ORL; journal for oto-rhino-laryngology and its related specialties最新文献_第6页

Fluoroquinolone-resistant Pseudomonas aeruginosa in chronic rhinosinusitis. 慢性鼻窦炎中的氟喹诺酮类耐药铜绿假单胞菌。

IF 1.3

ORL; journal for oto-rhino-laryngology and its related specialties Pub Date : 2009-01-01 Epub Date: 2009-09-30 DOI: 10.1159/000242428

Joel Guss, W M Abuzeid, Laurel Doghramji, Paul H Edelstein, Alexander G Chiu

{"title":"Fluoroquinolone-resistant Pseudomonas aeruginosa in chronic rhinosinusitis.","authors":"Joel Guss, W M Abuzeid, Laurel Doghramji, Paul H Edelstein, Alexander G Chiu","doi":"10.1159/000242428","DOIUrl":"https://doi.org/10.1159/000242428","url":null,"abstract":"Background: Pseudomonas aeruginosa is cultured in nearly 1 of 5 patients with chronic rhinosinusitis and a history of sinus surgery. Fluoroquinolones are the only enterally administered antibiotics with efficacy against P. aeruginosa, but their frequent empiric use in the community raises concern for a rise in resistance.Objective: It was the aim of this study to determine the prevalence of fluoroquinolone-resistant P. aeruginosa in a tertiary rhinology practice.Methods: All bacterial sinus culture results from the outpatient otolaryngology clinic that yielded P. aeruginosa over a 5-year period (2002-2007) were reviewed along with the medical records of a randomly selected subset of patients.Results: In total, 689 culture results of 324 patients were examined. Nearly all patients had a history of endoscopic sinus surgery. Of all P. aeruginosa cultured, 13% were resistant to levofloxacin and 5% were intermediately sensitive, while 5% were resistant to ciprofloxacin and 7% intermediately sensitive. Of the 324 patients in the study, 19 and 15% had a history of a P. aeruginosa culture resistant to levofloxacin or ciprofloxacin, respectively. Mucoid strains of P. aeruginosa were significantly more likely to be fluoroquinolone resistant. No patient comorbidities were associated with a higher rate of resistance. The prevalence of resistant cultures remained stable over the 5-year study period.Conclusions: P. aeruginosa is cultured primarily in patients with previous sinus surgery. Nearly 20% of isolates are resistant to fluoroquinolones. Resistance to levofloxacin is more common than resistance to ciprofloxacin. This study supports the use of culture-directed therapy in the management of the postfunctional endoscopic sinus surgery patient and the avoidance of empiric use of fluoroquinolones.","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"263-7"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000242428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40050336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Complications of suppurative otitis media: still a problem in the 21st century. 化脓性中耳炎的并发症:21世纪仍是一个问题。

IF 1.3

ORL; journal for oto-rhino-laryngology and its related specialties Pub Date : 2009-01-01 Epub Date: 2009-01-15 DOI: 10.1159/000191472

Badr Eldin Mostafa, Lobna M El Fiky, Mohammed M El Sharnouby

{"title":"Complications of suppurative otitis media: still a problem in the 21st century.","authors":"Badr Eldin Mostafa, Lobna M El Fiky, Mohammed M El Sharnouby","doi":"10.1159/000191472","DOIUrl":"https://doi.org/10.1159/000191472","url":null,"abstract":"The purpose of this study was to review the incidence of complicated suppurative otitis media in 10 years at a tertiary referral university hospital. During this period, 3,364 patients with suppurative otitis media (acute and chronic) were admitted to the department. The number of patients presenting with complications was 422 (12.54%). The ratio of extracranial to intracranial complications was nearly 1:1. The most frequent extracranial complication was mastoiditis while the most frequent intracranial one was lateral sinus thrombophlebitis. Multiple complications may present in the same patient. The onset of complications was insidious and 96% of the patients were already aware of their disease. There were 6 mortalities (1.42%), and additional morbidity was recorded in 16 patients (3.79%). Changes in the clinical picture should always alert the physician to the onset of a complication. Complications tended to occur in young patients from a lower socioeconomic class and without sex preponderance. Physicians should be aware of the continuing incidence of complications and the subtleness of their onset and investigate patients for the presence of more than one complication.","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"87-92"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000191472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39993490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 68

