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At least 613 records · Page 34Linked to original sources
PubMed1993

[Usefulness of carotid sinus massage for Doppler quantification of mitral stenosis in sinus rhythm].

The quantification of mitral stenosis by pressure half-time method may be difficult in sinus rhythm with short deceleration slopes. To evaluate the usefulness of carotid sinus massage (CSM) for measuring mitral valve area by pressure half-time, 80 consecutive patients with mitral stenosis in sinus rhythm underwent a echo-Doppler study at basal heart rate and during right CSM. In both situations we measured: heart rate, mitral area by pressure half-time and E-F interval (time from E peak velocity to onset of atrial contraction). In 38 consecutive patients we also determined the mitral area by planimetry. The study group was divided into patients with basal E-F interval < or = 150 ms and a HR > or = 75 bpm (group A, 28 patients [35%]) and those with a basal E-F interval > 150 ms who showed a heart rate < 75 bpm (group B, 52 patients). In the group A, the values obtained at basal heart rate vs after CSM were: heart rate, 86 +/- 9 vs 61.6 +/- 10.5 lpm; E-F interval, 109 +/- 33 vs 372 +/- 136 ms; mitral area, 1.88 +/- 0.5 vs 1.23 +/- 0.29 cm2 (p < 0.001). In the group B, these values were: 69.7 +/- 6.6 vs 53 +/- 11 bpm, 253 +/- 60 vs 510 +/- 212 ms y 1.34 +/- 0.3 vs 1.18 +/- 0.32 cm2, respectively (p < 0.01). Mean differences in Doppler mitral areas between both situations for groups A and B were: 0.63 +/- 0.3 cm2 and 0.17 +/- 0.1 cm2, respectively (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

[Mucormycosis-actinomycosis and caseous dental sinusitis associated with sinusal foreign body].

The authors report an uncommon case of caseous dental sinusitis with infection or superinfection by mocorales and actinomycetes. The patient was healthy, without diabetes mellitus, but was treated for lymphoma 18 years before. This observation leads to a discussion of nosologic, diagnostic and therapeutic features of caseous sinusitis, dental or not, fungal or not, which are often or too often called aspergillosis sinusitis. The recovery of the patient was complete after surgery, amphotericin B and hyperbaric oxygen.

Actinomycosis, Cervicofacial↗
PubMed1997

[Treatment of acute sinusitis using sinus catheter IaMIK-3].

Potentialities of a new design of sinus-catheter YMIK-3 are considered in the treatment of 68 patients with acute sinusitis. Essential details of the procedure are described. A mechanism of action of controlled pressure on nasal mucosa edema is specified. The use of YMIK-3 catheter has the advantage of reduced duration of the procedure, low traumaticity for patients, wide adjustment range for the patient's size. In the block of the sinus shunt the delayed procedure is recommended.

Acute Disease↗
PubMed1997

Radiofrequency catheter modification of sinus node for inappropriate sinus tachycardia: a case report.

We present here, the case of a 22-year-old male suffering from persistent tachycardia for the past 3 years. His resting pulse rate was rarely below 100 beats/min, and it frequently increased to as high as 150 beats/min even after a minimal of activity. Associated symptoms included palpitation, chest tightness, dyspnea and presyncope, either during rest or with exercise. Propranolol and verapamil could not control the tachycardia. The application of radiofrequency energy to an area in the superior right atrium that demonstrated a discrete electrogram with earliest endocardial activation during tachycardia resulted in a decrease in sinus rate from 120 beats/min to 70 beats/min. Follow-up on Holter monitor, performed one month later, demonstrated an average heart rate of 84 beats/min (range 60-125). In exercise tolerance test, the patient exercised for 9 minutes, achieving a maximum heart rate of 140 beats/min. This patient remained asymptomatic without any antiarrhythmic drug during the 3-month follow-up period. Medical management in case of patients showing disabling inappropriate sinus tachycardia refractory, sinus node modification could be considered as an suitable alternative to complete atrioventricular junctional ablation.

