Search PubMed⌕ Search

Biomedical subjects

S D Salman

Publications and source records attributed to S D Salman.

At least 19 recordsLinked to original sources
PubMed2000

Bacteriology of nontraumatic maxillary sinus mucoceles versus chronic sinusitis.

OBJECTIVE: To compare the bacteriology of maxillary sinus mucoceles to chronic sinusitis and understand the pathogenesis of nontraumatic maxillary sinus mucoceles (NTMSM). STUDY DESIGN: Retrospective review. METHODS: Review of intraoperative bacteriology culture results obtained in patients with NTMSM. Patients with history of facial trauma or previous paranasal sinus surgery were not included in the study. The results were compared to intraoperative cultures obtained from patients with chronic sinusitis (CS). RESULTS: The study groups consisted of 16 patients with NTMSM (9 male and 7 female patients) and 211 patients with CS (86 male and 125 female patients). Cultures in the NTMSM group were positive in 7 of 16 patients (44%) (four cultures had more than one isolate). There was no growth in cultures of 9 patients (56%). On the other hand, cultures in 176 patients with CS (83%) grew organisms (42 cultures had more than one isolate); there was no growth in 35 of 211 patients (17%) (P = .0007). The cultures grew aerobic bacteria in 7 of 16 (44%) and 160 of 211 (76%) patients of the NTMSM and CS groups, respectively. Anaerobic bacteria were detected in cultures of 2 of 16 patients (12.5%) with NTMSM compared with 13 of 211 patients (6.2%) in the CS group (P = .286). The most common pathogenic aerobe in the NTMSM group was alpha-hemolytic Streptococcus, while Staphylococcus aureus was the most common in the CS group. CONCLUSION: The bacteriology of maxillary sinus mucoceles is different from that of CS. The majority of patients with mucoceles have sterile intraoperative cultures. The data do not support infection as the main origin of NTMSM.

Adult↗
PubMed1999

Selection of antibiotics after incision and drainage of peritonsillar abscesses.

Despite the fact that peritonsillar abscess is the most common complication of acute tonsillitis, the treatment of peritonsillar abscess remains controversial. One element of controversy is the choice of antibiotics after drainage of the abscess. In an attempt to assess the effect of antibiotic choice on the treatment of peritonsillar abscess, we conducted a retrospective review of records from patients with peritonsillar abscess treated with incision and drainage. Our review identified 103 patients, comprising two groups: 58 patients treated with broad-spectrum intravenous antibiotics and 45 patients treated with intravenous penicillin alone. These patients were hospitalized after incision and drainage, and therefore their clinical courses and responses to therapy could be rigorously assessed. Characterization of illness based on patient age, temperature, and white blood cell count revealed similar severity of illness between the two groups. Comparison of clinical outcomes with respect to hours hospitalized (mean 44.3 +/- 6.6 and 38.3 +/- 7.1 hours, 95% confidence interval, for broad-spectrum and penicillin groups, respectively) and mean hours febrile (16.9 +/- 5.0 and 13.3 +/- 4.2 hours, 95% confidence interval) were not statistically significantly different (p = 0.222 and 0.269, respectively) between groups, indicating that broad-spectrum antibiotics failed to show greater efficacy than penicillin in the treatment of these patients. The microbiologic characteristics of these infections, failures of therapy, and complication rates were similar to those reported in the literature. These results suggest that intravenous penicillin remains an excellent choice for therapy in cases of peritonsillar abscess requiring parenteral antibiotics after drainage.

Adolescent↗
PubMed1999

Maxillary sinus mucoceles: clinical presentation and long-term results of endoscopic surgical treatment.

OBJECTIVE: To describe the clinical presentation of maxillary sinus mucoceles, understand their pathogenesis, and determine the long-term efficacy of the endoscopic surgical treatment. STUDY DESIGN: Retrospective review. METHODS: Thirteen consecutive patients who presented with maxillary sinus muco(pyo) celes were studied. Subjects with history of preceding sinus/nasal surgery or facial trauma were excluded. The presenting signs and symptoms, radiological findings, and surgical management were reviewed. RESULTS: There were six women and seven men with an age range of 31 to 71 years. Two patients had environmental allergies. Nine patients complained of cheek pressure or pain, six of nasal obstruction, and eight of nasal drainage. On endoscopic nasal examination, the medial wall of maxillary sinus was bulging with prolapsed middle meatal mucosa in 10; drainage was seen in 7, but none had polyps. The sinus involvement was limited to the maxillary sinus and the ipsilateral ethmoid on computed tomographic studies in 10 cases. Patients were treated with endoscopic ethmoidectomy, middle meatal antrostomy, and marsupialization of the mucocele. Intraoperative cultures grew organisms in five patients. Postoperative follow-up ranged between 10 and 66 months. Two patients required lysis of adhesions in the middle meatus, and one, revision antrostomy. All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa at latest follow-up. The presenting symptoms resolved or improved in 12 cases. CONCLUSIONS: The etiology of maxillary sinus mucoceles is not well understood. Mechanical obstruction or allergy or both do not seem to play an important role. An infectious origin is also not supported by the above data. Endoscopic sinus surgery is a reliable therapeutic measure with a favorable long-term outcome.

