Correlation Between Clinical Diagnosis and Pathological Diagnosis in Laryngeal Lesions.

OBJECTIVES: To evaluate the degree of agreement between the clinical and the pathological diagnosis in patients undergoing laryngeal microsurgery due to epithelial or edematous lesions of the vocal folds. STUDY DESIGN: This is a retrospective study. METHODS: The study was developed in the ear, nose, and throat clinic of a tertiary hospital, through chart review. We included all patients who underwent microsurgery of the larynx, whose videolaryngoscopic tests showed vocal fold lesions, from January 2003 to August 2014. During the study period, we identified 48 patients with epithelial and edematous lesions. The patients were divided into two groups. In group A, patients with edematous lesions with clinical diagnosis of polyps and Reinke edema were included. Group B comprised patients with epithelial lesions, as leukoplakic injuries. A correlation between histopathological findings and clinical hypothesis between these two groups of lesions was performed. RESULTS: In group B, there was agreement in 88.9% of cases between the clinical and pathological diagnosis. In group A, compatibility occurred in only 46.4% of cases. We observed a statistically significant difference between the compatibility of the clinical and pathological diagnosis just in edematous lesions (P = 0.029). CONCLUSIONS: The study showed the limitation of the pathological examination on edematous laryngeal lesions. On the other hand, on the epithelial lesions, there was more agreement between those diagnosis.

Giant cystadenoma of the floor of the mouth: a case report

INTRODUCTION: Cystadenoma is an uncommon epithelial neoplasia that arises from the salivary glands. The malignancy can affect structures such as the larynx, nasopharynx, buccal mucosa, and palate. OBJECTIVE: To describe a case of a giant cystadenoma of the floor of the mouth treated at a public hospital in midwestern Brazil. CASE REPORT: The patient was a 46-year-old woman with complaints of difficulties in articulating words and swallowing solid food and vocal fatigue. The progression of the disease since the initial consultation, the results of clinical examinations, and the outcome of surgery are described. FINALS COMMENTS: Cystadenoma must be considered in the differential diagnosis of cystic injuries in the floor of the mouth if the patient's symptoms are suggestive of this malignancy.

Giant cystadenoma of the floor of the mouth: A case report.

INTRODUCTION: Cystadenoma is an uncommon epithelial neoplasia that arises from the salivary glands. The malignancy can affect structures such as the larynx, nasopharynx, buccal mucosa, and palate. OBJECTIVE: To describe a case of a giant cystadenoma of the floor of the mouth treated at a public hospital in midwestern Brazil. CASE REPORT: The patient was a 46-year-old woman with complaints of difficulties in articulating words and swallowing solid food and vocal fatigue. The progression of the disease since the initial consultation, the results of clinical examinations, and the outcome of surgery are described. Finals Comments: Cystadenoma must be considered in the differential diagnosis of cystic injuries in the floor of the mouth if the patient's symptoms are suggestive of this malignancy.

Prevalência de alterações auditivas em recém-nascidos em hospital escola / Prevalence of auditory changes in newborns in a teaching hospital

Introdução: O diagnóstico e a intervenção precoces na surdez são de fundamental importância no desenvolvimento infantil. A perda auditiva e mais prevalente que outros distúrbios encontrados ao nascimento. Objetivo: Estimar a prevalência de alterações auditivas em recém-nascidos em um hospital escola. Método: Estudo transversal prospectivo que avaliou 226 recém-nascidos, nascidos em um hospital público, entre maio de 2008 a maio de 2009. Resultados: Dos 226 triados, 46 (20,4%) apresentaram ausência de emissões, sendo encaminhados para a segunda emissão. Das 26 (56,5%) crianças que compareceram no reteste, 8 (30,8%) permaneceram com ausência e foram encaminhadas ao otorrinolaringologista. Cinco (55,5%) compareceram e foram examinadas pelo médico. Destas, 3 (75,0%) apresentaram otoscopia normal, sendo encaminhadas para avaliação do Potencial Evocado Auditivo de Tronco Encefálico (PEATE). Do total de crianças estudadas, 198 (87,6%) tiveram presença de emissões em um dos testes e, 2 (0,9%) com diagnóstico de surdez. Conclusão: A prevalência de alterações auditivas na população estudada foi de 0,9%. O estudo oferece dados epidemiológicos relevantes e apresenta o primeiro relatório sobre o tema, fornecendo resultados preliminares para futura implantação e desenvolvimento de um programa de triagem auditiva neonatal...

