Treatment of nasal polyposis in Byzantine times

The goal of this study was to describe the therapeutic methods and surgical techniques used during Byzantine times (AD 324-1453) for a disease that has occupied physicians since antiquity: nasal polyps. The original Greek-language texts of the Byzantine medical writers, most of which were published after the 17th century, were studied in order to identify the early knowledge of the definition, symptoms, conservative treatments, and surgical intervention in cases of this disease. A considerable number of conservative treatments, etiologic and local (with inunctions or blowing of caustic substances), with evident influence from Roman medicine, were identified even in the early Byzantine medical texts (4th century). Further, some surgical techniques were described that seem to constitute evolution of the Hippocratic tradition. From the study of the original texts of Byzantine medical writers, their interest in the rhinological diseases is evident; in the case of nasal polyps, new techniques were mentioned. The first meticulous intranasal surgical removal of polyps was described. These techniques, obviously developed during the Hellenistic period, initially influenced European medicine and later the rest of the world.     

Development of otorhinological care of the child

During the last third of the 20th century, pediatric otolaryngology became a defined specialty in many nations, resulting in focused training, fellowships, societies, journals, textbooks, etc. This development occurred as a result of an interaction between the changing sociological and economic status of the child and medical advances. In this paper the history of the status of children is investigated during the Reformation/Counter-Reformation, Enlightenment and Romantic periods, and during the recent era of Entitlement, and an analysis is made of the relationships between otolaryngological care of children during these periods, including a consideration of selected medical advances made during the 17th to 21st centuries, and the evolving status of children. Advances in education of the deaf, understanding the role of the adenoid and care of the airway were applied to the child patient not directly, as it may sometimes seem to physicians caring for a patient in a hands-on fashion, but rather via the bridge of the social and economic context of the time. This interactive process created a special body of knowledge that is now applied in a society that places a high value on the child. In the second half of the 20th century, i.e. during the period of Entitlement, the otolaryngological needs of the child became a demand, based in part upon a need for care of airway pathology in the premature infant, which fostered the establishment of pediatric otolaryngology as a specialty.     

Development of otorhinological care of the child

During the last third of the 20th century, pediatric otolaryngology became a defined specialty in many nations, resulting in focused training, fellowships, societies, journals, textbooks, etc. This development occurred as a result of an interaction between the changing sociological and economic status of the child and medical advances. In this paper the history of the status of children is investigated during the Reformation/Counter-Reformation, Enlightenment and Romantic periods, and during the recent era of Entitlement, and an analysis is made of the relationships between otolaryngological care of children during these periods, including a consideration of selected medical advances made during the 17th to 21st centuries, and the evolving status of children. Advances in education of the deaf, understanding the role of the adenoid and care of the airway were applied to the child patient not directly, as it may sometimes seem to physicians caring for a patient in a hands-on fashion, but rather via the bridge of the social and economic context of the time. This interactive process created a special body of knowledge that is now applied in a society that places a high value on the child. In the second half of the 20th century, i.e. during the period of Entitlement, the otolaryngological needs of the child became a demand, based in part upon a need for care of airway pathology in the premature infant, which fostered the establishment of pediatric otolaryngology as a specialty.     