Adult↗
PubMed1997

Long-term follow-up of aviators after functional endoscopic sinus surgery for sinus barotrauma.

Prior to endonasal endoscopic advances for the treatment of sinus disease, surgical results for aviators with recurrent sinus barotrauma (RSB) were inconsistent. Between 1988 and 1992, 54 aviators, who were permanently or temporarily grounded, underwent functional endoscopic sinus (FES) surgery in an attempt to return them to active flying status. Follow-up in the immediate postoperative period revealed that 98% of these aviators returned to active flight duty. A questionnaire was mailed to each of these aviators to compare their preoperative and long-term postoperative symptoms and determine their current flying status. Long-term follow-up time ranged from 20 to 72 mo with average of 48 mo. Of the aviators who responded to the survey, 92% have continued their flying duties and do not report difficulties with RSB. We conclude that FES surgery is effective in the short- and long-term management RSB in aviators.

Aerospace Medicine↗
PubMed1998

Antibiotic treatment of patients with mucosal thickening in the paranasal sinuses, and validation of cut-off points in sinus CT.

We compared the efficacy of penicillin V and amoxycillin treatment with placebo in 70 adult patients from Norwegian family practice with a clinical diagnosis of acute sinusitis and mucosal thickening on CT, but without fluid level or total opacification. The study was randomized and double-blind. Three different outcomes were evaluated; subjective status after 10 days of treatment, difference in clinical score between day 0 and day 10, and duration of the illness episode. Amoxycillin and penicillin V gave no better response to treatment than placebo, evaluated by all three outcome measures. The median duration of the sinusitis episode was 10 days in the amoxycillin- and placebo groups and 13 days in the penicillin-V group. In patients with a clinical diagnosis of acute sinusitis, fluid level and total opacification on CT are good criteria to differentiate between groups of patients that need or do not need antibiotic treatment.

Acute Disease↗
PubMed1998

Olfactory function after functional endoscopic sinus surgery for chronic sinusitis.

One hundred and fifteen patients suffering from chronic sinusitis were observed to analyse the prevalence of olfactory dysfunction and the influence of FESS. Pre-operative questionnaires were supplemented by examination of olfactory thresholds and discrimination. Pre-operatively, 58% of the collective were aware or complained of any olfactory deficit. However, the olfactory tests demonstrated that of the collective 52% were hyposmic and 31% anosmic. Eight per cent of the hyposmic patients presented with an isolated reduction of their ability to discriminate odours. Post-operative improvements were found in 70%. Normosmia was post-operatively achieved in 25% of the hyposmic patients, but only in 5% of the anosmic patients. Olfaction changed to the worse in 8% after FESS. Therefore, the prevalence of olfactory dysfunction in chronic sinusitis is pre-operatively higher, and the rate of improvement is lower than generally assumed. The extent of sinus disease as measured by the degree of intranasal polyposis correlates with olfactory dysfunction. Resections of the middle turbinate may have a negative effect on olfaction, due to damage to the olfactory fila or alteration of the normal aerodynamic pattern within the olfactory cleft. However, this hypothesis is based on a few observations and needs to be verified by further investigations.

Adolescent↗
PubMedDate not supplied

Paranasal sinus radiology, Part 4A: Maxillary sinuses.

The maxillary sinus is frequently involved by inflammatory change. It is also the sinus that is most affected by intrinsic or nearby neoplasms. Since neoplasia and inflammatory disease may mimic each other, radiologic examination often becomes the principal means of differentiating them. Principles of radiologic diagnosis, with attention to changes in the various bony margins in maxillary disease processes, form the basis of this article.

Adolescent↗
PubMedDate not supplied

Functional endoscopic sinus surgery for isolated sphenoid sinus disease.