Introduction: The precocious diagnosis and the intervention in the deafness are of basic importance in the infantile development. The loss auditory and more prevalent than other joined riots to the birth. Objective: Esteem the prevalence of auditory alterations in just-born in a hospital school. Method: Prospective transversal study that evaluated 226 just-been born, been born in a public hospital, between May of 2008 the May of 2009. Results: Of the 226 screened, 46 (20.4%) had presented absence of emissions, having been directed for the second emission. Of the 26 (56.5%) children who had appeared in the retest, 8 (30.8%) had remained with absence and had been directed to the Otolaryngologist. Five (55.5%) had appeared and had been examined by the doctor. Of these, 3 (75.0%) had presented normal otoscopy, being directed for evaluation of the Evoked Potential Auditory of Brainstem (PEATE). Of the total of studied children, 198 (87.6%) had had presence of emissions in one of the tests and, 2 (0.9%) with deafness diagnosis. Conclusion: The prevalence of auditory alterations in the studied population was of 0,9%. The study it offers given excellent epidemiologists and it presents the first report on the subject, supplying resulted preliminary future implantation and development of a program of neonatal auditory selection...

Prevalence of auditory changes in newborns in a teaching hospital.

INTRODUCTION: The precocious diagnosis and the intervention in the deafness are of basic importance in the infantile development. The loss auditory and more prevalent than other joined riots to the birth. OBJECTIVE: Esteem the prevalence of auditory alterations in just-born in a hospital school. METHOD: Prospective transversal study that evaluated 226 just-been born, been born in a public hospital, between May of 2008 the May of 2009. RESULTS: Of the 226 screened, 46 (20.4%) had presented absence of emissions, having been directed for the second emission. Of the 26 (56.5%) children who had appeared in the retest, 8 (30.8%) had remained with absence and had been directed to the Otolaryngologist. Five (55.5%) had appeared and had been examined by the doctor. Of these, 3 (75.0%) had presented normal otoscopy, being directed for evaluation of the Evoked Potential Auditory of Brainstem (PEATE). Of the total of studied children, 198 (87.6%) had had presence of emissions in one of the tests and, 2 (0.9%) with deafness diagnosis. CONCLUSION: The prevalence of auditory alterations in the studied population was of 0,9%. The study it offers given excellent epidemiologists and it presents the first report on the subject, supplying resulted preliminary future implantation and development of a program of neonatal auditory selection.

Linfoma nasossinusal de células T natural killer: relato de caso / Nasosinusal lymphoma of T natural killer cells: case report

Introdução: O linfoma nasal primário é um tumor extranodal raro e representa 0,44% de todos os linfomas extranodais nessa localização. O linfoma nasal primário deriva da linhagem T em torno de 75% dos casos. Objetivo: Descrever um caso de Linfoma nasossinusal de células T Natural Killer, atendido no Hospital das Clínicas da Universidade Federal de Goiás. Relato do Caso: Paciente de 48 anos, sexo feminino, apresentando tumefação difusa na hemiface esquerda, de consistência firme-elástica e dolorosa a compressão digital. Tomografia dos seios da face identificou um velamento maxilar total à esquerda e de algumas células etmoidais posteriores. Com a hipótese diagnóstica de uma afecção tumoral, optou-se por remoção cirúrgica via transmaxilar, sendo encaminhado o material para biopsia. O exame histopatológico diagnosticou um tumor altamente necrótico padrão angiocêntrico, população linfoide polimórfica e atípica (Linfoma T/NK), diante do diagnóstico a paciente foi submetida à quimioterapia com regressão total do edema facial. Comentários Finais: O otorrinolaringologista deve estar atento para a existência dos linfomas entre as doenças nasossinusais, pois o diagnóstico precoce melhora a sobrevida na medida em que previne metástases, crescimento e destruição local.

Introduction: The primary nasal lymphoma is an uncommon extranodal tumor and represents 0.44% of all Extranodal lymphomas in this region. The primary nasal lymphoma derives from the T-lineage in nearly 75% of the cases. Objective: To describe a case of nasosinusal lymphoma of T Natural Killer cells, attended in the Clinical Hospital of the Federal University of Goiás. Case Report: 48-year-old female patient with diffuse tumefaction in the left hemiface of firm-elastic consistency and painful upon digital compression. Face sinuses tomography identified a total maxillary veiling to the left and some posterior ethmoidal cells. With the diagnostic hypothesis of a tumor affection, we opted for the surgical removal via a transmaxillary approach and the material was sent for biopsy. The histopathological exam diagnosed a highly necrotic tumor of angiocentric pattern, polymorphic and atypical lymphoid population (T /NK Lymphoma); with the prognosis, the patient was submitted to chemical therapy with total regression of the facial edema. Final Comments: The otorhinolaryngologist must be attentive as regards the existence of lymphomas among the nasosinusal diseases, because the early diagnosis improves the survival as it prevents metastases, growth and local destruction.

