Assuntos
Brônquios/lesões , Corpos Estranhos/complicações , Brônquios/patologia , Pré-Escolar , Feminino , Humanos , Necrose/etiologia , RespiraçãoRESUMO
Epistaxis represent a relatively common symptom in the hospitalary Emergencies Services. In our casuistry of 250 consecutive patients assisted and admitted because of that cause in 2 different hospitals of the region between 1996 and 2005, we have noticed the presence of one or more base pathologies or risk factors in originate most of them which could the nose bleeding. These causes are analysed beside the location of the epistaxis and the different treatment options that were used until its resolution.
Assuntos
Epistaxe/etiologia , Interpretação Estatística de Dados , Serviço Hospitalar de Emergência , Epistaxe/diagnóstico , Epistaxe/terapia , Feminino , Hemostasia Cirúrgica , Técnicas Hemostáticas , Hospitalização , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fatores de TempoRESUMO
Mucocele has its origin by blockage of the paranasal sinuses ostium with mucinous retention inside, sometimes purulent (mucopiocele), and progressive slimming with gradual destruction on the bone walls. We report an own review of 7 patients with diagnosis of frontoethmoidal mucocele, 4 men and 3 women, 50-years average. The oftalmologic clinical symptoms (diplopia, exoftalmos and the eyeball movement restrictiv) were the most frequentjointly to cefalea. The kind of surgery that we have performed, in 6 of 7 cases, was FES with marsupialization (4 times) and external ethmoidectomy (2). We have performes a literature review at this respect.
Assuntos
Seio Etmoidal , Seio Frontal , Mucocele , Doenças dos Seios Paranasais , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Mucocele/diagnóstico por imagem , Mucocele/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/cirurgia , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
We report the clinical case of a hematoma after surgery of cervical spondylosis which required an urgent tracheotomy due to failure in the orotracheal intubation. This illness in advanced degree, so called cervical spondylotic myelopathy, is the most serious consequence of cervical intervertebral disc degeneration.
Assuntos
Vértebras Cervicais/cirurgia , Hematoma/etiologia , Hematoma/cirurgia , Complicações Pós-Operatórias , Osteofitose Vertebral/cirurgia , Traqueotomia , Idoso , Vértebras Cervicais/patologia , Hematoma/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Insuficiência Respiratória/etiologia , Osteofitose Vertebral/patologiaRESUMO
Parathyroid hyperfunction condition has a very diverse and unspecific symptoms and signs. We have performed an anatomopathologic study of 146 parathyroid gland from patients diagnosed from hyperparathyroidism. About a 72.6% of the patients presented a parathyroid adenoma while in the rest 27.4% it was observed principal cells hyperplasia. Up to now we have not registered any cases of parathyroid carcinoma after anatomopathological exam of the removed gland. The mayority of the adenomas (85%) were found on the lower parathyroids and its size varied between 6 mm and 5 cm. In one case an double adenoma was diagnosed and in another two cases the adenoma was located in the superior mediastine.
Assuntos
Hiperparatireoidismo Primário/patologia , Glândulas Paratireoides/patologia , Glândulas Paratireoides/cirurgia , Adenoma/patologia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Hiperparatireoidismo Primário/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias das Paratireoides/patologiaRESUMO
Althouh lymphomas are an illness that characteristically affects the lymph nodes they can present in other locations (extranodes). The lymphoid tissue of the salivary glands can be considered part of the called mucosa-associated lymphoid tissue (MALT). We report the case of a diffuse large B-cells parotid lymphoma. The location on the parotid gland, within its rareness, is the most common for salivary gland lymphomas whose diagnosis is always histological by examination of the removed piece since the biopsy can be nonsufficient and take to a wrong diagnosis besides the greater risk of injury on the facial nerve.
Assuntos
Linfoma de Células B/patologia , Linfoma Difuso de Grandes Células B/patologia , Neoplasias Parotídeas/patologia , Idoso , Humanos , Linfoma de Células B/diagnóstico por imagem , Linfoma de Células B/cirurgia , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/cirurgia , UltrassonografiaRESUMO
We report two adult cases of sudden cardiorespiratory arrest because an acute epiglottitis that ocurred in our hospital. Although it is an uncommon pathology nowdays with good prognosis generally, we try to call the attention about this complication which can happen of unforseeable way even in previous absence of respiratory obstruction. One of the patients required coniotomy in ICU due to impossibility of orotracheal intubation (OI) and the other died in spite of an urgent performance.
