Infections and foreign bodies in ENT

Infections of the ear, nose and throat are common. The majority of these infections are managed by the primary care physicians and they settle with conservative and medical management. However, a small group can progress to become troublesome and develop complications to the extent that they may require surgical intervention. Some of the infections can lead to life-threatening complications, therefore awareness and correct diagnosis along with appropriate management is paramount. Foreign bodies in the ear, nose and throat are commonly encountered. The location and type of foreign body can have an implication on the urgency of action and the possible complications. In this article the common ENT infections and foreign bodies and their management are discussed.     

冷光源治疗化脓性扁桃体炎32例

[目的 ]观察冷光源治疗化脓性扁桃体炎的疗效 .[方法 ]将 6 4例化脓性扁桃体炎患儿随机分为治疗组与对照组 ,两组均静脉点滴青霉素 15～ 2 0万U/kg ,每日 1次 ,连用 3～ 5d .治疗组加用冷光源治疗 3～ 5d .[结果 ]治疗组疼痛消失时间、退热平均天数、疗程与对照组相比均明显地缩短 .[结论 ]青霉素加用冷光源治疗化脓性扁桃体炎疗效显著     

微波治疗慢性肥大性扁桃体炎167例临床总结

目的：解决传统慢性扁桃体炎手术治疗的出血问题,通过微波在扁桃体组织内辐射,达到了治疗不出血的效果。方法：以针状辐射器刺入病理扁桃体组织内,以65－96W功率使病理扁桃体组织升温,凝固,变性,坏死,脱落,达到治疗目的。结果：因针状辐射器刺入深度达腭扁桃体基底,故所有病例均一次治愈。结论：微波治疗慢性扁桃体炎具有简捷,安全,不出血,疗效确切的优点,是慢性扁桃体炎治疗史上有意义的科技创新的治疗方法,值得推广。     

慢性扁桃体炎病儿细胞免疫功能的变化

1目的　探讨慢性扁桃体炎病儿细胞免疫功能的变化及临床意义。2方法　采用碱性磷酸酶抗碱性磷酸酶法及红细胞酵母菌花环法 ,检测了 40例慢性扁桃体炎病儿及 30例健康儿童红细胞 C3b受体花环率 (E- C3bRR )、红细胞免疫复合物花环率 (E- ICR)、T淋巴细胞亚群和可溶性白细胞介素 2受体 (s IL - 2 R)的变化。3结果慢性扁桃体炎病儿外周血 T淋巴细胞亚群 CD4阳性细胞及 CD4/ CD8比值较对照组降低 (t=2 .10 ,3.70 ,P <0 .0 1,0 .0 5 ) ,CD8阳性细胞较对照组升高 (t=6 .83,P<0 .0 1) ;E- C3b RR,E- ICR较对照组降低 (t=10 .47,3.35 ,P<0 .0 1) ;血清中 s IL- 2 R水平较对照组升高 (t=9.11,P<0 .0 1) ;CD4/ CD8比值与 s IL- 2 R水平呈显著负相关 (r=- 0 .8436 ,P<0 .0 1)。4结论　慢性扁桃体炎病儿细胞免疫功能低下且紊乱。     