[Vocal care: question of prevention and health]. / Cuidados vocais: questão de prevenção e saúde.

Planned by Brazilian doctors, the National Week of the Voice (Semana Nacional da Voz) conquered the world due to the huge reached success. This study has the objective to demonstrate the results reached during the 9th National Week of the Voice (9ª Semana Nacional da Voz) that took place in the Hospital das Clínicas of the Federal University of Goiás. During the event, 125 patients had been selected by the phonoaudiology team and manually filled a questionnaire elaborated for the campaign in the validity of possible pharyngolaryngeal alterations. The patients had been examined by the otorhinolaryngologist using indirect laryngoscopy and, when necessary, submitted to videolaryngoscopy. After medical evaluation, it was observed that 52 people (41.6%) had presented alterations in the speech organs or in proximal regions, in one patient paralysis of left vocal fold was detected and one patient presented tumoral injury. Considering all the patients attended, only one presented malignant neoplasm (squamous cell carcinoma), confirmed later by biopsy.

Otomastoidite por lagochilascaris minor em criança: relato de caso / Minor lagochilascaris otomastoiditis in a child: case report

Introdução: A lagochilascariose é uma a zoonose emergente determinada pela presença do helminto Lagochilascaris minor em tecidos humanos. A infecção ocorre por meio da ingestão de larvas encistadas no tecido subcutâneo, na musculatura e vísceras de animais silvestres consumidos pelo homem de forma crua ou mal cozidos. A doença é rara, insidiosa, de caráter crônico, caracterizada pelo surgimento de lesões, principalmente na região do pescoço, mastoide, ouvido, rino e orofaringe. A gravidade, por vezes fatal, dependerá da localização do parasito. Objetivo: Descrever um caso de otomastoidite por L. minor em criança, atendida no Hospital das Clínicas da Universidade Federal de Goiás. Relato do Caso: Paciente 10 anos, sexo feminino, com queixa de otalgia intensa e otorreia purulenta à direita. À otoscopia, a orelha esquerda apresentava-se normal, enquanto na orelha direita havia edema retroauricular, pólipo no conduto auditivo externo e fístula com drenagem de secreção purulenta. A membrana timpânica estava íntegra. As etapas do atendimento foram descritas desde a consulta inicial até a recuperação da paciente. Comentários Finais: O clínico deve estar alerta para importância em se considerar o diagnóstico diferencial de tal afecção diante de indivíduos residentes em zonas rurais.

Introduction: The lagochilascariosis is an emerging zoonosis determined by the presence of helminth Lagochilascaris minor in human tissues. Infection occurs through ingestion of larvae encysted in the subcutaneous tissue, muscles and viscera of wild animals consumed by man so raw or undercooked. The disease is rare, insidious, chronic condition, characterized by the appearance of lesions, especially in the neck, mastoid, ear, nose and oropharynx. A serious, sometimes fatal, depend on the location of the parasite. Objective: To describe a case of otomastoiditis by L. minor in child, attended at the Hospital das Clinicas, Federal University of Goias. Case Report: Patient 10 years old female, complaining of otalgia and purulent otorrhea right. Otoscopy left ear was normal, while the right ear had retroauricular edema, polyps in the external ear canal and fistula with drainage of pus. The tympanic membrane was intact.The stages of treatment were described since the initial consultation to the recovery of the patient. Final Comments: The clinician should be alert to the importance in considering the differential diagnosis of this disease on individuals residing in rural areas.

Cuidados vocais: questão de prevenção e saúde / Vocal care: question of prevention and health

Idealizada por médicos brasileiros, a Semana Nacional da Voz conquistou o mundo devido ao enorme sucesso alcançado. Este estudo tem por objetivo demonstrar resultados obtidos durante a 9ª Semana Nacional da Voz, realizada no Hospital das Clínicas da Universidade Federal de Goiás (UFG). Durante o evento, 125 pacientes foram triados pela equipe de fonoaudiologia, preencheram manualmente um questionário elaborado para a campanha, na vigência de possíveis alterações laringofaríngeas. Os pacientes foram examinados pelo otorrinolaringologista por meio da laringoscopia indireta e, quando necessário, submetidos à videolaringoscopia. Após avaliação médica, observou-se que 52 pessoas (41,6 por cento) apresentaram alterações no aparelho fonador ou em regiões proximais, em um paciente foi detectada paralisia de prega vocal esquerda e em outra lesão tumoral. Do total de pacientes atendidos, apenas um apresentou neoplasia maligna (carcinoma escamoso), confirmada posteriormente por meio de biopsia.

