Biomedical subjects

Somchai Srirompotong

Publications and source records attributed to Somchai Srirompotong.

14 recordsLinked to original sources

PubMed2007

Otosyphilis: a review of 85 cases.

OBJECTIVE: To review the clinical manifestations and the follow-up hearing results of the treatment modalities in the patients with otosyphilis. STUDY DESIGN AND SETTINGS: A retrospective review between 1984 and 2000 at a university hospital. Patients who presented with cochleovestibular symptoms and were confirmed seropositive for specific treponemal tests were included. Excluded were patients older than 70, or who had other identified causes of cochleovestibular symptoms. RESULTS: Subjects included 56 males and 29 females with an average age of 59.5 years (range, 40 to 70). Common presenting symptoms included hearing loss (90.6%), tinnitus (72.9%), and vertigo (52.9%). The cerebrospinal fluid analysis was positive in 5.4%. The overall respective hearing results in the short- and long-term follow-up were improved or stable in 93.4% and 83.3% of patients. Even though adding steroids and neurosyphilis regimens tended to improve and stabilize hearing, the results were not statistically significant among treatment modalities. CONCLUSION: Further study about hearing outcomes among treatment modalities is suggested.

Adult↗

PubMed2006

Ear wiggling tics: treatment with botulinum toxin injection.

Ear wiggling tics are a rare disorder and there is no reported satisfactory treatment. We had a patient present with ear wiggling tics, which we treated with injections (totaling 40 units) of botulinum toxin A to the pinna muscle (i.e., the auricularis anterior and superior). The tics completely disappeared within 9 days of injection without any side effects.

Adult↗

PubMed2006

Botulinum toxin injection for treatment of spasmodic dysphonia: experience at Srinagarind Hospital.

BACKGROUND: Spasmodic dysphonia (SD) is a focal dystonia and adductor SD is the most common form. The standard treatment for adductor SD is EMG-guided, transcutaneous injections of botulinum toxin into the thyroarytenoid muscle. OBJECTIVE: Report the clinical presentation of SD, treatment with botulinum toxin injection, injection technique, results, and adverse effects. MATERIAL AND METHOD: A reviewed of clinical records of patients diagnosed with SD at the Voice Clinic between April 1999 and December 2004 at Srinagarind Hospital, Khon Kaen University, Thailand. Thirty-seven patients were identified but only twenty-five were treated with EMG-guided botulinum toxin injection to the thyroarytenoid muscle. RESULTS: In the presented 37 patients, SD was more common in women (89%) than men (11%). The median duration of symptoms prior to diagnosis was 12 months: all were the adductor type. The average age at onset was 46 years. The presenting symptoms included influence to the voice (84%), hoarseness (70%), strained or strangled voice (65%), decreased loudness (27%), and breathy voice (22%). A vocal tremor coexisted with dystonia in 60% of the presented patients. Treatment with botulinum toxin injection was carried out on 25 patients for 78 injections (mean, 3 per patient). The time for botulinum toxin to take effect averaged 2.3 days (peak effect, 7 days). The patients received substantial relief from their SD symptoms, an average functional improvement of 39.2% (37.6% initially vs. 76.8% finally). Patients' best voice was achieved within one week and persisted for an average of 13.6 weeks. Side effects from the injections included mild breathiness (68%) and mild choking on fluid (56%). After injection, decreased potential for volume was a common complaint, but since all of the patients experienced increased fluency, they were satisfied. Almost all of the patients returned for repeat injections when the benefit diminished. CONCLUSION: Botulinum toxin therapy has become the standard care for the treatment of SD. An acceptable and flexible treatment plan to produce a balance between decreased spasms and loss of function must be developed for each patient.

Botulinum Toxins↗

PubMed2004

Nasopharyngeal tuberculosis: manifestations between 1991 and 2000.

OBJECTIVES/HYPOTHESIS: To present the clinical manifestation of nasopharyngeal tuberculosis. STUDY DESIGN: Clinical analysis of 23 patients with pathologically confirmed nasopharyngeal tuberculosis was carried out retrospectively. SETTING: Srinagarind Hospital, Khon Kaen University. Thailand. RESULTS: The most common presenting symptom was cervical lymphadenopathy (91.3%). The common locations of nodes were the superior and middle cervical. The abnormalities of the nasopharynx were found in 16 patients. The pathological findings were caseous granuloma with positive acid-fast bacilli (AFB) in 15 cases, caseous granuloma with negative AFB in 3 cases, and chronic granulomatous inflammation with negative AFB in 5 cases. Pulmonary tuberculosis was found in 8 of 18 patients. Sixteen patients who received complete treatment responded well. CONCLUSION: Nasopharyngeal tuberculosis commonly presents with cervical lymphadenopathy. The differential diagnosis of tuberculosis from nasopharyngeal carcinoma is difficult. In the patients who have cervical lymphadenopathy and no other identified causes, biopsy of nasopharynx would give an additive information for diagnosis.

