Nasal spine implant to correct nasal asymetry and to enable nose correction accompanying orthognathic surgery.

OBJECTIVES: Orthognathic surgery is gaining importance as an aesthetic procedure. The aim of this work is the first case report of a simultaneous rhinoplasty and orthognathic surgery, using a nasal spine implant. CASE REPORT: This is a retrospective study based on the CARE guideline. A nasal spine implant was virtually planned and printed in polyetheretherketone (PEEK) to correct a nasal deviation and enable a rhinoplasty in the same surgical time. Both the surgeon and the patient were very satisfied with the clinical result. CONCLUSIONS: Virtually planned and printed nasal spine implant is feasible. A helpful method to support rhinoplasty in orthognathic surgery to avoid deviations in the tip of the nose or asymmetries in the nostrils.

Outcome of Free Diced Cartilage Grafts in Rhinoplasty: A Systematic Review.

Diced cartilage grafts are used to increase and refine the nasal contour, providing easy molding and versatility when compared with block grafts. However, all grafts present the possibility of visibility, distortion, and absorption. The aim of this study is to evaluate, through a systematic review, the outcome of the use of the free diced graft cartilage in rhinoplasty. A systematic search of the literature was performed in the databases (PubMed, Lilacs, Scielo, Cochrane) with the terms "diced cartilage" and "rhinoplasty." Studies were selected according to the inclusion and exclusion criteria and data extracted and grouped for analysis. Six eligible studies were included. In total, 4,044 patients underwent rhinoplasty with free diced cartilage graft, with 61 (1.51%) of them requiring reoperation. The main reasons were overcorrection and irregularities of the nasal dorsum. The infection rate was reported in three studies, with 2 (0.06%) of 3,252 patients presenting infection at the graft site. Two cases of displacement were treated with external molding, without reoperation. The graft resorption was reported in four articles, which described 22 (0.67%) cases of partial resorption in 3,288 patients. Therefore, the available evidence suggests that resorption of the graft and unfavorable outcomes are rare.

The seasonality of respiratory viruses in patients with chronic rhinosinusitis.

BACKGROUND: Chronic rhinosinusitis (CRS) is a common illness, yet little is known about its pathogenesis, including the role played by respiratory viruses. METHODS: A transversal prospective study was conducted to analyze the seasonality of CRS using real-time polymerase chain reaction to detect respiratory virus genomes in secretions and tissue samples from patients with CRS with and without nasal polyps. RESULTS: The frequency of viral detection was 41% (31/75). The respiratory virus most frequently detected was human rhinovirus, found in 18 patients (24%), followed by human metapneumovirus, human enterovirus, human respiratory sincicial virus, human adenovirus, human bocavirus, human coronavirus, and human influenza virus, detected in 12 (16%), five (6.6%), four (5.3%), four (5.3%), two (2.6%), two (2.6%), and one (1.3%) patient(s), respectively. Although none of the patients presented symptoms when the samples were collected, there was a peak in detection of the most prevalent virus in the autumn and winter seasons of both years, similar to the pattern that occurs in acute conditions. CONCLUSIONS: The pattern of respiratory virus seasonality found in nasal mucosa, polyps, and paranasal sinus samples in patients with CRS reinforces the possibility of asymptomatic respiratory viral infections.

Efficacy of cidofovir in recurrent juvenile respiratory papillomatosis.

UNLABELLED: The efficacy of cidofovir in juvenile recurrent respiratory papillomatosis (JRRP) remains uncertain due to the lack of published case-control studies. AIM: To establish factors affecting the progression of JRRP prognosis, and to evaluate cidofovir for eradicating JRRP. STUDY DESIGN: Retrospective. METHODS: 22 children with JRRP were evaluated at a referral center. All children underwent surgical debulking, followed by cidofovir injection (Group 2) or not (Group 1). Age at diagnosis was correlated with the Derkay score and disease outcome. Disease progression was compared between groups 1 and 2. RESULTS: fifteen children were considered disease-free; 8 were in Group 2 and 7 in Group 1. Age and total and clinical scores (P<0.05) were negatively correlated. The mean number of surgeries required to control the disease was identical in both groups; the duration of treatment until remission was significantly higher in Group 1 (P<0,05). CONCLUSION: JRRP is more aggressive in earlier onset disease. The duration of treatment was significantly lower in patients treated with cidofovir until eradication of JRRP compared to patients treated with surgery only.

