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1.
Eur Arch Otorhinolaryngol ; 274(2): 861-865, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27640142

RESUMO

The basic aim of our study is to compare the results of the conventional and piezoelectric osteotomy in rhinoplasty by complete subperiosteal degloving of nasal bone to minimize soft-tissue injury. The study was designed as a prospective, double-blind, randomized, and controlled study. Setting is a tertiary referral hospital in Turkey. Ninety patients who underwent primary open rhinoplasty with osteotomy, performed by either the conventional instruments or the piezoelectric device. The complete subperiosteal degloving of the entire nasal bone was done up to the nasal maxillary sulcus, medial canthus, and nasion in all patients, independent of the type of osteotomy device used. Patients subsequently underwent median-oblique and lateral osteotomy, either with an ultrasonic device or a conventional 2-mm guarded, straight osteotome. The postoperative edema and ecchymosis were evaluated by another surgeon who was blinded to the osteotomy procedure on postoperative days 2 and 7. The edema scores were significantly increased on the second day compared with the seventh day in both groups 1 and 2. However, there was no significant difference between groups. The ecchymosis scores were slightly higher in postoperative day 2, compared with day 7, in both groups 1 and 2, but statistically not significant. This study showed that the main reason edema and ecchymosis are seen post-rhinoplasty is related to soft-tissue injury during osteotomy.


Assuntos
Equimose/etiologia , Edema/etiologia , Doenças Nasais/etiologia , Osteotomia/métodos , Piezocirurgia , Complicações Pós-Operatórias , Rinoplastia/métodos , Adulto , Método Duplo-Cego , Feminino , Humanos , Masculino , Osso Nasal/cirurgia , Estudos Prospectivos , Resultado do Tratamento
2.
Eur Arch Otorhinolaryngol ; 274(10): 3637-3642, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28707085

RESUMO

Atrophic rhinitis (AR) is a disease characterized by the extensive dilatation of the nasal cavity and atrophy of the mucosa, submucosa and bone tissue. Its etiological factors are unknown. There is not a satisfying treatment yet and the treatment of the functional impairment in the atrophic cells is still subject to investigation. The objective of this study is to determine at the histopathological level the possible effects of the submucosal fat injection in an experimental model of AR. 12 albino Wistar-Hannover male rats were included in the study. AR was induced with the Pasteurella multocida toxin, which was diluted with saline. As one of the rats died during the study, it was excluded from the evaluation. The right nasal cavities of all rats (11 nasal cavities) were defined as the control group (Group 1). Fat tissue obtained from the abdominal area was injected in the seven left nasal cavities (Group 2). All injections, which were done to the abdominal regions were also done in the left nasal cavities of the remaining four rats, which constituted the sham group (Group 3). After 14 days, all rats were decapitated and the squamous metaplasia and keratinization in the superficial epithelium, degeneration, vacuolar changes in the basal layer, congestion, inflammatory infiltration, vascular proliferation and glandular atrophy in the submucosa are histopathologically classified. The results were analyzed with statistical methods. Although glandular atrophy was significantly regressed in the fat injection group (Group 2) compared to other groups (p < 0.05), the remaining parameters did not show any significant difference among these three groups. The histopathological effect of the fat injection was modest. We concluded that fat injection treatment has no or at the most a very limited effect in the treatment of atrophic rhinitis.


Assuntos
Gordura Abdominal/transplante , Osso Nasal/patologia , Mucosa Nasal/patologia , Rinite Atrófica , Animais , Atrofia , Injeções , Masculino , Depuração Mucociliar , Cavidade Nasal/patologia , Ratos , Ratos Wistar , Rinite Atrófica/patologia , Rinite Atrófica/fisiopatologia , Rinite Atrófica/terapia , Resultado do Tratamento
3.
Eur Arch Otorhinolaryngol ; 274(1): 489-493, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27496207

