Biomedical subjects
Publications and source records attributed to S Kristensen.
Previous investigations have demonstrated a good uptake of metronidazole in the middle ear mucosa. We have now presented a trial study in which there was also a significant uptake of metronidazole in the cholesteatomatous membranes of patients with chronic otitis media.
A prospective open and controlled study of perioperative antibiotics was conducted in patients with chronic otitis media (COM). Drug efficacy was found in a subgroup of 26 patients, who were characterized by preoperative aural drainage culturing Pseudomonas aeruginosa. Fourteen of these patients were randomized to receive ceftazidime (cephalosporin) for 5 days at the operation, while 12 had no antibiotic treatment. The occurrence of subsequent aural drainage was compared with the actual clinical and microbiological conditions of the ears 2 months after the operation; statistically significant differences were found in favor of the group treated with ceftazidime. Further studies must define the role of ceftazidime and other antibiotics in the management of patients with COM.
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A retrospective study of zygomatic fractures is presented in order to analyse late complications and to evaluate the different radiographic classifications. The study comprises 109 patients with 111 zygomatic fractures. The aetiology was violence in 39% and traffic accidents in 28%. Associated fractures of the craniofacial skeleton occurred in 42% of the patients. Seventy-two patients were available for the follow-up study. Malar flattening was found in 16% of the patients operated on. Thirty-four per cent of the patients had sensory disturbances, 6% had enophthalmos, and 1% had diplopia. Classifications of zygomatic fractures are reviewed. The fractures in the current study were grouped in accordance with the classifications of Knight & North and Larsen & Thomsen. Neither of these classifications was found to be useful in the preoperative evaluation of the postreductive fracture stability. The most reliable method of evaluating this stability is the preoperative evaluation, but CT classification systems may in the future demonstrate their value.
The word trismus, from the Greek 'trismos', is defined as a prolonged, tetanic spasm of the jaw muscles by which the normal opening of the mouth is restricted (locked jaw). The designation was originally used only in tetanus, but as inability to open the mouth may be seen in a variety of conditions, the term is currently used in restricted jaw movement regardless of aetiology. As the literature on the subject mainly consists of case reports, the authors have reviewed the pathogenesis, aetiology and management of trismus.
An unusual cause of life-threatening stridor in infancy due to a congenital lateral saccular cyst of the larynx in association with an upper respiratory infection is presented. The literature is reviewed. The histopathogenesis, classification, clinical manifestations, and therapeutical principles of congenital laryngeal cysts are discussed. As almost 50% of the reported cases of congenital laryngeal cysts were diagnosed at autopsy, the gravity and importance of early recognition of these lesions must be stressed to the pediatrician and otolaryngologist.
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A case of Schneiderian papilloma of the nasal septum is presented. The condition is rare, as indicated by a review of previously published cases. The clinical course of the lesion suggests that it behaves like Schneiderian papillomas elsewhere in the nasal cavity and paranasal sinuses. The need for aggressive surgical management and careful follow-up is emphasized.
Following a minimum observation time of 14 months, 74 patients having undergone surgical correction of prominent ears were re-examined. The applied surgical technique was modified from Stenström and Warrer utilizing the scoring technique and subcutaneous mattress chrome catgut sutures for fixation. Satisfactory results were achieved in more than 95 per cent of the patients, when assessed by both the patient and the surgeon. Only few complications were revealed.
Bilateral peritonsillar abscesses are rare and often not diagnosed until tonsillectomy. As the condition may create diagnostic problems and serious complications, a case history is presented. The importance of rapid otorhinolaryngological examination and treatment is stressed.
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Squamous odontogenic tumour (SOT) is a rare benign odontogenic neoplasm, apparently arising from rests of Malassez. It was first described in 1975 and since then only 17 cases have been recorded in the literature. A new, not previously reported, characteristic case of SOT is presented in connection with a review of the literature. It is concluded that the lesion occurs with equal frequency in the maxilla and mandible and now and then multifocally. Maxillary lesions seem to grow more aggressively than do mandibular ones. The symptoms are modest. SOT has a characteristic pathologic picture which differs decisively from ameloblastoma and which, in connection with its benign nature, warrants the classification of SOT. Although most cases have been treated by conservative surgical therapy without recurrence, there are cases, especially in the maxilla with diffuse lesions, which have required en bloc resection or hemimaxillectomy. The diagnostic problems are stressed and recommendations are made for the pathologist and the surgeon to pay attention to this rare but benign tumour.
Hibernoma is the designation for a rare, benign, soft-tissue tumour composed of cells similar to those of brown adipose tissue. Review of the world literature reveals about 80 cases, but only six hibernomas in the cervical region have previously been reported. A case of cervical hibernoma showing descending behaviour is presented, and the histological, histogenetical, and clinical features of hibernomas are discussed. It is stated that the tumours are adequately treated by local excision, as the neoplasms are histologically and clinically benign, but the extensive vascularity may cause troublesome bleeding in some instances.
Nasal Schneiderian papillomas are unique lesions involving the mucosa of the nasal cavity and paranasal sinuses. Most often epidermoid in histological appearance, they favour 2 sites: the septum and the lateral wall of the nasal cavity. The medical literature on these tumours contains a plethora of contradictions concerning the nomenclature and no less than 54 separate designations are used. The synonyms are discussed and the term Schneiderian papilloma is proposed as the most suitable alternative. This study includes 83 patients with Schneiderian papillomas in whom the history, clinical and radiological findings, treatment procedures, pathological sections, recurrences, and associated malignancies were analyzed. Histological and clinical features were not helpful in predicting recurrence, but the recurrence rate was related to the treatment modalities; with 17% recurrences using an extranasal approach (lateral rhinotomy) and 59% using intranasal approach with limited excision. Schneiderian papillomas were associated with squamous cell carcinoma in 7 patients. Simultaneous papilloma and carcinoma were demonstrated in 4 patients at presentation (5%) and subsequently developing carcinoma in 3 patients (4%). As recurrences are frequent after inadequate removal and as association with maligancies may occur in both septal and lateral wall papillomas, radical aggressive surgery, thorough histological examination of the entire specimen, and careful follow-up are advocated.
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