Maria T Apostolidou

General University Hospital of Larissa, Lárissa, Thessaly, Greece

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Publications (8)6 Total impact

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    ABSTRACT: Skilful airway management is critical in deep neck space infections. Although relatively uncommon, this spectrum of disease presents a clinical challenge for otolaryngologists and anesthetists. There is currently no universal agreement on the ideal method of airway control for these patients because this depends on various factors including available local expertise and equipment. We review the literature and discuss the available options of airway management in these head and neck emergencies. Special consideration is given to awake fiberoptic intubation and tracheotomy under local anesthesia. Relevant anatomy, route of spread and microbiology of deep neck space infections are also briefly discussed.
    No preview · Article · Nov 2007 · American Journal of Otolaryngology
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    ABSTRACT: Common complications of tonsillectomy are well recognized and are frequently explained to patients during the process of informed consent. This systematic review serves as a reminder of the unusual complications of this routine procedure. Studies were located using systematic searches in Medline, Embase, Cinahl, and the Cochrane Library electronic databases, together with hand searching of key texts, references, and reviews relevant to the field. Keywords used included the terms tonsillectomy, complications, unusual, and rare. References from the relevant articles were also searched for. The review was limited to English-language articles. Because of the low incidence of these complications, all cases were included regardless of age. Complications of tonsillectomy in children with various syndromes were excluded. Based on our criteria, 20 articles were identified. Only 10 articles were found suitable for review. All articles were either single case reports or small case series. Because of the small study cohort, the patients' ages ranged widely, from 3 to 21 years, with no sex dominance. The complications were categorized into intraoperative and immediate postoperative (<24 hours), intermediate (<2 weeks), and long-term (>2 weeks) unusual complications. Rare complications reviewed include intraoperative vascular injury, subcutaneous emphysema, mediastinitis, Eagle syndrome, atlantoaxial subluxation, cervical osteomyelitis, and taste disorders. It is important that the otolaryngologist is aware that although the complications discussed are rare and interesting, they are associated with significant morbidity and mortality risks. Tonsillectomy, a very common ear, nose, and throat procedure, may not be so straightforward after all.
    No preview · Article · Nov 2007 · American Journal of Otolaryngology
  • P D Karkos · S C Leong · AK Arya · S M Papouliakos · M T Apostolidou · W J Issing
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    ABSTRACT: To assess the evidence surrounding the use of certain complementary supplements in otolaryngology. We specifically focussed on four commonly used supplements: spirulina, Ginkgo biloba, Vertigoheel and nutritional supplements (cod liver oil, multivitamins and pineapple enzyme). A systematic review of the English and foreign language literature. Inclusion criteria: in vivo human studies. Exclusion criteria: animal trials, in vitro studies and case reports. We also excluded other forms of 'alternative medicine' such as reflexology, acupuncture and other homeopathic remedies. Lack of common outcome measures prevented a formal meta-analysis. Three studies on the effects of spirulina in allergy, rhinitis and immunomodulation were found. One was a double-blind, placebo, randomised, controlled trial (RCT) of patients with allergic rhinitis, demonstrating positive effects in patients fed spirulina for 12 weeks. The other two studies, although non-randomised, also reported a positive role for spirulina in mucosal immunity. Regarding the use of Ginkgo biloba in tinnitus, a Cochrane review published in 2004 showed no evidence for this. The one double-blind, placebo-controlled trial that followed confirmed this finding. Regarding the use of Vertigoheel in vertigo, two double-blind RCTs and a meta-analysis were identified. The first RCT suggested that Vertigoheel was equally effective in reducing the severity, duration and frequency of vertigo compared with betahistine. The second RCT suggested that Vertigoheel was a suitable alternative to G. biloba in the treatment of atherosclerosis-related vertigo. A meta-analysis of only four clinical trials confirms that Vertigoheel was equally effective compared with betahistine, G. biloba and dimenhydrinate. Regarding multivitamins and sinusitis, two small paediatric pilot studies reported a positive response for chronic sinusitis and otitis media following a course of multivitamins and cod liver oil. Regarding bromelain (pineapple enzyme) and sinusitis, one randomised, multicentre trial including 116 children compared bromelain monotherapy to bromelain with standard therapy and standard therapy alone, for the treatment of acute sinusitis. The bromelain monotherapy group showed a faster recovery compared with the other groups. The positive effects of spirulina in allergic rhinitis and of Vertigoheel in vertigo are based on good levels of evidence, but larger trials are required. There is overwhelming evidence that G. biloba may play no role in tinnitus. There is limited evidence for the use of multivitamins in sinus symptoms, and larger randomised trials are required.
    No preview · Article · Sep 2007 · The Journal of Laryngology & Otology
  • P. D. Karkos · A. Ahmad · N. Sivaji · A. Hargreaves · M. T. Apostolidou
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    ABSTRACT: We report a parapharyngeal abscess in an infant that was drained transorally with a modified angled needle. Although transoral drainage of parapharyngeal abscesses has been described, there are no reports – to our knowledge – on the use of a modified angled needle. Our approach was effective and resulted in a rapid resolution of the symptoms. Management and different approaches for management of parapharyngeal abscess are briefly discussed.
    No preview · Article · Mar 2007 · International Journal of Pediatric Otorhinolaryngology Extra
  • S.C.L. Leong · P.D. Karkos · M.T. Apostolidou
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    ABSTRACT: To define the role of medical or surgical treatment in patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA syndrome). A Medline search was performed using the terms PFAPA, periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis, treatment. A systematic review of the English literature was performed. Papers on pyrexia of unknown origin in the pediatric population were excluded; this was because the clinical entities included in the differential diagnosis of pyrexia of unknown origin share many clinical characteristics with PFAPA, and may be ill defined. Twenty-seven papers have been published since 1989, of which 20 were in English language. There were five single case reports and two papers involving two patients each. There were 6 retrospective reviews of case notes, involving 5-94 patients over a 3-10 year review period. Given that current evidence on the effectiveness of tonsillectomy in PFAPA is extremely weak (level of evidence V), tonsillectomy should not be performed. PFAPA usually resolves without any long-term adverse effect, and as such, there is no role for tonsillectomy in these patients.
    No preview · Article · Dec 2006 · International Journal of Pediatric Otorhinolaryngology
  • P.D. Karkos · M.T. Apostolidou · T Apostolidis

    No preview · Article · May 2006 · International Journal of Pediatric Otorhinolaryngology
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    ABSTRACT: Pediatric laryngopharyngeal reflux (PLPR) refers to the atypical, otorhinolaryngological, and respiratory manifestations of gastroesophageal reflux disease in children. PLPR is believed to be an important inflammatory cofactor in disorders such as subglottic stenosis, asthma, recurrent croup, chronic rhinosinusitis, and middle ear infections. We review the literature, present clinical manifestations, and focus on diagnostic controversies and therapeutic challenges of PLPR in relation to laryngeal manifestations. Current evidence linking reflux to many laryngeal problems is mainly based on animal studies or uncontrolled human studies. Future efforts should concentrate on developing well-designed controlled studies to provide more information on diagnosis and treatment.
    No preview · Article · May 2006 · American Journal of Otolaryngology
  • P.D. Karkos · S.P. Potamianos · M.T. Apostolidou · T.I. Apostolidis

    No preview · Article · Feb 2006