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At least 127 records · Page 7Linked to original sources

Peculiar enlargement of the nasopharynx in patients with anorexia nervosa.

We examined the nasopharynx and brain in 17 patients with anorexia nervosa by CT and compared the findings with those of 44 normal subjects and of 5 patients of the same age with marked emaciation caused by various psychiatric disorders. An enlarged nasopharyngeal space with a flattened posterior wall and enlarged lateral pharyngeal recesses were demonstrated in all patients with anorexia nervosa whose weight was lowest at the time of the CT examination, and these CT features regressed or became normal quickly after they had gained some weight. This characteristic enlargement of the nasopharynx and lateral pharyngeal recesses was observed neither in the markedly emaciated patients (2 with schizophrenia, 1 with major depression, 1 with stupor and the other with an extremely unbalanced diet) nor in 44 normal subjects without emaciation. These features were therefore thought to be characteristic and of diagnostic significance.

Adolescent↗

Analysis of isolates recovered from multiple sites of the nasopharynx of children colonized by nontypeable Haemophilus influenzae.

To determine whether the nasopharynx of children is colonized by a single or multiple strains of nontypeable Haemophilus influenzae, cultures were obtained from six nasopharyngeal sites in five children. For each child, all isolates yielded identical polymerase chain reaction fingerprints. The results indicate that these children were colonized in the nasopharynx with a single strain of nontypeable Haemophilus influenzae at one time.

Child, Preschool↗

Identification of attached bacteria in the nasopharynx of the child.

Bacteria attached to epithelial cells in mucus and cell scrapings obtained from the nasopharynx in children undergoing adenoidectomy appear rather monomorphic under the microscope, and for this reason it is not possible to identify different species. To overcome this difficulty, a micromanipulation method has been devised which allows the isolation of single squamous epithelial cells seen to carry bacteria. The cells are transferred to culture media for bacteriological analysis. Ciliated epithelial cells were never seen to carry bacteria, and cultures or these cells gave no growth. Bacterial growth was found in 36 of 47 cultures of single epithelial cells seen to carry 10 to 50 bacteria. Two species were isolated from 11 cultures and three species from one culture. Viridans streptococci dominated; the most frequently isolated species was Streptococcus mitior, followed by Streptococcus group K. In all, 15 different species were found to adhere to squamous epithelial cells in the nasopharynx.

Adhesiveness↗

Dermoid (hairy polyp) of the nasopharynx.

Dermoids or hairy polyps, the most primitive forms of teratoma are rare lesions affecting the nasopharynx. They arise during early embryogenesis, being derived from only two germinal layers, ectoderm and mesoderm and are invariably benign. They usually present at or soon after birth with signs of upper aerodigestive tract obstruction. A case of hairy polyp of nasopharynx in a neonate is reported for its rarity. The etiology of teratomas, their classification in head and neck region, clinical features, and management in neonates are discussed.

Dermoid Cyst↗

[Tubercular osteomyelitis of the clivus and the nasopharynx].

Involvement of the skull base is rare in tuberculosis. We report here the case of a 28-year-old female patient with an osteolytic process of the clivus with compression of the brain stem and involvement of the nasopharynx. She reported suffering from headaches for the last 6 months, and diplopia had occurred 1 week before her diagnosis as a result of paresis of the VIth cranial nerve on the right side. A biopsy was obtained endoscopically via a transnasal approach, revealing a granulomatous inflammation with acid-fast rods and thus confirming the diagnosis of a tuberculoma. When the biopsy was taken there was no evidence of any further tuberculomas in this patient. The clinical picture, diagnosis, and treatment of tuberculosis of the skull base and nasopharynx are discussed and the literature on this rare clinical entity is reviewed with reference to this patient's case report.

Adult↗

Marble impaction in the nasopharynx following oral ingestion.