RESUMO

External ear reconstruction is a controversial topic in reconstructive plastic surgery. Here, we prepared a pedicled biosynthetic flap for full-thickness, partial ear defects in rabbits. We operated on six adult female New Zealand rabbits weighing 3-4 kg. The dimensions of the lateral thoracic fasciocutaneous flap were 7 × 6 cm. The flap was elevated based on one of the bilaterally located internal thoracic arteries, which were dissected proximally. The pedicled flap was folded in two, and polypropylene mesh was sandwiched in the middle. The flap was adapted to a defect of 3.5 × 3 cm in diameter. In fact, the defect was created before elevation of the flap. Rabbits were followed up for 4 weeks, at the end of which they were killed and their ears were evaluated histopathologically. The survival rate of the rabbits was 100 %. All pedicled biosynthetic flaps were viable, but one showed partial (20 %) necrosis (1/6) and one was partially detached (1/6). Macroscopic (color, thickness, texture) and histological (polymorphonuclear leukocyte invasion in the skin, subcutaneous tissue, and at the junction between the polypropylene mesh and the flap) features of the flap were compared to the ipsilateral ear. A new technique was developed for partial external ear reconstruction with sufficient inner skeletal support and outer skin lining. Level of evidence Level NA.


Assuntos
Orelha Externa/cirurgia , Retalhos Cirúrgicos , Telas Cirúrgicas , Animais , Fáscia/transplante , Modelos Animais , Polipropilenos , Coelhos , Artérias Torácicas/transplante
4.
Eur Arch Otorhinolaryngol ; 274(1): 261-266, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27496208

RESUMO

The aim of this study is to determine the effectiveness and biocompatibility of polypropylene mesh for the repair of nasal septal perforations in an animal model on rabbits. A full-thickness nasal septal perforation with a diameter of nearly 10 × 10 mm was created on 12 rabbits, and then the perforation was reconstructed with two different methods. We used mucosal flaps and polypropylene mesh as an interpositional graft in group 1. Only mucosal flaps were used for reconstruction and are identified as group 2. After 4 weeks, we removed the nasal septum of the rabbits and performed histopathological examinations for acute rejection, infection, inflammatory response, fibrosis, and granuloma formation. We found perforation closure rates of 75 and 25 % in groups 1 and 2, respectively. Inflammatory response was seen in all specimens of group 1 (100 %). The inflammatory response was +1 in five of the specimens (62.5 %), +2 in one specimen (12.5 %), and +3 in two specimens (25 %). Mild fibrosis around the mesh was detected in four specimens (50 %), medium-level fibrosis was detected in one (12.5 %), and no fibrosis was detected in three (37.5 %). Severe fibrosis was not seen in any specimens. The foreign-body reaction was limited to a few giant cells, and granuloma formation was seen in two specimens (25 %). The propylene mesh showed excellent biocompatibility with the septal mucosa, and it can, therefore, be used for the repair of septal perforation as an interpositional graft safely.


Assuntos
Materiais Biocompatíveis , Perfuração do Septo Nasal/cirurgia , Procedimentos de Cirurgia Plástica/instrumentação , Polipropilenos , Telas Cirúrgicas , Animais , Teste de Materiais , Mucosa Nasal/cirurgia , Coelhos , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Resultado do Tratamento
5.
J Craniofac Surg ; 28(3): e260-e263, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28468213

RESUMO

OBJECTIVES: The authors' aim was to investigate whether serum neutrophil to lymphocyte ratio might be used as a predictive biomarker to help differentiate active from inactive chronic otitis media (COM). METHODS: Two hundred fifty-nine patients having inactive COM received tympanoplasty without mastoidectomy and were identified as Group 1. On the other hand, 254 patients having active COM received tympanoplasty with mastoidectomy and were identified as Group 2. Routine hemogram tests were performed preoperatively for both the groups. By performing a chart review, white blood cell count, red blood cell count, hemoglobin, hematocrit, platelet, and mean platelet volume values were compared between the groups in an age-matched and sex-matched manner. RESULTS: A total of 513 COM patients with age range of 7 to 65 years were included in the study. Two hundred seventy-five patients (53.6%) were male, 238 were (46.4%) female. Preoperatively both serum neutrophil and lymphocyte counts were significantly higher in Group 2 (P = 0.015 and P = 0.004, respectively). However, the neutrophil-to-lymphocyte ratios between the groups were not significantly different (P = 0.511). CONCLUSION: No statistically significant differences were identified from preoperative neutrophil-to-lymphocyte ratios between patients having active COM and inactive COM. LEVEL OF EVIDENCE: Level NA.


