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Biomedical subjects

John G Bizakis

Publications and source records attributed to John G Bizakis.

17 recordsLinked to original sources

Osteoid osteoma of the ethmoid bone associated with dacryocystitis.

BACKGROUND: Osteoid osteomas (OO) are small, benign osteoblastic lesions. Ethmoid bone OO has been very rarely reported so far. CASE PRESENTATION: We report a case of a 16-year-old boy suffering from persistent epiphora and a mild pain in the area of median canthus, due to a bone density mass within the right ethmoid air cells extending to the ipsilateral right orbit. The mass was removed via an external ethmoidectomy approach. Histopathologic examination of the specimen set the diagnosis of OO. One year after the operation the patient is free of symptoms, while no recurrence occurred. CONCLUSION: A case of ethmoid bone OO associated with dacryocystitis is reported. Although benign and rare, OO should be considered in differential diagnosis of the ethmoid bone osteoblastic lesions.

Adolescent↗

Oral mucosal melanoma: a malignant trap.

Oral mucosal melanomas are highly malignant tumors. The 'chameleonic' presentation of a mainly asymptomatic condition, the rarity of these lesions, the poor prognosis and the necessity of a highly specialized treatment are factors that should be seriously considered by the involved health provider. We present the case of a 75-year-old man who was referred to the Ear, Nose and Throat department. His symptoms were voice alteration and saliva drooling, progressively worsening during the last few weeks. The absence of pain was the reason for the delay of seeking medical care. The diagnosis was an oversized oral melanoma. This is an example of how the time of diagnosis and the evolution of a disease could be seriously influenced by patient's behavior. Melanomas arising from oral mucosa have poor prognosis unless they are discovered and treated early. The vigilance of the physicians is necessary to have success in this difficult task.

Journal Article↗

Canal wall down mastoidectomy for cholesteatoma: experience at the University of Crete.

OBJECTIVE: To evaluate clinical and audiologic data as well as operative findings and postoperative follow-up in the management of chronic cholesteatomatous otitis media with canal wall down mastoidectomy (CWDM). STUDY DESIGN: A retrospective review of cases followed up between 1990 and 2002. SETTING: Tertiary referral centre. METHOD: Two hundred one patients with chronic otitis media with cholesteatoma underwent CWDM. MAIN OUTCOME MEASURES: Clinical presentation, surgical findings, and audiologic evaluation were assessed. RESULTS: Preoperatively, eight patients suffered from vertigo and four presented with facial nerve paralysis. In 40 patients (20%), erosion of the lateral semicircular canal was found, and in 31 patients (15%), there was dehiscence of the facial nerve canal. Dural plate erosion and sinus plate dehiscence were found in 13 and 17 patients, respectively. Nine patients experienced serious endocranial complications at their admission. The malleus was noted to be intact in the majority of patients in all age groups. The incus was eroded or absent in most of the cases in all age groups. On postoperative evaluation 3 months after surgery, 195 audiograms were performed, with a mean pure-tone average of 55 dB HL and a mean air-bone gap of 30 dB HL. CONCLUSION: Although CWDM has the disadvantages of the necessity to avoid water insertion in the external auditory canal and lifelong mastoid care, it is an effective treatment in a single-step procedure for patients with advanced disease and for those who refuse to submit to postoperative follow-up.

Adolescent↗

Malignant mixed tumor of the nasal cavity.

Parotid gland is the most common location of malignant mixed tumors. Three different subtypes of these tumors exist: carcinoma ex pleomorphic adenoma, carcinosarcoma, and metastasizing mixed tumor. Carcinoma ex-pleomorphic adenoma is by far the most common subtype. Although unusual sites of these tumors have been published, we report an extremely rare case of a malignant mixed tumor located in the nasal cavity.

Aged↗

Kikuchi's disease: a benign cause of fever and cervical lymphadenopathy.

Histiocytic necrotizing lymphadenitis (Kikuchi's disease, KD) is a rare benign condition of unknown origin, usually characterized by lymphadenopathy and fever, affecting mainly young women. We describe three cases of patients, one man and two women, with biopsy-proven KD detected at our university hospital during the past 3 years and we review the literature.

Journal Article↗

Implications of laser assisted tympanostomy in adults.

