From - Tue Dec 18 17:48:33 2001 Message-ID: <3C1F410E.999E6F8B@earthops.net> Date: Tue, 18 Dec 2001 08:13:50 -0500 From: Tiny Human Ferret Organization: copyright 2001 all rights reserved -- non-UseNet transmission prohibited. X-Mailer: Mozilla 4.5 [en] (X11; U; Linux 2.2.17 i586) X-Accept-Language: en MIME-Version: 1.0 Newsgroups: alt.gothic Subject: Re: Megan and Sarah want to know where you live References: <3c190e4d_2@news.iglou.com> <3C198980.9BC106B8@clark.net> <3c1a2206_2@news.iglou.com> <9vd8oj$okf$1@mailgate2.lexis-nexis.com> <3c1a3ad9_3@news.iglou.com> <9vdgqu$9s5$1@mailgate2.lexis-nexis.com> <_qyS7.106628$lV4.16425873@e420r-atl1.usenetserver.com> <3C1B7E7D.3516590C@clark.net> <3C1E8CDB.D2C2A3F9@clark.net> Content-Type: text/plain; charset=us-ascii Content-Transfer-Encoding: 7bit NNTP-Posting-Host: 65.205.1.226 X-Trace: vienna7.his.com 1008681233 65.205.1.226 (18 Dec 2001 08:13:53 -0500) Lines: 181 X-Authenticated-User: tjh22isp Path: vienna7.his.com Xref: vienna7.his.com alt.gothic:832315 `Una wrote: > > klaatu@clark.net wrote: > > >Jennie wrote: > >> If she was actively having a reproductive life, chances are > >> sshe'd be killed by complications during childbirth before her wisdom > >> tooth complications got her, no? > > > >Not as I understand it. Either you had no wisdom teeth or they came in > >perfectly, in about 80 percent of cases an exposed impaction led to > >mastoiditis which is certainly incapacitating if not fatal. Basically, the > >sides of your skull near your ears rot from the inside, very unpleasant. > > What's an exposed impaction? An exposed impaction is when your wisdom teeth break through the gums, but don't emerge fully or don't emerge enough for the gums to seal around them. Food debris gets caught below the gums sufficiently to host a colony of bacteria. Some of those will almost certainly be streptococcus type A and those infiltrate surrounding tissues, generally causing a sore throat but they can also cause necrotizing fascitis (flesh-eating strep). > What's mastoiditis? The "mastoid process" is that point of bone right behind your ear. Find a model of a skull online, it's probably clearly labelled. It's one of the thicker bones of the body, and doesn't have many ways for antibodies to get to it to kill infections in the bone. Once a colony of bacteria get going in there, it can be almost impossible to stop, even with excellent modern antibiotics. One treatment is to drill a small hole into it and fill the hole with a gel containing the best antibiotics available, and cap it, and this is usually successful, but a last resort. From http://www.bcm.tmc.edu/oto/grand/2394.html Acute mastoiditis is rarely seen today. Prior to the discovery of antibiotics, acute mastoiditis was the most common complication of acute otitis media and often resulted in death. The incidence has dropped significantly with the advent of antibiotics. Likewise, the frequency of mastoidectomy for this condition has decreased ten fold, down from 20% in 1938 to 2.8% in 1948 with a 90% decrease in mortality rate. Acute mastoiditis is a natural extension of acute otitis media. At the onset of infection, acute inflammation of the middle ear also involves inflammation of the mastoid air cells, which is not associated with bony resorption and must be differentiated from clinically significant mastoiditis. Temporal bone development is integral in the ability to develop this disease. The degree of pneumatization varies greatly in temporal bones. Infection, heredity, ventilation, environment, and nutrition all play a role in the pneumatization process. Inflammation that develops is easily passed through these contiguous pneumatized regions. Not only can inflammation spread to these pneumatized regions, but it can spread to adjacent areas. The evolution of acute mastoiditis begins when the mucosal lining of the pneumatized cells become inflamed and produce an exudate. Serosanguinous fluid eventually becomes mucopurulent. Spontaneous perforation of the tympanic membrane or myringotomy would halt the process at this point. However, 1-5% of these cases go on to the next phase. The cellular walls of the pneumatized cells then become demineralized due to: increased osteoclastic activity, pressure of the purulent exudate on the thin bony septae, and ischemia of the septae secondary to reduced blood flow. As the bony septae breakdown small abscess cavities form leading to coalescence. Finally the coalescent cells form an empyema, or pus under pressure, which then escapes to surrounding areas. Treatment of acute mastoiditis depends on the pathologic