Dysphagia in patients with coronavirus disease undergoing orotracheal intubation.

Objective: To assess the incidence and the risk factors for the development of dysphagia in patients with coronavirus disease 2019 (COVID-19) undergoing orotracheal intubation. Study Design: Prospective cohort study. Methods: In this prospective cohort study, we evaluated consecutive patients diagnosed with COVID-19 and underwent orotracheal intubation were evaluated. During hospitalization, extubated patients were classified as dysphagic and nondysphagic based on bedside functional assessment of swallowing. Patients discharged from hospital were asked to complete the Eating Assessment Tool-10 (EAT-10) questionnaire, followed by an endoscopic examination to identify laryngotracheal lesions, and a fiberoptic endoscopic evaluation of swallowing (FEES). The food consistencies used for FEES were moderately thick, extremely thick, thin, and regular. Results: Based on the functional assessment of swallowing, performed a mean of 5.3 days and a median of 4 days after extubation, the incidence of dysphagia in patients with COVID-19 undergoing orotracheal intubation was 53.6%. In the late evaluation, performed a mean of 102 days after extubation, 12.8% of patients had an EAT-10 score >2. Orotracheal intubation (OTI) duration and tracheostomy were risk factors for the development of dysphagia. There was an association between EAT-10 > 2 and the presence of laryngotracheal lesion, with no difference between lesion type and EAT score >2. Conclusions: The incidence of dysphagia varied according to the time of assessment, being higher the earlier the assessment after extubation. OTI duration and tracheostomy were risk factors for the development of dysphagia, and the presence of laryngotracheal lesions demonstrated an association with dysphagia. Level of Evidence: 3.

The Importance of Inspiratory Maneuver for Benign Laryngeal Lesions

Abstract Introduction Inspiratory maneuver corresponds to a simple method used during videolaryngoscopy to increase characterizations of laryngeal findings, through the movement of the vocal fold cover and exposure of the ligament, facilitating its evaluation. Objective To evaluate the increase in diagnosis of benign laryngeal lesions from the usage of inspiratory maneuvers during videolaryngoscopy in patients with or without vocal complaints. Methods A cross-sectional study performed from March 1 to July 1, 2018, in the Laryngology sector of a tertiary hospital. The age of the patients varied from 18 to 60 years old. They were divided into two groups, symptomatic and asymptomatic vocals, and evaluated through videolaryngoscopy together with inspiratory maneuvers. The exams were recorded and later evaluated by three trained laryngologists who determined the laryngeal lesions before and after the inspiratory maneuver. Results There were 60 patients in this sample, 41 of which were vocal symptomatic and 19 asymptomatic. The majority was female and the main complaint was about dysphonia. Before the inspiratory maneuver, the most observed lesions in both groups were chronic laryngitis, followed by vascular dysgenesis. After the inspiratory maneuver, sulcus vocalis was the most frequent additional finding. Conclusion With the inspiratory maneuver, it was possible to increase the identification of structural lesions in the vocal fold, and the most frequent lesion in patients with or without vocal complaints was sulcus vocalis.

The Importance of Inspiratory Maneuver for Benign Laryngeal Lesions.

Introduction Inspiratory maneuver corresponds to a simple method used during videolaryngoscopy to increase characterizations of laryngeal findings, through the movement of the vocal fold cover and exposure of the ligament, facilitating its evaluation. Objective To evaluate the increase in diagnosis of benign laryngeal lesions from the usage of inspiratory maneuvers during videolaryngoscopy in patients with or without vocal complaints. Methods A cross-sectional study performed from March 1 to July 1, 2018, in the Laryngology sector of a tertiary hospital. The age of the patients varied from 18 to 60 years old. They were divided into two groups, symptomatic and asymptomatic vocals, and evaluated through videolaryngoscopy together with inspiratory maneuvers. The exams were recorded and later evaluated by three trained laryngologists who determined the laryngeal lesions before and after the inspiratory maneuver. Results There were 60 patients in this sample, 41 of which were vocal symptomatic and 19 asymptomatic. The majority was female and the main complaint was about dysphonia. Before the inspiratory maneuver, the most observed lesions in both groups were chronic laryngitis, followed by vascular dysgenesis. After the inspiratory maneuver, sulcus vocalis was the most frequent additional finding. Conclusion With the inspiratory maneuver, it was possible to increase the identification of structural lesions in the vocal fold, and the most frequent lesion in patients with or without vocal complaints was sulcus vocalis.

