RESUMO
Background: Nasal vestibulitis (NV) and nasal vestibular furunculosis (NVF) are two infectious processes of the nasal vestibule, sharing common etiology, the same risk of complications, and similar treatment while remaining two different pathological entities. Methods: We performed a comprehensive literature research on NV and NVF in PubMed, Cochrane, and Google Scholar databases, with the aim to review the evidence on these two conditions and discuss the therapeutic approaches. Results: We identified a total of 248 records; according to our inclusion/exclusion criteria, 27 of them, published over a period of 59 years (1962-2021), were included in this review. Conclusion: NV and NVF are reported to be common conditions, with well-known etiological agents and risk factors. The diagnosis is clinical and topical antibiotics are the mainstay of treatment. Complications appear to be infrequent. Further studies are necessary to clarify the pathogenetic mechanisms and the exact prevalence of both conditions.
Assuntos
Furunculose , Animais , Humanos , Furunculose/terapia , Furunculose/tratamento farmacológico , Antibacterianos/uso terapêuticoRESUMO
Microvascular free-flaps have been in clinical use for nearly 3 decades becoming the gold standard in oral and oropharyngeal reconstruction. In this study, a comparison has been made between the radial forearm fasciocutaneous flap with the thinned anterolateral thigh cutaneous flap (tALT), showing the advantage of the anterolateral thigh cutaneous flap in oral and oropharyngeal reconstruction. Between January 2003 and January 2007, 48 reconstructions were performed in patients submitted to surgery for oral and oropharyngeal carcinoma using, in 17 cases, a radial forearm fasciocutaneous flap and, in 31, an anterolateral thigh cutaneous flap. In patients treated with the radial forearm fasciocutaneous flap, results showed 94.1% flap survival; in cases treated with the anterolateral thigh cutaneous flap, 93.5% flap survival (p < 0.9). Functional results, at receiving site, were comparable in both groups. Functional results, at donor site, were less successful in the radial forearm fasciocutaneous flap group, with permanent forearm movement impairment in 35.3% of cases; in the anterolateral thigh cutaneous flap group, only transitory gait impairment occurred in 12.9% of patients. In conclusion, in our experience, the thinned anterolateral thigh cutaneous flap is comparable to radial forearm fasciocutaneous flap in terms of functional results at receiving site, but, having no limitation in availability of donor tissue, it allows a more extended resection of the tumour. Moreover, the donor site can be closed primarily with only an inconspicuous curvilinear scar left over the thigh and with significantly reduced functional impairment.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Bucais/cirurgia , Neoplasias Orofaríngeas/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Antebraço , Humanos , Masculino , Pessoa de Meia-Idade , Coxa da PernaRESUMO
SUMMARY: Schwannomas are rare benign tumours that arise from Schwann cells. The most known and studied is the intracranial vestibular schwannoma, even if it is not the most frequent. More often schwannomas arise from peripheral sensitive nerves, and the vagous is most involved among the cranial nerves. Intraparotid schwannomas account for just 10% of all facial involvement, so they are an extremely rare localisation. At present, there are less than 100 cases described in the literature. We performed a retrospective analysis of parotidectomy in two Italian hospitals and present two cases of intraparotid schwannoma and a review of the literature. In the first case, we performed a parotidectomy with a stripping of tumour from the nerve. In the other case, a hypoglossal-facial neurorrhaphy was performed. Follow-up was 24 months in the first (House-Brackmann II degree in temporal-ocular and III in facial-cervical branches) and 30 months in the second case (House-Brackmann III degree in both temporal-ocular and facial-cervical branches). Preoperative diagnosis of facial nerve schwannoma is a challenge; however, it is extremely important since post-operative palsy is common and often higher grade. Unfortunately, schwannoma has similar radiologic finding as more common pleomorphic adenoma and often FNAC is not helpful. Due to its rarity and benign nature, there is debate in the literature on the need for surgical removal. Wait-and-see is a valid option, but may could give problems in secondary surgery. Stripping or near-total removal can be useful in cases of limited involvement of the nerve. Neurorrhaphy can provide good functional results when facial sacrifice is needed.
Assuntos
Neurilemoma , Neoplasias Parotídeas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neurilemoma/cirurgia , Neoplasias Parotídeas/diagnóstico , Neoplasias Parotídeas/cirurgia , Estudos RetrospectivosRESUMO
OBJECTIVES: The aim of our study was to evaluate the efficacy of 30 days treatment with glucan solution nasal spray vs. saline in the treatment of signs and symptoms of chronic rhinosinusitis. MATERIALS AND METHODS: 100 patients affected by chronic rhinosinusitis were enrolled. At the beginning and at the end of the study were evaluated: nasal congestion, headache, rhinorrea, facial pain, rhinopharyngeal exudate, inferior turbinate hypertrophy; a complete instrumental analysis of nasal functions by Active Anterior Rhinomanometry, nasal Muco-Ciliary Transport time and scraping of nasal mucosa was also performed. The patients were randomized 1:1 for receiving intranasal saline or intranasal glucan solution spray. Treatment was administered as follows: 2 puffs/nostril 3 times a day for 30 days. RESULTS: The patients in therapy with the glucan solution showed a significant improvement concerning rhinorrea facial pain, intensity of headache, inferior turbinate hypertrophy, rhinopharyngeal exudates, inspiratory/expiratory nasal resistences, Muco-ciliary transport time, normalization of nasal mucosas and rhinocytogram; saline lavage didn't show this effects. Both treatment improved rhinorrea, instead both treatment didn't affect nasal congestion. CONCLUSIONS: According to the results of our multicentric double blind randomized study, we suggest the use of glucan solution nasal spray as an efficacious therapeutic tool in the management of nasal symptoms in patients affected by chronic rhinosinusitis.