The root and development of otorhinolaryngology in traditional Chinese medicine

There is an increasing trend in society to look beyond conventional medicine to find answers to problems in health. Traditional Chinese medicine (TCM) is one of the most popular alternative, complementary therapies worldwide. It is becoming a popular alternative in otorhinolaryngology where its use in the treatment of sinusitis, tinnitus, deafness and Meniere’s disease is growing. Despite the general awareness of TCM, the literature relating specifically to otorhinolaryngology is relatively scarce. In this review, we have traced the origin and development of otorhinolaryngology with respect to TCM and have provided a few interesting insights into otorhinolaryngology, as it used to be practised. Archaeological sources have shown that diseases affecting the ear, nose and throat were of medical concern as early as the 18th century BC. The first practising otorhinolaryngologist can be traced back to the 5th century BC. Acupuncture, moxibustion, herbal therapy and massage were amongst his treatments. Otorhinolaryngology was recognised as a major specialty when formal medical education began in the 7th century AD. Therapeutic measures since then expanded to include exercise, food therapy and surgery. References to using oesophageal speech as a substitute voice generator, the use of copper wire to excise nasal polyps, procedures for removal of sharp foreign bodies in the oropharynx, repair of lacerated trachea and treatment of cancer of lips can be found in historical notes. In conclusion, from its primitive roots, TCM has developed into a distinct branch of health care system in China today that works alongside Western medicine.     

Relative distribution of the tumours of ear, nose and throat in the paediatric patients

OBJECTIVE: The purpose of this study is to observe the type and anatomical distribution of various tumours of the otolaryngological region in the paediatric age group of patients. METHODS: A prospective study was carried out over a period of 2 years between May 2001 and April 2003 in a Teaching Hospital and tertiary referral centre in India. Patients 15 years of age or under who presented with a tumour of the otolaryngological region to the department of Otolaryngology were included in this study. Lymphoma of the cervical lymph nodes was not included in this study. Site of origin and histology of the tumours were noted. The minimum follow-up period was 18 months. RESULTS: Forty-three patients of above age group with a neoplasm of the otolaryngological region were managed in our department, the incidence was 0.5%. The ratio of benign to malignant lesion was 7.6:1. Juvenile nasopharyngeal angiofibroma was the commonest tumour (11 cases, 26%) and embryonal rhabdomyosarcoma was the commonest malignant tumour (3 cases, 7%). The commonest site of neoplasm was the nose and paranasal sinuses (13 cases, 30%). CONCLUSION: A tumour in the otolaryngological site in the paediatric population is rare, the incidence being 1 in 200 new cases in the age group of 15 years or under, 12% of the tumours were malignant. Awareness of relative distribution of neoplastic lesions is valuable for early detection and correct management. This study indicates that the distribution of otolaryngological tumours in the Indian subcontinent is different from the western countries, particularly the juvenile nasopharyngeal angiofibroma and laryngeal papilloma.     

History of epistaxis since the ancient times to the first half of the XXth century

Epistaxis is one of the more frequent entities in the otolaryngological practice. The term is attributed to CULLEN (1785). Since them, multiple theories concerning etiology, clinical manifestacions, diagnosis and management have been reported in the medical literature. Nevertheless, an impressive improvement of awareness about these questions have emerged in the last half of past century. The objective of this work is to revise the history of epistaxis since the ancient times to the first half of the 20th century.     

A Longitudinal Study of Ear Disease and Hearing Sensitivity in Children

A longitudinal study of hearing sensitivity and ear disease is described in a representative cross-section of the elementary public school population in Pittsburgh, Pa. Periodic hearing level determinations and otolaryngological examinations were conducted between 1957 and 1964. Medical histories were also obtained. Children were in attendance at school, without obvious illness at the time examinations were made. The purpose of the study included identification of those predictive signs and symptoms available to a school medical service which may indicate that particular children need special otological and audiological attention. A total of 5 748 children are included in the study population, Of these, 3 059 remained in the study between 2 and 6 years and form the group on which the longitudinal study was conducted.

The principal group on which data are presented are the 1 191 children who were observed for a period of at least 5 years. Children in this report are divided into otoscopically normal and otoscopically abnormal groups because it was found that abnormal otoscopic findings, particularly of the tympanic membrane, are related to variations in hearing sensitivity. No such relationships were unconvered in the nose and oral pharynx.     

Cytology of nasal secretions: further diagnostic help.

