The effect of changes in perilymphatic K+ on the vestibular evoked potential in the guinea pig

To investigate the effect on the functioning of the vestibular system of a rupture of Reissner’s membrane, artificial endolymph was injected in scala media of ten guinea pigs and vestibular evoked potentials (VsEPs), evoked by vertical acceleration pulses, were measured. Directly after injection of a sufficient volume to cause rupture, all ears showed a complete disappearance of VsEP, followed by partial recovery. To investigate the effect of perilymphatic potassium concentration on the vestibular sensory and neural structures, different concentrations of KCl were injected directly into the vestibule. The KCl injections resulted in a dose-dependent decrease of VsEP, followed by a dose-dependent slow recovery. This animal model clearly shows a disturbing effect of a higher than normal K+ concentration in perilymph on the vestibular and neural structures in the inner ear. Potassium intoxication is the most probable explanation for the observed effects. It is one of the explanations for Menière attacks

Endoscopic endonasal ligation in treatment of severe posterior epistaxis

The technique and indications of an endonasal endoscopic technique for treatment of posterior epistaxis are presented. Three cases were successfully treated in our department in 1999. The posterior vascularisation of the nose is reviewed with emphasis on surgical anatomy. Endoscopic endonasal ligation of posterior nasal arterial vascularisation is compared with other treatment choices in posterior epistaxis. The technique is save and efficient. Since it is also a minimally invasive technique, it has become our first choice surgical procedure for posterior epistaxis

Stridor caused by a blue laryngeal mass in an infant: case report

Stridor caused by a blue laryngeal mass in an infant: case report. We describe an infant who had inspiratory stridor that began a few weeks after birth. Flexible upper airway endoscopy while the infant was awake showed a large blue mass at the posterior glottis, above the esophageal inlet. The lesion was only visible upon crying or coughing; it was undetectable when we examined the infant in the supine position during spontaneous breathing and did not respond to systemic treatment with propranolol. Based upon these typical features, we established a diagnosis of pressure-dependent postcricoid mass.</p

An unusual tumour causing neonatal respiratory distress

Problem: We present the case of a term neonate referred shortly after birth because of breathing and feeding difficulties. Methodology: Fiber-endoscopic examination of the nasal cavity showed a pendulating mass in the nasopharynx. Results: A complete surgical resection was performed and the baby recovered completely. Microscopic examination of the mass showed an overlying non-keratinized squamous cell lining with an atypical cell population in some fragments. Histological features were compatible with a high-grade epithelial tumour like a midline carcinoma, but a final diagnosis of a salivary gland anlage tumour was established. Conclusion: Flexible fiber endoscopy is the method of choice for examining the nasal passages and oropharynx in neonates with respiratory distress. Congenital salivary gland anlage tumour is a rare cause of neonatal nasal obstruction; it is benign and complete excision results in a cure. Histologically, it may mimic a malignant tumour owing to the high mitotic index

Adenotonsillectomy to Treat Obstructive Sleep Apnea: Is It Enough?

Although adenotonsillectomy is the first line treatment for children with obstructive sleep apnea syndrome (0SAS),(1) improvement in objectively documented outcomes is often inadequate and a substantial number of children have residual disease. Early recognition and treatment of children with persistent OSAS is required to prevent long-term morbidity. The management of these children is frequently complex and a multidisciplinary approach is required as most of them have additional risk factors for OSAS and comorbidities. In this paper, we first provide an overview of children at risk for persistent disease following adenotonsillectomy. Thereafter, we discuss different diagnostic modalities to evaluate the sites of persistent upper airway obstruction and the currently available treatment options. (C) 2017 Wiley Periodicals, Inc