Assuntos
Reanimação Cardiopulmonar , Epiglotite/complicações , Parada Cardíaca/etiologia , Doença Aguda , Corticosteroides/administração & dosagem , Corticosteroides/uso terapêutico , Adulto , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Clindamicina/administração & dosagem , Clindamicina/uso terapêutico , Cartilagem Cricoide/cirurgia , Emergências , Epiglotite/mortalidade , Epiglotite/cirurgia , Epiglotite/terapia , Parada Cardíaca/terapia , Humanos , Recém-Nascido , Unidades de Terapia Intensiva , Intubação Intratraqueal , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Netilmicina/administração & dosagem , Netilmicina/uso terapêutico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/mortalidade , Traqueotomia/métodosRESUMO
We report the case of a 86 years old male who, in the course of a coughing attack, refers spontaneous cervical and pharyngeal pain in addition to hoarness, dysphagia and some dyspnea. His exploration revealed a small right neck hematoma but with infiltration of the orohypopharynx and right hemilarynx for spreading later to posterior pharyngeal wall and left aryepiglottic fold. The patient was sent to ICU although he did not required a control of airway by intubation or tracheotomy finally.
Assuntos
Tosse/complicações , Hematoma/etiologia , Doenças da Laringe/etiologia , Pescoço , Doenças Faríngeas/etiologia , Idoso , Idoso de 80 Anos ou mais , Tosse/terapia , Endoscopia , Seguimentos , Hematoma/diagnóstico , Hematoma/diagnóstico por imagem , Humanos , Unidades de Terapia Intensiva , Doenças da Laringe/diagnóstico , Tempo de Internação , Masculino , Orofaringe , Doenças Faríngeas/diagnóstico , Doenças Faríngeas/diagnóstico por imagem , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
We report the results of a microbiological clinic study that was performed by our ENT Department between years 2000 and 2001 whose main objective was to determine, in Badajoz Area of Health, which bacteria were involved in the acute diffuse external otitis of patients without previous antibiotic treatment (two weeks before obtaining the samples). Of 79 isolated microorganisms in 62 patients that fulfilled the requirements established Pseudomonas, mainly P. Aeruginosa, represented a 46.83% altogether followed by Staphylococcus (18.98%). In almost one fourth part of the cases strains of associated fungi were identified.
Assuntos
Otite Externa/microbiologia , Infecções por Pseudomonas/diagnóstico , Doença Aguda , Administração Oral , Adolescente , Adulto , Fatores Etários , Idoso , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/uso terapêutico , Antifúngicos/administração & dosagem , Antifúngicos/uso terapêutico , Ciprofloxacina/administração & dosagem , Ciprofloxacina/uso terapêutico , Interpretação Estatística de Dados , Feminino , Fungos/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Micoses/diagnóstico , Micoses/tratamento farmacológico , Micoses/epidemiologia , Netilmicina/administração & dosagem , Netilmicina/uso terapêutico , Otite Externa/tratamento farmacológico , Prevalência , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/epidemiologia , Pseudomonas aeruginosa/isolamento & purificação , Fatores Sexuais , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Fatores de Tempo , Resultado do TratamentoRESUMO
Benign paroxysmal positional vertigo (BPPV) is the most common of the peripheral vertigo. We report the case of a 45 years old female with that pathology suspected by the symptoms which the patient related to head changes of positions and movements. Her diagnosis was confirmed by the maneuver of Dix-Hallpike, that was positive, and the treatment consisted in a maneuver of canalicular reposition according to Epley's technique. Such maneuver was successful and actually the patient is without symptoms after more than 2 years since the first episode. Finally we have performed a bibliographic review to verify the effectiveness of that treatment.
Assuntos
Modalidades de Fisioterapia , Vertigem/terapia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Postura , Canais Semicirculares , Fatores de Tempo , Resultado do Tratamento , Vertigem/diagnósticoRESUMO
Recurrent thyroid abscesses in children are an uncommon clinical disorder that use to be due to 3rd or 4th branchial anomalies and pyriform sinus fistula. We are reporting the clinical case ofa 6 year-girl who was diagnosed as left thyroid lobe and istmic abscess of 3 cm, drained by general anesthesia with positive culture for St. Viridans. Four months later she was re-admitted by the same cause and we performed a new drainage, by punction, and endovenous antimicrobial therapy for aerobic and anaerobic pathogens with good evolution. The imaging tests showed no anatomical alterations.