Assuntos
Linfócitos/metabolismo , Neutrófilos/metabolismo , Otite Média/diagnóstico , Adolescente , Adulto , Idoso , Biomarcadores/sangue , Criança , Doença Crônica , Diagnóstico Diferencial , Feminino , Humanos , Contagem de Linfócitos , Masculino , Mastoidectomia , Pessoa de Meia-Idade , Otite Média/sangue , Otite Média/imunologia , Otite Média/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Timpanoplastia , Adulto Jovem
6.
Eur Arch Otorhinolaryngol ; 273(12): 4153-4159, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27221387

RESUMO

The aim of this study is to investigate the effect of rectal ozone and intratympanic ozone therapy on cisplatin-induced ototoxicity in rats. Eighteen female Wistar albino rats were included in our study. External auditory canal and tympanic membrane examinations were normal in all rats. The rats were randomly divided into three groups. Initially, all the rats were tested with distortion product otoacoustic emissions (DPOAE), and emissions were measured normally. All rats were injected with 5-mg/kg/day cisplatin for 3 days intraperitoneally. Ototoxicy had developed in all rats, as confirmed with DPOAE after 1 week. Rectal and intratympanic ozone therapy group was Group 1. No treatment was administered for the rats in Group 2 as the control group. The rats in Group 3 were treated with rectal ozone. All the rats were tested with DPOAE under general anesthesia, and all were sacrificed for pathological examination 1 week after ozone administration. Their cochleas were removed. The outer hair cell damage and stria vascularis damage were examined. In the statistical analysis conducted, a statistically significant difference between Group 1 and Group 2 was observed in all frequencies according to the DPOAE test. In addition, between Group 2 and Group 3, a statistically significant difference was observed in the DPOAE test. However, a statistically significant difference was not observed between Group 1 and Group 3 according to the DPOAE test. According to histopathological scoring, the outer hair cell damage score was statistically significantly high in Group 2 compared with Group 1. In addition, the outer hair cell damage score was also statistically significantly high in Group 2 compared with Group 3. Outer hair cell damage scores were low in Group 1 and Group 3, but there was no statistically significant difference between these groups. There was no statistically significant difference between the groups in terms of stria vascularis damage score examinations. Systemic ozone gas therapy is effective in the treatment of cell damage in cisplatin-induced ototoxicity. The intratympanic administration of ozone gas does not have any additional advantage over the rectal administration.


Assuntos
Antineoplásicos/toxicidade , Cisplatino/toxicidade , Células Ciliadas Auditivas Externas/efeitos dos fármacos , Emissões Otoacústicas Espontâneas/efeitos dos fármacos , Ozônio/farmacologia , Animais , Cóclea/efeitos dos fármacos , Cóclea/patologia , Feminino , Células Ciliadas Auditivas Externas/patologia , Distribuição Aleatória , Ratos Wistar , Estria Vascular/efeitos dos fármacos , Estria Vascular/patologia
7.
J Craniofac Surg ; 27(5): e469-71, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27391515

RESUMO

PURPOSE: Comparison of Frey syndrome rates following superficial parotidectomy and partial superficial parotidectomy for pleomorphic adenoma. METHODS: Fifty patients diagnosed with pleomorphic adenoma and received surgical treatment at the Otolaryngology Department of Bagcilar Training and Research Hospital between January 2009 and October 2015 were reviewed retrospectively. The patients were specifically queried for Frey syndrome symptoms. The syndrome was investigated with Minor starch iodine test. The patients who underwent superficial parotidectomy were compared to those who underwent partial superficial parotidectomy in terms of Frey syndrome development and recurrence. RESULTS: In the partial superficial parotidectomy group, Frey syndrome symptoms were edema and increased sweating and burning sensation on the face in 7 patients (21.9%, P = 0.735). In the superficial parotidectomy group, 5 patients exhibited edema (27.8%), 3 exhibited increased sweating (16.7%), and 5 exhibited burning sensation (27.8%). Minor test results were positive for 7 patients in the partial superficial parotidectomy group (21.8%) and 5 patients were positive (27.8%) in the superficial parotidectomy group. No recurrence was found in either group during the 5-year follow-up. No significant difference was found between 2 groups in terms of postoperative complications and recurrence. CONCLUSION: In terms of their effect on Frey syndrome development, there is no significant difference between partial superficial parotidectomy and superficial parotidectomy.