Influence of age on rhinoplasty outcomes evaluation: a preliminary study.

BACKGROUND: The aim of this study was to evaluate the satisfaction of patients who underwent rhinoplasty by using the Rhinoplasty outcomes evaluation (ROE) questionnaire and determine the influence of patient age on the outcomes. METHODS: We conducted a longitudinal study to assess patients' pre- and postoperative degrees of satisfaction with their results. The study was done at a tertiary-care medical center. The ROE questionnaire was applied twice in the same visit and aimed at measuring the patient's satisfaction in both pre- and postoperative moments. RESULTS: The initial sample of this study was composed of 112 patients, 61 of whom have answered the ROE questionnaire. A mean difference of 50.5 (P < 0.0001) was observed between the pre- and postoperative satisfaction scores. No statistically significant difference was observed on the mean difference between pre- and postoperative satisfaction scores (CHANGE) according to sex (P = 0.673), the follow-up time period (P = 0.629), or the kind of surgical procedure (P = 0.904). The mean postoperative score of the <30-year-old group was lower than the mean of 30 to <50-year-old (P < 0.003) and ≥50-year-old groups (P < 0.009). CONCLUSION: The ROE questionnaire is a tool for evaluating the outcomes of different surgical indications for correcting nasal deformities. The kind of surgical procedure had no influence on the mean difference between pre- and postoperative satisfaction scores. By using this tool we found that the younger age group reported lower postoperative satisfaction scores than older patients.

Ressecção endoscópica escalonada para Amiloidose extensa do trato aéreo-digestivo superior: uma alternativa eficaz e viável / Endoscopic escalated to extensive amyloidosis of the upper aero-digestive tract: a feasible and effective alternative

Introdução: a amiloidose localizada é uma doença rara, caracterizada pelo depósito extracelular de proteínas que pode ocorrer em várias regiões do corpo. A laringe é o sítio mais comum da doença na região de cabeça e pescoço. Objetivo: apresentaremos uma revisão literária e o caso de um paciente com amiloidose extensa em trato aéreo-digestivo superior, cuja ressecção foi realizada em quatro etapas. Relato do caso: SMS, 28 anos, disfonia há 4 meses. Exames complementares evidenciaram lesão de grande dimensão em supraglote que foi ressecada em quatro etapas por microlaringoscopia. Comentários finais: a abordagem por microlaringoscopia escalonada mostrou-se eficaz e segura na ressecção de lesão por amiloidose de grande dimensão (AU)

Assessment of symptom improvement following nasal septoplasty with or without turbinectomy.

UNLABELLED: Most studies show that objective measures to quantify and determine surgical success in the treatment of nasal obstruction do not correlate with subjective improvement as reported by patients. AIM: To evaluate the subjective improvement of nasal symptoms in patients undergoing septoplasty with or without turbinectomy. MATERIALS AND METHODS: A prospective study. We evaluated 72 septoplasty patients with or without partial inferior turbinectomy; the patients answered a questionnaire preoperatively and on the 60th day after surgery. RESULTS: Septoplasty was done associated with bilateral partial inferior turbinectomy in 83.3% of patients; it was unilateral in 9.7%; there was no need for turbinate reduction in 6.9%. An improvement of all symptoms was observed after surgery. Nasal obstruction had improved in 68 patients (94.4%) by the 60th postoperative day. The average nasal obstruction score in patients with and without allergic symptoms was similar before surgery and on the 60th postoperative day. Older patients had milder preoperative allergic symptoms. CONCLUSIONS: Nasal symptoms in patients undergoing septoplasty, with or without turbinectomy, improved. Patients with and without allergic symptoms showed a similar improvement of nasal obstruction on the 60th postoperative day.