Planned by Brazilian doctors, the National Week of the Voice (Semana Nacional da Voz) conquered the world due to the huge reached success. This study has the objective to demonstrate the results reached during the 9th National Week of the Voice (9ª Semana Nacional da Voz) that took place in the Hospital das Clínicas of the Federal University of Goiás. During the event, 125 patients had been selected by the phonoaudiology team and manually filled a questionnaire elaborated for the campaign in the validity of possible pharyngolaryngeal alterations. The patients had been examined by the otorhinolaryngologist using indirect laryngoscopy and, when necessary, submitted to videolaryngoscopy. After medical evaluation, it was observed that 52 people (41,6 percent) had presented alterations in the speech organs or in proximal regions, in one patient paralysis of left vocal fold was detected and one patient presented tumoral injury. Considering all the patients attended, only one presented malignant neoplasm (squamous cell carcinoma), confirmed later by biopsy.

Afonia com etiologia desconhecida: relato de caso / Aphonia with unknown etiology: a case report

Introdução: A afonia de conversão é definida como a perda total da voz, é uma doença rara que acomete frequentemente as mulheres. O diagnóstico é clínico, pois não há alterações nas estruturas laríngeas. Objetivo: Descrever um caso de afonia de conversão, atendida em um hospital público no Centro-Oeste do Brasil. Relato do Caso: Paciente de 32 anos, sexo feminino, com queixa de afonia há dois dias, sem outros sintomas aparentes. Os exames não revelaram alterações nas estruturas laríngeas e/ou extralaríngeas. As etapas do atendimento foram descritas desde a consulta inicial até a recuperação da paciente. Comentários Finais: É importante considerar os aspectos psicoemocionais que envolvem os pacientes com alterações vocais, uma vez que os mesmos podem originar ou alterar os sintomas e comprometer o prognóstico da doença.

Introduction: The conversion aphonia is defined as the total loss of voice, is a rare disease that often affects women. The diagnosis is clinical, because there are no changes in the laryngeal structures. Objective: To describe a case of conversion aphonia, seen in a public hospital in the Midwest of Brazil. Case Report: Patient 32 years old female, complaining of hoarseness for two days without other apparent symptoms. The examinations revealed no changes in the laryngeal structures and / or extra laryngeal. Stages of care have been described since the initial consultation to the recovery of the patient. Final Comments: It is important to consider the psycho-emotional aspects involving patients with voice disorders since they may cause or modify the symptoms and affect the prognosis.

[Hearing evaluation on newborn babies and its ethical implications]. / Avaliação auditiva no recém-nascido e suas implicações éticas.

The study has as purpose to examine the bibliographic production that investigates the use of the test of otoacoustic emissions in newborn babies done in hospitals. It gives emphasis in the approval of the mentioned article along the Research Ethics Committee. The method consists on bibliographic revision of national articles published in Brazilian journals. The research was realized in databases of the virtual library in health (http://www.bireme.br) and at the search engine Google (http://www.google.com.br), considering the period of 2004 to 2006. The key words used were: otoacoustic emissions and hearing triage or equivalent expressions in newborn babies in hospitals. Another source was the manual search in reference lists of the selected articles. After the application of the inclusion rules, nine articles were selected in five different journals. The citation of the approval of the Ethics Committee and the signature of the Free Consent Term, which were cleared by the responsible, were present in the majority of the articles and it demonstrates the concern and respect of the researchers of this area with the participant citizen on the study.

