Signs Of Osteitis Research Articles

Influence of computed tomographic dimensions of the nasopharynx on middle ear effusion and inflammation in pugs and French bulldogs with brachycephalic airway syndrome

To compare the prevalence of middle ear abnormalities in pugs and in French bulldogs and evaluate the influence of nasopharyngeal dimensions on middle ear effusion. Retrospective study. Thirty pugs and 30 French bulldogs with brachycephalic airway syndrome and no known history of ear disease. Computed tomographic (CT) studies were reviewed for middle ear effusion, mucosal contrast enhancement, signs of osteitis, and tympanic wall thickness. Soft palate thickness and cross-sectional areas of the nasopharynx at the opening of the auditory tube were measured and normalized to each individual's skull index before statistical comparison between breeds. Statistical dependence of middle ear abnormalities and nasopharyngeal dimensions was assessed by using Spearman's rank correlation tests. Middle ear effusion was observed in 17 of 30 (56.7%) French bulldogs and five of 30 (16.7%) pugs. Contrast enhancement of the tympanic bulla was noted in 25 of 60 (41.6%) French bulldog ears and three of 60 (5.0%) pug ears. The cross-sectional airway dimensions (difference [Δ] = 0.31 cm2 , P < .0001) and soft palate thickness (Δ = 0.44 cm, P < .0001) were reduced in pugs compared with in French bulldogs. Weak correlations were detected between soft palate thickness and nasopharyngeal dimensions and presence of tympanic bulla effusion (r = 0.324 and r = 0.198, respectively) or contrast enhancement (r = 0.270 and r = 0.199, respectively). Middle ear effusion and inflammation were more common in French bulldogs than in pugs and did not seem related to nasopharyngeal dimensions. French bulldogs with brachycephalic airway syndrome seem predisposed to middle ear effusion and inflammation.

Порівняння частоти виявлення окремих рентгенологічних ознак при хронічному верхньощелепному синуситі грибкового та негрибкового ґенезу

The one of the most informative method of preoperative diagnosis of fungal paranasal sinuses is computed tomography. The radiological marker that allows to identify chronic sinusitis of fungal origin is an eclipse with hyperintensive inclusions. The sensitivity of this criterion for fungal ball is about 80%. In addition, a sign of recalcitrant chronic sinusitis is the presence of reactive changes in the bone wall of the sinus – "osteitis". The purpose of the work was to study the frequency of radiological signs of osteitis and areas of increased radiological density in the maxillary sinuses of the patients with chronic sinusitis of fungal and non-fungal etiology, to clarify the diagnostic significance of these symptoms in the differential diagnostics. Material and methods. The results of a retrospective study of computer tomography data of 60 people with chronic rhinosinusitis (intraoperative was verified fungal ball in the maxillary sinus space of 30 patients, other 30 patient had no signs of fungal etiology). Results and discussion. In patients with chronic rhinosinusitis of non-fungal nature, hyperintensive inclusions in the sinus were found in 13.3%, and signs of osteitis were detected in 36.7%, which was significantly less common than in patients with fungal processes, 83.3% and 80,0% respectively (p &lt;0,05). The presence of both of the radiological symptoms was observed in 63.3% of patients from the group of chronic rhinosinusitis in the presence of a fungal body in the space of the sinus and in 6.7% of cases the chronic rhinosinusitis of non-fungal etiology. The severity of osteitis according to KOS, in patients with a fungal body in the sinus was 0.71 ± 0.15 points, and 0.55 ± 0.2 points in patients without a fungus. The pathogenesis of osteitis in the cases of sinusitis with fungal origin is a violation of bone trophism, which develops due to periostitis after the influence of biologically active substances secreted by the fungus. The increase of radiation density in areas of osteitis indicates the predominance of osteogenesis over osteolysis in the inflammatory focus of the bone wall of the maxillary sinus. Conclusion. The frequency of detecting radiological signs of osteitis in patients with chronic rhinosinusitis of the maxillary sinus with fungal bodies was 80%, that was comparable to the frequency of detecting hyperintense inclusions in the lumen of the sinus in these patients (83.3%), and was significantly more than in patients with chronic sinusitis nonfungal etiology. The presence of radiological signs of osteitis of the bone wall of the maxillary sinus in computed tomography should be regarded as an additional symptom in the differential diagnosis of maxillary sinusitis of fungal origin

