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https://www.readbyqxmd.com/read/28819362/recurrent-csf-rhinorrhea-misdiagnosed-as-chronic-allergic-rhinitis-with-subsequent-development-of-bacterial-meningitis
#1
Michael T Ulrich, Lawrence K Loo, Michael B Ing
INTRODUCTION: Cerebrospinal fluid (CSF) rhinorrhea results from an abnormal communication of the dura mater to the nasal mucosa. The majority of cases of CSF rhinorrhea are the result of trauma or surgery involving the skull base. Spontaneous CSF rhinorrhea is a rare clinical entity with increased risk of ascending infection. Delay in diagnosis places the patient at risk of developing meningitis. CASE PRESENTATION: A 36-year-old African American female with significant medical history of obesity and hypertension presented to the emergency department with headache, altered level of consciousness, fever, and neck stiffness...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28814623/a-3-week-old-with-an-isolated-blueberry-muffin-rash
#2
John B Darby, Gregory Valentine, Kirsty Hillier, Raegan Hunt, C Mary Healy, Valeria Smith, Wendy Allen-Rhoades
A 3-week-old boy, former 39-week term infant, presented to the emergency department with a rash. One week before presentation, he developed dark, purple papules on his forehead, which then spread to the abdomen and inguinal regions. Throughout this time, he was eating well, gaining weight, developing appropriately, and was afebrile without cough, congestion, or rhinorrhea. On presentation, the patient was well appearing with normal vital signs. His weight was 4.83 kg (86th percentile for age), his length was 56 cm (47th percentile for age), and his head circumference was 37 cm (62nd percentile for age)...
June 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/28799727/cryosurgical-posterior-nasal-tissue-ablation-for-the-treatment-of-rhinitis
#3
Peter H Hwang, Bryant Lin, Raymond Weiss, James Atkins, Jacob Johnson
BACKGROUND: Endoscopic posterior nasal nerve (PNN) resection has been described as an efficacious surgical treatment of allergic and nonallergic rhinitis, but the requirement for surgery under general anesthesia has limited its acceptance. We report the first series of patients treated for chronic rhinitis using a novel device designed for office-based cryosurgical ablation of the PNN. METHODS: Twenty-seven patients with chronic rhinorrhea and/or nasal congestion for >3 months were recruited (allergic or nonallergic rhinitis), with minimum rhinorrhea and/or congestion subscores of 2 as part of the Total Nasal Symptom Score [TNSS])...
August 11, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28797520/symptoms-of-allergic-rhinitis-in-parakou-benin-prevalence-severity-and-associated-factors
#4
M-C Flatin, S Ade, S-H-R Hounkpatin, B Ametonou, U-B Vodouhe, W Adjibabi
AIMS: Allergic rhinitis (AR) is an extremely common disease. This study aimed to determine the prevalence and severity of AR symptoms and potential associated factors, in Parakou, a city in Benin. MATERIALS AND METHODS: A cross-sectional study was conducted between April and July 2016, involving inhabitants of the city aged between 6 and 65 years. Cluster sampling was carried out. AR symptoms were defined as the simultaneous presence of rhinorrhea, nasal obstruction and sneezing without evidence of respiratory infection...
August 7, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28780516/diagnosis-of-endocrine-disease-primary-empty-sella-a-comprehensive-review
#5
Sabrina Chiloiro, Antonella Giampietro, Antonio Bianchi, Tommaso Tartaglione, Antonio Capobianco, Carmelo Anile, Laura De Marinis
Primary empty sella (PES) is characterized by the herniation of the subarachnoid space within the sella, which is often associated with variable degree of flattening of the pituitary gland in patients without previous pituitary pathologies. PES pathogenetic mechanism are not well known but seem due to a sellar diaphragm incompetence, associated to the occurrence of upper sellar or pituitary factors, as intracranial hypertension and change of pituitary volume. As PES represents in majority of cases a neuroradiological findings, without any clinical implication, the occurrence of endocrine, neurological and opthalmological symptoms, due to the above describes anatomical alteration, delineates the so called PES syndrome...