stage at which it is encountered. The bacteriology of acute mastoiditis surprisingly differs from that of acute otitis media. The causative organism in acute otitis media are usually S Pneumo or H Flu. However, acute mastoiditis is more commonly due to Group A Beta-Hemolytic Strep and S Pneumo with rare involvement by H. Flu. Subacute and chronic disease is usually attributed to S. Aureus and gram negative rods such as E. Coli, Proteus and Pseudomonas. The signs and symptoms of acute mastoiditis mimic severe acute suppurative otitis media; the disease entities are distinguished by the duration of symptoms. When the symptoms persist or recur after several weeks of acute otitis media, they point toward development of a coalescent process within the mastoid. The most common symptoms are otorrhea and otalgia. Subperiosteal abscess is noted by a fluctuant mass with overlying edema and erythema. This process produces displacement of the ear downward, outward, and forward. Sagging of the posterosuperior meatal wall occurs secondary to thickening of the periosteum overlying the bone in the area of the antrum. The tympanic membrane can simply appear normal, thickened or can demonstrate a small central perforation. Neurologic changes may be seen with intracranial complications. Perforation of the mastoid tip along the medial aspect of the SCM through the incisura mastoidea produces a deep abscess in the neck known as a Bezold's abscess. Acute mastoiditis is one of the 10 basic complications of acute otitis media. Some worth noting are listed here. Petrositis is indicated by Gradenigo triad -- acute or subacute otitis media, retro-orbital pain and abducens palsy. Labyrinthitis due to suppurative ear disease is potentially fatal with spread to the cerebrospinal fluid producing meningitis. Presence of an extradural abscess is best evaluated by CT scan but must be excluded intraoperatively by visualizing normal dura through thin intact bone. Sigmoid sinus thrombosis may be asymptomatic or associated with toxemia or septic emboli. Griesinger's sign may be encountered and is noted by the presence of edema erythema of the posterior aspect of the mastoid process associated with mastoid emissary vein thrombosis. The Tobey - Ayer or Queckenstedt test is usually of historic significance and shows a rise in CSF pressure with occlusion of the normal IJ and NO change in CSF pressure with occlusion of the thrombosed vein. Brain abscess formation begins with cerebritis and should be closely monitored if suspected with CT scan every 1-2 weeks. > And what complications can you have if you leave > impacted wisdom teeth in your head? Death, if you get mastoiditis. See also http://www.emedicine.com/ped/topic1379.htm or search AltaVista for "complications of mastoiditis". If you don't get mastoiditis, you will still have lots of problems, including decay on the adjacent molars, very bad breath once your teeth start to rot, related infections of the throat and respiratory tract, etc. > > I have three impacted and I'm wondering if they have > anything to do with the increasing amounts of pain > I'm in (headaches, toothaches, that kind of thing) > and if I should look into doing something about it. Yes, you should definitely look into doing something about it! > > My skull isn't going to rot away is it? It's more likely that you might wind up like Van Gogh. > > `Una - the love platypus > has no money, no insurance, and noone will see me > without the money. If it gets bad enough, go to the hospital emergency room. They may not turn you away due to inability to pay. Also get to the local free/cheap clinic, if there isn't one in your town, why are you still in that town? If you're still there because you're going to college, consult the college health department. But maybe try the emergency room. If they tell you to go away, tell them the pain is driving you insane. Tell them about Van Gogh (there's a theory that he had chronic mastoiditis). They will probably call for a psych consult. Complain relentlessly about the pain in your ear and jaw and how you can't take it anymore. The psych will take a look at your wisdom teeth and ears and probably call whoever dragged them down there and curse them for fools. You will almost certainly get a big prescription for heavy-duty antibiotics, ask them if they can give you physician samples since you can't afford a prescription. If they can't do that, ask for a prescription for generics. -- Be kind to your neighbors, even though they be transgenic chimerae. Whom thou'st vex'd waxeth wroth: Meow. <-----> http://earthops.net/klaatu/