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.     

小儿热速清颗粒联合抗生素治疗小儿急性化脓性扁桃体炎的临床观察

目的:观察小儿热速清口服液联合抗生素治疗小儿急性化脓性扁桃体炎的临床疗效。方法:选取2013年1月至2015年12月在北京市大兴区人民医院儿科就诊的急性化脓性扁桃体炎患儿300例,按照随机数字表法均分为观察组和对照组,每组150例。对照组患儿给予阿奇霉素干混悬剂;观察组患儿除了对照组治疗的基础上,给予小儿热速清颗粒进行治疗,2组患儿治疗疗程均为5 d。观察2组患儿退热时间、咽痛消失时间,疗效情况,白细胞计数变化,C反应蛋白水平,治疗前后T淋巴细胞及不良反应发生情况。结果:观察组患儿平均退热时间和咽痛消失时间观察组均短于对照组,疗效明显优于对照组,2组治疗后白细胞计数和C反应蛋白水平均降低,观察组明显低于对照组,差异均有统计学意义(P0.05);治疗前后2组患儿CD4~+/CD3~+、CD8~+/CD3~+、CD4~+/CD8~+比较差异均有统计学意义(P0.05)。观察组治疗前后CD8~+/CD3~+比较,差异无统计学意义(P0.05)。2组患儿不良反应发生率比较,差异无统计学意义(P0.05)。结论:在抗生素的基础上加用小儿热速清颗粒治疗小儿急性化脓性扁桃体炎的疗效值得肯定,安全性好,适合临床推广运用。     

六神胶囊联合头孢呋辛酯片治疗急性扁桃体炎的临床效果

目的 观察六神胶囊联合头孢呋辛酯片治疗急性扁桃体炎的临床效果。方法 将我院收治的84例急性扁桃体炎患者随机分为治疗组和对照组,各42例。治疗组给予六神胶囊联合头孢呋辛酯片治疗,对照组给予头孢呋辛脂片治疗。比较两组的临床疗效、中医证候积分、临床症状消失时间及炎症因子水平。结果 治疗组的治疗总有效率高于对照组（P<0.05）。治疗后,治疗组的主症、次症积分均低于对照组（P<0.05）。治疗后,治疗组的体温恢复时间、咽痛消失时间、扁桃体充血肿大消失时间、脓性分泌物消失时间均短于对照组（P<0.05）。治疗后,治疗组的血清TNF-α、IL-1β、IL-6、CRP、PCT、G-CSF水平低于对照组（P<0.05）。结论 六神胶囊联合头孢呋辛酯片可显著减轻急性扁桃体炎患者的临床症状、炎症反应,临床疗效显著。