BACKGROUND: This article reviews 12 cases of isolated sphenoid sinus disease: chronic inflammatory sinusitis (7), mucoceles (2), aspergillus lesions (2), and isolated polyp (1). METHODS: Criteria for diagnosis were based on clinical symptoms, nasal endoscopic evaluation, and computed tomography (CT). Magnetic resonance imaging was used only in cases of bone erosion and when patients presented with vision problems. All patients were treated by functional endoscopic sphenoidotomy. Any postoperative complications were noted. CONCLUSION: The reported good results, on the basis of regression of functional symptoms and with nasal endoscopic and CT evaluation, suggest that intranasal sphenoidotomy under endoscopic control is a safe and effective method of treatment of nonmalignant isolated sphenoid disease. The mean follow-up is 26 months.

Adult↗
PubMed2004

Recurrence rates after endoscopic sinus surgery for massive sinus polyposis.

BACKGROUND AND OBJECTIVES: Most studies on outcome after endoscopic sinus surgery (ESS) include patients with varying degrees of disease severity. Recurrence rates cited by those studies may not apply to the subset of patients with severe polyposis. Our aim is to provide reference information for recurrence rates and need for revision surgery in patients with severe disease. STUDY DESIGN, PATIENTS, AND METHODS: Review of patients with severe polyposis with a minimum Lund-McKay score of 16 and with a Kennedy computed tomography stage 3 or 4. Data collection included demographics, presence of asthma or documented allergy, history of previous surgery, extent of surgery, preoperative and postoperative management, recurrence rates, revision surgery rates, and follow-up. RESULTS: One hundred and eighteen records were reviewed. Fifty-nine (50%) patients had asthma, and 93 (79%) had documented allergy. All patients required extensive bilateral nasal polypectomy, complete anterior and posterior ethmoidectomy, and maxillary sinusotomy. One hundred (85%) also had frontal or sphenoid sinusotomy. Follow-up ranged from 12 to 168 (median 40) months. Seventy-one (60%) developed recurrent polyposis. Fifty-five (47%) were advised to undergo revision surgery, and 32 (27%) underwent surgery. History of previous sinus surgery or asthma predicted higher recurrence (P <.005, P <.001) and revision surgery rates (P =.02, P <.001). History of allergy also predicted recurrence and need for revision (P <.001, P <.001). CONCLUSIONS: Recurrence rates after ESS for severe polyposis are significant. In our study, patients with asthma are at higher risk of recurrence.

Adult↗
PubMed1983

Cancer of the paranasal sinuses with particular reference to maxillary sinus cancer.

Paranasal sinus cancer usually presents at an advanced stage and of 261 patients seen between the years 1964-79 in the Toronto centre only 214 patients could be treated with curative intent, 43% surviving five years. (The overall survival for all patients seen is 33%). Of 112 patients with maxillary sinus cancer, half were suitable for management by radical radiation plus surgery with a corrected five year survival of 51%. Patients with residual disease in the surgical specimen fared badly with a corrected five year survival of 29% compared to 76% for those patients with no residual disease in the surgical specimen. The contribution of surgery is called into question since relapse occurred in seven out of the 26 patients who had no residual disease in the operation specimen, while the operation failed to prevent relapse in 24 out of the 31 patients whose operation specimen did contain residual disease. The group treated by radical radiation alone had a corrected survival at five years of 40%. Most of the failures occurred within the first year.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

[Influence of cycle length shortening, atropine and beta-receptor blockage on sinus node recovery time (SRT) in patients with healthy sinus node (author's transl)].

