Direct maxillary irrigation therapy in non-operated chronic sinusitis: a prospective randomised controlled trial.

Objective: This study aimed to compare the effectiveness of pharmacological therapy with and without direct maxillary sinus saline irrigation for the management of chronic rhinosinusitis without polyps.

Methods: In this prospective randomised controlled trial, 39 non-operated patients were randomly assigned to be treated with direct maxillary sinus saline irrigation in conjunction with systemic antibiotics and topical sprays (n = 24) or with pharmacological therapy alone (n = 15). Endoscopy, Sino-Nasal Outcome Test and Lund-MacKay computed tomography scores were obtained before, six weeks after and one to two years after treatment.

Is Nasal Endoscopy of Diagnostic Value in Chronic Rhinosinusitis Without Nasal Polyps?

Endoscopic examination of the nasal cavity is an integral part of the assessment of patients with chronic rhinosinusitis. However, the benefit gained by performing endoscopy with respect to the patient's medical condition has not been completely assessed. We conducted a prospective cohort in an academic medical center.

Upper airway involvement in bronchiectasis is marked by early onset and allergic features.

The association of bronchiectasis with chronic rhinosinusitis (CRS) has been reported. However, apart from primary ciliary dyskinesia (PCD) and cystic fibrosis (CF), predisposing conditions have not been established. We aimed to define clinical and laboratory features that differentiate patients with bronchiectasis with upper airway symptoms (UASs) and without PCD from patients without UASs.

The role of surgery in necrotizing otitis externa.

This retrospective case review describes a subset of 5 patients with necrotizing otitis externa (NOE) with a refractory disease course who underwent surgery as part of their management plan between 2008 and 2013. Surgery promoted the cure of 4 of the 5 patients, and a fungal pathogen was recovered in 4 of 5 surgical samples. We conclude that surgery may be a necessary diagnostic and treatment adjunct in selective cases of NOE, especially in patients with a refractory disease course or with a suspected fungal etiology.

Idiopathic nasal bone osteitis: A preliminary report on a recently recognized entity.

Osteitis of the nasal bones is a rare disease; when it occurs, it usually has a known etiology. To the best of our knowledge, idiopathic nasal bone osteitis (NBO) has not been described before. We conducted a study to analyze the behavior of idiopathic NBO and its outcome and to determine a cutoff level for diagnosis using technetium-99m-methylene-diphosphonate (Tc-MDP) bone scanning.

Clinical utility of a polymerase chain reaction assay in culture-negative necrotizing otitis externa.

Objective: This study describes a subset of necrotizing otitis externa (NOE) patients with a refractory disease and negative cultures. In these cases, we decided to use a polymerase chain reaction (PCR) assay from surgically obtained tissue under sterile conditions to improve pathogen detection sensitivity.

Study Design: Retrospective case review.

Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis: diagnostic criteria.

Background: Chronic sinusitis is one of the most common otolaryngological diagnoses. Allergic fungal sinusitis and eosinophilic mucin rhinosinusitis can easily be misdiagnosed and treated as chronic sinusitis, causing continuing harm.

Aim: To better identify and characterise these two subgroups of patients, who may suffer from a systemic disease requiring multidisciplinary treatment and prolonged follow up.

Primary NK/T-cell lymphoma of the larynx.

Laryngeal extranodal non-Hodgkin lymphoma is uncommon, accounting for less than 1% of all laryngeal neoplasms; the B-cell phenotype is predominant. Lymphomas outside the nasal cavity are rare and highly aggressive. We present a case of primary natural killer T-cell (NK/T-cell) lymphoma of the larynx that arose in a 45-year-old man.

Prevalence of rhinosinusitis among atypical cystic fibrosis patients.

The objective of this paper is to study the correlation between sinonasal involvement and type of cystic fibrosis (CF) in Israeli's CF patients. The comparative study includes 70 CF patients: 40 typical and 30 atypical CF patients. History and physical examination data were recorded, including endoscopic nasal examination as well as sinus computer tomography scan.

A case of nasogastric tube perforation of the nasopharynx causing a fatal mediastinal complication.

Iatrogenic nasopharyngeal perforations secondary to improper nasogastric tube insertion probably occur more frequently than has been reported. Our review of the literature found very few cases. We report the case of a 79-year-old woman who died of mediastinal complications following the improper insertion of a nasogastric tube that resulted in a nasopharyngeal perforation.

[Neuroendocrine carcinoma with large cells of the breast: case report and review of the literature].

Neuroendocrine carcinoma with large cells is a slightly different tumor from the high rank of malignity. We report a case of breast localization in a 28-year-old patient. It is a locally advanced classified T4dN1M0 tumor that required neoadjuvant chemotherapy.

Hemifacial spasm associated with otitis media with effusion: a first reported case.

Hemifacial spasm is a condition consisting of unilateral paroxysmal involuntary contractions of the muscles innervated by the facial nerve. The most common etiology is a vascular loop compression at the root exit zone of the nerve. We present here a first reported case of hemifacial spasm associated with otitis media with effusion, in a 6-year-old girl, which was relieved immediately following ventilation tubes insertion.

