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Biomedical subjects

C E Papadakis

Publications and source records attributed to C E Papadakis.

At least 19 recordsLinked to original sources

Transtympanic versus intramuscular steroid administration in a histamine-induced inflammatory middle-ear model.

OBJECTIVES: Assessment of the histopathologic effect of transtympanic and intramuscular administration of dexamethasone in an in vivo experimental animal model of middle-ear mucosal inflammation. METHODS: Fifty healthy rabbits weighting 1500-1800 g were randomly divided in three groups. In 10 animals (control group), 0.5 ml of a 20 mg/ml histamine solution was injected transtympanically. In 20 rabbits (group A), histamine challenge followed a three day intramuscular pretreatment with dexamethasone at 1 mg/kg per day. In 20 rabbits (group B), histamine challenge followed pretreatment with dexamethasone via a transtympanic route (0.3 ml, 1.2 mg dexamethasone). Middle-ear mucosa was obtained for histopathology 30 minutes after histamine administration. The following parameters were assessed: inflammation, acute inflammatory component, presence of eosinophils, inflammatory activity and fibrosis. RESULTS: Oedema, vascular dilatation and congestion, inflammation, the presence of an acute (polymorphonuclear) inflammatory component, the presence of eosinophils, and inflammatory activity were found to be of a lesser grade in the mucosae of group B. All differences were found to be statistically highly significant (p<0.01) using the Mann-Whitney test. CONCLUSION: Our findings validate the transtympanic route of dexamethasone administration in counteracting histamine effects.

Animals↗

The combined endoscopic CO(2) laser posterior cordectomy and total arytenoidectomy for treatment of bilateral vocal cord paralysis.

Upper airway obstruction, because of bilateral vocal cord paralysis, presents a serious challenge to the Otolaryngologist. Various surgical techniques have been advocated for the management of patients with vocal cord paralysis. Among these techniques, the individual use of laser CO(2) arytenoidectomy and posterior cordotomy has gained wide acceptance. In this report, we describe our experience in the management of bilateral vocal cord paralysis by combining posterior partial cordotomy as described by Dennis and Kashima, with total arytenoidectomy as described by Ossoff et al. We report the long-term results in the management of 18 patients treated in our department during the last 8 years.

Adult↗

PFAPA syndrome in children evaluated for tonsillectomy.

Among 40 children undergoing tonsillectomy for recurrent pharyngitis, 15 (37.5%) had presented preoperatively with complaints compatible with PFAPA syndrome. All 15 had had periodic fever every three to four weeks and pharyngitis; 12 (80%) had cervical adenitis and five (33%) aphthous stomatitis. All children had been well between episodes and showed a dramatic postoperative improvement. PFAPA syndrome is not uncommon among children having tonsillectomy. Tonsillectomy is curative in most of these patients.

Child↗

Adenoid cystic carcinoma of the temporal bone with distant metastases.

Malignant tumors of the temporal bone are rare neoplasms. Adenoid cystic carcinoma (ACC) is the most common malignant tumor of minor salivary glands, while a quite rare tumor of the major. It is considered a slow-growing tumor with a course that is characterized by local recurrences and late distant metastases to lungs (80-90%), bone and liver. When metastases occur in bone especially the spine, the course of disease is usually fulminant. Intracranial involvement can occur by direct extension, hematogenous or perineural spread and represents an advanced stage of the disease. In this paper, we present a rare case of temporal bone ACC reporting for the first time simultaneous bony and pulmonary distant metastases. The origin, the pathology, the imaging techniques, the differential diagnosis, the treatment options and the prognosis of these tumors are discussed.

Aged↗

Efficacy of 'two-man' FNAB technique in the assessment of patients with non-thyroid neck masses.