Adult↗

PubMed2004

Retropharyngeal space infection.

Retropharyngeal space infections are relatively rare since the widespread use of modern antibiotics. In children, retropharyngeal space infections usually occur following an upper respiratory tract infection, while in adults they are usually caused by trauma, foreign bodies or extension from adjacent spaces. The authors reviewed 12 patients with retropharyngeal space infection between July 1996 and June 2002. Age, sex, duration of symptoms and hospitalization time, clinical presentation, etiology, underlying disease, bacteriology, treatment and complications were analyzed. Widening of the prevertebral soft tissue as seen on a plain film of the lateral neck was the most important diagnostic tool. Fever was the most common symptom (91.6%) and showed a high prevalence in adult populations (66.6%). Half of the cases were caused by ingestion of a foreign body. Nine cases underwent surgical drainage which was positive in eight cases (88.8%). Staph. aureus, K. pneumoniae and Enterobacter species were the predominant pathogens. Early diagnosis and appropriate use of antibiotics lessened morbidity. Only two cases had postoperative complications and both recovered.

Adult↗

PubMed2004

Acute suppurative parotitis.

The parotid is the salivary gland most affected by inflammatory process. The authors reviewed the records of 36 patients with acute suppurative parotitis admitted between July 1996 and June 2002. All patients had unilateral swelling of the cheek that extended to the angle of the jaw; 23 had fever (64%) and 6 diabetes (17%). Even though Staphylococcus aureus is the usual pathogen in acute suppurative parotitis, in the present study, alpha-hemolytic streptococci predominated. Adequate hydration and administration of parenteral antimicrobials are essential managements of suppurative parotitis. In the event a well formed abscess, surgical drainage was necessary. The choice of antibiotics depends on the causal microbes.

Adolescent↗

PubMed2003

Ludwig's angina: a clinical review.

Ludwig's angina is caused by a rapidly expanding cellulitis of the floor of the mouth and is characterized by a brawny induration of the floor and suprahyoid region (bilaterally), with an elevation of the tongue potentially obstructing the airway. In the pre-antibiotic era, Ludwig's angina was frequently fatal; however, antibiotics and aggressive surgical intervention have significantly reduced mortality. We reviewed nine patients with Ludwig's angina between July 1996 and June 2002, all of whom presented with fever, neck swelling, bilateral submandibular swelling and elevation of the tongue. In eight patients (89%) a dental infection appeared to be the underlying cause. High-dosage intravenous antibiotics directed towards the suspected causative microorganisms were given to all of the patients: two were treated successfully with conservative medical management, while seven underwent surgical drainage (a tracheotomy was necessary in one patient). Routine aerobic cultures were done on samples of drained material and the predominant microorganisms were Streptococcus species in two patients; there were none in the other five. Two patients had post-operative complications, but all recovered.

Academic Medical Centers↗

PubMed2003

A randomized trial of the canalith repositioning procedure.

OBJECTIVE: To compare the effectiveness and complications of our adaptation of the canalith repositioning procedure (CRP) with the expectation treatment for benign paroxysmal positional vertigo. STUDY DESIGN: A randomized, controlled trial in the setting of a neurotological clinic in Thailand. METHODS: Fifty-eight patients with posterior benign paroxysmal positional vertigo were randomly assigned to treatment and control groups using a block of four. The treatment group was treated with the modified CRP technique until the nystagmus disappeared. A mastoid oscillator was not used, nor were any instructions given for patients after the maneuver. Both groups recorded the daily grading of symptoms and the amount of anti-vertiginous drugs (cinnarizine) taken. Objective and subjective assessments were made weekly until the nystagmus disappeared or until 4 weeks had passed since treatment began. RESULTS: The rates of effectiveness of CRP treatment and the control treatment for benign paroxysmal positional vertigo were 75.9% and 48.2%, respectively. There was a significant difference in the treatment outcomes of the CRP and control groups (P =.03). The CRP group used significantly fewer drugs than the control group (P =.001). Complications in the CRP group, such as lateral canalithiasis and fainting, were observed in 13.8% of the patients. CONCLUSIONS: The CRP was more effective than the expectation treatment for benign paroxysmal positional vertigo insofar as it provided faster recovery and required less dependence on medication. Complications of CRP were limited to 13.8% of patients.

Adult↗

PubMed2003

Disseminated septicaemic melioidosis: an unusual presentation of masticator space infection.