Assessment of symptom improvement following nasal septoplasty with or without turbinectomy / Avaliação da melhora dos sintomas nasais após septoplastia com ou sem turbinectomia

Most studies show that objective measures to quantify and determine surgical success in the treatment of nasal obstruction do not correlate with subjective improvement as reported by patients. AIM: To evaluate the subjective improvement of nasal symptoms in patients undergoing septoplasty with or without turbinectomy. MATERIALS AND METHODS: A prospective study. We evaluated 72 septoplasty patients with or without partial inferior turbinectomy; the patients answered a questionnaire preoperatively and on the 60th day after surgery. RESULTS: Septoplasty was done associated with bilateral partial inferior turbinectomy in 83.3 percent of patients; it was unilateral in 9.7 percent; there was no need for turbinate reduction in 6.9 percent. An improvement of all symptoms was observed after surgery. Nasal obstruction had improved in 68 patients (94.4 percent) by the 60th postoperative day. The average nasal obstruction score in patients with and without allergic symptoms was similar before surgery and on the 60th postoperative day. Older patients had milder preoperative allergic symptoms. CONCLUSIONS: Nasal symptoms in patients undergoing septoplasty, with or without turbinectomy, improved. Patients with and without allergic symptoms showed a similar improvement of nasal obstruction on the 60th postoperative day.

A maioria dos estudos mostra que medidas objetivas para quantificar e determinar o sucesso das cirurgias para a obstrução nasal não têm correlação com a melhora subjetiva relatada pelo paciente. OBJETIVO: Avaliar a melhora dos sintomas nasais nos pacientes submetidos à septoplastia, com ou sem turbinectomia. MATERIAL E MÉTODO: Estudo prospectivo. Foram avaliados 72 pacientes submetidos à septoplastia, com ou sem turbinectomia inferior parcial, que responderam ao questionário no préoperatório até o 60º dia de pós-operatório (PO). RESULTADOS: Foi realizada septoplastia associada à turbinectomia inferior parcial bilateral em 83,3 por cento dos pacientes, unilateral em 9,7 por cento e não houve necessidade de redução das conchas nasais em 6,9 por cento. Foi observada melhora para todos os sintomas no pós-operatório. Sessenta e oito (94,4 por cento) pacientes apresentaram melhora da obstrução nasal no 60º PO. A média da nota da obstrução nasal entre os pacientes com e sem sintomas alérgicos foi semelhante no pré-operatório e no 60º PO. Os pacientes mais velhos apresentaram menor intensidade dos sintomas alérgicos no pré-operatório. CONCLUSÕES: Os pacientes submetidos à septoplastia, com ou sem turbinectomia, evoluem com melhora de todos os sintomas nasais. Os pacientes com e sem sintomas alérgicos apresentam melhora da obstrução nasal de forma semelhante no 60º PO.

Crooked nose: outcome evaluations in rhinoplasty.

UNLABELLED: A crooked nose is the result of deformities that might involve the bony nasal pyramid, the upper and lower lateral cartilages, and nasal septum, causing complaints of aesthetic and/or functional nature. PURPOSE: To evaluate how satisfied are those patients who underwent rhinoplasty to correct crooked nose, through the questionnaire Rhinoplasty Outcomes Evaluation (ROE). MATERIAL AND METHOD: A longitudinal study with retrospective analysis of preoperative satisfaction and prospective analysis of postoperative satisfaction of patients who underwent rhinoplasty. ROE questionnaire was applied twice in the same visit aiming at measuring patient satisfaction in both pre and postoperative periods. Nineteen patients who underwent rhinoplasty answered the ROE. RESULTS: For all patients who underwent rhinoplasty, the average preoperative satisfaction score was of 24. 6 ± 11. 3, while the average postoperative score was of 76. 1 ± 19. 5 (p<0. 0001). Average differences between pre and postoperative satisfaction scores in patients younger than 30 years of age were lower than those reported by >30-year-old patients (p = 0. 05). CONCLUSIONS: From the Rhinoplasty Outcomes Evaluation questionnaire, it is possible to demonstrate the impact that rhinoplasty to correct a crooked nose determines the quality of life of patients. Approximately 90% of patients undergoing rhinoplasty believed they achieved a good or excellent postoperative result.