Assuntos
Adenoma Pleomorfo/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Complicações Pós-Operatórias , Sudorese Gustativa/epidemiologia , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Estudos Retrospectivos , Sudorese Gustativa/etiologia , Turquia/epidemiologia
8.
Eur Arch Otorhinolaryngol ; 272(2): 337-43, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24337899

RESUMO

We compared the effects of repetitive transcranial magnetic stimulation (rTMS) and paroxetine [a selective serotonin reuptake inhibitor (SSRI)] on tinnitus in terms of effectiveness and medium-term results. This is a randomised, double-blind, placebo-controlled study. Seventy-five patients with moderate tinnitus were divided into five equal groups. Each group was treated for 1 month as follows: group 1 received rTMS alone at 1 Hz frequency; group 2 received rTMS alone at 10 Hz frequency; group 3 received rTMS at 1 Hz frequency combined with paroxetine; group 4 received paroxetine alone; and group 5 received a placebo (sham rTMS). Participants were tested using the Tinnitus Handicap Inventory (THI), Tinnitus Severity Index (TSI), the Beck Anxiety Scoring (BAS), and Psychiatric Sign Screening (PSS) tests. THI, TSI, BAS, and PSS were measured prior to treatment, and at the first and sixth month post-treatment. The THI and TSI scores improved after treatment in all groups, except the placebo group. The THI scores in groups 1 and 2 showed a statistically significant improvement after the first and sixth month compared to pretreatment scores, whereas a significant improvement in THI scores occurred only after the sixth month in groups 3 and 4. The TSI scores in group 3 showed a significant improvement at the first and sixth month marks after treatment. The rTMS and SSRI play potential roles in the reduction of tinnitus severity, but without cumulative or synergistic effects when a combination of treatment regimens is applied. These positive effects might be due to the relationship between the auditory cortex areas related to emotions and tinnitus.


Assuntos
Antidepressivos de Segunda Geração/uso terapêutico , Paroxetina/uso terapêutico , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Zumbido/terapia , Estimulação Magnética Transcraniana , Adulto , Córtex Auditivo/fisiologia , Doença Crônica , Terapia Combinada , Método Duplo-Cego , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Zumbido/psicologia , Adulto Jovem
9.
Eur Arch Otorhinolaryngol ; 272(11): 3347-52, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25534286

RESUMO

The aim of this study was to evaluate the relationship between the maxillary sinus volumes and the nasal septal deviation angles in patients with antrochoanal polyps (ACP). 76 patients who underwent ACP surgery were included in the study. Of those 36 patients who had multislice computed tomography (MSCT) were evaluated to calculate maxillary sinus volume. The records of paranasal MSCT of 36 healthy people without any paranasal sinus diseases or surgery constituted age- and gender-matched healthy controls. Maxillary sinüs volumes and septal deviation angles were calculated using the paranasal MSCT volume-rendering technique. Thirty-six patients in the ACP group were compared with 36 polyp side-matched healthy people. The mean age was 16.6 ± 6.7 years in both groups. Statistically, the mean value of the maxillary sinus volume was significantly higher in the ACP group compared with the ACP side-matched control group (15.1 ± 4.6 versus 12.0 ± 3.5 mm(3)) (p = 0.002). Furthermore, the mean value of the maxillary sinus volume in the non-polyp side (14.2 ± 4.7 mm(3)) was statistically higher in the ACP group compared with the side-matched control group volume (11.9 ± 3.8 mm(3)) (p = 0.024). In addition, Fifty-three of 76 ACP patients had septal deviation. While the septal deviation was on the same side with the ACP in 17 patients, it was on the opposite side in 36 patients. In conclusion, the maxillary sinus volumes increased in ACP patients compared with the healthy control group. Many patients had nasal septal deviation on the opposite side of the ACP.