Olfactory dysfunction in allergic rhinitis. 过敏性鼻炎的嗅觉功能障碍。

IF 1.3

ORL; journal for oto-rhino-laryngology and its related specialties Pub Date : 2009-01-01 Epub Date: 2009-09-30 DOI: 10.1159/000242429

Joel Guss, Laurel Doghramji, Christine Reger, Alexander G Chiu

{"title":"Olfactory dysfunction in allergic rhinitis.","authors":"Joel Guss, Laurel Doghramji, Christine Reger, Alexander G Chiu","doi":"10.1159/000242429","DOIUrl":"https://doi.org/10.1159/000242429","url":null,"abstract":"Background: Olfactory dysfunction in patients with allergic rhinitis has long been thought to be secondary to coexisting chronic rhinosinusitis and polyposis with obstruction of airflow over the olfactory epithelium. Recent evidence suggests that the allergic inflammatory infiltrate may itself affect olfaction in the absence of mucosal hypertrophy.Objective: We undertook a study to determine olfactory function in patients with allergic rhinitis in the presence and absence of chronic sinusitis.Methods: Fifty-one subjects with symptoms of rhinitis who presented for allergy testing were administered the University of Pennsylvania Smell Identification Test. In addition each patient underwent computed tomography (CT) scanning of the sinuses.Results: Eighty percent of subjects were allergic. Subjects with allergic rhinitis and no evidence of sinusitis scored on average in the 30th percentile (95% CI 20-40th percentile) on objective olfactory testing compared to age- and gender-specific norms. Half the allergic patients were classified as normosmic, while half had some degree of hyposmia.Conclusions: Our study demonstrates that even in the absence of mucosal disease on CT scan, a significant subset of patients with allergic rhinitis will exhibit hyposmia, mostly to a mild or moderate degree. The pathophysiology and potential treatments for olfactory loss in these patients should be further explored.","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"268-72"},"PeriodicalIF":1.3,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000242429","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40050337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 37

Investigations of the influence of external nose deformities on nasal airflow. 外鼻畸形对鼻腔气流影响的研究。

IF 1.3

ORL; journal for oto-rhino-laryngology and its related specialties Pub Date : 2005-01-01 DOI: 10.1159/000086017

S Grützenmacher, D M Robinson, C Lang, E Lebe, U Knape, G Mlynski

{"title":"Investigations of the influence of external nose deformities on nasal airflow.","authors":"S Grützenmacher, D M Robinson, C Lang, E Lebe, U Knape, G Mlynski","doi":"10.1159/000086017","DOIUrl":"https://doi.org/10.1159/000086017","url":null,"abstract":"Background: Abnormalities of the external shape of the nose are often felt as cosmetically disturbing. In many cases an additional hampering of the respiratory function of the nose is seen and causes pathological nasal airflow patterns. For the functional outcome of aesthetic-surgery of the nose, knowledge of nasal flow is essential. In the medical literature there are some discrepancies between the relationship of nasal shape and nasal flow. We investigated typical airflow patterns in different abnormalities of the external nose.Methods: We performed fluid dynamic experiments on exact, anatomical nasal models and functional nasal models (so-called modified Mink boxes). We investigated the inspiratory flow pattern in nose-models with typical variations of the shape of the external nose.Results and conclusions: There were typical airflow patterns for every external nasal abnormalities. The normal nose shows a disturbance of the streamlines over the entire nasal cavum. Under physiological flow velocities we find laminar and turbulent flow. The pathological variations of the nasal shape show mostly different airflow patterns and characteristics. The main reason for that is a deformed or anatomically false configurated inflow area (vestibulum, isthmus and anterior cavum). During rhinoplasty the reconstruction of the nasal inflow area has to be taken into account.","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"154-9"},"PeriodicalIF":1.3,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000086017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41017126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 26