Crooked nose: outcome evaluations in rhinoplasty / Nariz torto: avaliação de resultados em rinoplastia

A crooked nose is the result of deformities that might involve the bony nasal pyramid, the upper and lower lateral cartilages, and nasal septum, causing complaints of aesthetic and/or functional nature. PURPOSE: To evaluate how satisfied are those patients who underwent rhinoplasty to correct crooked nose, through the questionnaire Rhinoplasty Outcomes Evaluation (ROE). MATERIAL AND METHOD: A longitudinal study with retrospective analysis of preoperative satisfaction and prospective analysis of postoperative satisfaction of patients who underwent rhinoplasty. ROE questionnaire was applied twice in the same visit aiming at measuring patient satisfaction in both pre and postoperative periods. Nineteen patients who underwent rhinoplasty answered the ROE. RESULTS: For all patients who underwent rhinoplasty, the average preoperative satisfaction score was of 24. 6±11. 3, while the average postoperative score was of 76. 1±19. 5 (p<0. 0001). Average differences between pre and postoperative satisfaction scores in patients younger than 30 years of age were lower than those reported by >30-year-old patients (p=0. 05). CONCLUSIONS: From the Rhinoplasty Outcomes Evaluation questionnaire, it is possible to demonstrate the impact that rhinoplasty to correct a crooked nose determines the quality of life of patients. Approximately 90 percent of patients undergoing rhinoplasty believed they achieved a good or excellent postoperative result.

O nariz torto ou laterorrinia é resultado de deformidades que podem envolver a pirâmide nasal, as cartilagens laterais superiores, alares e o septo nasal, causando queixas estéticas e/ou funcionais. OBJETIVO: Avaliar a satisfação dos pacientes submetidos à rinoplastia para a correção do nariz torto, a partir do questionário Rhinoplasty Outcomes Evaluation (ROE). MATERIAL E MÉTODO: Estudo longitudinal, tipo coorte retrospectivo, com análise retrospectiva da satisfação pré-operatória e prospectiva da satisfação pós-operatória. Dezenove pacientes submetidos à rinoplastia responderam ao questionário ROE. RESULTADOS: A média da nota da satisfação de todos os pacientes submetidos à rinoplastia, para a correção do nariz torto, no pré-operatório foi de 24,6±11,3 e no pós-operatório foi de 76,1±19,5 (p<0,0001). Os pacientes com idade <30 anos apresentaram menor média da diferença das notas da satisfação entre pós e pré-operatório que os pacientes >30 anos (p=0,05). CONCLUSÃO: A partir da aplicação do questionário Rhinoplasty Outcomes Evaluation, é possível demonstrar o impacto que a rinoplastia para a correção do nariz torto determina na qualidade de vida dos pacientes. Aproximadamente 90 por cento dos pacientes submetidos à rinoplastia para a correção do nariz torto consideram que atingiram bom ou excelente resultado pós-operatório.

Avaliação da necessidade do uso do tampão nasal após septoplastia com turbinectomia / Evaluation about the requirement to use a pack after septoplasty with turbinectomy

Introdução: A septoplastia associada a turbinectomia inferior parcial é uma das cirurgias mais realizada no pacientes com obstrução nasal. O tampão nasal tem sido usado para controle primário do sangramento nestas cirurgias. Várias complicações têm sido relacionadas com o uso do tampão nasal, alem de causarem dor e desconforto importante com seu uso. Alguns estudos têm questionado a eficácia do tampão nasal no controle do sangramento e das complicações após septoplastia e turbinectomia. Objetivo: Comparar o grau de sangramento nasal entre os pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral que usaram ou não tampão nasal. Método: Foi realizado estudo prospectivo no qual foram avaliados 60 pacientes com diagnóstico de desvio do septo nasal com hipertrofia das conchas inferiores. Os pacientes foram submetidos à septoplastia com turbinectomia bilateral com visualização direta. Foram divididos em 2 grupos: sem tampão e com tampão (Merocel® e dedo de luva). Estes foram avaliados no pós-operatório, a partir da avaliação da intensidade do sangramento. Resultado: Foi observado que o grau de sangramento no pós-operatório no grupo submetido à turbinectomia inferior parcial bilateral e que usou tampão nasal foi menor, do que no grupo que não usou tampão. Conclusão: Pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral e não usaram tampão nasal no pós-operatório apresentaram mais sangramento do que os pacientes que usaram tampão nasal.

