Biomedical subjects

N Navacharoen

Publications and source records attributed to N Navacharoen.

4 recordsLinked to original sources

PubMed1995

Surgery for intractable vertigo: Chiang Mai experience.

If medical therapy fails (6-12 months or more), careful consideration of surgical therapy should be followed with; the patient's hearing, severity of symptoms, age, and occupation. Cochleosacculotomy is reserved for elderly Meniere's patients with poor health, poor hearing and good vestibular function. Endolymphatic sac shunt should be considered as the first procedure for disabled Meniere's patients with aidable hearing and may also be used in those patients with bilateral Meniere's disease. Retrolabyrinthine vestibular nerve section (RLVNS) is indicated for patients with disabling vertigo and normal or aidable hearing. It could be done for all peripheral vertigo and for failed endolymphatic sac procedure. A destructive procedure, such as labyrinthectomy, should be a procedure of choice in a patient who presents with peripheral incapacitating vertigo and nonserviceable hearing loss in the solely affected ear. Again, patients with failed cochleosacculotomy, endolymphatic shunt then go on to receive either labyrinthectomy or RLVNS, based on residual hearing. To obtain a satisfactory surgical result, the surgeon must be precise in selecting the patient with the right disease at the right time.

Humans↗

PubMed1995

Intracranial complications of suppurative otitis media: 13 years' experience.

Among 24,321 patients with otitis media treated at the Otolaryngology Department of Chiang Mai University Hospital from 1978 through 1990, 87 patients had 140 central nervous system complications (0.36%). Multiple complications existed simultaneously in almost 45% of the patients. The group developing the complications were mainly in their second decade of life. Meningitis occurred in 43 patients, brain abscess in 29, perisinus abscess in 23, lateral sinus thrombosis in 16, and extradural abscess in 12 patients. The most striking symptoms and signs were increasing otorrhea, visible cholesteatoma and/or granulations, fever, headache and otalgia, and vestibular symptoms. Proteus mirabilis, Pseudomonas aeruginosa, and staphylococcal organisms were found in almost 80% of patients. Overall mortality was 18.4% with brain abscess being the main cause (31%). Epidemiologic presentation, clinical features, and results of treatment for each disease are compared and contrasted to those of previous studies.

Acute Disease↗

PubMed1993

Extracranial and intracranial complications of suppurative otitis media. Report of 102 cases.

During the eight-year period, 1983-1990, 102 cases of intracranial (IC) and extracranial (EC) complications from 17 144 suppurative otitis media were reviewed. The prevalence of each complication was 0.24 and 0.45 per cent respectively. Facial paralysis, subperiosteal abscess and labyrinthitis were the common complications among the EC group, while meningitis and brain abscess were common in the IC group. Twenty five per cent of the EC group and 44 per cent of the IC group had more than two complications. The reliable warning signs and symptoms for IC complications were fever, headache, earache, vestibular symptoms, meningeal signs and impairment of consciousness. Proteus spp., Pseudomonas aeuruginosa and Staphylococcus spp. were the commonest organisms isolated from both groups. Cholesteatoma and granulation/polyp in the middle ear/mastoid were the major findings in both patient groups. Mortality rate in the IC group was 18.6 per cent. Morbidity rate in each group was 14.3 per cent (EC) and 27.9 per cent (IC) respectively. Epidemiological presentations, clinical features and the result of treatment are discussed.

Acute Disease↗

PubMed1985

Oropharyngeal anthrax.

The first bacteriologically confirmed case of oropharyngeal anthrax is described. A 59-year-old male patient presented with sore throat and extensive swelling of the neck and anterior chest wall five hours after the ingestion of uncooked water buffalo meat. Marked inflammation of the oropharynx and a small necrotic area in the left tonsil were found. Culture taken from this area grew Bacillus anthracis. In anthrax-susceptible areas, this acute illness should be added to the differential diagnoses of inflammatory lesion of the oropharynx with extensive neck swelling.

Anthrax↗