Ipoestesia del nervo mentoniero causata da infezioni odontogene: casi clinici

ObjectivesWe describe a case series in which the presence of Numb Chin Syndrome (NCS) was the most relevant symptom related to odontogenic infections and cystic lesions. This neuropathy of the mental nerve is characterized by the presence of hypoesthesia or paresthesia of the lower lip and chin. Materials and methodsWhen not related to iatrogenic causes, the condition is clinically significant because of its frequent association with malignant diseases, especially lymphoma and metastatic lesions. However, several cases have been ascribed to dental pathologies, such as dentoalveolar abscesses or benign tumours. Three cases of NCS are described. A 59-year-old man (case I) presented with violent pain in the right premolar region; after a few days, hypoesthesia of right mental nerve also appeared. Clinical and radiologic examinations confirmed the presence of an osteolytic infective lesion originated from 4.5. A 45-year old-woman (case II) reported a continuous not evoked pain at 3.5, 3.6 and hypoesthesia of left mental nerve; dental panoramic tomography revealed an expanding lytic lesion involving the mandibular canal suggesting a cystic lesion in relation to 3.6. A 63-year-old man (case III) reported a violent pain in the right lower molar and premolar region; hypoesthesia of the right mental nerve soon followed. In the CT imaging, signs of osteitis with sequestrum originated from apical periodontitis of 4.7 and 4.5 were found. Discussion and conclusionsAlthough the mental nerve neuropathy is considered a “red flag” symptom of a distant malignant neoplasm, odontogenic infective causes or benign tumours should be considered.

A detached pedestal during cardiac assist with Jarvik 2000

A 71-year old man with a left ventricular assist device, Jarvik 2000 ( Jarvik Heart, New York, NY, USA), presented with unusual complications. Preoperative positron emission tomography and computed tomography (CT) scan revealed no signs of osteitis, but intraoperative bacterial cultures identified Enterobacter aerogenes. The retroauricular pedestal was completely detached from the temporal bone (Figs 1 and 2). A new retroauricular pedestal was successfully repositioned after the detachment of the first one.

A ′two-staged retention coverage reconstruction protocol′ for early exposed septic knee prosthesis with patellar ligament disruption

Background The worst scenario in total knee arthroplasty is early wound breakdown causing prosthesis exposure and necrosis of the patellar ligament. We describe a new protocol for the salvage of early exposed septic knee prosthesis with patellar ligament disruption. Patients and methods Between October 2001 and August 2010, 15 patients (15 knees) presenting with early infected, exposed knee prosthesis with patellar ligament disruption were treated using this new protocol. Strict criteria were used for patient selection suitable for this plan of treatment. Patients had to have presented within 30 days of the index arthroplasty. In addition, no radiographic signs of osteitis or loose prosthetic component were present. In the first stage, thorough debridement accompanied by polyethylene insert removal was performed, along with intraprosthetic antibiotics-impregnated cement spacer insertion. This was followed by a 1-week parentral antibiotic regimen. On the eighth day, a second-stage procedure was performed with spacer removal and new polyethylene insertion, accompanied by medial gastrocnemius flap transposition for prosthesis coverage and patellar ligament reconstruction. Results At the latest follow-up (55.2 months), 13 knees (86.6%) have been retained; Knee Society knee and functional scores in these averaged 79.6 and 74 points, respectively, and these patients had regained sufficient extensor mechanism function to return to ambulation. Conclusion We recommend this protocol for the management of early exposed infected knee prosthesis with patellar ligament disruption. Level of evidence Level IV.