Endoscopy↗
PubMed1997

Analysis of pain and endoscopic sinus surgery for sinusitis.

This prospective clinical descriptive study was designed to see whether patients who had endoscopic sinus surgery for sinusitis had relief of pain, and whether they had new pain postoperatively. The sample was 252 consecutive patients who underwent endoscopic sinus surgery after presenting with inflammatory sinus disorders meeting specific clinical definitions of sinusitis and criteria for surgically treatable sinus disorders developed by the treating surgeon. Of the 252 consecutive endoscopic sinus surgery patients, 106 (42%) had no preoperative pain and 146 (58%) patients had preoperative sinus pain. At 6- to 12-month postoperative evaluations, patients with no preoperative pain did not develop any new postoperative pain. Among the 146 patients with preoperative pain, 82 (56%) had no pain, residual symptoms, or further sequelae, and were considered cured; 42 (29%) reported a marked improvement of pain or discomfort; 9 (6%) had the same degree of pain or discomfort as before; 3 (2%) reported worse pain or discomfort; and 10 (7%) reported new pain or discomfort. These results suggest that the application of consistent definitions and clinical criteria for various forms of surgically treatable sinusitis will more likely predict improvement of pain and discomfort following surgical treatment. The risk of developing new pain and discomfort following endoscopic sinus surgery in individuals without preoperative pain or discomfort is negligible. The risk of worsening pain or new pain was less than 10% in patients with preoperative pain. Ongoing efforts such as the International Conference on Sinus Disease in the development of consistent terminology, staging, and therapy, and future modifications from additional clinical experience, should result in more predictable and effective care in the surgical treatment for pain of sinus disease.

Endoscopy↗
PubMed1995

Rhinoscleroma treated with ciprofloxacin: a case report.

Rhinoscleroma, a chronic progressive infection of the nose and associated structures caused by Klebsiella rhinoscleromatis, has posed a therapeutic dilemma since its identification in the late 1800s. Although a number of antibiotics have been found to be effective in this relapsing disorder, the lengthy duration of treatment can lead to problems with adverse effects and compliance, especially with the traditional therapies of streptomycin and tetracycline. We report on a patient with extensive nasal rhinoscleroma who achieved pathologic and bacteriologic resolution during treatment with oral ciprofloxacin after previous courses of tetracycline and trimethoprim-sulfamethoxazole. Ciprofloxacin may prove to be useful in the therapy of rhinoscleroma because it is convenient for oral administration, achieves good tissue levels, is concentrated in macrophages, and is generally well tolerated as long-term therapy. As mentioned in a recent review of patients with rhinoscleroma at the Mayo Clinic, the fluoroquinolones deserve further study as potentially highly effective agents for this uncommon but significant infectious condition.

Adult↗
PubMed1994

Significance of false-positive auditory brainstem response: a clinical study.

Auditory brainstem response (ABR) is a good screening test for cerebellopontine angle (CPA) tumors and other retrocochlear diseases. The pathologic correlates of many cases with positive ABR remain unknown. A two-staged clinical study was performed to help us understand the significance of a false-positive ABR. In the first stage, data from 66 patients with abnormal ABR were reviewed. Nineteen patients had identifiable causes for the ABR abnormality, whereas 47 patients had no lesions identified. In the second phase of the study 21 of the 47 patients were re-evaluated with a minimum follow-up period of 1 year. A detailed interval history was obtained, and the work-up, including imaging studies, was repeated in an attempt to reach a diagnosis. One patient was found to have a CPA tumor, but for nine patients a definite final diagnosis could not be determined. The implications of abnormal ABR and normal initial imaging study are discussed, and a plan for the work-up of these patients is suggested.

Adult↗
PubMed1994

The diagnosis of sinusitis.

The diagnosis of sinusitis is usually based on evidence obtained from history taking and physical examination. The making of the diagnosis has been made easier recently by CT scanning and by the availability of the rigid Hopkins endoscopes. However, the diagnosis remains basically a clinical one. Radiologic and bacteriologic evidence may also help, but should be considered neither necessary nor required. Minor radiologic abnormalities are not infrequently seen in normal asymptomatic people and require no medical or surgical attention. Fungal sinusitis is on the increase. Sinusitis in children is briefly reviewed.

