Alcohol Sniff Test (AST): An Important Tool for Screening Post-Viral Olfactory Loss in Acute Flu-Like Dysfunction.

Olfactory disorders have a significant impact on patients' quality of life but are often underestimated in clinical practice. Upper respiratory tract infections (URTIs) are a common cause of olfactory loss. While most cases of olfactory loss due to URTIs are conductive and reversible, post-viral olfactory dysfunction (PVOD) persists despite symptom improvement. PVOD is attributed to damage to the olfactory epithelium and nerves or central olfactory pathway lesions. The Alcohol Sniff Test (AST) has been proposed as a tool to assess olfactory function in the acute phase and aid in differentiating PVOD from conductive disorders. This study aims to evaluate the effectiveness of the AST as a predictor of post-viral olfactory loss in patients with flu-like syndrome. An observational cross-sectional study was conducted among employees with flu-like syndrome at a tertiary hospital. Three groups were formed: flu-like syndrome with conductive disorder without COVID-19 (PVOD-), flu-like syndrome with neurosensory and/or central disorder due to COVID-19 (PVOD +), and an asymptomatic control group. The Alcohol Sniff Test was performed to assess olfactory function. Statistical analysis was conducted to evaluate the AST's performance. For a cut off of 10 cm, 88.57% of PVOD + patients and 60.53% of PVOD - patients showed AST alteration, respectively (p = 0.013, OR = 5.05, 95% CI [1.48-17.25]). There was a statistically significant difference in the mean distance between the PVOD + group (4.35 ± 4.1 cm) and the control group (20 ± 4.33 cm) (p < 0.05). This relationship was also observed between the PVOD + and PVOD- groups (9 cm ± 7.5) (p < 0.05) and between the PVOD- and control groups (p < 0.05). For a cut off of 10 cm, the AST showed a sensitivity of 88% and specificity of 41%, resulting in an Odds Ratio of 9.7 (95% CI 3.3-28.1) (p < 0.001) and a Positive Predictive Value of 69.4% for PVOD. PVOD, including cases associated with COVID-19, is a prevalent cause of olfactory loss. The Alcohol Sniff Test demonstrated promising results in identifying PVOD in patients with flu-like syndrome. The test's simplicity and accessibility make it a valuable tool for early screening and identifying individuals who may benefit from prompt treatment. The Alcohol Sniff Test (AST) shows potential as an effective tool for screening post-viral olfactory loss in patients with flu-like syndrome. It can aid in early identification of PVOD cases and facilitate timely interventions to reduce the likelihood of persistent hyposmia.

Olfactory dysfunction in COVID-19: a marker of good prognosis? / Disfunção de olfato na Covid-19: marcador de bom prognóstico?

Abstract Introduction In May 2020, the World Health Organization recognized olfactory dysfunction as a COVID-19 symptom. The presence of hyposmia/anosmia may be a marker of good prognosis in COVID-19. Objective To associate the presence of olfaction disorder to the clinical condition severity in patients with COVID-19. Methods Individuals with the flu syndrome caused by SARS-CoV-2, diagnosed from March to June 2020, were recruited. They were divided into three groups: mild flu syndrome, severe flu syndrome (admitted to hospital wards) and critical illness (admitted to the ICU). Inpatients were interviewed by telephone contact after hospital discharge and their medical records were also evaluated regarding complementary test results. Outpatients answered an electronic questionnaire containing only clinical information. Results A total of 261 patients participated in the study: 23.75% with mild flu syndrome, 57.85% with severe flu syndrome and 18.40% with critical illness. A total of 66.28% patients with COVID-19 had olfaction disorders. In approximately 56.58% of the individuals the smell alterations lasted between 9 days and 2 months. There was a significantly higher proportion of individuals with olfactory dysfunction in the group with mild flu syndrome than in the severe flu syndrome group (mild × severe - p< 0.001; Odds Ratio = 4.63; 95% CI [1.87-10.86]). This relationship was also maintained between patients with mild flu syndrome and critically-ill patients (mild × critical - p< 0.001; Odds Ratio = 9.28; 95% CI [3.52-25.53]). Conclusion Olfaction dysfunction was significantly more prevalent in patients with mild flu syndrome in COVID-19. It may be a predictor of a good prognosis for this infection. New population-based studies must be carried out to corroborate these findings.