Role of leukotriene inhibitors in the postoperative management of nasal polyps. 白三烯抑制剂在鼻息肉术后治疗中的作用。

IF 1.3

ORL; journal for oto-rhino-laryngology and its related specialties Pub Date : 2005-01-01 DOI: 10.1159/000086016

Badr E Mostafa, Hossam Abdel Hay, Hussam E Mohammed, Mohammed Yamani

{"title":"Role of leukotriene inhibitors in the postoperative management of nasal polyps.","authors":"Badr E Mostafa, Hossam Abdel Hay, Hussam E Mohammed, Mohammed Yamani","doi":"10.1159/000086016","DOIUrl":"https://doi.org/10.1159/000086016","url":null,"abstract":"This was a prospective double blind comparative study on 40 patients. It compared the effects of the leukotriene receptor antagonist montelukast and beclomethasone nasal spray on the post-operative course of patients with sinonasal polyps. All patients underwent endoscopic sphenoethmoidectomy and were randomized post-operatively into two groups. Group I: 20 patients (9 females and 11 males) age 17 to 67 (32.4 +/- 9.5 years), receiving 10 mg montelukast orally daily and Group II: 20 patients (6 females and 14 males) age 17 years to 57 years (33.5 +/- 11.9 years), receiving 400 ug beclomethasone local sprays daily. All patients were followed up for 1 year and a symptom score was recorded throughout this period. There was a significant reduction in symptom scores in both groups throughout the study period. In the montelukast group improvement was more marked in itching, post-nasal discharge and headache. The control of sneezing and rhinorrhea was comparable in both groups with a marginal advantage of montelukast. Steroids had a more marked effect on smell disturbances and obstruction. There was no difference in the recurrence rate or in the need for rescue medications between both groups. Both drugs seem to have a complementary action and further studies are needed to determine which patients should receive which treatment.","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"148-53"},"PeriodicalIF":1.3,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000086016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41017125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 55

The nasal airflow in noses with septal perforation: a model study. 鼻中隔穿孔鼻腔气流的模型研究。

IF 1.3

ORL; journal for oto-rhino-laryngology and its related specialties Pub Date : 2005-01-01 DOI: 10.1159/000085958

S Grützenmacher, R Mlynski, C Lang, S Scholz, R Saadi, G Mlynski

{"title":"The nasal airflow in noses with septal perforation: a model study.","authors":"S Grützenmacher, R Mlynski, C Lang, S Scholz, R Saadi, G Mlynski","doi":"10.1159/000085958","DOIUrl":"https://doi.org/10.1159/000085958","url":null,"abstract":"Background: Septal perforation is a common clinical problem in rhinology. Affected patients suffer from a dry nose, crusts as well as recurrent epistaxis and sometimes an inspiratory whistle. The aim of this study was to investigate the underlying flow dynamic mechanisms.Methods: The physical flow effects of such pathologies were examined in functional nose models (box models) and anatomically exact models of the nose. Therefore, septal perforations of different sizes and localisations were studied in straight and deviated nasal septa.Results and conclusions: It could be seen that the localisation of the perforation has no impact on the flow pattern. In large septal perforations, the air jet collides with the posterior edge of the perforation and disintegrates turbulently. Since airflow is physiologically turbulent in the posterior part of the nose, posterior perforations do not cause clinical complaints. The inspiratory whistling sound during respiration is based on the principle of a lip whistle. Large perforations do not cause a whistling sound. The necessary high flow velocity needed in large perforations is usually not achievable.","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"142-7"},"PeriodicalIF":1.3,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000085958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41017124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 25