Seropositivity, adenoid hypertrophy, and secretory otitis media in adults--a recognized clinical entity

Hearing loss and acquired immune deficiency syndrome: systematic review

PURPOSE: To investigate the occurrence of hearing loss in individuals with HIV/AIDS and their characterization regarding type and degree. RESEARCH STRATEGY: It was conducted a systematic review of the literature found on the electronic databases PubMed, EMBASE, ADOLEC, IBECS, Web of Science, Scopus, Lilacs and SciELO. SELECTION CRITERIA: The search strategy was directed by a specific question: "Is hearing loss part of the framework of HIV/AIDS manifestations?", and the selection criteria of the studies involved coherence with the proposed theme, evidence levels 1, 2 or 3, and language (Portuguese, English and Spanish). DATA ANALYSIS: We found 698 studies. After an analysis of the title and abstract, 91 were selected for full reading. Out of these, 38 met the proposed criteria and were included on the review. RESULTS: The studies reported presence of conductive, sensorineural, and mixed hearing loss, of variable degrees and audiometric configurations, in addition to tinnitus and vestibular disorders. The etiology can be attributed to opportunistic infections, ototoxic drugs or to the action of virus itself. The auditory evoked potentials have been used as markers of neurological alterations, even in patients with normal hearing. CONCLUSION: HIV/AIDS patients may present hearing loss. Thus, programs for prevention and treatment of AIDS must involve actions aimed at auditory health.

Nasal and sinus endoscopy for medical management of resistant rhinosinusitis, including postsurgical patients

Nasal endoscopy has been practiced by allergists since the early 1980s; however, allergists in general have not embraced endoscopic evaluation of patients with sinus disease, either before or after surgery. Allergists are in a unique position to render medical (as opposed to surgical) care of patients with sinusitis. There has been a growing realization that endoscopy is a valuable procedure for the evaluation and medical treatment of patients with difficult sinusitis. This has resulted in the need for a resource to allow allergists to understand the nature of endoscopic findings in patients with sinusitis, either preoperatively or postoperatively. This article introduces the findings at endoscopy that are common in patients with sinusitis, including those that may be seen after surgery. The findings include perforation of the septum, retained secretions, small surgical ostium caused by postoperative ostial stenosis, previous Caldwell Luc procedure, recirculation of mucus, hyperplastic nasal disease, synechiae, recurrent disease in previously unaffected sinuses, empty nose syndrome, frontal sinus disease, dental disease, and other, more complicated entities.

[Morphological changes in adenotonsillar tissue as early manifestation of asymptomatic HIV patient]

The HIV virus induces in the host several changes in your immunological system, which heads to the AIDS. We report two cases diagnosed by pathological studies after adenotonsilectomy for adenotonsilar hypertrophy. The diagnosis of HIV patients is suspected by epidemiologic (risk groups) or clinical features (opportunist diseases). But, it exists a early diagnosis, the histological findings in the extranodal lymphoid tissues, unusual on the literature. These phenomenons re-enforce the contamination way by means of the superior aerodigestive tract mucosis.

Age-specific size of the normal adenoid pad on magnetic resonance imaging

Conclusions regarding the significance and appearance of the adenoids incidentally noted on magnetic resonance (MR) scans of the brain largely rely on observations of previously published plain film data. In order to determine the age specific appearance of normal adenoid tissue as measured on sagittal T1-weighted midline MR images, we evaluated 189 patients without a history or clinical evidence of adenoid disease, who were sequentially referred for an MR scan of the brain. The thickness of the adenoid pad was measured to the nearest 1 mm along a line through the pharyngeal tubercle constructed perpendicular to the anterior clival surface. Patients were grouped according to age. Normal subjects demonstrated an age specific variation in the size of the pad with the maximal size being attained in early childhood and then steadily decreasing in later childhood and adulthood (P = 0.0001). The adenoids were largest in the 7-10 years age group (mean, 14.59 mm) and steadily declined to 4.83 mm by 60 years of age. Previous surgery had no effect on adenoid measurement (P = 0.582). Magnetic resonance scans provide an excellent method for assessing the adenoid pad.

Mass in the post nasal space and acquired immune deficiency syndrome

We report a case of previously undiagnosed acquired immunodeficiency syndrome (AIDS) who had a mass in the post-nasal space causing almost complete nasal obstruction. Histology showed both respiratory and squamous epithelium covering an active chronic inflammatory infiltrate. Lymphoma, Kaposi's sarcoma and infiltrative fungal sinusitis were excluded. There was no evidence of the common viruses associated with lesions in AIDS. Unlike adenoid hypertrophy, the lesion was an exuberant growth with an additional chronic inflammatory reaction due to ulceration of the surface epithelium.

Nasopharyngeal lymphoid tissue masses in patients with human immunodeficiency virus-1. Histologic findings and clinical correlation

BACKGROUND

Although the histologic changes in lymph nodes in patients infected with the human immunodeficiency virus-1 (HIV-1) are well described, the histology and resulting clinical symptoms of hyperplastic nasopharyngeal lymphoid tissue (NPLT) in these patients are not widely known, particularly to pathologists and oncologists.

METHODS

Nine patients with HIV-1 presented with a nasopharyngeal mass, nasal stuffiness, nasal bleeding, hearing loss, and cervical lymphadenopathy in various combinations. Tonsillar tissue was biopsied or removed from all nine.

RESULTS

The tonsillar tissue showed a spectrum of the changes of reactive lymphoid hyperplasia.

CONCLUSIONS

Clinicians and pathologists must be aware of the spectrum of histologic changes and clinical features relating to biopsies from NPLT to interpret the changes correctly and to avoid a misdiagnosis of malignant lymphoma.