Assuntos
Glucanos/administração & dosagem , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Cloreto de Sódio/administração & dosagem , Administração Intranasal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nebulizadores e VaporizadoresRESUMO
During the preovulatory period, cumulus cells (CCs) form a hyaluronan-protein extracellular matrix (cumulus expansion) that positively influences oocyte fertilization. Degradation of this matrix and CC-oocyte complex (COC) dissociation occurs within a few hours of ovulation and parallels the aging of oocytes. Modulation of CC proteolytic activity by gonadotropins and oocyte soluble factors has been hypothesized to determine such cumulus matrix changes. In the present study, we investigated plasminogen activator (PA) synthesis by COCs during the expansion and disassembly processes. Our results show that the secretion of tissue type PA and urokinase type PA (uPA) by oocytes and CCs, respectively, does not change significantly during expansion but dramatically increases thereafter. Compact COCs were isolated from immature mice, primed 48 h earlier with 5 IU PMSGs, and were induced to expand in vitro with 100 ng/ml FSH in the presence of 1% FCS. Full expansion was achieved at 16 h, when hyaluronan synthesis ceased. Release of hyaluronan and CCs from the COC matrix began between 18 and 20 h of culture, which indicates that matrix degradation started at this time. PA activities in culture media were determined by SDS-PAGE, followed by a zymography at various time intervals between 4 and 32 h of culture. Secreted tissue type PA and uPA activity abruptly increased between 16 and 20 h after FSH stimulation. Slot blot hybridization of CC messenger RNA showed that uPA messenger RNA levels correlated with the increase in uPA activity. Similar temporal patterns of PA synthesis and matrix degradation were found in COCs induced to expand in vivo by injection of 5 IU human CG into PMSG-primed mice. Cultures of CCs, both in the presence and absence of oocytes, revealed that uPA synthesis is repressed in FSH-stimulated CCs by an oocyte-soluble factor for the first 16 h of culture, whereas CC responsiveness to this factor is lost thereafter. In conclusion, the data show that a sophisticated interplay between oocyte and CCs causes the two cell types to simultaneously secrete PA activity after ovulation. The fact that matrix degradation parallels PA production strongly supports the hypothesis that these enzymes may destabilize the expanded COC matrix.
Assuntos
Matriz Extracelular/metabolismo , Oócitos/fisiologia , Folículo Ovariano/fisiologia , Ovulação/fisiologia , Ativadores de Plasminogênio/biossíntese , Animais , Células Cultivadas , Feminino , Camundongos , Folículo Ovariano/citologia , Fatores de Tempo , Ativador de Plasminogênio Tecidual/biossíntese , Ativador de Plasminogênio Tipo Uroquinase/biossínteseRESUMO
Roxithromycin 300 mg once daily was compared with clarithromycin 250 mg b.i.d. in an open randomized trial in 200 patients with upper respiratory tract infection: sinusitis, pharyngotonsillitis, and otitis media. Average treatment duration was 9 days. Roxithromycin was more effective (p less than 0.01) particularly in otitis media and pharyngotonsillitis, and better tolerated (only 4% side effects, p less than 0.05).
Assuntos
Eritromicina/análogos & derivados , Infecções Respiratórias/tratamento farmacológico , Roxitromicina/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Claritromicina , Tolerância a Medicamentos , Eritromicina/administração & dosagem , Eritromicina/efeitos adversos , Eritromicina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média/tratamento farmacológico , Faringite/tratamento farmacológico , Roxitromicina/administração & dosagem , Roxitromicina/efeitos adversos , Sinusite/tratamento farmacológico , Tonsilite/tratamento farmacológicoRESUMO
Eighty adult patients affected by acute bacterial otitis media were selected and randomized into two balanced groups of treatment: 1) brodimoprim 200 mg tablets at the dosage of 2 tablets in single dose on the first day and one tablet on the following days; 2) josamycin 500 mg tablets at the dosage of 3 tablets/day. The average duration of treatment was 8 days: all patients completed the trial. The symptoms were evaluated by score method (on the 3rd, 7th and on the last day of therapy) and a thermometric curve was made daily. Microbiological examination of the exudate was performed in the patients with auricular discharge (28), at the beginning of the treatment and 7 days after the end of therapy. The tolerability was assessed through registration of side effects. Brodimoprim resulted more effective in the reduction of hypoacusis and tinnitus; other symptoms demonstrated higher percentage reductions in the group under brodimoprim therapy. Bacteriological exams were negative at the second checkup, except in 6 patients (3 per group). Side effects were reported in 5 patients (12.5%) treated with brodimoprim and in 9 (22.5%) treated with josamycin. Abnormal values in laboratory tests were not observed.
