the animals before the diets was compared with that after the diets by means of auditory brainstem responses. The basal and apical turns of the cochleas were examined by light microscopy and transmission electron microscopy. RESULTS: The control group showed normal cochlear ultrastructures consistent with normal hearing thresholds, whereas the cholesterol group had profound edema in the strial marginal layer and slight edema in the outer hair cells, in line with data from auditory brainstem responses revealing changes in hearing sensitivity in various degrees. The pathologic changes in the basal turn and the stria vascularis were qualitatively prominent in comparison with those of the apical turn and the outer hair cell. CONCLUSIONS: These observations confirm that hypercholesterolemia alone may cause auditory dysfunction if dietary cholesterol is kept at a high level for a long time. Alterations attributed to hypercholesterolemia begin in the stria vascularis and then spread over the outer hair cells, mainly in the basal turn.
Asunto(s)
Cóclea/ultraestructura , Pérdida Auditiva Sensorineural/diagnóstico , Hipercolesterolemia/diagnóstico , Animales , Umbral Auditivo/fisiología , Cóclea/irrigación sanguínea , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Cobayas , Células Ciliadas Auditivas Externas/ultraestructura , Pérdida Auditiva Sensorineural/etiología , Hipercolesterolemia/complicaciones , Masculino , Estría Vascular/ultraestructuraRESUMEN
Sphenochoanal polyp is a rare entity originating from sphenoid sinus. It may be confused with antrochoanal polyp on anterior rhinoscopy because of its similar appearance. Computerized tomography and nasal endoscopy have contributed to an increase of accuracy in the diagnosis of these masses. Simple polypectomy that leaves some part of the polyp inside the sphenoid sinus carries a high risk of recurrence. Destructive external approaches to gain access to the sphenoid sinus are also not advisable in children for a benign disease. We present two cases of sphenochoanal polyps in two children that were operated by endonasal endoscopic approach. They were free of symptoms after surgery. No complications and recurrences were observed at 28 and 18 months of follow-up periods respectively.
Asunto(s)
Endoscopía/métodos , Obstrucción Nasal/etiología , Pólipos Nasales/cirugía , Seno Esfenoidal , Adolescente , Femenino , Estudios de Seguimiento , Humanos , Masculino , Obstrucción Nasal/diagnóstico , Obstrucción Nasal/cirugía , Pólipos Nasales/complicaciones , Pólipos Nasales/diagnóstico , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Relapsing Polychondritis (RP) is a rare disorder characterised by episodic inflammation of the cartilaginous structures. Differential diagnosis of this pathology is a challenging enigma since it appears only intermittently and none of the clinical features are pathognomonic, although most of the patients are usually referred to an ENT physician initially. The natural history of the disease is unpredictable. Initiating effective treatment sooner considerably reduces the rate of mortality. Patients with RP should be seen on a regular basis even if the patient is non-symptomatic. This study reports a retrospective analysis of the otolaryngological manifestations of 7 patients with RP as well as their long-term progress and reviews the symptomatology, histopathology, immunology and management.
Asunto(s)
Enfermedades Otorrinolaringológicas/diagnóstico , Policondritis Recurrente/diagnóstico , Adulto , Audiometría , Sordera/diagnóstico , Sordera/etiología , Diagnóstico Diferencial , Endoscopía , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Enfermedades Otorrinolaringológicas/inmunología , Policondritis Recurrente/inmunología , Estudios Retrospectivos , Factores de TiempoAsunto(s)
Cuerpos Extraños/diagnóstico por imagen , Seno Frontal/diagnóstico por imagen , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Adulto , Cuerpos Extraños/cirugía , Seno Frontal/cirugía , Humanos , Masculino , Enfermedades de los Senos Paranasales/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Headache due to the pressure on nasal mucosa of anatomical variations, nasal polyps, or mucosal swelling in the absence of inflammation of the paranasal sinuses is a clinical entity that has gained wide acceptance. In this paper, the outcomes of surgical treatment in 30 patients whose headaches were believed to be the result of intranasal contact points are presented. Total relief of the headache and significant improvement were achieved in 43% and 47% of the patients, respectively, after endoscopic endonasal surgery. The intensity of the headache was the same as preoperatively in 10% of the patients. In the absence of any other identifiable etiological factors, intranasal mucosal contacts must be kept in mind as a cause of the headache.
