Modified extracorporeal septoplasty: prospective study.

OBJECTIVES: This study aimed to evaluate quality-of-life and satisfaction outcomes in patients undergoing the MES using the Portuguese version of the Nasal Obstruction Symptom Evaluation (NOSE-p) and Rhinoplasty Outcome Evaluation (ROE), and also to evaluate the frequency of possible complications of this technique. METHODS: We conducted a single-center prospective study with patients who had the indication for MES, from May 2016 to September 2020 at the Facial Plastic Surgery Clinic of Otolaryngology Department of the Hospital de Clinicas de Porto Alegre. The primary outcome was the relative postoperative change in NOSE-p. Secondary outcome was the variation in ROE, a validated quality-of-life questionnaire for rhinoplasty patients. RESULTS: Of the 31 patients submitted to extracorporeal septorhinoplasty who were evaluated, twenty-seven patients were included. Preoperative and postoperative NOSE-p scale scores were 65.2 ±â€¯29.9 and 23.5 ±â€¯26.7, respectively (mean differences of 42.04; [95% CI 27.35-56.73]; p <  0.0001). Pre and postoperative ROE scores were 38.3 ± 24.3 vs. 67.29 ± 29.7, respectively (mean differences of -29.02; [95% CI -40.5 to -17.5]; p =  0.0001). Residual septal deviation was verified in 2 patients (7.4%). CONCLUSION: Most of the patients submitted to modified extracorporeal septoplasty had a significant improvement in quality of life scores of nasal obstruction, with good aesthetical outcomes and low indices of postoperative complications. LEVEL OF EVIDENCE: Level 3.

Effectiveness of hypopharyngeal packing during nasal and sinus surgery in the prevention of PONV.

OBJECTIVE: Evaluate the hypopharyngeal packing effectiveness on prevention of postoperative nausea and vomiting (PONV) in nasal surgery. STUDY DESIGN AND SETTING: A randomized clinical trial was conducted from July 2004 to October 2005. The intervention group was submitted to hypopharyngeal packing after orotracheal tube placement. The control group had no hypopharyngeal packing. Occurrence of nausea, vomiting, use of antiemetic drugs, and throat pain were checked blindly on recovery period. RESULTS: One hundred forty-four patients were included in the study. There was no difference related to postoperative nausea (RR 1.34; CI 0.72-2.48), vomiting (RR 0.52; CI 0.19-1.47), use of antiemetic drugs (RR 1.54; CI 0.80-2.95), and throat pain (RR 0.91; 0.62-1.34) between both groups. A beta error could not be excluded. CONCLUSION: Results suggest there is no benefit in hypopharyngeal packing on PONV prevention in nasal surgery. New studies with a greater number of patients should be carried out in order to confirm these results.

Hyperinsulinemia and tinnitus: a historical cohort.

Tinnitus affects millions of people worldwide, and it signals the presence of several underlying diseases, including hyperinsulinemia. The aim of this study was to evaluate the response to dietary treatment in 80 patients with associated tinnitus and hyperinsulinemia. On the basis of data obtained by a questionnaire, two groups were established: One included patients who followed the prescribed diet; the other group included patients who did not comply with the treatment. The likelihood of improving tinnitus symptoms was fivefold higher in hyperinsulinemic patients who followed the diet than in those who did not (relative risk [RR], 5.34; 95% confidence interval [CI], 1.85-15.37; p < .05). In addition, resolution of tinnitus was reported by 15% of the patients who followed the diet as compared to 0% of those who did not. These findings underscore the importance of including hyperinsulinemia in the routine diagnostic investigation of patients with tinnitus regardless of whether associated with neurosensory dysacusis or vertigo (or both).

O papel do sistema dopaminérgico na fobia social / The role of the dopaminergic system in social phobia

Os autores descrevem o papel do sistema dopaminérgico na fobia social. Evidências que indicam disfunçäo dopaminérgica säo descritas, e o papel da dopamina como um regulador da atividade social é discutido

Estudo de 100 pacientes com clínica sugestiva de hipoglicemia e manifestaçöes de vertigem, surdez e zumbido / Study of 100 patients with suggestive clinics of hypoglycemia and manifestations of vertigo, deafness and tinnitus

O estudo avaliou a sensibilidade da história clínica para detectar alterações metabólicas em pacientes com hipoacusia e/ou zumbido e/ou vertigem associados à clínica sugestiva de hipoglicemia. Para tanto, 100 pacientes com este quadro foram submetidos a teste de tolerância à glicose de 5h com dosagem simultânea de insulina (hipoglicemia = glicose < ou = 55 mg/dL em qualquer momento da curva glicêmica). Curvas glicêmicas alteradas foram observadas em 59 pacientes (44 hipoglicêmicas). A hipoglicemia foi detectada apenas após a terceira hora do exame em 38 pacientes. As curvas insulinêmicas foram compatíveis com hiperinsulinismo em 73 pacientes. Apenas quatro pacientes apresentaram ambas as curvas dentro da normalidade. O valor preditivo positivo para detecção de anormalidades no metabolismo glicídico pela história clínica foi de 96 por cento. Este fato sugere a implantação de um teste terapêutico, com dieta específica, como parte da avaliação de pacientes com clínica sugestiva de hipoglicemia e manifestações de vertigem, surdez e zumbido.

Síndrome de Menière: diagnóstico etiológico / Ménièreïssyndrome: etiologic diagnosis

A correta identificação da etiologia da síndrome de Ménière, alcançada em até 50 por cento dos casos permite, via de regra, uma melhora significativa do quadro, através do manejo da doença de base. O presente estudo objetiva discutir as principais doenças possívelmente asssociadas à gênese da síndrome de Ménière, enfocando prevalência, mecanismo etiopatogênico, implicação prognóstica. Além disso, apresentamos um fluxograma que serve como guia de busca etiológica para a síndrome de Ménière

Teste cutâneo de leitura imediata em um serviço terciário do sul do Brasil: relação com diagnóstico clínico e gravidade da rinite alérgica / Skin prick test in a southern Brazilian tertiary hospital: link between clinic diagnosis and severity in allergy rhinitis

Objetivo: investigar a possível correlação entre o diagnóstico clínico de rinite alérgica (RA) e a positividade dos testes cutâneos, os valores de IgE total e a eosinofilia. Além disso, verificar a influência da estação do ano e do tratamento da rinite nos resultados dos testes cutâneos. Métodos: estudo transversal envolvendo 165 pacientes atendidos em nível ambulatorial de um hospital terciário do sul do Brasil. Pacientes com diagnóstico clínico de RA foram avaliados com o Escore de Sinais e Sintomas (ESS) e submetidos a testes cutâneos por puntura, dosagem de IgE total e contagem de eosinófilos. Resultados: Houve uma prevalência de 36% de testes cutâneos positivos e uma correlação fraca entre o valor do ESS e a positividade para D. pteronyssinus (r=O,298/IC95%=O,131¬0,447/p

Objective: The aim of this report is to find a possible link between clinicai diagnosis of AR and positivity in prick tests, total serum IgE leveis and eosinophilia. Plus, we intend to verify a possible influence of season and treatment over prick test results. Methods: 165 outpatients of a Brazilian tertiary hospital, evaluated with the "Signs and Symptoms Score (SSE)", had undergone prick tests, total serum IgE leveis and eosinophils measurement. Their results were compiled and analyzed. Results: There were a 36% prevalence of positive prick tests and a weak correlation was found between the SSE and positivity for D. pteronyssinus(r=O,298/CI95%=O,131-0,447/ p