Assuntos
Abscesso , Infecções Estreptocócicas , Doenças da Glândula Tireoide , Estreptococos Viridans , Abscesso/diagnóstico , Abscesso/diagnóstico por imagem , Abscesso/microbiologia , Abscesso/cirurgia , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Criança , Drenagem , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Cuidados Pós-Operatórios , Recidiva , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/diagnóstico por imagem , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/cirurgia , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/diagnóstico por imagem , Doenças da Glândula Tireoide/microbiologia , Doenças da Glândula Tireoide/cirurgia , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento , UltrassonografiaRESUMO
INTRODUCTION: A prospective study is presented to evaluate some practical and financial aspects regarding surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoidal (AE) arteries performed to control posterior nasal bleeding. PATIENTS AND METHODS: 35 patients admitted at the ENT ward between 2004 and 2006 were included in the study, and distributed into two groups depending on the protocol applied in each case. Until March 2005 the surgery was performed if there was failure or insecurity of the posterior packing, and since that date a substitutive surgical protocol (not including posterior packing) was applied. RESULTS: 82.9% of the patients were male, with a mean age of 55.74 years and a left bleeding in a 60% of the cases. Ligature/cauterization was performed on SP in 28 (80%) patients, on AE in 4 (11.4%), and on both arteries in 3 cases (8.6%). 38.7% of the SP approach only one sphenopalatine foramen was observed, through which an only branch of the artery passed; 42% of the cases two branches passed through an only foramen, and in 19.3% two or more branches were present, breaking into the nose through two or more independent clefts. AE was intradural in 3 cases, intranasal attached to the cranial base in other 3 and intranasal detached to the cranial base in 1 patient. Besides, highly significant differences were found between the two protocols, observing a mean reduction of hospital stay of 3.1 days, which throws up savings of 939.3 euros per patient. DISCUSSION AND CONCLUSIONS: Surgical treatment for epistaxis has proved to be effective (91.2% in our experience) and safe, determining an important reduction in hospital stay and avoiding the morbility of posterior packing. Accurate knowledge of the anatomy of the arteries implied and specific actuation upon the correct bleeding territory are essential to perform this surgery.
Assuntos
Endoscopia/economia , Endoscopia/métodos , Epistaxe/economia , Epistaxe/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
We report the case ofa 61 years old woman with multiple pathologies: HTA, diabetes, relapsing polychondritis, hypercholesterolemia, iatrogenic Cushing, cardiopathy, cystic fibrosis, etc. She began, an increment of TA (220/130 mm Hg) or hypertensive crisis, with a sudden left cervical hematoma located on the carotid bifurcation according to CT imaging. We oractice an arteriography that was informed as normal and the patient was admitted and controlled of an ORL as Vascular Surgeon. The bleeding stop spontaneously we treat the patient conservativity.
Assuntos
Artéria Carótida Externa/diagnóstico por imagem , Hematoma/etiologia , Hipertensão/complicações , Pescoço/diagnóstico por imagem , Doença Aguda , Angiografia , Anti-Hipertensivos/uso terapêutico , Artéria Carótida Externa/patologia , Feminino , Hematoma/diagnóstico por imagem , Hematoma/tratamento farmacológico , Humanos , Hipertensão/tratamento farmacológico , Pessoa de Meia-Idade , Pescoço/patologia , Ruptura Espontânea , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We report the clinical case of an adenoid cystic carcinoma on the base of the tongue, a rare malignant tumor of slow-growing but aggressive with a propepnsity for perineural invasion. Treatment modalities more common include surgery and radiotherapy but locorregional recurrences are frequent and relatively early in the first years. A review of the literature of this pathology is performed.