Melioidosis is an infectious disease caused by a saprophytic bacterium, Burkholderia pseudomallei. It is endemic to Southeast Asia and Northern Australia. The spectrum of melioidosis in humans varies from sub-clinical to overwhelming protean manifestations resembling other acute and chronic bacterial infections. Disseminated septicaemia melioidosis presenting as a masticator space infection is reported here. This is germane to those treating diabetic patients with deep neck infections living in, or having visited, areas endemic for B. pseudomallei.

Adult↗

PubMed2003

Tuberculosis in the upper aerodigestive tract and human immunodeficiency virus coinfections.

OBJECTIVE: To describe the clinical manifestations of tuberculosis in the upper aerodigestive tract. DESIGN: Retrospective chart analysis. SETTING: Srinagarind Hospital, Department of Otolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. METHODS: A review of medical records of patients diagnosed with mycobacterial infection of the upper aerodigestive tract between January 1991 and December 2000. MAIN OUTCOME MEASURES: Presenting symptoms, clinical findings, pathologic findings, pulmonary involvement, and outcome of treatment. RESULTS: Forty-five patients presented with upper aerodigestive tract tuberculosis. The nasopharynx was involved in 23 patients, the larynx in 16, the tonsils in 6, and the soft palate in 1. One patient had tuberculous infections in both the nasopharynx and tonsils. The mean duration of symptoms before diagnosis was 2.1 months. The pathologic findings included caseous granuloma and/or positive acid-fast bacilli (AFB) in 39 cases and chronic granulomatous inflammation with negative AFB in 6 cases. Pulmonary tuberculosis was found in 19 of the 36 patients who underwent radiography. A positive serologic test for human immunodeficiency virus (HIV) infection was found in 4 of 26 patients. These 26 patients, who received a full course of treatment, responded well. CONCLUSION: The most common site of tuberculosis in the head and neck involved the cervical lymph nodes and nasopharynx. Upper aerodigestive tract tuberculosis is difficult to differentiate from carcinoma; thus, tissue biopsy is necessary for a definite diagnosis. Chest radiography and screening for HIV infection are recommended in all patients with upper aerodigestive tract tuberculosis.

Adult↗

PubMed2002

Clinical aspects of tonsillar tuberculosis.

A clinical analysis of 6 patients with pathologically confirmed tonsillar tuberculosis was carried out retrospectively. The subjects comprised three men and three women, ranging in age from 20 to 74 years. All of the patients presented with a sore throat and 5 had lymphadenopathy. Ulcerations, masses and white patches characterized the tonsillar lesions; the pathological findings included caseous granuloma with positive acid-fast bacilli (AFB) in 5 patients and chronic granulomatous inflammation with negative AFB in one patient. Four of the six patients had pulmonary tuberculosis. The three patients who received complete treatment responded well. The presenting symptoms and abnormal tonsillar findings associated with tonsillar tuberculosis are similar to those of malignant tumors and therefore it is difficult to differentiate the two pathologies; moreover, tonsillar tuberculosis often occurs with pulmonary tuberculosis and AIDS and therefore, a chest X-ray and HIV-screening are recommended for all patients with tonsillar tuberculosis.

Adult↗

PubMed2002

Otolaryngological complications of osteopetrosis.

Osteopetrosis is a rare inherited bone disease that affects both humans and various mammals. The authors report on two cases of osteopetrosis with otolaryngological complications. One patient had the childhood form and presented with chronic otitis media and brain abscess. The second patient had the adult form and presented with sinusitis from tooth extraction which developed into chronic osteomyelitis of the maxillary bone.

Adolescent↗

PubMed2002

The masticator space infection.

The masticator space is an important suprahyoid tissue compartment. Infection of the masticator space can break through the fascia and involve the adjacent space. Severe complications including mediastinitis, pericarditis and death have been reported. The correct diagnosis and proper management are, therefore, crucial in order to reduce this complication. The authors reviewed 22 patients with masticator space infection between July 1996 and June 2001. All of the patients presented with trismus and 18 patients (81.8%) had a suspected dental cause of infection. Five patients had underlying disease; three were diabetic and two had human immunodeficiency virus (HIV) infection. High dosage intravenous antibiotics directed towards the causative microorganism were given to all of the patients. Fourteen patients underwent surgical drainage and surgical drain was positive in eleven patients (78.5%). Routine aerobic cultures were done on samples of the drained material. Bacteriology showed Streptococcus spp. the dominant microorganism in three patients, Pseudomonas spp. in one patient and no growth in ten patients. Blood culture grew Burholderia pseudomallei in one patient who responded to medical treatment. Three patients had post-operative complications but all recovered.

Adolescent↗

PubMed2002

Surgical emphysema following intraoral drainage of buccal space abscess.

The authors present a case of surgical emphysema following intraoral drainage of a buccal space abscess, a complication not previously reported. Surgical emphysema was remedied after removing a penrose drain and conservative treatment, suggesting retention of the drain caused the emphysema.

Abscess↗