Asunto(s)
Cefalea/etiología , Enfermedades Nasales/complicaciones , Enfermedades Nasales/cirugía , Nariz/cirugía , Adolescente , Adulto , Endoscopía , Humanos , Persona de Mediana Edad , Mucosa Nasal/fisiopatología , Enfermedades Nasales/diagnóstico por imagen , Enfermedades Nasales/fisiopatología , Cuidados Paliativos/métodos , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
The acoustic properties of the reconstructed ear canals of 13 patients after atresia surgery were investigated by comparing them with those of contralateral healthy ear canals. In the third post-operative month, resonant frequency, amplitude and bandwith of the ear canals with Q-factor were measured. Probe microphone measurements showed a significant shift in resonant frequency in the direction of the higher frequencies, and a non-significant change in bandwith in the atresia surgery group. The suggested reason may be a change in ear canal curvature, altered vibration pattern and sound-absorption characteristics of the skin graft lining the reconstructed ear canal.
Asunto(s)
Acústica , Conducto Auditivo Externo/anomalías , Conducto Auditivo Externo/cirugía , Adolescente , Adulto , Femenino , Humanos , Masculino , Periodo Posoperatorio , Resultado del TratamientoRESUMEN
Large vestibular aqueduct syndrome (LVAS) is a common inner ear anomaly responsible for some unusual vestibular and audiological symptoms. The gross appearance of CT scan of the inner ear is generally normal. However, precise measurement of the inner ear components reveals abnormal dimensions, which may account for accompanying auditory or vestibular dysfunction. It has been reported that sudden increase in cerebrospinal fluid pressure can cause further deterioration of hearing due to transmission of pressure to the inner ear through the enlarged vestibular aqueduct. However, vestibular function is not often studied. In this report, audiovestibular function of 10 patients with large vestibular aqueducts was analysed and compared with the severity of the radiological deformity. The literature was reviewed and typical findings were discussed to emphasize varying aspects of audiovestibular function. It was found that some patients with LVAS have some spontaneous or provoked vestibular disturbance such as vertigo after watching revolving objects. The mean value of electronystagmographic abnormality in patients with hearing loss is greater than in patients with normal hearing. However, there is no statistical correlation between the level of hearing loss, electronystagmographic abnormality and severity of radiological deformity.
Asunto(s)
Acueducto Vestibular/anomalías , Enfermedades Vestibulares/diagnóstico , Vestíbulo del Laberinto/fisiopatología , Adolescente , Adulto , Anciano , Audiometría de Tonos Puros/estadística & datos numéricos , Potenciales Evocados Auditivos del Tronco Encefálico/fisiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Estadísticas no Paramétricas , Síndrome , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Acueducto Vestibular/diagnóstico por imagen , Acueducto Vestibular/fisiopatología , Enfermedades Vestibulares/fisiopatología , Pruebas de Función Vestibular/estadística & datos numéricos , Vestíbulo del Laberinto/diagnóstico por imagenRESUMEN
A certain number of patients with elongated styloid process may not have the classic cervicofacial complaints which were originally described by W. Eagle in 1937. Some of those cases who have radiologic evidence of elongated styloid process are symptom free and can be accepted as normal anatomical variants. On the other hand, some of those symptomatic cases may present uncommon neurologic signs and can be misdiagnosed as neurologic or infectious disease. Sometimes, the radiologic presence of an elongated process may cause the clinician to miss another pathology. Therefore, it is essential for the clinician to be aware of the clinical variants with different symptomatology or to particularly seek the origin of the pain in the head and neck before reaching a conclusion, since the only effective treatment in symptomatic cases is the surgical shortening of the process. We report five patients with elongated processes. Problems related to an elongated styloid process with different symptomatology are discussed and the associated literature is reviewed.
