耳鼻咽喉科人类免疫缺陷病毒抗体筛查实验阳性患者临床分析

目的:了解我院耳鼻咽喉科人类免疫缺陷病毒(HIV)筛查实验阳性患者情况,并探讨其临床特性.方法:对2005-2010年耳鼻咽喉科采用酶联免疫吸附试验筛查HIV阳性患者,进行免疫印迹试验确认试验,分析其HIV阳性结果和临床表现.结果:经HIV筛查,阳性患者10例,确认阳性9例,符合率为90.00%.结论:近年来耳鼻咽喉科HIV抗体筛查实验阳性患者有增加趋势,有假阳性患者.HIV/AIDS患者临床表现因急性期、无症状期及艾滋病期不同表现出临床多样性,重视HIV/AIDS诊断对预防医源性感染、医疗人员职业暴露和减少医患纠纷都有重要意义.     

艾滋病在咽喉部表现6例

目的 通过对以咽痛和(或)发热为首诊症状的人类免疫缺陷病毒(HIV)感染者的分析,提高耳鼻喉科医生对该病的认识,避免误诊。方法 对首诊于耳鼻喉科的6 例HIV感染者的病史、临床表现及实验室检查等进行回顾性分析。结果 6例患者中3例为扁桃体炎,2例为口腔念珠菌感染,1例为咽喉部Kaposi肉瘤。结论 以咽痛为首诊的艾滋病患者,结合病史、临床表现及血清学检查可确诊,耳鼻喉科医生应予以重视。     

以突发性聋首诊的HIV感染患者两例报告

目的探讨人类免疫缺陷病毒(HIV)感染患者突发性聋的临床表现、诊断和治疗。方法回顾性分析2例HIV感染患者突发感音神经性聋的临床症状、体征、血清学检测及疗效。结果 2例患者分别以突发右耳听力下降6小时和12小时入院,无其他症状,全身体检无异常,入院诊断均为"右耳突聋",血清学检测均发现HIV抗体阳性。经给予营养神经及改善微循环等药物治疗,听力无明显改善。2例均经北京市疾控中心确诊为HIV感染者后,转至传染病专科医院继续治疗。结论 HIV感染患者可以以突发性聋或耳鸣首发起病,临床上易漏诊;对于突发性聋患者,应常规行感染性疾病筛查以明确诊断。     

HIV阳性孕妇鼻出血32例分析

妇女感染人类免疫缺陷病毒(HumanImmun odeficiencyVirus,HIV)占世界感染HIV总人数的一半左右,黑人妇女感染率更高,可达60%～70%左右,在我国也有逐年增多的趋势。妊娠期妇女因鼻腔局部因素和内分泌的变化鼻出血并不少见,但HIV阳性妊娠妇女鼻出血的情况较少见。作者1999年9月～2     

抗-HIV阳性患者扁桃体手术探讨

目的探讨抗-HⅣ阳性患者行扁桃体手术的可行性。方法应用放射免疫沉淀试验法检出36 例抗-HⅣ阳性慢性扁桃体炎患者并行扁桃体切除术。6例在全麻下行扁桃体切除术。4例8岁患儿表面 麻醉后行挤切术，其余26例均在局麻下坐位手术。另取30例抗体阴性患者作对照组。术后分别观察并发 症的发生率及治疗对策。结果36例患者均顺利渡过手术。1例因局部伤口感染术后6d发生扁桃体术后继 发性出血，1例继发肺部感染，并发症发生率为5.6％。结论扁桃体切除术亦适用于抗-HⅣ阳性患者。术 后严密观察、及时发现和处理并发症至关重要。     

获得性免疫缺陷综合征合并中耳感染的临床观察

目的探讨获得性免疫缺陷综合征(AIDS)合并中耳感染的临床特点.方法回顾分析在坦桑尼亚姆希比利大学医学院医疗中心工作期间收治的20例AIDS合并中耳感染患者的临床资料.结果AIDS合并中耳感染患者服中药和全身用抗生素,局部用抗生素滴耳,Ⅱ期患者的症状暂时可得到缓解;Ⅲ～Ⅳ期患者中,2例死于颅内感染,1例死于肺结核,余者均进行性加重.结论AIDS合并中耳感染的患者发病急,病程短,发病后症状严重,伴有多脏器感染.虽有严重感染,但WBC不升高者,需查HIV.     