OBJECTIVE: To show the superiority of 'two-man' FNAB technique comparing to the standard FNAB technique, in order to identify the cause of non-thyroid neck masses. METHODS: Over an 18 months period, a consecutive paired study was conducted in the tertiary referral Venizelion General Hospital. Forty-four cytologic examinations were performed in patients with non-thyroid head and neck masses. The samples were taken from the same side using both techniques the standard FNAB technique and the 'two-man' FNAB technique (for which two persons carried out the procedure). The slides were seen by the pathologist and were defined as diagnostic, suggestive or inconclusive. The diagnosis was confirmed in any case by definite histology after surgical treatment or open biopsy. RESULTS: From 44 samples taken with the 'two-man' technique, 34 were diagnostic (all true) verified by histopathology, seven suggestive (five true and two false) and three inconclusive (6.82%). The correct diagnosis was confirmed in 39 cases (88.64%). From 44 samples of standard technique, 22 were diagnostic (all true), 12 suggestive (five true and seven false) and 10 inconclusive (22.72%). The correct diagnosis was confirmed in 27 cases (61.36%). The accuracy of diagnosis with the standard FNAB technique was 0.79 (SE=0.07), while with the 'two-man' FNAB technique was 0.95 (SE=0.03), a significant statistical difference (Fischer exact test, P=0.041). CONCLUSIONS: 'Two-man' FNAB technique proved to be as safe and patient friendly as the standard FNAB, but more accurate and may be easier to perform than this. The 'two-man' FNAB technique could become the preferred method for fine-needle cytology, particularly for difficult to reach areas of the head and neck.

Biopsy, Needle↗

Mucus plugging as a cause of acute lobar overdistension.

Acute lobar overdistension in children is usually indicative of foreign body aspiration, especially when a history of a choking episode is recalled. An unusual presentation of asthma as recurrent overdistension of the left lung in a toddler is described. The child had undergone two consecutive negative bronchoscopies with a presumptive diagnosis of foreign body aspiration; however, it was only the antiasthmatic treatment that resulted in an excellent outcome.

Acute Disease↗

Facial nerve palsy associated with Rickettsia conorii infection.

Facial nerve palsy has been occasionally attributed to infectious agents, but Rickettsiae species have not been documented as causative agents. We report two adolescent girls with facial nerve palsy and serological evidence of R conorii infection. These cases indicate that rickettsioses should be included among the causes of facial nerve palsy, particularly in endemic areas.

Adolescent↗

Bronchoscopy for foreign body removal in children. A review and analysis of 210 cases.

OBJECTIVE: A foreign body aspiration in the tracheobronchial tree is a dangerous and common medical emergency in childhood, with serious and potentially lethal consequences. It must be suspected in children with a suggestive history, even though the clinical symptoms or radiographic findings are not pathognomonic for foreign body aspiration. METHODS: In this study 210 pediatric cases, with a suggestive history of foreign body aspiration undergoing bronchoscopy in the last 8 years in the department, were reviewed. In all cases bronchoscopy was performed under general anesthesia using a Storz ventilation bronchoscope with distal cold light illumination. RESULTS: In 130 patients a foreign body was discovered, in 17 cases pus was aspirated and in 63 cases there were no findings. Seventy-eight (60%) foreign bodies were found in the right main bronchus, 43 (33.1%) in left main bronchus, seven (5.4%) in both bronchi and two (1.5%) were found in the subglottic area. The incidence of bronchoscopy during the last 8 years was 28 procedures per 100000 children population per year in the island of Crete. CONCLUSION: More attention should be given to the need for a careful history and the use of radiographs as supplemental information to make the decision to perform a bronchoscopy. The parents, also, should pay attention not to allow children dry fruits and small toys, as well as, teaching their children to avoid any physical or emotional activity while having a full mouth.

Adolescent↗

Frontal lobe abscess secondary to head trauma and nasal polyposis.

Cerebral frontal lobe abscess may be a frequent intracranial complication of paranasal sinusitis. An unusual case of cerebral abscess complicating massive polyposis is described in a patient with history of previous severe head trauma 30 years ago. Imaging evaluation using both computed tomography and magnetic resonance imaging is important to diagnose such rare entities.