Assuntos
Seio Maxilar/patologia , Pólipos Nasais/patologia , Septo Nasal/patologia , Deformidades Adquiridas Nasais/patologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Feminino , Humanos , Masculino , Seio Maxilar/cirurgia , Pólipos Nasais/cirurgia , Septo Nasal/diagnóstico por imagem , Nasofaringe , Deformidades Adquiridas Nasais/cirurgia , Radiografia , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-24833456

RESUMO

PURPOSE: To analyze the clinical outcomes of external (EX-), endoscopic (EN-), and transcanalicular multidiode laser (TC-) with dacryocystorhinostomy (DCR). METHODS: Ninety-two patients with primary acquired nasolacrimal duct obstruction were enrolled (divided into EX-DCR [n = 33], EN-DCR [n = 30], and TC-DCR groups [n = 29]) in this prospective study. Primary outcome measures were the anatomical and functional success of operations at the last control examination. Secondary outcome measures were the ostium size, surgical time, and complications. RESULTS: The difference in mean surgical time among the 3 groups was statistically significant (p < 0.0001). External DCR required the longest surgical time (46.6 ± 15.3 minutes), while TC-DCR was the shortest (20.3 ± 7.7 minutes). There were no significant differences between the groups regarding anatomical (81.8%, 75.9%, and 76.7% in EX-, EN-, and TC-DCR groups, respectively; p = 0.824) and functional success rates (81.8%, 72.4%, and 73.3% in EX-, EN-, and TC-DCR groups, respectively; p = 0.626). Final ostium size was the largest with EX-DCR (33.7 ± 17.4 mm) and smallest with EN-DCR (19.0 ± 8.9 mm; p = 0.001). The complication rate was similar in all groups. The most common complications were the formation of granulation tissue (16.3%) and intranasal synechiae (9.8%), all of which led to surgical failure and were more frequent in the EN- and TC-DCR groups. CONCLUSIONS: External DCR, EN-DCR, and TC-DCR had similar success and complication rates in patients with primary acquired nasolacrimal duct obstruction. External DCR resulted in the largest ostium size. Transcanalicular DCR appeared to be effective with the shortest surgical time.


Assuntos
Dacriocistorinostomia/métodos , Endoscopia , Lasers Semicondutores/uso terapêutico , Ducto Nasolacrimal/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Complicações Intraoperatórias , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos
11.
J Craniofac Surg ; 26(1): e3-6, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25569410

RESUMO

Skull-base metastasis is rarely reported in thyroid carcinoma. We are presenting an unusual interesting case mimicking metastatic renal cell carcinoma with intense clear cell morphology, the thyroid origin of which was detected via positron emission tomography/computerized tomography scan proposed by the oncology council, while we were monitoring the subject with the initial diagnosis of paranasal sinus tumor. A mass was detected in the left nasal cavity in the endoscopic examination of the 68-year-old female patient referred by the ophthalmology clinic with the preliminary diagnosis of retro-orbital tumor upon being admitted with proptosis. A soft tissue lesion at a size of 68 × 39 × 53 mm located intracranially was detected by the brain computerized tomography. The biopsy taken and the immunohistochemical results were not satisfactory. Intense fluorodeoxyglucose involvement was observed in both lobes of the thyroid gland at positron emission tomography/computerized tomography taken with the recommendation of the council. Moreover, hypermetabolic nodules were seen in both lung parenchyma areas, whereas intense hypermetabolic lytic lesions were observed in the skeletal system. Thyroglobulin and thyroid transcription factor 1 stains displayed a strong staining on paraffin block. On the basis of these characteristics, the case was regarded as compatible metastatic follicular thyroid carcinoma, with skull-base, cranial, retro-orbital, paranasal sinus, lung, and bone metastases. This case showed us that multidisciplinary work and assessment of the oncology council play a highly critical role in making the diagnosis and guiding the treatment.