August 5, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28759392/a-3-week-old-with-an-isolated-blueberry-muffin-rash
#6
John B Darby, Gregory Valentine, Kirsty Hillier, Raegan Hunt, C Mary Healy, Valeria Smith, Wendy Allen-Rhoades
A 3-week-old boy, former 39-week term infant, presented to the emergency department with a rash. One week before presentation, he developed dark, purple papules on his forehead, which then spread to the abdomen and inguinal regions. Throughout this time, he was eating well, gaining weight, developing appropriately, and was afebrile without cough, congestion, or rhinorrhea. On presentation, the patient was well appearing with normal vital signs. His weight was 4.83 kg (86th percentile for age), his length was 56 cm (47th percentile for age), and his head circumference was 37 cm (62nd percentile for age)...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28758381/the-impact-of-allergic-rhinitis-on-symptom-improvement-in-pediatric-patients-after-adenotonsillectomy
#7
Dong-Jun Lee, Young-Jun Chung, Yeon-Jun Yang, Ji-Hun Mo
Objectives: It is well known that allergic rhinitis (AR) has positive association with adenotonsillectomy. However, the impact of AR on symptom improvement after adenotonsillectomy is not well documented. Hence, we aimed to evaluate the effect of AR on the symptom improvement after adenotonsillectomy between AR and nonallergic patients. Methods: A retrospective analysis was performed on 250 pediatric patients younger than 10 years old who received adenotonsillectomy from June 2009 to June 2014 in a tertiary referral hospital...
August 1, 2017: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/28731403/safe-and-sustainable-the-extracranial-approach-toward-frontoethmoidal-meningoencephalocele-repair
#8
Paul I Heidekrueger, Myat Thu, Wolfgang Mühlbauer, Charlotte Holm-Mühlbauer, Philippe Schucht, Hans Anderl, Heinrich Schoeneich, Kyawzwa Aung, Mg Mg Ag, Ag Thu Soe Myint, Sabrina Juran, Thiha Aung, Denis Ehrl, Milomir Ninkovic, P Niclas Broer
OBJECTIVE Although rare, frontoethmoidal meningoencephaloceles continue to pose a challenge to neurosurgeons and plastic reconstructive surgeons. Especially when faced with limited infrastructure and resources, establishing reliable and safe surgical techniques is of paramount importance. The authors present a case series in order to evaluate a previously proposed concise approach for meningoencephalocele repair, with a focus on sustainability of internationally driven surgical efforts. METHODS Between 2001 and 2016, a total of 246 patients with frontoethmoidal meningoencephaloceles were treated using a 1-stage extracranial approach by a single surgeon in the Department of Neurosurgery of the Yangon General Hospital in Yangon, Myanmar, initially assisted by European surgeons...
July 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28717092/cerebrospinal-fluid-rhinorrhea-and-subsequent-bacterial-meningitis-due-to-an-atypical-clival-fracture
#9
Rie Tohge, Makio Takahashi
Cases of cerebrospinal fluid (CSF) rhinorrhea due to clival fracture are rare. We present a case of bacterial meningitis with CSF rhinorrhea after a clival fracture. Heavily T2-weighted images showed a bone flap in the thinned clivus and fluid collection in the sphenoid sinus. CSF rhinorrhea developed at 1 month after mild trauma. The fracture may have been caused by the trauma and/or by the pressure gradient between the intracranial CSF space and the sphenoid sinus. A detailed history to identify trauma and an examination to detect bone defects in the skull base are necessary when patients present with bacterial meningitis and persistent rhinorrhea...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28717069/atypical-clival-fracture-due-to-minor-trauma-and-cerebrospinal-fluid-rhinorrhea
#10
Hajime Ono
No abstract text is available yet for this article.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28716176/systematic-review-of-patient-reported-outcomes-after-revision-endoscopic-sinus-surgery
#11
Shashi Prasad, Eric Fong, Eng H Ooi
BACKGROUND: Revision endoscopic sinus surgery (RESS) may be required for partially controlled or uncontrolled chronic rhinosinusitis. Studies that reported technical success, e.g., sinus ostia patency after RESS, do not address whether the patient's symptoms and quality of life (QOL) improve after surgery. However, patient-reported outcome measures (PROM) are useful to assess the impact of sinus surgery on a patient's symptoms and QOL. OBJECTIVE: This systematic review was undertaken to evaluate the impact of RESS on PROMs...