Introduction: Septoplasty associated with a partial inferior turbinectomy is one of the most frequent surgeries performed in patients with nasal obstruction. The nasal pack has been used to control primary bleeding in these surgeries. Several complications have been related to the nasal pack, besides causing pain and a relevant discomfort. Some studies have investigated both the efficiency of the nasal pack to control bleeding and the complications after septoplasty and turbinectomy. Objective: To compare the degree of nasal bleeding among patients submitted to septoplasty with partial bilateral inferior turbinectomy, whether using the nasal pack or not. Method:An outlook study was performed to evaluate 60 patients diagnosed of a deviated nasal septum with an inferior concha hypertrophy. The patients were submitted to bilateral turbinectomy septoplasty under direct visualization. They were divided into 2 groups: without pack and with pack (Merocel* and protective sheath). These were evaluated after surgery, based on the evaluation of bleeding intensity. Result: It was observed that the post-surgical bleeding degree of the group submitted to partial bilateral inferior turbinectomy, who used the nasal pack, was lower than the group not using a pack. Conclusion: Patients submitted to septoplasty with partial bilateral inferior turbinectomy, not using a post-surgical nasal pack, appeared to bleed more than patients using a nasal pack.

Avaliação de resultados em rinoplastia de redução / Results evaluation in reduction rhinoplasty

Introdução: A avaliação do resultado final após rinoplastia é um tema pouco estudado pela visão do paciente. Objetivo: Avaliar a satisfação dos pacientes submetidos à rinoplastia de redução, a partir do questionário Rhinoplasty Outcomes Evaluation (ROE). Método: Estudo longitudinal, tipo coorte retrospectivo, da satisfação pré-operatória e pós-operatória. A amostra foi composta por 28 pacientes submetidos à rinoplastia que responderam ao questionário ROE. Foram obtidas três variáveis: nota da satisfação que o paciente tinha com sua imagem antes da cirurgia; nota da satisfação com a atual aparência; e a diferença das médias das notas da satisfação entre pós e pré-operatório. Resultados: A nota pós-operatória foi superior a pré-operatória em todos os pacientes. Foi observada diferença entre as médias das notas do pós e pré-operatório de 48,3 (p<0,0001). No pré-operatório foi observado que 100% dos pacientes apresentaram satisfação <50. No pós-operatório foi observado que 92,9% migraram da classe <50 para as classes: 50 a <75 considerado bom (25%); >75 considerado excelente resultado (67,9%). Conclusão: O questionário ROE é uma ferramenta útil em demonstrar a satisfação do paciente submetido à rinoplastia de redução. Cerca de 92% dos pacientes submetidos à rinoplastia de redução consideram bom ou excelente resultado no pós-operatório.

Introduction: Final results evaluation after rhinoplasty is a not a topic widely studied from the patient's viewpoint. Objective: Evaluate the satisfaction of the patients submitted to reduction rhinoplasty, from the questionnaire Rhinoplasty Outcomes Evaluation (ROE). Method: Longitudinal study, retrospective cut type, of the preoperative and postoperative satisfaction. The sample was composed by 28 patients who were submitted to rhinoplasty and answered the ROE questionnaire. Three variables were obtained: satisfaction note that the patient had with his/her image before the surgery; note of satisfaction with the current appearance; the difference of the average satisfaction notes between postoperative and preoperative approaches. Results: The postoperative note was higher than the preoperative in all patients. We noticed a difference between the average of the postoperative and preoperative of 48.3 (p<0.0001). In the preoperative approach we noticed that 100% of the patients had satisfaction of <50. In the postoperative there was a 92.9% migration from classification <50 to classes: 50 to <75 considered to be good (25%); >75 considered to be an excellent outcome (67.9%). Conclusions: The ROE questionnaire is a helpful tool to show the satisfaction of the patient submitted to reduction rhinoplasty. About 92% of the patients submitted to reduction rhinoplasty consider the postoperative result to be good or excellent.