OBJECTIVES: To assess outcome in adult individuals undergoing laser-assisted tympanostomy without ventilation tube placement. STUDY DESIGN: Case series with 2-month follow-up. SETTING: Faculty practice, research protocol, tertiary care academic medical center. PATIENTS AND METHOD: Laser-assisted tympanostomy was performed on a total of 142 ears (108 individuals). Indications included serous otitis media with effusion (66 ears/47 patients), functional eustachian tube dysfunction (48 ears/36 patients), acute otitis media (19 ears/16 patients), and endoscopic visualization of the middle ear (9 ears/9 patients). INTERVENTION: The laser-assisted tympanostomy procedure is performed with a CO2 laser under local anesthesia on an outpatient basis. MAIN OUTCOME MEASURES: Patency time of the tympanostomy, presence of fluid after the closure of the tympanostomy, tympanometry and tone audiometry findings, relief of symptoms. RESULTS: Middle ear disease was resolved after the closure of tympanostomy in 47.9% of patients with serous otitis media with effusion. In 79.1% of patients with functional eustachian tube dysfunction, symptoms were diminished. All patients with acute otitis media had a satisfactory outcome. Laser-assisted tympanostomy was found to be quite helpful in patients undergoing middle ear endoscopy. CONCLUSIONS: Laser-assisted tympanostomy without ventilation tubes provides a safe alternative surgical option in adult patients in certain cases. The selection criteria for this procedure are addressed in detail.

Acute Disease↗

Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists.

The use of angiotensin-converting enzyme inhibitors (ACEIs) has been implicated in many cases of angioedema, but, given the potential mechanism of this complication, it was not expected to be caused by angiotensin II receptor blockers (ARBs). However, in the past few years, scattered reports of angioedema associated with ARBs have appeared in the medical literature. We performed a retrospective chart review from January 1, 1998, through June 30, 2003, and a review of the literature. During this time, we managed head and neck angioedema induced by ACEIs (n = 27) and ARBs (n = 4) in 31 patients. All of them had significant mucosal swelling, and in some of them dyspnea and dysphagia coexisted. The most frequently involved areas were the oral tongue (13 cases), uvula and soft palate (5 cases), and larynx, mouth floor, and lips (3 cases each). Angioedema may be a more common complication of ACEI and/or ARB use than originally thought. This complication may occur after long-term use of these drugs. We advise that ARBs not be prescribed to patients with a history of angioedema, particularly that due to the use of ACEIs.

Angioedema↗

Otorhinolaryngology or otolaryngology? An etymological approach.

The variety and the confusion over the name of many medical terms, including otorhinolaryngological ones prompted us to search their etymology. The term "otorhinolaryngology" (combined form from the ancient Greek words :ous, rhina, larynx, and logos) and the term indicating the specialized doctor who practices "0torhinolaryngology," widely known as ENT in a brief version, are being examined. The investigation leads us to see which of these terms is the appropriate and etymologically correct one, and to support clearly the term "otorhinolaryngology" instead of "otolaryngology" and "otorhinolaryngologist" instead of "ENT."

Humans↗

Cocaine flakes versus tetracaine/adrenaline solution for local anaesthesia in septoplasty.

The aim of this prospective study was to evaluate the efficacy of cocaine flakes compared to tetracaine with adrenaline solution, as a local anaesthetic for patients undergoing septoplasty. From January 2001 to December 2002, 220 patients underwent septoplasty under local anaesthesia. Patients were randomly classified in group A and group B, where cocaine and the solution of tetracaine/adrenaline were used respectively. A visual analogue scale was used to evaluate the severity of the patients'pain during the procedure. The patients of group B showed a statistically significant lower pain score than patients of group A. We believe that the solution of tetracaine/adrenaline is an effective and safe anaesthetic for patients undergoing septoplasty under local anaesthesia.

Adolescent↗

Bilateral sudden sensorineural hearing loss caused by Charcot-Marie-Tooth disease.