Asunto(s)
Dolor Facial/etiología , Dolor de Cuello/etiología , Osificación Heterotópica/diagnóstico , Hueso Temporal/patología , Adulto , Anciano , Diagnóstico Diferencial , Dolor de Oído/etiología , Femenino , Humanos , Ligamentos/patología , Masculino , Persona de Mediana Edad , Osificación Heterotópica/complicaciones , Osificación Heterotópica/cirugía , Síndrome , Hueso Temporal/cirugía , Síndrome de la Disfunción de Articulación Temporomandibular/diagnóstico , Acúfeno/etiología , Vértigo/etiologíaRESUMEN
After traumatic perforation of the tympanic membrane (TM), healing occurs spontaneously in most cases, although occasional perforations will fail to close. Healing of epithelia at any site involves cell movement, with injury providing the stimulus to initiate changes in the behavior of cells that are normally static. Epidermal proliferation at the margins of the TM perforation can be accelerated by using such growth factors as epidermal growth factor, basic fibroblast growth factor (bFGF) and hyaluronan. bFGF is chemotactic and mitogenic for both fibroblasts and endothelial cells and is also mitogenic for keratinocytes. The effect of bFGF is significant in the enhancement of fibroblast production and angiogenesis. In this study, bFGF was used to enhance the healing process of chronic TM perforations in a guinea pig animal model. Chronic perforations were created since acute TMs could heal spontaneously without using any bioactive substance. In all, 30 TMs of 15 guinea pigs were used. A thermal myringotomy loop was employed to create a subtotal TM perforation at the area of the pars tensa. After establishing a permanent, non-infected perforation, bFGF in buffered saline solution was applied as 400 ng/day to 15 ears, while the opposite (control) ear was treated with only saline solution. At 20 days, 13 of 15 perforations treated with bFGF had closed. Light microscopy was used to assess organization of the healed TMs. The effects of bFGF on the healing process of TM perforations were compared in treated and non-treated ears.
Asunto(s)
Factor 2 de Crecimiento de Fibroblastos/farmacología , Membrana Timpánica/lesiones , Animales , Capilares/efectos de los fármacos , Capilares/patología , Movimiento Celular , Factores Quimiotácticos/farmacología , Enfermedad Crónica , Tejido Conectivo/efectos de los fármacos , Tejido Conectivo/lesiones , Tejido Conectivo/patología , Modelos Animales de Enfermedad , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/patología , Epitelio/efectos de los fármacos , Epitelio/lesiones , Epitelio/patología , Fibroblastos/efectos de los fármacos , Fibroblastos/patología , Cobayas , Ácido Hialurónico/farmacología , Hiperplasia , Queratinocitos/efectos de los fármacos , Queratinocitos/patología , Mitógenos/farmacología , Neovascularización Fisiológica/efectos de los fármacos , Cloruro de Sodio , Factores de Tiempo , Membrana Timpánica/efectos de los fármacos , Membrana Timpánica/patología , Cicatrización de Heridas/efectos de los fármacosRESUMEN
In this study of 22 patients with laryngeal cancer, computed tomographic (CT) scans in the axial plane were compared with histopathological sections prepared in the same plane. The value of the preoperative CT for evaluating tumor invasion, location and size was then investigated. Findings demonstrated that CT was most sensitive in determining tumor invasion to the paralaryngeal and preepiglottic spaces, anterior and posterior commissures and subglottis. In contrast, CT was less sensitive in determining actual tumor invasion to the laryngeal cartilages, extralaryngeal tissues and metastases to cervical lymph nodes.