Foreign body ingestion is an important emergency occurring in childhood. In this article, we report the case of a 5-year-old girl with marble impaction in the nasopharynx, which had not been discovered by routine X-rays of the chest and abdomen at the time of ingestion. The patient presented 4 months after the event with typical symptoms of adenoid hypertrophy and sinusitis, and the diagnosis was established on the basis of a plain film of the nasopharynx. This rare situation is potentially dangerous, since the foreign body may descend and cause sudden airway obstruction. Therefore, in all cases with vanishing foreign bodies in the aerodigestive system, nasopharyngeal impaction and its fatal consequences should be kept in mind and endoscopic examination of the region should be considered.

Adenoidectomy↗

Is attachment of bacteria to the epithelial cells of the nasopharynx the key to otitis media?

Epithelial cells from the nasopharynx of 42 young healthy individuals were obtained by swabbing. The filtered cellular mixture was stained with acridine orange and bacteria attached to the epithelial cells were counted using a fluorescence microscope. Simultaneously qualitative and quantitative bacteriological analyses were performed. Young individuals (less than 2 years) had significantly more attached bacteria than older ones (11-15 years) (P = 0.0001). The presence of middle ear pathogens in the nasopharynx of young children was significantly more prominent than in the older age groups (P less than 0.001). Attachment of middle ear pathogens to nasopharyngeal epithelial cells of young individuals may predispose to otitis media.

Adolescent↗

Event-related potentials recorded from the scalp and nasopharynx. I. N1 and P2.

Event-related potentials were recorded from the scalp and nasopharynx during a signal-detection task. These responses were evaluated with respect to the effects of interstimulus interval, intensity, frequency, attention and modality. Our results indicate the existence of at least 4 distinct processes occurring in the 75-150 msec latency range following auditory stimuli. The first process is indexed in the vertex-N1b/temporal-N1a component. This component does not reverse in polarity below the sylvian fissure and is not seen in nasopharyngeal recordings. The location of its generator is not known. Probably there are two or more sources active at this latency. The second process finds reflection in the N1c/PgP120 component. This component is recorded with maximum amplitude on the side contralateral to the ear of delivery. A source in the lateral surface of the temporal lobe is a likely generator. The third process corresponds to Wolpaw and Penry's (1975) Ta positivity. How much of this represents the underside of a vertically oriented dipole and how much a surface positivity is unknown. Finally, during attention, a lateralized processing negativity seems to overlap these components at the scalp, but not at the nasopharynx. The auditory vertex N1 peak is quite distinct from the visual N1 which is more posteriorly recorded on the scalp and which is associated with a definite nasopharyngeal positive wave. The P2 peak is quite similar across auditory and visual modalities. In both modalities it is maximally recorded from the vertex and has no nasopharyngeal concomitant.

Adult↗

Eradication of pathogens from the nasopharynx after therapy of acute maxillary sinusitis with low- or high-dose amoxicillin/clavulanic acid.

The growing resistance of Streptococcus pneumoniae to penicillin can be overcome by increasing the dose of the penicillin administered. This generated the recommendation that the adult dose of amoxicillin for the treatment of acute maxillary sinusitis (AMS) be increased from 1.5 g/day to 4.0 g/day. The objective of this study was to investigate whether the higher dose of amoxicillin is more effective than the previously recommended dose in eradicating S. pneumoniae from the nasopharynx of patients who present with AMS. Nasopharyngeal cultures obtained from 58 patients with AMS were studied: 30 received amoxicillin 1.5 g/day given in divided doses three times a day for 10 days (amoxicillin/clavulanic acid 4:1 formulation) and 28 were treated with amoxicillin 4.0 g/day given in divided doses twice a day for 10 days (amoxicillin/clavulanic acid 16:1 formulation). Seventy-one potentially pathogenic organisms were isolated: S. pneumoniae (27 isolates), Haemophilus influenzae non-type b (25), Moraxella catarrhalis (5), Streptococcus pyogenes (5) and Staphylococcus aureus (9). The number of S. pneumoniae isolates in the 1.5 g/day group was reduced from 14 to 9 (2 intermediately resistant and 3 highly resistant). In contrast, the number of S. pneumoniae isolates in the 4.0 g/day group was reduced from 13 to 2 (1 highly resistant) (P<0.05). No differences were noted in the eradication rate of other groups of isolates, which were all susceptible to amoxicillin/clavulanic acid. These data illustrate the superiority of 4.0 g/day amoxicillin/clavulanic acid compared with 1.5 g/day amoxicillin/clavulanic acid in the eradication of S. pneumoniae from the nasopharynx.

