trimethoprim--sulfamethoxazole-drug-combination and Ear-Diseases

A diagnosis of Wegener granulomatosis requires granulomatous manifestations in the respiratory tract. With the increasing use of antineutrophil cytoplasmic autoantibodies as a diagnostic tool, Wegener granulomatosis is diagnosed earlier than in the past, and not infrequently when only ear, nose and throat manifestations are present, placing the otorhinolaryngologist in a central role in diagnosis and management. Diagnostic biopsies should be obtained from active lesions in the nose and paranasal sinuses and concomitant infection should be identified. Because of the apparent relation between infection and activation of disease, the management of infections-especially those due to Staphylococcus aureus-requires special attention. The increasing numbers of early cases identified warrants further investigations of whether less toxic treatment regimens will be of advantage in such cases. Medical and surgical treatment of the acute and chronic manifestations presents specific problems because of altered immune competence, prevalent superinfection, and tissue destruction, and is therefore best taken care of by specially dedicated otorhinolaryngologists.

Topics: Ear Diseases; Granulomatosis with Polyangiitis; Humans; Laryngeal Diseases; Mouth Diseases; Nasal Mucosa; Nose Diseases; Paranasal Sinus Diseases; Salivary Gland Diseases; Staphylococcal Infections; Tracheal Diseases; Trimethoprim, Sulfamethoxazole Drug Combination; Vasculitis

It appears that true otologic manifestations of AIDS are rare and that incidental otologic disease associated with AIDS is more common. A review of the literature revealed that otitis externa, acute otitis media, recurrent acute otitis media, otitis media with effusion, chronic suppurative otitis media with cholesteatoma, and herpes zoster oticus may all represent incidental otologic disease occurring in patients with AIDS. Chronic otitis media without cholesteatoma (P carinii-infected aural polyps), sensorineural hearing loss, acceleration of otosyphilis from the latent stage, and development of Kaposi's sarcoma of the external auricle or nasopharynx may represent true otologic manifestations of AIDS.

Topics: Acquired Immunodeficiency Syndrome; Acyclovir; Ear Diseases; Humans; Interferon Type I; Opportunistic Infections; Penicillins; Trimethoprim, Sulfamethoxazole Drug Combination

Two horses with chronic empyema of the auditory tube diverticulum (guttural pouch) were refractory to medical treatment; empyema was bilateral in 1 horse and unilateral in the other. Both horses were treated by fistulation of the cartilage of the pharyngeal orifice by use of a neodymium:yttrium-aluminum-garnet laser in a noncontact manner. To maintain patency of the fistulae, indwelling catheters were placed into the openings created by the laser. For both horses, long-term follow-up did not reveal complications, and both owners were satisfied with results of the procedure. The authors recommend this procedure for horses that are unresponsive to medical treatment for chronic guttural pouch empyema.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Chronic Disease; Dexamethasone; Ear Diseases; Empyema; Endoscopy; Eustachian Tube; Female; Horse Diseases; Horses; Laser Therapy; Male; Penicillin G Procaine; Phenylbutazone; Prednisone; Trimethoprim, Sulfamethoxazole Drug Combination