Assuntos
Adenocarcinoma Folicular/secundário , Neoplasias Ósseas/secundário , Estesioneuroblastoma Olfatório/diagnóstico , Neoplasias Pulmonares/secundário , Neoplasias Nasais , Neoplasias dos Seios Paranasais/secundário , Neoplasias da Glândula Tireoide/patologia , Adenocarcinoma Folicular/patologia , Idoso , Carcinoma de Células Renais/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Renais/diagnóstico , Cavidade Nasal , Seios Paranasais , Neoplasias Cranianas/secundário
12.
J Ultrasound Med ; 33(3): 503-8, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24567462

RESUMO

OBJECTIVES: The purpose of this study was to evaluate whether the relative proportions of stromal to cellular components of pleomorphic adenomas have an effect on the shear elastic modulus determined by shear wave elastography (SWE). METHODS: This study was approved by the Ethics Committee of our institution and performed between September 2011 and December 2012. Thirty-five patients who underwent surgery for a parotid mass were included in the study. The maximum shear elastic modulus of the mass was measured by SWE. Pleomorphic adenomas were histopathologically subdivided into stroma-poor, intermediate-stroma, and stroma-rich tumors based on the relative proportion of stromal to cellular components. RESULTS: The maximum shear elastic modulus values of the pleomorphic adenomas ranged from 12.6 to 291.9 kPa (mean ± SD, 120.9 ± 92.8 kPa). The Friedman test revealed a statistically significant relationship between the stromal amount and maximum shear elastic modulus (P < .001). Stroma-poor adenomas (mean, 32.3 ± 27.7 kPa; range, 12.6-81.1 kPa) were softer on SWE than stroma-rich adenomas (mean, 174.1 ± 48.4 kPa; range, 92.7-217.2 kPa; P = .009). No such significant difference was detected between stroma-poor and intermediate-stroma tumors (mean, 146.3 ± 106.1 kPa; range, 19.1-291.9 kPa; P = .062) or between intermediate-stroma and stroma-rich tumors (P = .465). CONCLUSIONS: Shear wave elastography depicts pleomorphic adenomas with a variable appearance, which is due to the relative proportions of stromal to cellular contents in the tumors.


Assuntos
Adenoma Pleomorfo/diagnóstico por imagem , Adenoma Pleomorfo/patologia , Técnicas de Imagem por Elasticidade/métodos , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Parotídeas/patologia , Células Estromais/diagnóstico por imagem , Células Estromais/patologia , Adulto , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
13.
J Craniofac Surg ; 25(3): e244-5, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24820726

RESUMO

The malignant parotid lesions are fast growing and rapidly become symptomatic. Ultrasonography and fine needle aspiration biopsy are mainly used in the differential diagnosis of parotid lesions. The most common treatment of all parotid lesions is surgical excision. Here, we present a case of a very rapidly enlarging, painful parotid lesion with no etiology. A 30-year-old man presented with a rapidly progressive, enlarging, painful mass on the left side of the parotid region. The size of the lesion had enlarged rapidly day by day. The patient had no history of head and neck surgery or trauma. After evaluation of the patient with radiologic examinations, no certain diagnosis could be made; we thought that the patient might be experiencing spontaneous intraparotid bleeding with unknown etiology. We decided to wait for a time for spontaneous resolution. The lesion resolved spontaneously in a few months, without any complications or sequelae.


Assuntos
Hematoma/patologia , Regressão Neoplásica Espontânea , Neoplasias Parotídeas/patologia , Adulto , Diagnóstico Diferencial , Humanos , Masculino
14.
J Craniofac Surg ; 25(3): 775-9, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24785754