Assuntos
Carcinoma Adenoide Cístico/diagnóstico , Neoplasias da Língua/diagnóstico , Carcinoma Adenoide Cístico/cirurgia , Humanos , Laringectomia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Língua/patologia , Língua/cirurgia , Neoplasias da Língua/cirurgia , Resultado do TratamentoRESUMO
Retropharyngeal phlegmons and abscesses in the adult are uncommon nowdays. We report the case of a 48 years old male diagnosed as retropharyngeal phlegmon of idiopatic cause because no reasons were able to justify the clinical symptoms. Cervical CT was negative for purulent collection and the patient was treated by endovenous antibiotics and steroids until the resolution of his process. The final hospital stay was 12 days and after 10 years follow-up he has not been readmitted due to that pathology.
Assuntos
Abscesso Retrofaríngeo/tratamento farmacológico , Antibacterianos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Faringe/diagnóstico por imagem , Abscesso Retrofaríngeo/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We report the case of a female patient who consulted to the Room Emergencies due to abundant watery otorrea of 3 months without another symptom or apparent cause. The studys confirmed the presence of cerebrospinal fluid (CSF) and the imaging tests (CT and MRI) demonstrated the existence of a communication between the right ear and middle cerebral fossa through tegmen timpani. The woman was operated by ORL (closing the fistula) and neurosurgery (placing an external lumbar drainage) with good postsurgical evolution.
Assuntos
Otorreia de Líquido Cefalorraquidiano/diagnóstico , Idoso , Otorreia de Líquido Cefalorraquidiano/cirurgia , Orelha Média/diagnóstico por imagem , Orelha Média/patologia , Orelha Média/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Procedimentos Cirúrgicos Otológicos/métodos , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Varicella herpes zoster (VZV) virus reactivaction can produce multiple neuropathies of the cranial and cervical region being the peripheral facial paralysys the most common one. We report one case of Ramsay-Hunt syndrome with eruption of vesicles on left auricular pinna and face besides facial palsy which associated to ipsilateral laryngeal or recurrential paralysis nonexisting previously. Our patient was treated by oral aciclovir (800 mg, 5 times daily) for 1 week. 3 months later she returned to Emergencies due to another cause and the ENT exploration showed a recovery in the mobility of the left cord but it persisted the affectation of VII pair, specially the inferior branch or cervicofacial. It is advised that the larynx should be examined in all cases of herpes zoster that involve the head and neck.
Assuntos
Paralisia Facial/virologia , Herpes Zoster da Orelha Externa/complicações , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Paralisia Facial/diagnóstico , Paralisia Facial/terapia , Feminino , Herpes Zoster da Orelha Externa/diagnóstico , Herpes Zoster da Orelha Externa/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Recidiva , Resultado do TratamentoRESUMO
Laryngeal or hypopharyngeal localization of adenoid cystic carcinoma is rare due to the poor distribution of the accesory salivary glands in this area. We report one case of such neoplasm on that area, with its diagnosis confirmed histologically. The required a total laryngectomy with later reoperations because of hemorrhage and pharyngeal fistula. One year after the surgery and in spite of postoperative radiotherapy multiple pulmonary metastasis were detected causing the death of the patient. We review the literature of this tumor whose prognosis is much worse than epidermoid or scamous carcinoma.
Assuntos
Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/cirurgia , Neoplasias Hipofaríngeas/patologia , Neoplasias Hipofaríngeas/cirurgia , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de NeoplasiasRESUMO
We report the clinical case of a 39 years old female diagnosed as a chronic lymphocytic tiroiditis by F.N.A.B. with multinodular goiter of long evolution. The patient was operated by total thyroidectomy and her final anatomopathologic result was papillary carcinoma diffuse sclerosing variant. During the surgical act several cervical nodes were detected and removed being informed the most of them as metastasic. A review of the literature at respect of this malignant neoplasm is performed.
Assuntos
Carcinoma Papilar/patologia , Linfócitos/metabolismo , Neoplasias da Glândula Tireoide/patologia , Tireoidite/sangue , Tireoidite/diagnóstico , Adulto , Carcinoma Papilar/radioterapia , Diagnóstico Diferencial , Feminino , Humanos , Dosagem Radioterapêutica , Esclerose/patologia , Doenças da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/radioterapiaRESUMO
The pathologic processes involving the parotid gland include a vast group of lesions, acute and chronic inflammations, benign and malign tumors, traumas or degenerative processes. We report the case of a 55 years old male diagnosed as left parotid phlegmon with involvement of both lobes, especially the deep one, who required admission and endovenous medical treatment for 6 days up to the resolution of the symptoms.