Charcot-Marie-Tooth (CMT) disease or hereditary motor and sensory neuropathy (HMSN) is a relatively common neurological syndrome, which has seldom been associated with hearing dysfunction, particularly sudden sensorineural hearing loss (SNHL). Families with autosomal dominant, autosomal recessive and X-linked forms of inheritance have been described. Sudden sensorineural hearing loss is a frustrating and frightening condition, especially if the hearing loss is bilateral. Regarding the site of the lesion, the evidence from the literature on HMSN suggests that either the VIIIth nerve or central auditory pathways are primarily involved in patients with hearing loss. We report the first case in the English literature of a patient with Charcot-Marie-Tooth type II disease presenting bilateral SNHL in the course of his disease. The patient was hospitalized for 15 days, and undergoing treatment without any audiological improvement. Detailed clinical, audiological and laboratory examination was performed. The aetiology and prognostic indicators of bilateral SNHL are discussed, as well as, the incidence of hearing loss in CMT patients.

Charcot-Marie-Tooth Disease↗

Laser-assisted uvulopalatoplasty for the treatment of snoring and mild obstructive sleep apnea syndrome.

OBJECTIVE: To determine the efficacy of the laser-assisted uvulopalatoplasty (LAUP) procedure on snoring and Apnea-Hypopnea-Index (AHI) improvement in patients with snoring and mild obstructive sleep apnea syndrome (OSAS). STUDY DESIGN: Prospective, nonrandomized, nonblinded assessment of outcomes after LAUP in patients suffering from benign habitual snoring and/or mild OSAS. METHODS: Fifty-nine patients with habitual snoring and 25 patients with mild OSAS underwent LAUP (6 of them underwent simultaneous classic tonsillectomy and 20 carbon-dioxide laser tonsillotomy). All patients and their bed partners completed pre- and post-treatment questionnaires ranking snoring, whereas the patients with mild OSAS underwent postoperative polysomnography (PSG). RESULTS: During a 6-month to 5-year follow-up (mean 40 months), 91.5% of the patients with habitual snoring reported significant short-term improvement based on post-treatment questionnaires, whereas 79.7% reported long-term subjective improvement. Nineteen of 25 patients (76%) with mild OSAS reported significant improvement of snoring based on posttreatment questionnaires. According to the postoperative PSG, only 2% showed a worse AHI, whereas 60% showed reduction of the AHI to < or = 5. Eight patients (32%) showed little or no improvement of AHI. CONCLUSIONS: LAUP, in combination with carbon-dioxide laser tonsillotomy in some cases, is a safe, cost-effective, outpatient procedure for the treatment of many cases of habitual snoring and mild OSAS when preceded by careful selection of the candidates.

Adult↗

Arteriovenous malformation of the neck presented during delivery.

Vascular anomalies in the head and neck area are not infrequent and, in most cases, are congenital in origin. We present a congenital arteriovenous malformation (AVM) of the neck that manifested in a young woman during delivery. Imaging findings on ultrasonography (US), computed tomography (CT) and angiography were inconclusive and the diagnosis was reached by magnetic resonance imaging. A total excision of the mass was performed.

Adult↗

Seborrheic keratosis of the auricle: report of an unusual case.

Seborrheic keratoses are superficial epithelial lesions. They are usually pigmented and often warty, but sometimes they appear as smooth papules. These lesions frequently occur on the face during middle and old age. We report an unusual case of a large seborrheic keratosis of the auricle. We also emphasize the importance of the differential diagnosis, and we discuss the treatment strategy for these usually benign but disfiguring tumors.

Aged↗

Excision of rhinophyma with a laser scanner handpiece--a modified technique.

Rhinophyma is a slowly progressive, benign dermatological disorder of the tip of the nose. The most widely accepted theory is that rhinophyma is the end stage result of chronic acne rosacea. The primary reason for excision of rhinophyma is cosmetic deformity. However, nasal obstruction may present, as rhinophyma may obstruct nasal vestibules. Surgery is the treatment of choice for rhinophyma. Medical therapy has not given satisfactory results. The surgical treatment modalities are divided into two main groups. The first is complete excision, with primary closure for small lesions, or skin grafting for large lesions. The second group includes incomplete excision followed by re-epithelialization from the remaining glandular epithelium. The carbon dioxide (CO2) laser has been advocated for excision of rhinophyma. Newer instrumentation, such as Swiftlase and SurgiTouch (ESC Sharplan) or Ultrapulse (Coherent) is more effective in vaporization and carbonization resulting in better hemostasis (Ries and Speyer, 1996). In this report, 7 patients with rhinophyma treated with the Swiftlase are reviewed. The surgical technique, the complications and the follow-up are discussed.

Aged↗