Avaliação de resultados em rinoplastia de redução / Results evaluation in reduction rhinoplasty

Introduction: final results evaluation after rhinoplasty is a not a topic widely studied from the patient's viewpoint. Objective: evaluate the satisfaction of the patients submitted to reduction rhinoplasty, from the questionnaire Rhinoplasty Outcomes Evaluation (ROE). Method: longitudinal study, retrospective cut type, of the preoperative and postoperative satsfaction. The sample was composed by 28 patients who were submitted to rhinoplasty and answered the ROE questionnaire. Three variables were obtained: satisfaction note that the patient had with his/her image before the surgery; note of satisfaction with the current appearance; the difference of the average satisfaction notes between postoperative and preoperative approaches. Results: the postoperative note was higher than the preoperative in all patients. We noticed a difference between the average of the postoperative and preoperative of 48,3 (p<0,0001). In the preoperative approach we notice that 100% of the patients had satisfaction of <50. In the postoperative there was a 92,9% migration from classification <50 to classes: 50 to <75 considered to be good (25%); > or =75 considered to be an excellent outcome (67,9%). Conclusions: the ROE questionnaire is a helpful tool to show the satisfaction of the patient submitted to reduction rhinoplasty. About 92% of the patients submitted to reduction rhinoplasty consider the postoperative result to be good or excellent (AU)

Avaliação da necessidade do uso do tampão nasal após septoplastia com turbinectomia / Assessment of need for the use of nasal packing after septoplasty with turbinectomy

Introdução: a septoplastia associada a turbinectomia inferior parcial é uma das cirurgias mais realizadas nos pacientes com obstrução nasal. O tampão nasal tem sido usado para controle primário do sangramento nestas cirurgias. Várias complicações têm sido relacionadas com o uso do tampão nasal, além de causarem dor e desconforto importante com seu uso. Alguns estudos têm questionado a eficácia do tampão nasal no controle do sangramento e das complicações após septoplastia e turbinectomia. Objetivo: comparar o grau de sangramento nasal entre os pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral que usaram ou não tampão nasal. Método: foi realizado estudo prospectivo no qual foram avaliados 60 pacientes com diagnóstico de desvio do septo nasal com hipertrofia das conchas inferiores. Os pacientes foram submetidos à septoplastia com turbinectomia bilateral com visualização direta. Foram divididos em 2 grupos: sem tampão e com tampão [Merocel (R) e dedo de luva] . Estes foram avaliados no pós-operatório, a partir da avaliação da intensidade do sangramento. Resultado: foi observado que o grau de sangramento no pós-operatório no grupo submetido à turbinectomia inferior parcial bilateral e que usou tampão nasal foi menor, do que no grupo que não usou tampão. Conclusão: pacientes submetidos à septoplastia com turbinectomia parcial inferior bilateral e não usaram tampão nasal no pós-operatório apresentaram mais sangramento do que os pacientes que usaram tampão nasal (AU)

Ressecção endoscópica escalonada para amiloidose extensa do trato aéreo-digestivo superior: uma alternativa eficaz e viável / Endoscopic escalated resection to extensive amyloidosis of the upper aero-digestive tract: a feasible and effective alternative

Introdução: A amiloidose localizada é uma doença rara, caracterizada pelo depósito extracelular de proteínas que pode ocorrer em várias regiões do corpo. A laringe é o sítio mais comum da doença na região de cabeça e pescoço. Objetivo: Apresentaremos uma revisão literária e o caso de um paciente com amiloidose extensa em trato aéreo-digestivo superior, cuja ressecção foi realizada em quatro etapas. Relato do Caso: SMS, 28 anos, disfonia há 4 meses. Exames complementares evidenciaram lesão de grande dimensão em supraglote que foi ressecada em quatro etapas por microlaringoscopia. Comentários Finais: A abordagem por microlaringoscopia escalonada mostrou-se eficaz e segura na ressecção de lesão por amiloidose de grande dimensão...

