Biomedical subjects
Publications and source records attributed to F Gordts.
The problems inherent to the gathering of epidemiologic and prevalence data are outlined. The need for a better understanding of the natural history of chronic sinusitis in children is stressed.
In a population of 100 children with suspected intracranial neurological disease, the overall prevalence of sinusitis signs on magnetic resonance images (MRI) is 45%. This figure exceeds the adult prevalence of 39%, while the nature of the lesions is more severe in children. Furthermore, paediatric sinuses seem to be affected according to a different pattern: adults have mainly maxillary and anterior ethmoidal lesions, whereas in children the sphenoidal and posterior ethmoidal sinuses are frequently involved too. Among children, the overall prevalence increases in the presence of a history of nasal obstruction (prevalence: 50%) and recent upper respiratory tract infection (prevalence: 81%) as well as when bilateral mucosal swelling (prevalence: 80%) or purulent secretions (prevalence: 100%) are seen on anterior rhinoscopy.
Auditory Brainstem Response (ABR) findings in a series of 20 patients with cerebellopontine-angle (CPA) tumors are reported. Every patient was examined by computed tomography (CT) or magnetic resonance imaging (MRI) The aim of this study is to evaluate the usefulness of ABR since the introduction of MRI. Should the strategy for early diagnosis be changed? This paper tries to answer the question both by analyzing our data and by reviewing the literature. MRI is mandatory for diagnosis of small acoustic tumors because ABR lacks adequate sensitivity in this group.
A prospective MRI sinus study primarily applied to a group of patients with suspected neurological intercranial pathology is carried out. Even in this non-ENT population, the prevalence of inflammatory sinusitis abnormalities on MRI is high.
A prospective study was undertaken in 72 children comparing a new type of tympanostomy tube, the Lens tube, in one ear, and a Donaldson tube in the contra-lateral ear as a control. The average survival times of the tubes differed significantly: 17.20 months for the Lens tube, and 11.31 months for the Donaldson tube (P < 0.001). By contrast, the relapse rate (22% with the Lens tube vs 21% with the Donaldson tube) after extrusion or extraction, and the residual perforation rate (3% with the Lens tube vs 6% with the Donaldson tube) were not significantly different. Otorrhea was not significantly different either: 25% with the Lens tube vs 16% with the Donaldson tube.
High frequency jet ventilation permits an effective diagnostic and surgical approach with unobstructed view of a compromised airway allowing treatment ranging from imminent surgical intervention to an attitude of observation.
Three methods of rhinomanometry were compared with each other with respect to their ability to determine the histamine threshold (histamine concentration for a 100% increase of the initial total nasal resistance): the active anterior rhinomanometry (P.A.R.). Nasal challenge and consecutive measurement by the three methods of rhinomanometry were conducted in a group of 11 volunteers. The three methods gave significantly different histamine concentration thresholds (p = 0.002). Unilateral histamine thresholds as available from A.A.R. and P.A.R. (at a flow of 250 cm3/sec) did not differ significantly (p = 0.299). For A.A.R. and A.P.R., histamine thresholds were assessed at five different pressure values as well as at five different flow values. The thresholds did not appear to be significantly different at any one of those pressure gradients (p = 0.690) or flow values (p = 0.357).
A prospective study was undertaken in which in 72 children a new type of tympanostomy tube, the Lens drain, was inserted in one ear, and a Donaldson drain was inserted in the contralateral ear as a control. The average survival times of both tubes especially seemed to differ significantly: 15.25 months for the new tube, and 10.53 months for the conventional tube (p less than 0.05). By contrast, the relapse rate (20% with the Lens tube versus 27% with the Donaldson tube) after extrusion or extraction, and the residual perforation rate (8% with the Lens tube versus 5% with the Donaldson tube) were not significantly different. Otorrhea was apparently present equally frequently with either tube: 19% with the Lens tube versus 15% with the Donaldson tube.
Three methods of rhinomanometry were compared with each other with respect to their ability to determine the histamine threshold (histamine concentration for a 100% increase of the initial total nasal resistance): the active anterior rhinomanometry (AAR), the active posterior rhinomanometry (APR) and the passive anterior rhinomanometry (PAR). Nasal challenge and consecutive measurement by the three methods of rhinomanometry were conducted in a group of 11 volunteers. The three methods gave significantly different histamine concentration thresholds (p = 0.002). Unilateral histamine thresholds as available from AAR and PAR (at a flow of 250 cm3/sec) did not differ significantly (p = 0.299). For AAR and APR, histamine thresholds were assessed at 5 different pressure values as well as at 5 different flow values. The thresholds did not appear to be significantly different at any one of those pressure gradients (p = 0.690) or flow values (p = 0.357).
Relatively little is known about the prevalence of sinusitis in a general population. Patients with suspected intracranial neurological disease can be considered as representative of the general population. On magnetic resonance imaging nearly 60% of the sinuses were affected. If the most common lesion (a maxillary polyp or cyst) was excluded, still 40% of the sinuses were affected. Above all the maxillary sinuses are involved with 40% abnormal images followed by the anterior ethmoidal sinuses with 14%. The other sinuses are less likely to be affected with 2.5% of the sphenoidal, 2% of the frontal and 1.5% of the posterior ethmoidal sinuses.