A Clinicopathologic Series of 22 Cases of Tonsillar Granulomas

Objectives Tonsils are uncommonly affected by granulomatous inflammation, often with an obscure cause. This study attempts to elucidate the nature of tonsillar granulomatous inflammation. Design Retrospective clinicopathologic review. Methods Twenty‐two cases of tonsillar granulomas diagnosed between 1940 and 1999 were retrieved from the files of the Armed Forces Institute of Pathology. H&E slides and a series of histochemical stains were reviewed, and patient follow‐up was obtained. Results There were 11 males and 11 females, aged 7 to 64 years (mean, 29.9 y). Most of the cases presented bilaterally (n = 19) with sore throat, dysphagia, and/or nasal obstruction. The clinical differential included chronic tonsillitis, tuberculosis, nonspecific infection, sarcoidosis, and a neoplasm. Histologically, the granulomas were focal and scattered, or diffuse, identified in the interfollicular zones (n = 16) and/or the germinal centers (n = 13), and occasionally associated with necrosis (n = 6). Based on histochemical and clinical follow‐up information, the etiology of the granulomas included sarcoidosis (n = 8), tuberculosis (n = 3), Hodgkin's lymphoma (n = 2), toxoplasmosis (n = 1), squamous cell carcinoma (n = 1), and no specific known cause (n = 7). Twelve patients were either alive at last follow‐up or had died with no evidence of disease (mean, 12.4 y), and 9 were either alive at last follow‐up or had died with disease (mean, 24.9 y). One patient was alive with unknown disease status (lost to follow‐up after 13.3 y). Conclusions Although a cause for tonsillar granulomas is frequently identified, a number may not develop an identifiable etiology, with the granulomas probably representing an exaggerated immune response to chronic tonsillitis. However, a careful work‐up must be conducted to exclude specific causes and avoid clinical mismanagement.     

Tonsillitis and chronic psoriasis

Although the relationship between streptococcal tonsillitis and acute guttate psoriasis is well recognized, its relationship to chronic forms of psoriasis is less established. In order to explore this further, the authors questioned 35 patients with severe psoriasis and 35 age-matched eczema controls about their history of significant sore throats (i.e. requiring a GP visit) and any resultant worsening of the skin condition. A third of the psoriasis patients reported recurrent sore throats which worsened their skin condition. This was true of only one (3%) of the 35 eczema controls. The authors discuss these findings in the context of recent laboratory work on the association between streptococcal infection and psoriasis.     

改进灼烙法对慢性扁桃体炎临床及免疫功能的研究

目的观察灼烙法治疗慢性扁桃体炎的疗效及其对患者T细胞亚群的影响.方法采用灼烙法治疗慢性扁桃体炎90例,随访6月评定疗效.治疗前及随访结束时分别检测患者T细胞亚群,评定其变化趋势.结果本组病例总有效率97.78%,治疗后T细胞亚群数明显提高.结论灼烙法治疗慢性扁桃体炎有效,并可提高患者T细胞亚群数目.     

改良烙法治疗慢性扁桃体炎30例

目的：观察改良烙法治疗慢性扁桃体炎的优势，科学地评价该方法的有效性和安全性。方法取符合纳入观察标准的慢性扁桃体炎患者30例，给予改良烙法治疗，观察治疗前及治疗1个月后扁桃体形态的改变及治疗过程中不良事件发生情况和治疗后半年内扁桃体疼痛危象发作次数等，根据疗效判定标准判断疗效。结果扁桃体形态均较治疗前显著缩小，100%消除其慢性炎症，其中治愈20例，好转10例，治疗后半年内扁桃体疼痛危象发作次数明显减少。结论改良烙法对慢性扁桃体炎的治疗具有良好的疗效，绝对安全可靠。     

Fusobacterium necrophorum findings in Denmark from 2010 to 2014 using data from the Danish microbiology database

Fusobacterium necrophorum findings in Denmark and estimation of the incidence of F. necrophorum bacteraemia was described using data from the nationwide Danish microbiology database (MiBa). All microbiological reports on any Fusobacterium species in Denmark were extracted for a period of 5 years from 2010 to 2014 from MiBa and from the local department of clinical microbiology. The overall incidence of F. necrophorum bacteraemia from 2010 to 2014 was 2.8 cases per million/year vs 9.4 in the age group 15–24 years. F. necrophorum was rare in blood cultures from children and middle‐aged patients and then raised again. However, 48 of 232 cases of Fusobacterium bacteraemia were not identified to species level, so the incidences of F. necrophorum bacteraemia may be underestimated in our study. F. necrophorum was found in throat swabs in the age group between 13 and 40 years and in otitis media in children below 2 years in those departments which performed anaerobic culture. The incidence of F. necrophorum bacteraemia found was comparable to earlier reported figures for Lemierre's syndrome. Fusobacterium bacteraemia should always be identified to species level.