Nasal cytograms, as an aid to diagnosis of pathological conditions of the nose and paranasal sinuses, have not been adopted by the majority of otolaryngologists. This situation exists because of technical problems with the preparation of a slide and the difficulty in finding someone competent and interested in its interpretation. The work of the Bryans has provided an analysis of the cytology of nasal secretions. Adopting their methods, we have been using the nasal cytogram in clinical practice and find it helpful in determining appropriate therapy for problems encountered in otolaryngological practice. In the authors' experience, profuse nasal mastocytosis is a consistent finding in cytograms from patients having varied symptoms that are associated with hypersensitivities that are not accompanied by positive objective findings. This is especially true in patients with constantly recurring headaches and those with a chronically obstructed nose. Once many mast cells are found by the cytogram, attempts are made to relieve these patients by selective dietary restrictions. These attempts are often successful. The nasal cytogram is also used to help explain periodic symptom flares in the long term allergy patient undergoing immunotherapy for inhalants, by identifying superimposed viral and bacterial infections.     

东北三省空军选拔定选耳鼻咽喉科不合格原因及地区差异分析

目的分析东北地区空军青少年航空学校医学选拔定选耳鼻咽喉科的不合格原因,为合理制定耳鼻咽喉科选拔方案、指导耳鼻咽喉科初选标准把握尺度、指导学生身心维护提供科学依据。方法整理东北三省2015～2017年空军青少年航空学校学生医学选拔定选结果,筛选并分类整理357名耳鼻咽喉科淘汰的学生体检结果,并对淘汰原因的百分比构成和地区性差异进行统计学分析。结果各省的耳鼻咽喉科淘汰率之间差异具有统计学意义（P＜0.05）,A省淘汰率稍低。淘汰原因主要集中在鼻中隔偏曲82名（22.97%）,听力减退75名（21.01%）,咬颌不良71名（19.89%）,前庭功能不良52名（14.57%）,共占78.43%。结论耳鼻咽喉科医学选拔定选淘汰原因集中,因此在初选过程中要增加必要的耳鼻咽喉科检查项目,并针对原因指导学生及时进行干预。     

The organization and activity of the otolaryngological institutions in Warsaw in the second half of the 19th century and at the beginning of the 20th century

The importance of various otolaryngological institutions: hospital wards, outpatient clinics, infirmaries and consulting rooms in the formation of the new specialization, otolaryngology, is described in this paper. An important role of surgery in the first period of the development of otolaryngology is mentioned. At that time all major otolaryngological operations were performed by general surgeons. The necessity to create new separate hospital otolaryngological wards became evident. The attainment of general surgical education and management of suitable post-operation treatment by otolaryngologists as well as creation of autonomous operating rooms were also evident. Poor state of Warsaw otolaryngological outpatient clinics is described in detail. The state of otolaryngological institutions in Europe, in the United States of North America and in the Kingdom of Poland is described briefly.     

Severe combined immunodeficiency: otolaryngological presentation and management

In order to increase the awareness of otolaryngologists of severe combined immunodeficiency syndrome (SCIDS) so they may contribute to an earlier diagnosis of this disorder, we performed a retrospective chart review of a multicenter series from 2 children's hospital medical centers. Eighteen cases were identified, and 14 had an otolaryngological presentation. The average age of presentation was 3.3 months, and 72% were males. Most cases were inherited in an X-linked fashion. Five patients had thrush; 4 had recurrent otitis media. Other otolaryngological presentations included cough, mouth ulcers, pharyngitis, mastoiditis, and bilateral neck abscess. The most severe form of immunodeficiency, SCIDS is a rare condition that involves a disorder in both T and B cell functions. The manifestations involving the head and neck include recurrent upper respiratory tract infections, otitis media, thrush, oral ulcers, and abscesses. It is important that SCIDS be considered in any infant with recurrences of these common infections.     

How often do normal persons sneeze and blow the nose?