RESUMO

OBJECTIVE: Pharyngocutaneous fistula (PCF) is the most common postoperative complication after total laryngectomy. The aim of this study was to determine the relationship between PCF with pharyngeal repair time and the number of mucosal sutures. METHODS: The medical records of 47 patients who underwent total laryngectomy were assessed prospectively. The pharyngeal repair time and the number of horizontal, vertical, and cricopharyngeal muscle sutures were recorded. We observed the occurrence of PCF in 14 patients (29.8%). The mean time for pharyngeal repair in the PCF group was 22 minutes 59 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 8.57 ± 2.6, 11.14 ± 2.1, and 8.45 ± 1.9, respectively. The mean time for pharyngeal repair in the non-PCF group was 22 minutes 21 seconds ± 5 minutes, and the mean number of vertical, horizontal, and cricopharyngeal muscle sutures was 9.54 ± 2.6, 10.84 ± 2.3, and 7.36 ± 2.7, respectively. The differences in the pharyngeal repair time and the number of vertical, horizontal, and cricopharyngeal sutures between the 2 groups were not statistically significant (P > 0.05). Besides, there was no statistically significant difference between the mean suture counts per centimeter in horizontal plane (1.46 ± 0.35) and vertical plane (0.98 ± 0.25) in the PCF group and the mean suture counts per centimeter in horizontal plane (1.42 ± 0.37) and vertical plane (1.13 ± 0.3) in the non-PCF group (P > 0.05). CONCLUSIONS: There was no relation between PCF development with pharyngeal repair time, mucosal suture count, and suture frequency after total laryngectomy.


Assuntos
Fístula Cutânea/etiologia , Laringectomia/efeitos adversos , Doenças Faríngeas/etiologia , Fístula do Sistema Respiratório/etiologia , Adulto , Idoso , Carcinoma de Células Escamosas/cirurgia , Seguimentos , Humanos , Neoplasias Laríngeas/cirurgia , Pessoa de Meia-Idade , Duração da Cirurgia , Faringe/cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos , Técnicas de Sutura , Suturas/efeitos adversos , Suturas/estatística & dados numéricos
15.
Kulak Burun Bogaz Ihtis Derg ; 23(2): 112-4, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23611325

RESUMO

Tumors of the smooth muscles are rarely seen, as the number of smooth muscles is low within the intraoral region. Leiomyosarcoma is a type of malign tumor originating from smooth muscles. The most common regions of leiomyosarcoma of the oral cavity are the maxilla and mandible. In this article, we present a leiomyosarcoma detected in a 20-year-old male patient who was admitted to the clinic with the complaint of a mass for about three months. The mass was located in the left half of the soft palate and it was resected en bloc with the mucosa. No recurrence was observed during the two-year follow-up period of the patient.


Assuntos
Leiomiossarcoma/patologia , Neoplasias Palatinas/patologia , Palato Mole/patologia , Diagnóstico Diferencial , Humanos , Leiomiossarcoma/cirurgia , Masculino , Neoplasias Palatinas/cirurgia , Adulto Jovem
16.
Eur Arch Otorhinolaryngol ; 269(3): 1055-7, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22159883

RESUMO

Paranasal sinus anatomical anomalies with unknown etiology are common. Maxillary and/or frontal sinus aplasia or hypoplasia are more common than the other types. Although there are some reports about paranasal sinus anomalies in the literature, there is no case similar to ours, with total paranasal sinus aplasia. Here, we present a unique case of total paranasal sinus aplasia with a symptom of fullness on the face.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Doenças dos Seios Paranasais/congênito , Seios Paranasais/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Doenças dos Seios Paranasais/diagnóstico por imagem , Tomografia Computadorizada por Raios X
17.
J Craniofac Surg ; 23(2): e86-8, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22446466

RESUMO

Arteriovenous malformation (AVM) is a vascular abnormality resulting in the development of abnormal connection between an artery and vein without capillary connections. An AVM develops mainly intracranially. Extracranial AVMs are rarely seen. Cheek, ear, nose, auricle, and forehead are the more common sites in the extracranial involvement. They cause cosmetic problems when located in the head and neck region. We report a case of a giant AVM in the floor of the mouth, which has not been specified and has not been reported until now. The lesion, in an elderly man, was supplied by multiple vessels and caused difficulty in speaking and swallowing. The lesion was totally excised after embolization of feeding vessels.