Child↗
PubMed1994

Sinusitis and headache.

The association of headache and sinusitis was studied in 207 patients who underwent surgery for chronic sinusitis that failed to respond to medical management. Sixty-nine percent of the patients had headaches and 31% did not. In 9% headache was the only symptom and the diagnosis of sinusitis was made on clinical and/or CT grounds. The pain was usually pressure in character, moderate in intensity and lasted for hours. Its location usually, but not always, pointed to the sinuses involved. Discreet sphenoid or ethmoid disease discovered on imaging may be responsible for midline pains. Sinusitis may also trigger or aggravate vascular headaches.

Adult↗
PubMed1994

Management of upper airway obstruction: intubation vs tracheotomy.

Management of the obstructed upper airway may be very challenging. It requires careful clinical evaluation as well as supportive laboratory data and physiologic monitoring. A team approach is essential. This paper is an overall review of the subject of airway control intended to guide health care providers dealing with such patients. Various options of intervention including endotracheal intubation, tracheotomy and transtracheal jet ventilation are discussed. The indications, advantages, disadvantages and potential complications of each of these methods are detailed. Recent advances in this field are described such as new tube material and technology, non-invasive physiologic monitoring (oxygen saturation measurements) and modifications of the surgical techniques.

Airway Obstruction↗
PubMed1993

Sinus CT scan: an essential in sinus disorders and surgery.

This paper stresses the importance of CT scans in the evaluation of sinus disorders and in providing valuable anatomic information to the sinus surgeon to reduce the risks of surgical complications. The scans may also detect discreet pathology, otherwise missed, that may be responsible for unexplained symptoms like headache, facial pains, cough, midfacial congestion and postnatal drip. The CT technique and limitations are briefly discussed. The MRI is not recommended as a routine study in sinus disorders.

Chronic Disease↗
PubMed1986

Head and neck war injuries: 10-year experience at the American University of Beirut Medical Center.

Lebanon has witnessed over the past 10 years fierce outbreaks of violence resulting in heavy casualties. Head and neck injuries secondary to bullets, shrapnel, and/or glass were quite frequent: 1,357 injuries in 1,021 patients were taken care of by members of the Department of Otolaryngology between 1975 and 1984. They were distributed as follows: (Formula: see text). Fractures of the mandible were treated by closed reduction in 54% of cases and by open reduction in 46%; 74% healed well and 26% required secondary surgery. Primary repair of oral cavity injuries resulted in healing in 68% of cases; 32% had dehiscences or fistulae. In around one-third of the orbital injuries, the orbital contents herniated into the maxillary sinus, so orbital floor repairs had to be done with good results in 82% of cases. The nasal fractures were treated by closed reduction in 75% of cases and open reduction when the wound was open in the rest. The overall infection rate was 12%. The most common offending organisms were, in order of frequency, S. aureus, P. aeruginosa, and E. coli.

Bacteria↗
PubMed1981

The evaluation of vertigo and the electronystagmogram.

A four-year experience in a Vestibular Clinic led the author to the unconventional opinion that the ENG does not often make a significant contribution in the routine evaluation of patients with vertigo or dizziness. A good history by the doctor is usually enough to make a diagnosis. Audiometry and office ice calorics are done routinely. More sophisticated tests are done if judged necessary. Around 10 per cent of the 300 consecutive cases seen at the clinic had no diagnosis. An ENG on these did not prove to be of help in a diagnosis or getting closer to one. This paper is an invitation to good clinical and synthetic judgement in days when more and more responsibility is delegated to sophisticated equipment.

Audiometry↗
PubMed1977

Myringoplasty as an office procedure: a new technique.

An office technique uses preserved dry temporalis fascia homograft to close eardrum perforations smaller than subtotal. A follow-up on 36 patients who under-went this technique revealed a 64% success rate and 11% partial success rate. If the patients whose eardrum remnants were atrophic or scarred with or without calcareous deposits (11 cases) were excluded, the success rate becomes 76% and the partial success rate 8%. This technique is therefore recommended for patients whose eardrum remnants are healthy because it is simple and it saves time and money. In case of failure, the situation does not become worse and a regular myringoplasty may then be performed.

Adolescent↗
PubMed1975

Fatal bronchopulmonary hemorrhage due to unrecognized amyloidosis.

Amyloidosis of the larynx and tracheobronchial tree is usually described as a nonbleeding lesion. However, severe hemorrhage, often fatal, is reported in other organs involved by this disease. A fatal bronchopulmonary hemorrhage was found in a 23-year-old woman unsuspected of having amyloidosis. The possible causes of hemorrhage in this disease are a vessel wall involvement or disturbances of the blood clotting mechanism.

Adult↗