Avaliação auditiva no recém-nascido e suas implicações éticas: [revisão] / Hearing evaluation on newborn babies and its ethical implications: [review]r

O estudo tem por finalidade examinar a produção bibliográfica que investigou o uso do teste das emissões otoacústicas em recém-nascidos realizado em hospitais, dando ênfase à aprovação do referido artigo junto ao Comitê de Ética em Pesquisa. O método constitui-se numa revisão bibliográfica de artigos nacionais publicados em revistas brasileiras. A busca se deu por meio de bancos de dados da Biblioteca Virtual em Saúde (BVS) (http://www.bireme.br), e site de busca (http://www.google.com.br), referentes aos anos de 2004 a 2006, usando os descritores emissões otoacústicas e triagem auditiva ou expressões equivalentes em neonatos, em hospitais. Outro meio foi a busca manual nas listas de referências dos artigos selecionados. Após aplicação dos critérios de inclusão, foram selecionados nove artigos em cinco tipos de revistas. A citação da aprovação do Comitê de Ética e assinatura do termo de consentimento livre e esclarecido pelo responsável estiveram presentes na grande maioria dos artigos, demonstrando a preocupação e respeito dos pesquisadores da área para com o sujeito participante no estudo.

The study has as purpose to examine the bibliographic production that investigates the use of the test of otoacoustic emissions in newborn babies done in hospitals. It gives emphasis in the approval of the mentioned article along the Research Ethics Committee. The method consists on bibliographic revision of national articles published in Brazilian journals. The research was realized in databases of the virtual library in health (http://www.bireme.br) and at the search engine Google (http://www.google.com.br), considering the period of 2004 to 2006. The key words used were: otoacoustic emissions and hearing triage or equivalent expressions in newborn babies in hospitals. Another source was the manual search in reference lists of the selected articles. After the application of the inclusion rules, nine articles were selected in five different journals. The citation of the approval of the Ethics Committee and the signature of the Free Consent Term, which were cleared by the responsible, were present in the majority of the articles and it demonstrates the concern and respect of the researchers of this area with the participant citizen on the study.

Manifestações clínicas na Policondrite Recidivante: relato de caso / Clinical manifestations of Relapsing Polychondritis: case report

A Policondrite Recidivante - PR é uma afecção sistêmica grave, de natureza imunológica, caracterizada por um processo inflamatório que acomete as estruturas cartilaginosas nasais e auriculares, vias aéreas superiores e articulações periféricas. O diagnóstico é basicamente clínico e as complicações otorrinolaringológicas podem ser as manifestações iniciais da doença. Tendo em vista a raridade da doença, objetivou-se descrever um caso de PR, atendida no Hospital das Clínicas da UFG em agosto de 2006. Para tanto, as etapas seqüenciais do atendimento foram descritas desde a consulta inicial, diagnóstico, tratamento até a alta hospitalar. As dificuldades vivenciadas pelos profissionais em dar seguimento ao tratamento, em função da resistência da paciente, provavelmente colaborou para agravamento da doença, culminando em seu óbito. O clínico deve estar atento frente a suspeita clínica de Policondrite Recidivante visando o seu diagnóstico precoce e tratamento.

The Relapsing Polychondritis - RP is a rare systemic affection, of immunological nature, characterize by an inflammatory process that affects cartilaginous structures, upper airway and peripheral articulation. The diagnosis is basically clinical and the otorhinolaryngological complications can be the initial manifestations of the illness. Having in view the rarity of the disease, it was objectified to describe a PR case attended at Hospital das Clínicas of UFG in august of 2006. Therefore, the sequential stages of the attendance had been described since the initial appointment, diagnosis, high treatment until the hospital one. The difficulties lived deeply for the professionals to proceed the treatment, in function of the resistance of the patient, probably collaborated for aggravation of the illness, culminating in its death. The physician must be alert in the presence of the clinical suspicion of Relapsing Polychondritis aiming at its precocious diagnosis and treatment.

La Policondrite Recidivante - PR es una afección sistémica grave, de naturaleza inmunológica. Caracterizada un proceso inflamatorio que acomete estructuras cartilaginosa nasales, vías aereas superiores y articulaciones periféricas. El diagnóstico es basicamente clínico y las complicaciones otorrinolaringológicas pueden ser las manifestaciones iniciales de la enfermedad. Esta enfermedad por ser rara, se objetivó describir un caso de PR, atendida en El Hospital de las Clínicas de La UFG en agosto de 2006. Para tanto, las etapas secuenciales del atendimiento fueron descritas desde la consulta inicial, diagnóstico, tratamiento hasta la alta hospitalar. Las dificultades vividas por los profesionales en dar seguimiento al tratamiento, en función de La resistencia de La paciente, probablemente colaboro para el agravamiento de la enfermedad, culminando en su óbito. El clínico debe estar atento frente a la sospecha clínica de Policondrite Recidivante visando su diagnóstico precoz y tratamiento.