Assuntos
Malformações Arteriovenosas/complicações , Malformações Arteriovenosas/cirurgia , Transtornos de Deglutição/etiologia , Disartria/etiologia , Soalho Bucal/irrigação sanguínea , Malformações Arteriovenosas/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade
18.
J Craniofac Surg ; 23(1): e5-7, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22337463

RESUMO

Mucoceles are expansile, encapsulated, benign cystic lesions with the potential for adjacent bony remodeling and resorption. Previous nasal surgery, recurrent infections, allergies, and facial traumas are all possible causes of mucoceles involving mainly paranasal sinuses. When the mucocele is infected, it is referred to as mucopyocele. Nasal septal mucoceles seen in only very seldom cases might develop from pneumatized and infected nasal septa. In the current article, we present an interesting primary giant septal mucopyocele that destroys all paranasal cells as a tumoral lesion. The perpendicular plate of ethmoidal bone, vomer, and bilateral anterior and posterior ethmoidal cells were destroyed by mucopyocele. The nasal cavity was totally obstructed by lesions on both sides. On the left side, the lesion also eroded the left lateral nasal wall causing external swelling at the medial canthal region. This is the first case of a giant septal mucopyocele of its kind in the literature. Although nasal septal mucocele is very rare, it should be considered in differential diagnosis of intranasal masses.


Assuntos
Mucocele/diagnóstico , Septo Nasal/patologia , Doenças Nasais/diagnóstico , Diagnóstico Diferencial , Endoscopia , Osso Etmoide/patologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/patologia , Obstrução Nasal/diagnóstico , Supuração , Vômer/patologia
19.
J Craniofac Surg ; 22(5): 1898-999, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21959458

RESUMO

Malignant fibrous histiocytoma (MFH) is one of the most common soft-tissue sarcomas and generally arises in elderly patients. Most often, MFH occurs in the extremities and the retroperitoneum; MFH of the head and neck region is only reported in 3% of all cases. The distant metastasis appears in one third of all cases, and those cases mainly involve the lung, regional lymph nodes, the liver, or bones. The main treatment of MFH of the head and neck is radical excision of the tumor with modified or radical neck dissection. Recurrences of MFH are commonly seen and identified within the first 2 years of treatment. We report a case of simultaneous MFH tumors of the parotid gland and of the scalp skin in an elderly male patient. The patient underwent a wide surgical excision of the lesion and referred to the oncology department for further treatment. However, 1 month after chemoradiotherapy had commenced, there was a recurrence of the tumor over the skin on the right parotid region.


Assuntos
Histiocitoma Fibroso Maligno/patologia , Histiocitoma Fibroso Maligno/cirurgia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/cirurgia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Idoso , Histiocitoma Fibroso Maligno/diagnóstico , Humanos , Masculino , Esvaziamento Cervical , Recidiva Local de Neoplasia , Neoplasias Parotídeas/diagnóstico , Couro Cabeludo , Neoplasias Cutâneas/diagnóstico
20.
Aesthet Surg J ; 31(3): 297-301, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21385740

RESUMO

BACKGROUND: Anatomical structures of the nose (including muscles) are elevated, sutured, or reshaped during rhinoplasty. Electromyography and electroneurography are the objective electrophysiologic tests performed for the direct measurement of nasal muscle function. OBJECTIVES: The authors investigate the predictive values and functional status of nasal muscles during voluntary facial and nasal movements following open and closed rhinoplasty. METHODS: In 48 patients who underwent rhinoplasty, surface electrodes were placed to preoperatively and postoperatively measure nasal muscle function with electromyography and electroneurography. Results were analyzed according to whether the patient had undergone open or closed rhinoplasty. RESULTS: Electroneurography amplitudes were decreased postoperatively on both sides, in both groups. This increase was statistically significant (p < .001). Electromyography-recorded amplitude of nasal muscle contraction tension significantly decreased postoperatively in response to all voluntary movements in two cases in the closed rhinoplasty group (6.6%) and in two cases in the open rhinoplasty group (11.1%). In essence, the activity strength of the nasal muscles decreased postoperatively for some patients. The mean differences between the two groups were not statistically significant (p = .280). CONCLUSIONS: The data showed no meaningful difference in injury to the nasal muscular layer between open and closed rhinoplasty.


Assuntos
Contração Muscular , Nariz/cirurgia , Rinoplastia/métodos , Adolescente , Adulto , Eletromiografia/métodos , Fenômenos Eletrofisiológicos , Feminino , Seguimentos , Humanos , Masculino , Mucosa Nasal/metabolismo , Nariz/anatomia & histologia , Estudos Prospectivos , Adulto Jovem
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