获得性免疫缺陷综合征并发颈部感染1例

患者 ,男 ,3 8岁。双侧颈部疼痛性肿物并发热2 0d ,以“颈部淋巴结炎”在外院经大量抗生素静脉滴注 ,症状无明显缓解。鼻咽部CT报告鼻咽左侧壁软组织增厚 ,考虑鼻咽癌 ;鼻咽部活检示慢性炎症。于 2 0 0 3年 1月 2 5日转入我科治疗。体检 :体温 3 8℃ ,精神差 ,消瘦貌 ,左侧颈部胸锁乳突肌外侧缘见一约 3 .0cm× 4.0cm× 4.0cm大小、左下颌角处见一约 2 .0cm× 1 .5cm× 1 .5cm大小、右侧颈部胸锁乳突肌外侧缘见一约 2 .0cm× 2 .5cm× 2 .5cm大小的融合性肿物 ,局部红 ,皮温高 ,质中 ,固定 ,压痛明显 ,无波动感。专科检查 :鼻咽部稍充血 ,…     

与人类免疫缺陷病毒相关性耳鼻咽喉部卡波济肉瘤21例报告

报告２１例与人类免疫缺陷病毒（ＨＩＶ）相关性耳鼻咽喉部卡波济肉瘤，其主要局部表现是鼻出血、鼻塞、咽喉干燥、异物感及结节状新生物，并对ＨＩＶ感染与卡波济肉瘤的关系、病例特点及诊断依据进行讨论。     

53例全身性疾病在咽喉部的临床表现及诊治分析

近年来,由于流行病学的变化,抗生素的广泛应用及滥用,系统性疾病在咽喉部的发病情况表现出一些新的特点。本文对1997年10月～2004年12月就诊我科的53例全身性疾病患者进行回顾性分析,报告如下。     

人咽喉部良恶性肿瘤与乳头状瘤病毒关系的研究

采用免疫组化及ＤＮＡ斑点杂交技术检测人咽喉部乳头状瘤及鳞状细胞癌组织中人乳头状瘤病毒（ＨＰＶ）壳蛋白抗原及ＨＰＶ６、１１、１６、１８型ＤＮＡ。１１例乳头状瘤ＨＰＶ抗原与ＨＰＶ ＤＮＡ阳性率均为４５．５％。２２例鳞状细胞癌ＨＰＶ抗原阳性率２２．７％，ＨＰＶ ＤＮＡ阳性率２７．３％。乳头状瘤ＨＰＶ检出率与组织学检查的结果相符。提示咽喉部乳头状瘤及鳞状细胞癌的发生、发展与ＨＰＶ感染有关。     

艾滋病的耳鼻咽喉—头颈部临床表现

目的：识别艾滋病在耳鼻咽喉－头颈部的临床表现,探讨其治疗方法。方法：回顾性总结赞比亚６８例ＨＩＶ阳性患者的临床资料。结果：６８例发病年龄３个月－４６岁。其中急,慢性化脓性中耳炎１７例,萎缩性鼻为４例,鼻出血５例,慢性扁桃体炎１０例,口腔,咽喉部溃疡９例,颌下蜂窝织炎２例,腮区肿块９例,颈部及耳后肿块１２例。１８例合并肺结核,贫血,腹泻。     

Varicella zoster virus infection of the pharynx and larynx with multiple cranial neuropathies

Varicella zoster virus (VZV) infection of the head and neck region may present with various clinical symptoms, involving different entities and different routes of viral spreading. We present a case of VZV infection of the pharynx and larynx with multiple cranial nerve (CN) neuropathies (CN VII, VIII, IX, and X) of a 52-year-old woman who complained of the sudden onset of hoarseness, odynophagia, dysphagia, and hearing loss in the left ear, followed by left-side facial weakness lasting for 1 week. Endoscopic examination revealed multiple mucosal erosions over the oropharynx, with extension upward to the nasopharynx and downward to the mucosa overlying the epiglottis, arytenoid, and vocal cord. All of these lesions tended to lateralize to the left side, suggesting a VZV infection diagnosis; this was confirmed by polymerase chain reaction on eruptional exudates, as well as serologic examination.     

A critical analysis of human immunodeficiency virus transmission using human cartilage allografts

Summary Allogeneic cartilage represents an important source of tissue for reconstructive surgery in the head and neck. The use of allografts is now being discussed because of the possible transmission of the human immunodeficiency virus (HIV). The receptor for HIV in most cell types is the CD-4 molecule. Since cartilage is a popular homograft source, the purpose of this study was to investigate the presence of CD-4 molecules on cartilage tissue as detected with an immunoperoxidase staining and immunofluorescence flow cytometric analysis using a monoclonal antibody. Our results indicate clearly the absence of the HIV receptor on human cartilage tissue. We have concluded therefore that normal cartilage tissue cannot be infected by HIV, at least not through a CD-4-dependent mechanism.     