Introduction: Localized amyloidosis is a rare disease characterized by extracellular deposition of proteins that can occur in various regions of the body. The larynx is the most common site of disease in head and neck. Objective: We present a literature review and the case of a patient with extensive amyloidosis in the upper aero-digestive tract, whose resection was performed in four steps. Case Report: SMS, 28 years, 4 months ago dysphonia. Complementary exams showed large lesions in supraglottic that was removed in four stages by microlaryngoscopy. Final Comments: microlaryngoscopy tiered approach was effective and safe resection of lesions in amyloidosis large...

Mucocele esfenoidal causando síndrome da secreção inapropriada de hormônio anti-diurético / Sphenoid mucocele causing anti-diuretic hormone inappropriate secretion syndrome

Mucocele é uma lesão benigna que ocorre nos seios paranasais. Comumente acomete os seios frontal e etmóide e, raramente, o esfenóide. É apresentado caso de paciente de 69 anos, do gênero masculino, com queixa de perda visual e cefaléia, que evoluiu com hiponatremia e aumento do sódio urinário, caracterizando a síndrome da secreção inapropriada do hormônio anti-diurético, causada por compressão hipofisária devido à mucocele esfenoidal. Foi submetido a tratamento endoscópico nasal e evoluiu com regressão dos sintomas, mantendo déficit visual parcial unilateral.

Mucocele is a benign lesion which occurs in the paranasal sinuses. It commonly happens in the frontal and ethmoid sinuses and rarely in the sphenoid sinus. It is presented a case of 69 year-old man, complaining of visual loss and headache, which evaluated with hyponatremy and high natrium dosage in urine, characterizing the antidiuretic hormon innapropriate secretion syndrom caused by compression of the hypophysis by the sphenoid mucocele. He was treated through endoscopic sinus surgery and evaluated with regression of the symptoms, but with unilateral partial visual deficit.

Síndrome de Eagle: relatos de caso

Introdução: O processo estilóide do osso temporal é uma projeção óssea que corresponde à origem dos músculos estilo-faríngeo, estilo-hiódeo e estiloglosso. A síndrome de Eagle se caracteriza pela presença de sintomas, como otalgia, disfagia, odinofagia e dor facial, associados ao aumento do processo estilóide maior que 30 mm. Objetivo: Apresentar três casos clínicos de pacientes com diagnóstico de síndrome de Eagle e discutir a apresentação clínica e o tratamento desta doença. Conclusão: O tratamento cirúrgico com ressecção de parte do processo estilóide está relacionado à remissão dos sintomas nos pacientes com diagnóstico de síndrome de Eagle. A abordagem a partir de cervicotomia alta determina boas condições de exposição do processo estilóide, com ressecção mais ampla e preservação de estruturas vasculonervosas.

Afecções vasculares do osso temporal: diagnóstico diferencial e tratamento / Vascular affection of temporal bone: differential diagnostic and therapeutic approach

Introdução: As afecções vasculares do osso temporal cursam com história clínica e exame físico semelhantes e podem ser diferenciados através de exames de imagem, os mais comuns são: paragangliomas, bulbo de jugular alto e artéria carótida aberrante. Os paragangliomas são tumores bem vascularizados formados por capilares e pré-capilares interpostos por células de origem neuroectodérmica. O bulbo jugular é a região anatômica correspondente à união do seio sigmóide e da veia jugular interna e é denominado bulbo de jugular alto quando há protusão da veia jugular interna para o interior da cavidade timpânica. A artéria carótida interna normalmente penetra no osso petroso pelo canal carotídeo separada da veia jugular interna pela bainha carotídea, no segmento vertical inicial está separada da orelha média por uma placa óssea. O trajeto anormal da artéria carótida interna pode ser explicado por malformação embrionária que impede a formação da placa óssea. Objetivo: O objetivo deste estudo é relatar cinco casos de afecções vasculares do osso temporal e discutir o diagnóstico diferencial e tratamento destas lesões.