Indications for the Caldwell-Luc approach in the endoscopic era.

Objective: Caldwell and Luc described the Caldwell-Luc operation more than 100 years ago as the surgical treatment for maxillary sinus disease. During the last decades less radical interventions using endoscopic approach have mainly replaced the classical procedures done for chronic and recurrent maxillary sinusitis.

Study Design And Setting: Between 1991 and 2002, 62 patients had the Caldwell-Luc approach for different indications.

Acyclovir in the treatment of Ramsay Hunt syndrome.

Ramsay Hunt syndrome is an herpetic disease with ominous prognosis regarding the facial nerve. Treatment with acyclovir, a well-known virostatic agent, has been given in a small number of patients in recent years with excellent results. We report on the administration of acyclovir intravenously for 7 days in 31 patients with Ramsay Hunt syndrome, with overall recovery rate of 82.

Classification of fungal sinusitis in immunocompetent patients.

Objective: The objective of this study was to review the subgroup classification of fungal sinusitis in immunocompetent patients.

Methods: The study design included 19 immunocompetent patients with fungal sinusitis who were operated on between 1993 and 1998.

Results: Ten of 19 patients showed a fungus ball.

Acyclovir in the treatment of idiopathic sudden sensorineural hearing loss.

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a vexing problem that continues to pose a diagnostic and therapeutic enigma for the otologist. The aim of the study, adopting the viral theory, was to discover whether patients with ISSNHL would benefit from early treatment with acyclovir and hydrocortisone compared with patients treated by hydrocortisone alone.

Methods: Sixty patients with ISSNHL were treated in a prospective controlled randomized manner.

Functional endoscopic sinus surgery in the treatment of massive polyposis in asthmatic patients.

The association between asthma and sinonasal disease has been known for years. Effective treatment of sinonasal disease, which is one of the factors that exacerbate asthma, may also improve and stabilize the asthmatic condition. This study examines the outcome of functional endoscopic sinus surgery (FESS) on asthmatic patients with massive nasal polyposis.

A note on the use of conservation practices in U.S. agriculture.

This article measures the effect of an increase in productivity attributable to an increase in soil organic carbon associated with the increase in the use of conservation practices in agriculture in the United States. Both the direct and indirect effects are calibrated. The analytical approach used consists of a dynamic computable general equilibrium model composed of 14 producing sectors, 10 consuming sectors, seven household categories classified by income, and a government.

Endoscopic repair of choanal atresia: practical operative technique.

Choanal atresia is a well-known entity with various surgical approaches. The introduction of nasal endoscopic surgery made the endoscopic approach the most popular one because of excellent visualization and a good view of the choana to remove enough vomerian septal bone. Seven patients with choanal atresia were treated with 9 endoscopic procedures.

Conservation practices in U.S. agriculture and their impact on carbon sequestration.

Increase in the use of conservation practices by agriculture in the United States will enhance soil organic carbon and potentially increase carbon sequestration. This, in turn, will decrease the net emission of carbon dioxide. A number of studies exist that calibrate the contribution of various individual, site-specific conservation practices on changes in soil organic carbon.

Using insurance to enhance nitrogen fertilizer application to reduce nitrogen losses to the environment.

The advantage of using insurance to help a farmer adopt a best nitrogen management plan (BNMP) that reduces the impact of agricultural production on the environment is analytically and empirically demonstrated. Using an expected value analysis, it is shown that an insurance program can be structured so as to reduce a farmer's cost of bearing the adoption risk associated with changing production practices and, thus, to improve the farmer's certainty equivalent net return thereby promoting the adoption of a BNMP. Using the adoption of growing-season only N fertilizer application in Iowa as a case study, it is illustrated how insurance may be used to promote the adoption of this practice to reduce N fertilizer use.

The environmental implications of soil erosion in the United States.

Soil erosion has both on-farm and off-farm impacts. Reduction of soil depth can impair the land's productivity, and the transport of sediments can degrade streams, lakes, and estuaries. Since 1933, soil conservation policies have existed in the United States.

The prognostic value of the tumour marker Cyfra 21-1 in carcinoma of head and neck and its role in early detection of recurrent disease.

This study examines a new tumour marker, Cyfra 21-1, as a prognostic marker in predicting the survival of H&N cancer patients, and its correlation with clinical outcome during prolonged follow up of these patients. The study included 67 patients with primary detection of carcinoma of H&N. The survival of these patients was evaluated in correlation with the disease stage and Cyfra 21-1 levels at initial diagnosis.

Conservation practices in US agriculture and their implication for global climate change.

Increase in the use of conservation practices by agriculture in the United States will enhance soil organic carbon and potentially increase carbon sequestration. This, in turn, will decrease the net emission of carbon dioxide. A number of studies exist that calibrate the contribution of various individual, site-specific conservation practices on changes in soil organic carbon.

Acute mastoiditis in children: is surgical treatment necessary?

Acute mastoiditis in children remains an otological problem. Although the widespread use of antibiotics has reduced the need for surgical intervention, surgery is frequently used in the treatment of acute mastoiditis and its complications. The charts of 44 patients hospitalized with signs of acute mastoiditis were reviewed.