Anatomical dissections employing the endoscopic sphenoethmoidectomy technique were performed in 51 fresh Asian cadaveric heads. Specific data concerning the anatomical variations of the posterior ethmoid sinus and its relationships to the optic nerve were recorded. Approximately two-thirds (65%) of the specimens showed a direct relationship between the optic nerve and posterior ethmoid sinus. Posterior ethmoid cells with an optic canal bulge were found in 50.98% of the 102 sides dissected. In 14.7% no optic canal bulge was present, yet the optic nerve was intimately related to the posterior ethmoid sinus. In this latter group, the average thickness of bone separating the optic nerve from the posterior ethmoid sinus was 0.25 mm. The authors consider that in endoscopic sinus surgery, this type of relationship is potentially the most hazardous to the optic nerve.
Our study demonstrates direct evidence of allergic nasal response to B. tropicalis in sensitized adults. It shows that nasal provocation may also provoke concomitant asthmatic symptoms during the late-phase reaction, especially in people with a history of asthma.
Major complications of foreign bodies in the esophagus carry significant morbidity and mortality risks. A retrospective case control study was performed to assess the factors associated with major complications. In total, 273 patients seen within a 7-year period were divided into 2 groups; 253 had no or minor complications, and 20 had major complications. Age, sex, duration of the foreign body, total white cell count (TWC), and nature and site of the foreign body were analyzed in the 2 groups. The major complication rate was 7.3%. Duration of the foreign body and TWC were the only statistically significant factors associated with major complications. Six patients required open neck exploration, 1 had an open thoracotomy, and 13 were treated by endoscopic removal. There were 2 deaths. Given the significant morbidity and mortality risks, we conclude that patients with a prolonged history of a foreign body in the esophagus and a raised TWC should be treated urgently.
The standardization of the definition of rhinitis in epidemiological studies is of crucial importance, especially when comparing the prevalence between studies. Appropriate patient education by physicians with a good understanding of the nature of rhinitis and the available treatment options (e.g. evidenced-based efficacy, safety, and a good cost-benefit ratio) will maximize patient compliance and treatment outcomes.
The aim of this study was to determine whether neurotrophic factors such as brain derived neurotrophic factor (BDNF) and neurotrophin 3 (NT-3) would protect auditory hair cells from ototoxicity by aminoglycoside antibiotic. Twenty-seven Wistar guinea pigs were divided into three groups of nine animals each. BDNF and NT-3 (100 microg/ml) were delivered into the right scala tympani of guinea pig cochlea through a cannula-osmotic pump device. Artificial perilymph (AP) was used as control. Immediately after implantation of the device, each animal was given five successive doses of kanamycin (400 mg/kg). At 15, 30 and 60 days after infusion, surviving inner and outer hair cells were counted at each turn of every cochlea with a Philips 515 scanning electron microscope. Multiple comparison tests were carried out among the groups, using ANOVA and Dunnett T3/Tukey HSD. Protective effects of NT-3 on hair cells were observed at 30 and 60 days after kanamycin injection. BDNF had no protective effect on hair cells at 15 and 60 days, but some at 30 days. This study suggests that NT-3 and BDNF may protect against cochlear hair cell damage caused by kanamycin treatment. Possible mechanisms for the otoprotective effects were discussed. No single mechanism postulated can explain fully the results seen in this study. It is possible that the mechanisms act in concert to produce the observed effects, or there are as yet undiscovered mechanisms or secondary messengers responsible for the otoprotective effects.
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