Assuntos
Infecções Bacterianas , Otite Média/tratamento farmacológico , Trimetoprima/análogos & derivados , Doença Aguda , Adolescente , Adulto , Idoso , Tolerância a Medicamentos , Exsudatos e Transudatos/microbiologia , Feminino , Humanos , Josamicina/efeitos adversos , Josamicina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Otite Média/microbiologia , Trimetoprima/farmacologia , Trimetoprima/uso terapêuticoRESUMO
The authors suggest a conservative transmandibular approach for the surgical treatment of large latero-pharyngeal tumors extending towards the base of the skull. This technique, which may seem more radical and complex is, however, a more logical and conservative approach; and, owing to the excellent surgical field, it is able to keep the delicate surrounding structures intact and to reduce the risk of hemorrhagic and/or neurological complications.
Assuntos
Neoplasias Faríngeas/cirurgia , Humanos , Mandíbula/cirurgia , Métodos , OsteotomiaRESUMO
Surgical treatment of bilateral abductor paralysis of the vocal cords is still a question for debate, as can be seen by a review of the relevant literature. The authors describe their modification of Thornell's technique, as used in 12 cases of recurrent paralysis, and they suggest a variant to the basic method which has been proved to cause minimal trauma, is simple to carry out and has produced excellent results.
Assuntos
Cartilagem Aritenoide/cirurgia , Cartilagens Laríngeas/cirurgia , Paralisia das Pregas Vocais/cirurgia , Adulto , Humanos , Métodos , Pessoa de Meia-Idade , Fonação , RecidivaRESUMO
Haemangiopericytoma is only rarely localized in the nasal cavity. The authors' experience with one case has prompted them to review the literature critically, in order to understand better the most appropriate diagnostic procedures and therapeutic measures.
Assuntos
Hemangiopericitoma/patologia , Neoplasias Nasais/patologia , Hemangiopericitoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Nasal , Neoplasias Nasais/cirurgiaRESUMO
According to World Health Organization (WHO, 1991) papillomas of nasal cavity is subdivided in three main histopathological types: 1) Inverted papilloma; 2) exophytic papilloma; 3) vestibular papilloma. In particular, inverted papilloma represents 0.5%-4% of all nasal tumors and is characterized by local aggressivity and malignant evolution. During the years controversies arose about therapeutical treatment of inverted papilloma, with different results concerning conservative treatment (endoscopic resection; Caldwell-Luc operation) and an external approach resection (Weber-Fergusson approach). Our clinical experience is related to 33 patients submitted to surgery for inverted papilloma of nasal and paranasal cavity in the period 1982-1993. Diagnostic method was based on endoscopy and CT/RM integration in order to demonstrate local extension of tumor and to plan surgical approach. In particular 8 patients were submitted to endoscopic surgical approach (small and anterior papillomas). In 10 cases we performed a combined approach (endoscopic microsurgery plus Caldwell-Luc approach) and in 15 patients an external approach was carried out. Long-term results of the therapy are presented and discussed and a review of Literature is carried out.
Assuntos
Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Seios Paranasais/cirurgia , Adulto , Carcinoma/patologia , Carcinoma/cirurgia , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/patologia , Seios Paranasais/patologia , Tomografia Computadorizada por Raios XAssuntos
Cefaleia/tratamento farmacológico , Cefaleia/fisiopatologia , Ibuprofeno/uso terapêutico , Pseudoefedrina/uso terapêutico , Esquema de Medicação , Quimioterapia Combinada , Humanos , Ibuprofeno/administração & dosagem , Efeito Placebo , Pseudoefedrina/administração & dosagem , Rinite/tratamento farmacológicoRESUMO
OBJECTIVE: Nasal congestion is a common symptom in allergic and nonallergic rhinitis, rhinosinusitis and nasal polyposis. The present study evaluated the clinical effectiveness of Narivent(®), an osmotically-acting medical device with anti oedematous and anti-inflammatory effects, in nasal congestion. METHODS: A single-centre, prospective study with a pre- post design and consecutive patient enrolment was conducted in an Italian otolaryngology department. Patients with persistent nasal congestion were allocated to treatment groups as follows: group 1 (n = 36) treated for 7 days; group 2 (n = 56) treated for 30 days. In each group, patients received two puffs of Narivent(®) into each nostril twice daily. Symptom severity was assessed subjectively on a 0-10 visual analogue scale, and objectively by the presence/absence of signs and symptoms. Differences in subjective and objective severity measures before and after treatment were compared using Wilcoxon's signed rank test. RESULTS: All symptoms and objective scores improved after treatment with Narivent(®) for 7 or 30 days and no adverse effects were reported by the patients in either group. CONCLUSION: Narivent(®) appears to be efficacious in treating nasal congestion over a 7- or a 30-day period.