RESUMO
Nasal polyposis (NP) is a chronic inflammatory disease in which several molecular and cellular interactions play important roles. Tumor necrosis factor-alpha (TNF-alpha) is a major pro-inflammatory cytokine with a key role in immune inflammatory responses in NP. Altered levels of TNF-alpha, which may occur due to polymorphisms in the TNF-alpha promoter region, may also be associated with NP susceptibility. Given these facts, we investigated the possible association of the TNF-alpha -308 G/A single nucleotide polymorphism (SNP) with NP. In this study, 97 consecutive adult patients with NP and 95 age- and gender-matched controls were recruited. For identification of SNP, restriction fragment length polymorphism analysis after polymerase chain reaction was carried out. The NP group had a significantly higher rate of polymorphism compared to controls (p = 0.015). Logistic regression analysis revealed that the presence of the TNF-alpha -308 G/A SNP is an independent risk factor for NP development (OR, 3.68; CI, 1.27-10.7; p = 0.016). The presence of a mutation failed to influence disease severity on the basis of resistance to medical and/or surgical treatment. This study suggests a possible linkage of a SNP in the TNF-alpha promoter with NP. These results need to be confirmed with multicentre studies for more precise interpretation and corroborative studies for investigating the influence of polymorphism on transcriptional activity.
Assuntos
Alelos , Pólipos Nasais/genética , Mutação Puntual/genética , Polimorfismo de Nucleotídeo Único/genética , Fator de Necrose Tumoral alfa/genética , Adolescente , Adulto , Asma/diagnóstico , Asma/genética , Asma Induzida por Aspirina/genética , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença/genética , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/diagnóstico , Reação em Cadeia da Polimerase , Regiões Promotoras Genéticas/genética , Rinite Alérgica Perene/genética , Rinite Alérgica Sazonal/genética , Adulto JovemRESUMO
Eagle's syndrome represents a group of symptoms that includes recurrent throat pain, globus pharyngeus, dysphagia, referred otalgia, and neck pain possibly caused by elongation of the styloid process or ossification of the stylohyoid or stylomandibular ligaments. The medical history and physical and radiologic examinations are the main guides to the precise diagnosis. The radiologic diagnostic modality of choice is three-dimensional computed tomography (3-D CT). We describe a case of bilaterally symptomatic Eagle's syndrome that was diagnosed by 3-D CT of the styloid processes and successfully treated with surgery via a transoral approach.
Assuntos
Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/cirurgia , Calcinose/diagnóstico por imagem , Calcinose/diagnóstico , Osso Temporal/patologia , Tomografia Computadorizada por Raios X/métodos , Transtornos de Deglutição/etiologia , Feminino , Humanos , Imageamento Tridimensional , Ligamentos/patologia , Ligamentos/cirurgia , Pessoa de Meia-Idade , Dor/etiologia , Síndrome , Osso Temporal/cirurgiaRESUMO
PURPOSE: The purpose of this study was to discuss the current diagnosis of Eagle's syndrome and to present our experience in transoral surgical treatment of the syndrome. MATERIALS AND METHODS: Nineteen patients with Eagle's syndrome due to elongated styloid process were included in this clinical trial. Diagnostic work-up also consists of 3-dimensional computed tomography scanning in recent cases. Elongated styloid processes were resected via transoral approach under general anesthesia. RESULTS: Three-dimensional computed tomography scanning depicted how the preoperative estimation of the styloid length correlated with the true styloid length measure intraoperatively. No postoperative complications were encountered, while the chief symptoms of all patients regressed after surgery. CONCLUSIONS: Three-dimensional computed tomography scanning is an advanced technique that can measure the definitive length of styloid process and takes the physician straightforward to the exact diagnosis. The transoral approach is a safe surgical alternative that achieves adequate treatment of Eagle's syndrome.