Aged↗

In vitro ear cartilage shaping with carbon dioxide laser: an experimental study.

Deformed cartilage remodeling appears to be a challenge, as cartilage tends to keep its initial shape because of internal stresses. Cartilage can be remodeled with heat, and this report describes the use of a CO2 laser beam for in vitro cartilaginous tissue remodeling. Straight cartilage samples were removed from the ears of 21 rabbits deprived of perichondrium and remodeled with the CO2 laser at an output power of 3 W, a spot diameter of 2 mm, and an exposure time of 0.5 second. The remodeled cartilages and control samples were implanted into the rabbits' backs and retrieved 6 to 12 months later. Histologic and morphological analysis showed that the irradiated cartilages retained both their shape and their viability. This may be a useful clinical technique for in situ remodeling of a deformed cartilage in operations such as septoplasty.

Animals↗

Angiosarcoma of the maxillary sinus.

Angiosarcomas are rapidly growing malignant neoplasms arising from the vascular endothelial cells. Most common sites are the extremities and the retroperitoneal space, with only four per cent of angiosarcomas arising in the head and neck area, whilst the paranasal sinuses are one of the rarest locations. We report the case of a maxillary sinus angiosarcoma in a 72-year-old male patient. The first biopsy was inconclusive, whereas the second revealed an angiosarcoma. Medial maxillectomy was performed with subsequent external irradiation.

Aged↗

Fibrous dysplasia of the temporal bone: report of a case and a review of its characteristics.

Fibrous dysplasia is an uncommon benign disorder of unknown etiology. It represents a disturbance of normal bone development--specifically a defect in osteoblastic differentiation and maturation that originates in the mesenchymal precursor of the bone. Because fibrous dysplasia shows a predilection for the facial and cranial bones, where it causes deformity and dysfunction, the disease is of particular interest to the otolaryngologist. In this paper, we report a case of fibrous dysplasia of the temporal bone, the first symptom of which was a mixed hearing loss. We discuss the characteristic features of this specific location of the disease, the differential diagnosis, and the treatment policy. We also address the issue of secondary sensorineural hearing loss.

Fibrous Dysplasia of Bone↗

Acute candidiasis of the oro- and hypopharynx as the result of topical intranasal steroids administration.

Topical nasal steroids have become increasingly popular for the treatment of allergic and other types of rhinitis. However, undesirable local effects of intranasal steroids, such as nasal irritation and burning, crusting and epistaxis are quite common. Candidiasis of the pharyngeal mucosa is a complication, which has not been described so far after treatment of rhinitis with intranasal topical corticosteroids. Between March 1997 and September 1998, we managed to treat successfully three patients with acute erythematous candidiasis of the pharynx, which was the result of the use of intranasal topical steroids. Mechanism, clinical features of acute pharyngeal candidiasis, differential diagnosis and treatment are discussed.

Administration, Intranasal↗

Mucocele of the maxillary antrum in an eight-year-old boy.

Mucocele is a rare clinical entity in children. It is considered to be associated with fibrocystic disease. The capacity of mucocele to erode through the bone walls along with the increased density of its content, make the diagnosis difficult when mucocele has to be differentiated from benign or malignant tumors. In this paper, we present the case of an 8-year-old boy with mucocele of the left maxillary antrum. Both the differential diagnosis and the surgical treatment are described.

Child↗

Negative pressure suction in nasal septum surgery.

Operations for the correction of septal deviations are among the most common in otorhinolaryngology. Several approaches and techniques have been proposed, for securing the mucoperichondrial flap back in place. A new method of stabilizing the septum by applying a negative pressure suction tube, without the insertion of any kind of packing, is described. The advantages of the negative pressure suction are that the patient can breathe through the nose immediately after the operation, there is no pressure sensation and the pain, if any, is reduced, there is no epiphora, no skin edema and the patient feels very comfortable. Risks for complications are minimal.

Equipment Design↗