RESUMO
To call attention to complications of chronic otitis media, the case of a patient who simultaneously developed lateral sinus thrombosis and Bezold's abscess is reported. A 7 year old boy presented with fever, drowsiness, cervical mass and otorrhea not responding to medical management. Work-up revealed lateral sinus thrombosis and cervical abscess secondary to right ear cholesteatoma. After treatment with surgery and antibiotics, he had a favorable outcome. We review the literature regarding the diagnosis and management of these complications and concluded that although less frequent they remain a clinical challenge.
Assuntos
Abscesso/etiologia , Colesteatoma da Orelha Média/complicações , Otite Média com Derrame/complicações , Trombose dos Seios Intracranianos/complicações , Abscesso/diagnóstico por imagem , Abscesso/terapia , Antibacterianos/uso terapêutico , Otorreia de Líquido Cefalorraquidiano/etiologia , Criança , Colesteatoma da Orelha Média/cirurgia , Humanos , Masculino , Otite Média com Derrame/tratamento farmacológico , Faringe/diagnóstico por imagem , Faringe/cirurgia , Trombose dos Seios Intracranianos/cirurgia , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Vestibular nerve section is considered to be the most effective surgical procedure for control of intractable symptoms secondary to labyrinthine and eighth nerve function. This study was developed to retrospectively evaluate the efficacy of vestibular nerve section in patients treated for disabling labyrinthine dysfunction. METHODS: A retrospective review of hospital and office records was carried out on 39 patients who underwent vestibular nerve section. All patients received a comprehensive questionnaire to subjectively evaluate efficacy. RESULTS: Questionnaires were returned from 36 of 39 patients. Follow-up averaged 51 months. A decrease in vertiginous attacks was reported by 94% of patients. An improvement in activity tolerance was reported by 30% of patients. Preoperative tinnitus and ear fullness reportedly improved after surgery in 53% and 65% or patients respectively. Complications encountered included cerebrospinal fluid (CSF) leak (six patients), meningitis (two patients), and intracranial fluid collection (one patient). CONCLUSION: Vestibular nerve section is a relatively safe and effective method of treatment for intractable vertigo.
Assuntos
Doenças do Labirinto/cirurgia , Nervo Vestibular/cirurgia , Atividades Cotidianas , Otorreia de Líquido Cefalorraquidiano/etiologia , Tontura/cirurgia , Feminino , Audição , Transtornos da Audição/etiologia , Humanos , Masculino , Doença de Meniere/cirurgia , Pessoa de Meia-Idade , Satisfação do Paciente , Complicações Pós-Operatórias , Estudos Retrospectivos , Zumbido/etiologia , Vertigem/cirurgia , Doenças Vestibulares/cirurgia , Doenças do Nervo Vestibulococlear/cirurgiaRESUMO
In 1988, the authors reported their experience in medical treatment of 66 children who had chronic suppurative otitis media, including the administration of intravenous antimicrobial agents. At the time of their initial treatment, 89 percent were successfully treated with medical treatment only, and the remaining 11 percent required surgical intervention. This report presents the long-term follow-up of 51 of those children who were available for study. Of these 51 patients, 40 (78%) had resolution of their initial or recurrent otorrhea, whereas 11 (22%) had surgery either initially or at the time of a recurrence. Medical management is successful in most children who have chronic suppurative otitis media, but surgical intervention should be considered if a cholesteatoma is suspected, if medical treatment is not effective in rapidly improving the chronic infection, or if the patient has recurrent disease over a relatively short period.
Assuntos
Antibacterianos/uso terapêutico , Colesteatoma/diagnóstico , Otite Média com Derrame/tratamento farmacológico , Adolescente , Antibacterianos/administração & dosagem , Otorreia de Líquido Cefalorraquidiano/etiologia , Criança , Pré-Escolar , Colesteatoma/fisiopatologia , Doença Crônica , Orelha Média/microbiologia , Orelha Média/fisiopatologia , Orelha Média/cirurgia , Feminino , Seguimentos , Humanos , Lactente , Injeções Intravenosas , Masculino , Otite Média com Derrame/microbiologia , Otite Média com Derrame/cirurgia , Pseudomonas aeruginosa/isolamento & purificação , Staphylococcus aureus/isolamento & purificaçãoRESUMO
The study of CSF fistulae, and especially those involving otolaryngological anomalies, must be based on the search for the causative problem of recurrent meningitis. Congenital malformations, post-traumatic and post-operative situations or even diseases involving the cranial bones are basic causes that should be studied. Currently, cranial trauma is the most usual cause of CSF fistulae, with the possibility of recurrent bacterial meningitis.
Assuntos
Otorreia de Líquido Cefalorraquidiano/etiologia , Meningites Bacterianas/etiologia , Lesões Encefálicas/líquido cefalorraquidiano , Lesões Encefálicas/complicações , Otorreia de Líquido Cefalorraquidiano/complicações , Humanos , Meningites Bacterianas/complicações , RecidivaRESUMO
The authors present 11,074 patients with head trauma managed in the Xoco and Juarez Hospitals from Mexico City, from 1980 through 1990. They report a frequency of cerebrospinal fluid fistulas in 1.3% of head trauma: 55% were anterior fossa fistulas and 39% middle fossa fistulas. The most common symptoms and the treatment are presented.
Assuntos
Otorreia de Líquido Cefalorraquidiano/etiologia , Rinorreia de Líquido Cefalorraquidiano/etiologia , Traumatismos Craniocerebrais/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Otorreia de Líquido Cefalorraquidiano/epidemiologia , Otorreia de Líquido Cefalorraquidiano/terapia , Rinorreia de Líquido Cefalorraquidiano/epidemiologia , Rinorreia de Líquido Cefalorraquidiano/terapia , Derivações do Líquido Cefalorraquidiano , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Se presenta el caso de un escolar masculino de siete años, quien en el lapso de cinco años y medio sufrió cinco ataques de meningitis bacteriana de etiología neumococcica. Destacándose en él: déficit inmunológico de inmunoglobulina A, factores del complemento de hipoesplenismo; encontrando como factor predisponente un defecto anatómico a nivel de oído medio izquierdo, el cual se logró detectar en la quinta hospitalización por medio de una Politomografía de oído; no habiéndose evidenciado en dos oportunidades anteriores con estudio de Tomografía Axial Computada convencional