July 1, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28711543/clival-defect-with-primary-csf-rhinorrhea-a-very-rare-presentation-with-challenging-management
#12
Sheikh Asad, Jens Peters-Willke, Warwick Brennan, Saima Asad
BACKGROUND: Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea due to clival defect is an extremely rare presentation, and only 6 cases have been reported in the literature so far(17). CASE DESCRIPTION: We present a unique case of a 64-year-old woman who presented with a 2-year history of ongoing CSF rhinorrhea. She had similar episode at the age of 40 years and suffered from meningitis. She underwent magnetic resonance imaging, computed tomography cisternogram, as well as computed tomography of the brain, which showed clival defect with CSF leak into the sphenoid sinus...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28702154/a-case-report-on-late-presentation-of-occult-dural-lesions
#13
Timothy J Cochrane, Gurpreet Singh Ranger
BACKGROUND: Occult dural injuries are rare and can occur as a result of major or minor head injury. These injuries usually manifest with cerebrospinal fluid rhinorrhea alone, or with meningitis and cerebral abscess, sometimes many years after the original injury. CASE PRESENTATION: We present a case of occult dural injury with endocranial complications which occurred in a 34 year old man, with a history of head injury forty-three years ago. The patient presented with a triad of findings; meningitis, CSF rhinorrhoea and pneumocephalus...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28691009/endoscopic-vs-microscopic-resection-of-sellar-lesions-a-matched-analysis-of-clinical-and-socioeconomic-outcomes
#14
Tej D Azad, Yu-Jin Lee, Daniel Vail, Anand Veeravagu, Peter H Hwang, John K Ratliff, Gordon Li
BACKGROUND: Direct comparisons of microscopic and endoscopic resection of sellar lesions are scarce, with conflicting reports of cost and clinical outcome advantages. OBJECTIVE: To determine if the proposed benefits of endoscopic resection are realized on a population level. METHODS: We performed a matched cohort study of 9,670 adult patients in the MarketScan database who underwent either endoscopic or microscopic surgery for sellar lesions...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28688570/congenital-nasal-obstruction-in-infants-a-retrospective-study-and-literature-review
#15
REVIEW
Vijay A Patel, Michele M Carr
OBJECTIVES: To identify etiologies of congenital nasal obstruction and describe clinical practice patterns in the evaluation, diagnosis, and treatment of symptomatic infants. METHODS: An electronic chart review from 1/1/2006-10/1/2016 for all patients with a diagnosis of nasal obstruction within the first six months of life using ICD-9 and 10 codes 478.19 and J34.89. RESULTS: A total of 34 patients were evaluated by the Division of Otolaryngology for this chief complaint...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28681969/botolinum-toxin-in-rhinitis-literature-review-and-posterior-nasal-injection-in-allergic-rhinitis
#16
Edward Zhiyong Zhang, Sophocles Tan, Ian Loh
BACKGROUND: Current pharmacological management of allergic rhinitis (AR) varies in onset, duration, symptom control, and requires frequent administration. Single-dose botulinum toxin (BTX) has been documented in various trials as a treatment option in rhinitis. OBJECTIVE: We review the current literature on the use of BTX in rhinitis and investigate the efficacy and safety profile of a novel intranasal injection site for AR control. STUDY DESIGN: Single-arm pilot study...
July 6, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#17
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28665076/congenital-syphilis-presenting-with-only-nephrotic-syndrome-reemergence-of-a-forgotten-disease
#18
Yun Hee Kim, Ji Ho Song, Chan Jong Kim, Eun Mi Yang
Syphilis infection has re-emerged after years of declining incidence. The prevalence of congenital syphilis (CS) has increased in Korea and other countries during the last few decades. Untreated infants develop symptoms such as rhinorrhea, anemia, jaundice, cutaneous lesions, hepatosplenomegaly, and pseudoparalysis within weeks or months. Significant renal disease is uncommon in CS, and clinical renal involvement varies from mild transient proteinuria to frank nephrosis. We report a 2-month-old infant with CS who presented with only nephrotic syndrome (NS)...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28652757/transnasal-endoscopic-and-combined-intra-extranasal-approach-for-the-surgical-treatment-of-frontal-sinus-cerebrospinal-fluid-rhinorrhea
#19
Qintai Yang, Peng Li, Jiancong Huang, Weihao Wang, Shanyan Bian, Xuekun Huang, Xian Liu, Gehua Zhang
The aim of this study was to summarize and analyze the outcomes of frontal sinus cerebrospinal fluid rhinorrhea (FS-CSFR) treated by transnasal endoscopic and combined intra-extranasal approach. Clinical data on 20 cases of FS-CSFR patients from 2005 to 2013, with emphasis on the postoperative complications, clinical outcomes, and key technology involved in the combined intra-extranasal procedure, were retrospectively reviewed. Among the 20 cases, 12 were treated by combined intra-extranasal procedure; the other eight cases were initially treated by trans-nasal endoscopic approach alone, and five of them (5/8, 62...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28648251/immune-thrombocytopenia-of-childhood-responsive-to-tonsillectomy-in-the-setting-of-chronic-tonsillitis-a-case-report-and-literature-review
#20
Richard William Thompson, Anil Gungor
OBJECTIVES: Immune thrombocytopenia of childhood (platelet count <100,000/μL) is the most common cause of thrombocytopenia in children. Patients typically present with bruising and bleeding in the setting of thrombocytopenia. Although it is usually short-lived, some cases persist and are unresponsive to treatment. This can lead to exposure to a variety of treatment regimens including immunosuppressants and splenectomy. The goal of this report is to present a case of chronic ITP of childhood that responded to tonsillectomy addressing the tonsils as a source of chronic infection and inflammation triggering ITP...
November 23, 2016: American Journal of Otolaryngology
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