Avaliação da eficácia do cidofovir na papilomatose respiratória recorrente juvenil / Efficacy of cidofovir in recurrent juvenile respiratory papillomatosis

O uso do cidofovir para papilomatose respiratória recorrente juvenil (PRRJ) ainda não tem estudos caso-controle suficientes que comprovem sua eficácia em literatura. OBJETIVO: Avaliar fatores que influenciem o prognóstico da PRRJ, e observar a atuação do cidofovir na erradicação da PRRJ. DESENHO DO ESTUDO: Retrospectivo. MATERIAIS E MÉTODOS: 22 crianças com PRRJ foram avaliadas num centro terciário. Todas as crianças foram submetidas ao tratamento cirúrgico, seguido (Grupo 2) ou não (Grupo 1) pelo uso do cidofovir. A idade ao diagnóstico foi correlacionada ao escore de Derkay e à evolução da doença. Os Grupos 1 e 2 tiveram suas evoluções comparadas entre si. RESULTADOS: Quinze crianças foram consideradas curadas, 8 no Grupo 2 e 7 no Grupo 1. Houve uma correlação negativa entre idade e Escores Total e Clínico (P<0,05). O número médio de cirurgias necessárias para controlar a doença foi semelhante entre os Grupos, mas a duração do tratamento até remissão foi significativamente maior no Grupo 1 quando comparado ao Grupo 2 (P<0,05). CONCLUSÕES: A PRRJ é mais agressiva quanto mais nova a idade do paciente ao diagnóstico. Pacientes tratados com cidofovir apresentaram duração significativamente menor de tratamento até erradicação da PRRJ do que os submetidos apenas ao tratamento cirúrgico.

The efficacy of cidofovir in juvenile recurrent respiratory papillomatosis (JRRP) remains uncertain due to the lack of published case-control studies. AIM: To establish factors affecting the progression of JRRP prognosis, and to evaluate cidofovir for eradicating JRRP. STUDY DESIGN: Retrospective. METHODS: 22 children with JRRP were evaluated at a referral center. All children underwent surgical debulking, followed by cidofovir injection (Group 2) or not (Group 1). Age at diagnosis was correlated with the Derkay score and disease outcome. Disease progression was compared between groups 1 and 2. RESULTS: fifteen children were considered disease-free; 8 were in Group 2 and 7 in Group 1. Age and total and clinical scores (P<0.05) were negatively correlated. The mean number of surgeries required to control the disease was identical in both groups; the duration of treatment until remission was significantly higher in Group 1 (P<0,05). CONCLUSION: JRRP is more aggressive in earlier onset disease. The duration of treatment was significantly lower in patients treated with cidofovir until eradication of JRRP compared to patients treated with surgery only.

Comparação das curvas de crescimento da Organização Mundial da Saúde em relação ao padrão da national Center for Health Statistics em crianças com até cinco anos de idade / Comparison of the growth curves from the World Health Organization in relation to the standards of the National Center for Health statistics in children up to five years of age

Objetivo. Comparar os novos padrões de curva de avaliação de crescimento da Organização Mundial da Saúde(OMS) com aqueles do National Center for Health Statistics (NCHS) em crianças de até cinco anos, atendidas no Hospital Universitário da Universidade Católica de Brasília. Método. Estudo transversal com análise de 302 prontuários de crianças com até cinco anos de idade, atendidas no período de 13-5-2004 a 31-5-2006. O protocolo de pesquisa consistiu na elaboração de planilha do Excel, com dados demográficos e antropométricos. Foram verificados os indicadores altura e idade, peso e altura por meio do escore Z para os padrões do NCHS e da OMS. Para avaliar a concordância entre os dois padrões utilizou-se o teste de simetria de Bowker e o kappa ponderado. Para efeito de análise usou-se nível de significância de 5%. Resultados. As percentagens de baixa estatura moderada e desnutrição moderada foram maiores quando foi usado o padrão da OMS. Os resultados dos testes de simetria evidenciaram valores p < 1. Na interpretação do coeficiente kappa, evidenciou-se concordância em relação ao acaso. Conclusões. Houve concordância na forma de avaliação pelos padrões retrocitados, sendo estes comparáveis entre si. A desnutrição moderada foi mais observada pela nova curva da OMS em ambos os sexos. O padrão da OMS mostrou maior tendência em diagnosticar baixa estatura no sexo masculino. As novas curvas de crescimento da OMS servem como modelo normativo para o crescimento e o desenvolvimento das crianças, o que imprime assim um padrão internacional único.

Objective. To compare the new World Heath Organization (WHO) curves with the National Center For Health Statistics (NCHS) pattern in children younger than 5 years old at the hospital of the Universidade Católica de Brasília. Method. A cross-sectional study analyzing 302 medical records of children less than under 5 years old seen atthat hospital from may 2004 to may 2006. The research protocol consisted of Excel worksheet with demographic and anthropometric data. Height-age and weight-height were verified at the Z score under the NCHS and WHO patterns. To analyze the accordance between the two patterns the Bowker symmetry test and kappa ponderado were used. To analyse it, a significance level of 5% was used. Results. The percentage of low moderate height and moderate subnutrition was higher with WHO pattern. The symmetry test results showed values of p < 1. The kappa coefficient interpretation demonstrated accordance to randomization. Conclusions. There was concordance between the NCHS and WHO patterns, thus both were camparable. Moderate subnutrition was seen more often with the WHO data at both sexes. WHO pattern showed tendency to diagnose low height at the male. The new WHO data is useful to establish children's growth and development, being considered as an unique international pattern