Sinus node recovery time (SRT) was measured in 30 patients with healthy sinus nodes to examine the influence of the increase in atrial frequency, atropine and beta-receptor blockade. The measurements were performed following pacing with 3 atrial frequencies before and after administration of 1 mg atropine i.v. (13 patients) and 0.4 mg prindolol (Visken) i.v. (17 patients). Total group; Increase of frequency alone caused prolongation of the SRT in 17 patients and shortening in 13 patients. Atropine group: Blockade of the parasympathicus alone induced a highly significant reduction in the SRT. Simultaneous increase in frequency and blockade of the parasympathicus led to greater SRT-shortening during low frequency than with high frequency. This interrelationship of frequency and blockade of the parasympathicus influencing the SRT is statistically significant. Visken-group: Blockade of the sympathicus causes a highly significant prolongation of the SRT. Simultaneous increase in frequency and blockade of the sympathicus led to greater SRT-prolongation during low frequency than with high frequency. This interrelationship of frequency and blockade of the sympathicus influencing the SRT has slight statistical significance. The results are discussed in respect to the electrophysiological influences of atrial cycle length shortening, acetylcholine and catecholamines on the sinus node, the perinodal atrial fibres and the atrial working myocardium.

Atropine↗
PubMed1997

Dural arteriovenous shunt involving the superior petrosal sinus: presentation and treatment by transvenous embolisation via the occipital and transverse sinuses.

We report a dural arteriovenous shunt on the superior petrosal sinus at the origin of the petrosal vein, and its treatment. This is the first report of transvenous embolisation of such a shunt through the contralateral occipital and transverse sinuses. It was possible to achieve complete obliteration of the superior petrosal sinus shunt by coils and polyvinyl acetate liquid embolisation, in a combined venous and arterial approach.

Aged↗
PubMed1982

Electrophysiologic effects of procainamide on sinus function in patients with and without sinus node disease.

To compare the effects of procainamide on sinus node (SN) function in the presence (seven patients) and absence (nine patients) of SN dysfunction, sinus cycle length (SCL), maximal corrected sinus recovery time (maximal CRST), paced cycle length yielding peak SN suppression (PCLp), and indirect sinoatrial conduction time (SACT) were determined before and after intravenous administration of 10 to 15 mg/kg procainamide in each patient. Plasma procainamide concentration was in the therapeutic range in all patients. The mean SCL did not change significantly in either group (-24 +/- 58 and -73 +/- 171 msec for patients with normal and abnormal SN function, respectively). The maximal CSRT shortened 136 +/- 112 msec (p less than 0.01) in the group with normal SN function (nine of nine patients)( but tended to lengthen 85 +/- 95 msec (p less than 0.10) in the group with SN dysfunction (six of seven patients). PCLp shortened in only two of nine of the normal group but tended (NS) to shorten in five of seven patients with SN dysfunction. We conclude that in the absence of SN disease, procainamide does not adversely affect SN function. In apparent contrast in patients with SN dysfunction, procainamide tended (NS) to prolong CSRT and seemed (NS) to enhance conduction in the sinoatrial junction (PCLp and SACT both declined). The occasional lengthening of CSRT implies that procainamide might prolong post-tachycardia pauses and thus could worsen symptoms in certain patients with the bradycardia-tachycardia syndrome.

Adult↗
PubMed1987

Analysis of sinus cycle variation: a new method for evaluation of suspected sinus node dysfunction.

Momentary sinus cycle variations in 30 patients with unequivocal sinus node disease (SND) were compared with those found in 18 healthy control subjects to assess their potential diagnostic value. The range of variation of sinus cycle length (SCL; standardized by dividing by mean SCL) and the maximal change in SCL between any two consecutive cycles (max delta SCL) were measured in short (about 1 minute) continuous ECG recordings from invasive electrophysiologic investigations. Age-stratified reference values from 1 minute surface ECG recordings obtained at rest during quiet breathing in about 70 healthy persons were applied. For diagnosing SND, an increased standardized variation range had a sensitivity of 63%, a specificity of 94%, and a predictive value of a positive test of 95%. The corresponding figures for an increased max delta SCL were 77%, 78%, and 85%, respectively. A combination of increased range of variation and increased max delta SCL was observed in 63% of the patients but not in any healthy subject, which gives a specificity and a predictive value of a positive test of 100% for this combination.

Adult↗