Audiologic and vestibular findings in a sample of human immunodeficiency virus type-1-infected Mexican children under highly active antiretroviral therapy

OBJECTIVE: There is little information about audiologic and vestibular disorders in pediatric patients infected with the Human Immunodeficiency Virus type-1 (HIV-1). The aim of this study was to evaluate audiologic and vestibular disorders in a sample of HIV-1-infected children receiving Highly Active Antiretroviral Therapy. METHODS: Patients underwent pure tone audiometry, speech discrimination testing, auditory brainstem responses, electronystagmography, and rotatory testing. HIV-1 viral load and absolute CD4+ cell counts were registered. RESULTS: Twenty-three patients were included, aged 4.5 years (median, range 5 months to 16 years). Pure tone audiometry was carried out in 12 children over 4 years of age: 4 (33%) showed hearing loss, 2 were conductive. Auditory brainstem responses were measured in all 23 patients, suggesting conductive hearing loss in 6 and sensorineural hearing loss in 2. Most patients with conductive hearing loss had the antecedent of acute or chronic suppurative otitis media but with dry ears at the time of evaluation (p=0.003). Abnormal prolongations of interwave intervals in auditory brainstem responses were observed in 3 children (13%, 4 ears), an abnormal morphology in different components of auditory brainstem responses in 4 (17.4%, 7 ears), and abnormal amplitude patterns in 11 patients (48%, 17 ears). Vestibular tests were abnormal in all six patients tested, with asymmetries in caloric and rotatory tests. Although differences were not significant, in general, audiologic abnormalities were more frequent in patients with more prolonged HIV-1 infections, higher viral loads, or lower absolute CD4+ cell counts. CONCLUSIONS: Conductive hearing loss associated with previous otitis media events, abnormalities in auditory brainstem responses suggesting disorders at different levels of the auditory pathways, and unilateral vestibular hyporeflexia were frequent findings in our sample of HIV-1-infected children under Highly Active Antiretroviral Therapy. These findings suggest that HIV-1-infected children should be submitted to audiologic and vestibular evaluation as early as possible in order to reduce their impact on the psychosocial development of these patients.     

Thirty years of the human immunodeficiency virus epidemic and beyond

After more than 30 years of battling a global epidemic, the prospect of eliminating human immunodeficiency virus （HIV） as the most challenging infectious disease of the modern era is within our reach. Major scientific discoveries about the virus responsible for this immunodeficiency disease state, including its pathogenesis, transmission patterns and clinical course, have led to the development of potent antiretroviral drugs that offer great hopes in HIV treatment and prevention. Although these agents and many others still in development and testing are capable of effectively suppressing viral replication and survival, the medical management of HIV infection at the individual and the population levels remains challenging. Timely initiation of antiretroviral drugs, adherence to the appropriate therapeutic regimens, effective use of these agents in the pre and post-exposure prophylaxis contexts, treatment of comorbid conditions and addressin~ social and nsvcholo2ical factors involved in the care of individuals continue to be important considerations.     

窄带成像技术在咽喉肿瘤诊治中的应用

咽喉部恶性肿瘤是一种临床发病率低,发现时已到晚期,五年生存率低的一种疾病。对于如何提高咽喉部恶性肿瘤的早期发现这一问题,严重困扰着耳鼻喉科医师。目前咽喉部最常用的检查是白光电子喉镜。随着窄带电子喉镜(NBI)的出现,通过观察咽喉部黏膜及黏膜下毛细血管袢的形态,相对于普通白光电子喉镜,为早期发现咽喉部恶性肿瘤提供了可能性,同时在术中应用做到微创治疗及术后随访均起到重大作用。现就从NBI的起源原理,在咽喉恶性肿瘤中的应用优点、难点、临床应用发展前景等方面综述NBI技术在咽喉恶性肿瘤疾病中的应用。     

Management of benign lymphoepithelial lesions of the parotid gland in human immunodeficiency virus-positive patients

The diagnosis and radiotherapeutic treatment of these HIV-associated benign lympepithelilial lesions in the parotid gland are discussed. As an example of these lesions, a case is presented involving a 43-year-old HIV-infected man with a 2-year history of enlargements in both parotid glands. After evaluation by computer tomography and cytology, the diagnosis of benign lymphoepithelial lesions was made. Treatment by low-dose radiotherapy (15 Gy) caused regression of both lesions. The lesion on the left regressed completely, but the one on the right side responded only partially . A second course of high-dose radiotherapy (24 Gy) to the right lesion caused regression to a cosmetically acceptable size. Received: 20 March 1998 / Accepted: 1 April 1998     

The morphometric development of the fetal larynx during the fetal period

OBJECTIVE: The aim of the present study was to investigate morphometric growth patterns of the cartilaginous components and vocal cords in human fetal larynx. METHODS: This study was performed in the Anatomy Department of Meram Medicine Faculty in 2007. The fetuses were obtained from the Gynaecology Department of the Meram Medicine Faculty of Selcuk University, and Dr. Faruk Sükan Maternity Hospital (Konya, Turkey). Forty spontaneously aborted fetuses (25 males and 15 females) without detectable malformations were evaluated. The dimensions of the larynx and its cartilaginous components were measured and the relationship between the obtained data was statistically assessed with Student's t-test. RESULTS: Correlations were found between the cartilaginous components, size of the larynx, and gestational age. No gender differences were identified. The anatomical variations in the epiglottis cartilage dimensions and types were found in 15% of cases. The foramen thyroideum was observed in 12.5% of cases. CONCLUSION: The data of this study may contribute to the knowledge of the fetal larynx regarding laryngomalacia.