Introduction: The vascular affections of temporal bone follow similar clinical symptoms and signs and can be distinguished through radiological investigation. The usual ones are: paraganglioma, high jugular bulb and aberrant internal carotid artery. The paraganglioma are vascular tumor formed by capillaries and pre-capillaries vessels originating from neuroectodermical cells. The jugular bulb is the anatomic point which joins sigmoid sinus and jugular vein; it is called high jugular bulb when the jugular vein protrudes into tympanic cavity. The carotid artery enters the etrous bone through the carotid canal that is apart from jugular vein by carotid sheath, in initial vertical segment it is apart from the middle ear by a bone plate. The abnormal course of the carotid artery can be explained by an embryological malformation that prevents bone plate formation. Objective: The target of this study is to report five cases of vascular affections of temporal bone and to discuss their differential diagnostic and therapeutic approach.

Quantitative analysis of myelinic fibers in human laryngeal nerves according to age.

INTRODUCTION AND AIM: To carry out a morphometric analysis of myelinic fibers in laryngeal nerves aiming to identify quantitative changes as a result of aging. STUDY DESIGN: Clinical and experimental. MATERIAL AND METHOD: A 1cm fragment was collected from the superior laryngeal nerves and recurrent laryngeal nerves taken from twelve male cadavers. The sample was divided into two groups: those aged below 60 years (Adult) and those aged 60 years or more (Elderly). The material was evaluated under light microscopy coupled with an image analysis system. RESULTS: The total number of myelinic fibers from the superior laryngeal nerve was similar in both age groups; there was, however, a trend for a higher number of 1 microm fibers in the adult group (p=0.0744). The adult group had a higher total number of myelinic fibers in the recurrent laryngeal nerve (p=0.0006), and this difference was seen in fibers with diameters between 1-3 microm (p<0.007). The adult group had a higher total number of myelinic fibers in the laryngeal nerves (sum of superior laryngeal nerves and recurrent laryngeal nerves fibers) compared to the elderly group (p<0.0091). CONCLUSION: The total number of myelinic fibers in laryngeal nerves is higher for the group aged below 60 years.

Nasolabial cyst: diagnostic and therapeutical aspects.

UNLABELLED: Nasolabial cyst is a rare lesion situated behind the ala nasi, extending backwards into the inferior nasal meatus and forward into the labio-gingival sulcus. AIM: We present our case of a nasolabial cyst, with the purpose of discussing clinical presentation, diagnosis and the more suitable surgical techniques to treat this disorder. MATERIALS AND METHODS: A retrospective study of eight patients with diagnosis of nasolabial cyst, carried out in the period of january/2000 to december/2006. The diagnosis was suggested by otorhinolaryngology exam and computer tomography. All patients were submitted to surgical treatment (enucleation) and definitive diagnosis was confirmed by histopathology. RESULTS: Predominant symptoms were nasal obstruction, swelling in the nasal vestibule region and local pain. Patients had had symptoms for a median of 26.2 months. CT scan was performed in all patients, showing a well outlined cystic lesion with bone remodeling in some cases. Median sizes of the cysts were 2.18 cm. There was no evidence of recurrence during a mean follow-up of 19.5 months. CONCLUSION: Nasolabial cysts are rare lesions. Common presentation is a well-confined swelling, local pain and nasal obstruction. Enucleation is the treatment of choice with low recurrence rate.

Síndrome de eagle: relato de três casos / Eagle's syndrome; report of three cases

O processo estilóide do osso emporal é uma projeção óssea que corresponde ao local de origem dos músculos estilofaríngeo, estilo-jióideo e estiloglosso. A síndrome de eagle se caracteriza pela presença de sintomas como otalgia, disfagia, odinofagia e dor facial...

The styloid processo of temporal bone is a bone projection that come form stylopharyngeal and styloglossal muscles. The eagle's syndrome is characterized by presence of symptoms such cervical pain, dysphagia, odynophagia, otalgia...