Rhinitis is defined as an inflammatory disease, but in clinical practice the diagnosis is based on the occurrence of nasal symptoms. As all persons occasionally sneeze and blow the nose, it is necessary to define what is normal. In this study the daily number of sneezes and of nose blowing were recorded in diary-cards over a 14 day period by 80 hospital employees and medical students, who considered themselves not to suffer from rhinitis. The results showed that more than 95% of the normal persons sneezed and blew the nose less than 4 times a day, on average. It is concluded that it is normal to sneeze and blow the nose less than 4 times daily while a higher number can be a sign of rhinitis. It is recommended that counting of sneezes and of nose blowing is used in clinical trials in order to define the study population. Together with an objective measurement of nasal patency this can be useful in defining the effect profile of different types of treatment.     

Sarcoidosis and its otolaryngological implications

Sarcoidosis and its aetiopathogenesis, epidemiology and diagnostic procedures (including the Kveim reaction) are presented in this paper. The clinical manifestations of this disease, especially in otolaryngological organs, including the larynx, salivary glands, nose and paranasal sinuses, are described. Treatment procedures, including surgical interventions and prognosis, are also discussed.     

Safety pin — The UNSAFE foreign body of air passage

Foreign bodies in the air passage are familiar otolaryngological emergencies. The diagnosis and management in most cases is based on clinico-radiological findings. Here, we are reporting three cases of open safety pin at various locations in the respiratory tract i.e. in the nose, nasopharynx and larynx. Their clinical presentation and management are described in detail.     

From the roots of otology: diseases of the ear and their treatment in Byzantine times (324-1453 A.D.).

HYPOTHESIS: The aim of this study is to present the therapeutic methods and surgical techniques in diseases of the ear during Byzantine times (324-1453 A.D.). BACKGROUND/METHODS: The original Greek language texts of the Byzantine medical writers were studied to research early otologic knowledge of symptomatology, conservative treatments, and surgical confrontation of diseases of the ear. RESULTS: A considerable number of conservative treatments for many otologic conditions were identified; these therapies were especially based on herbs, animal and mineral substances applied either as eardrops, clysters, poultices, or by using special instruments and apparatus. Among these were identified otitis, rupture of the eardrum, hemorrhage from the ears, deficiency of hearing and deafness, vertigo, tinnitus, and earwax. Furthermore, in these early texts, there were also described some surgical techniques in cases of atresia of the external auditory canal, of defects in or lack of the pinna, and for removal of foreign bodies and fleshy tumors. Some of the earliest hearing aids were also mentioned. CONCLUSIONS: From the study of the original works of Byzantine writers, it is evident that numerous treatments and surgical techniques relating to otology were practiced; these were derived not only from compilation of knowledge obtained from the ancient Greek medical sources, a considerable part of which are now lost, but also enriched by Byzantine physicians' personal experience. This knowledge influenced medieval European medicine and, through it, that of the rest of the world.     

Dual-probe 24-hour ambulatory pH monitoring for diagnosis of laryngopharyngeal reflux

BACKGROUND: Patients with gastroesophageal reflux disease may suffer from a variety of symptoms from the upper aerodigestive tract. The objective of this study was to determine the impact of dual-probe 24-hr pH monitoring in the diagnosis of reflux-related otolaryngological disorders. METHODS: Twenty-two patients with symptoms such as chronic cough, globus pharyngeus, heartburn, dysphonia and burning sensation of the tongue underwent a complete ear, nose and throat examination, 24-hr dual-probe pH monitoring, and oesophago-gastro-duodenoscopy. RESULTS: pH monitoring revealed gastroesophageal (distal) reflux in all patients and pharyngeal (proximal) reflux in 21 patients. Treatment consisted of a proton pump inhibitor (esomeprazole). Within 4 weeks 68 per cent of patients had no laryngopharyngeal symptoms; within 8 weeks 95 per cent of patients were symptom-free. CONCLUSIONS: Patients with atypical reflux symptoms such as hoarseness, globus sensation or throat-clearing responded well to anti-reflux treatment.