Acute Disease↗

Presence of viral and bacterial pathogens in the nasopharynx of otitis-prone children. A prospective study.

OBJECTIVE: The purpose of the present study was to examine and follow up the presence of respiratory viral and bacterial pathogens in the nasopharynx of otitis-prone children during the cold season and compare the findings with the child's respiratory symptoms. METHODS: We enrolled 121 otitis-prone children, aged 10 months to 4 years for a prospective study. The nasopharyngeal swab (NPS) were studied at the baseline and after 12 and 24 weeks for respiratory viruses and at the baseline and after 24 weeks for bacteria. Presence of picorna(rhino-entero-parecho)-, influenza-, adenoviruses and Mycoplasma pneumoniae was detected by PCR. NPS specimens were cultured for Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis. Clinical data (the rate of respiratory symptom days, otitis media, tympanometry findings, day-care attendance and the number of siblings) were compared with microbiological data. RESULTS: Rhinovirus was found in 30% of the samples at the baseline, in 8% and in 19% of the samples after 12 and 24 weeks, respectively. Enterovirus was detected in 19% of the samples, in 21% and in 12% of samples after 12 and 24 weeks, respectively. Picornavirus positivity correlated with the respiratory symptoms but not with the number of otitis media or with abnormal tympanometry. Two samples were adeno- and three samples influenzavirus positive. Parechovirus and M. pneumoniae were negative in all samples. Rhinovirus positivity correlated with that of M. catarrhalis and S. pneumonia but not with H. influenzae. Microbiological positivity was not significantly associated with the type of day-care. CONCLUSIONS: Picornaviruses as well as bacteria were commonly found in the nasopharynx of otitis-prone children during the cold season, even in the absence of clinical symptoms.

Bacteria↗

Treatment of children with secretory otitis media (SOM) with amoxicillin and clavulanic acid (Spektramox) or penicillin-V (Primcillin). Bacteriological findings in the nasopharynx before and after treatment.

A total of 386 children, aged 1-10, with secretory otitis media for at least 3 months were randomly allocated to 2 or 4 weeks' treatment with penicillin-V (Primcillin) or amoxicillin + clavulanic acid (Spektramox). Spektramox was superior (p < 0.01) to Primcillin in eradicating Haemophilus influenzae and Branhamella catarrhalis from the nasopharynx. No difference was noted for Streptococcus pneumoniae and haemolytic streptococci, gr. A, B, C, G. No increase in the number of beta-lactamase-producing bacteria was noted after treatment. The nasopharynx was recolonized with the same bacteria within 4 weeks from cessation of treatment.

Amoxicillin-Potassium Clavulanate Combination↗

Bacteria in the middle ear and nasopharynx during tympanostomy tube insertion.

PURPOSE: To evaluate the efficacy of nasopharyngeal cultures in identifying pathogens in middle-ear effusions as an alternative to cultures obtained through tympanocentesis. MATERIALS AND METHODS: The study population consisted of 203 children with middle-ear effusions at the time of placement of tympanostomy tubes for recurrent otitis media or persistent otitis media with effusion. Isolates from the nasopharynx were compared with those from the middle ear to determine sensitivity, specificity, and predictive values for each of the three main pathogens. RESULTS: The predominant bacterial isolates from both ear and nasopharynx were Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae. Eighty-one percent (42% highly, 39% relatively) S pneumoniae nasopharyngeal isolates were resistant to penicillin. The negative predictive value of the nasopharyngeal cultures was at least 97% for each of these predominant bacteria. CONCLUSION: This study supports the conclusion that tympanocentesis is the most useful means of identifying pathogens in otitis media.

Child↗

The nasopharynx and the middle ear. Inflammatory reactions in middle ear disease.

The host-parasite interactions in the nasopharynx with bacterial colonization and antigen uptake in the lymphoid tissue, the adenoid, has an impact on the maturation of local and systemic immunity. The adenoid is a part of mucosa associated lymphoid tissue and is responsible for both effector and inductor functions in the nasopharynx. Increasing evidence supports the role of serum antibody in protecting the middle ear cavity from disease. There is evidence for a minor immunologic defect in a number of children with recurrent episodes of AOM.

Adenoids↗

Trans oral approach to the nasopharynx and clivus using the Le Fort I osteotomy with midpalatal split.

The Le Fort I level osteotomy is a procedure well known to oral and maxillofacial surgeons, who routinely use it to correct midfacial skeletal deformities and alter the dental occlusion. This osteotomy can also be used as a maxillotomy for access to more superiorly and posteriorly situated structures. The downfracture technique provides the surgeon with a safe approach that allows visualization of the maxillary sinuses, nasal cavity, nasopharynx, base of the skull and upper cervical spine. This approach can also be combined with a midline lip split, mandibulotomy and glossotomy to give access to retropharyngeal structures. By modifying the combined Le Fort I and transmandibular approach utilizing a midline split of the hard and soft palate, the access to the clivus can be improved considerably. The clinical applications of these combined procedures in the treatment of basilar invagination and tumors of the nasopharynx are discussed.

Adolescent↗

Study of the nasopharynx in man by scanning electron microscopy.

To date only few and often disagreeing studies about human nasopharynx are available. The present research has the purpose to give a contribution to the knowledge of nasopharyngeal epithelium using S.E.M. The study was carried out on biopsies taken from 20 healthy volunteers. The surface of nasopharynx is covered by ciliated cells, microvilli provided cells and goblet cells. Areas covered with squamous epithelium and presumably transitional epithelium were observed. The possibility that ciliated cells become microvilli provided cells is discussed.

Adolescent↗

Papillary adenocarcinoma of the nasopharynx.

The first case of low-grade papillary adenocarcinoma of the nasopharynx is described from an area where carcinoma in the nasopharynx is endemic. Clinicopathological features are detailed and differences between the prevalent nasopharyngeal cancer and low-grade nasopharyngeal papillary adenocarcinoma are emphasized. This tumour requires positive identification as surgical management is necessary to avoid the possibility of future recurrence.

Adenocarcinoma, Papillary↗

The nasopharynx, eustachian tube and otitis media.

It has been classically hypothesized that a mass in the nasopharynx causes an obstacle to air flow through the eustachian tube, thereby creating a negative pressure in the middle ear followed by an effusion. However, examination of the relevant data concerning the supposed obstruction of the eustachian tube by nasopharyngeal carcinomas, choanal polyps and adenoids does not seem to support this cause and effect relationship. Evidence points to other more sophisticated mechanisms which cause negative pressure and an effusion in pathological middle ear conditions. While the hypothesis of a nasopharyngeal mass as the usual obstructive cause of middle ear effusion is hard to maintain, evidence does exist to support the origin of middle ear infection, as seen in acute and secretory otitis media, as being associated, at times, with an ascending infection from the nasopharynx.

Adenoids↗

Pituitary adenomas with infra-sellar extension into the nasopharynx.

Three cases of pituitary adenomas with infra-sellar extension into the nasopharynx and the nasal cavities are reported. The clinical signs were epistaxis, nasal obstruction, painful sinuses and purulent rhinorrhoea. The initial diagnostic hypothesis was that of a carcinoma of the nasopharynx or the sinuses in all three cases. The diagnosis was made by histological examination and measurement of plasma hormone levels. These cases highlight the difficulty in the diagnosis of such tumours due to their misleading clinical, radiological and histological features.

Adenoma↗