Resumo Introdução Em maio de 2020, a Organização Mundial da Saúde reconheceu a disfunção do olfato como um sintoma da C-19. A presença de hiposmia/anosmia pode ser um marcador de bom prognóstico na Covid-19. Objetivos Relacionar a presença do transtorno do olfato à gravidade do quadro clínico nos pacientes com Covid-19. Método Foram recrutados indivíduos com síndrome gripal causada pelo SARS-CoV-2, diagnosticados de março a junho de 2020. Eles foram divididos em três grupos: síndrome gripal leve; síndrome gripal grave (internados em enfermarias) e doença crítica (internados em UTI). Os doentes internados foram entrevistados por ligação telefônica após alta hospitalar e também tiveram seus prontuários avaliados para registro de exames complementares; os ambulatoriais responderam a um questionário eletrônico com somente informações clínicas. Resultados Participaram do estudo 261 pacientes: 23,75% com síndrome gripal leve, 57,85% com síndrome gripal grave e 18,40% com doença crítica. Ocorreu alteração do olfato em 66,28% doentes com Covid-19. Dos indivíduos, 56,58% apresentaram duração da alteração do olfato entre 9 dias e 2 meses. Houve significativamente maior proporção de indivíduos com disfunção olfatória no grupo com síndrome gripal leve do que nos graves (leves × graves - p < 0,001; odds ratio = 4,63; 95% IC [1,87-10,86]). Essa relação também se manteve entre os doentes leves e críticos (leves × críticos - p < 0,001; odds ratio = 9,28; 95% IC [3,52-25,53]). Conclusão A disfunção do olfato foi significantemente mais prevalente nos doentes com síndrome gripal leve na Covid-19. Pode ser um preditor de bom prognóstico dessa infecção. Novos estudos populacionais devem ser feitos para corroborar esses achados.

CD133, a Progenitor Cell Marker, is Reduced in Nasal Polyposis and Showed Significant Correlations with TGF-β1 and IL-8

Abstract Introduction Combination of chronic inflammation and an altered tissue remodeling process are involved in the development of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Studies demonstrated that mesenchymal stem cells expressing the progenitor gene CD133 were involved in a significant reduction of the chronic inflammatory process in the polypoid tissue. Objective To evaluate the levels of CD133 (Prominin-1) in nasal polypoid tissue and its correlation with interleukin-8 (IL-8) and transforming growth factor β1 (TGF-β1). Methods A total of 74 subjects were divided in the following groups: control group (n = 35); chronic rhinosinusitis with nasal polyps nonpresenting comorbid asthma and aspirin intolerance (CRSwNPnonAI) group (n = 27); and chronic rhinosinusitis with nasal polyps presenting comorbid asthma and aspirin intolerance (CRSwNPAI) group (n = 12). Histologic analysis and also evaluation of the concentration of CD133, IL-8, and TGF-β1 by enzyme-linked immunosorbent assay (ELISA) kits were performed in nasal tissue obtained from nasal polypectomy or from middle turbinate tissue. Results Higher eosinophilic infiltration was found in both CRSwNP groups by histologic analysis. Lower levels of TGF-β1 and IL-8 were observed in both CRSwNP groups when compared with the control group, whereas the CD133 levels were significantly reduced only in the CRSwNPnonAI group compared with the control group. Conclusion It was demonstrated that the nasal mucosa presenting polyposis showed a significant reduction of CD133 levels, and also that this reduction was significantly correlated with the reduction of TGF-β1 levels, but not with IL-8 levels. Therefore, these findings may be involved in the altered inflammatory and remodeling processes observed in the nasal polyposis.

Olfactory dysfunction in COVID-19: a marker of good prognosis?

INTRODUCTION: In May 2020, the World Health Organization recognized olfactory dysfunction as a COVID-19 symptom. The presence of hyposmia/anosmia may be a marker of good prognosis in COVID-19. OBJECTIVE: To associate the presence of olfaction disorder to the clinical condition severity in patients with COVID-19. METHODS: Individuals with the flu syndrome caused by SARS-CoV-2, diagnosed from March to June 2020, were recruited. They were divided into three groups: mild flu syndrome, severe flu syndrome (admitted to hospital wards) and critical illness (admitted to the ICU). Inpatients were interviewed by telephone contact after hospital discharge and their medical records were also evaluated regarding complementary test results. Outpatients answered an electronic questionnaire containing only clinical information. RESULTS: A total of 261 patients participated in the study: 23.75% with mild flu syndrome, 57.85% with severe flu syndrome and 18.40% with critical illness. A total of 66.28% patients with COVID-19 had olfaction disorders. In approximately 56.58% of the individuals the smell alterations lasted between 9 days and 2 months. There was a significantly higher proportion of individuals with olfactory dysfunction in the group with mild flu syndrome than in the severe flu syndrome group (mild × severe - p < 0.001; Odds Ratio = 4.63; 95% CI [1.87-10.86]). This relationship was also maintained between patients with mild flu syndrome and critically-ill patients (mild × critical - p <  0.001; Odds Ratio = 9.28; 95% CI [3.52-25.53]). CONCLUSION: Olfaction dysfunction was significantly more prevalent in patients with mild flu syndrome in COVID-19. It may be a predictor of a good prognosis for this infection. New population-based studies must be carried out to corroborate these findings.

Topical therapy with high-volume budesonide nasal irrigations in difficult-to-treat chronic rhinosinusitis / Terapia tópica de irrigação nasal de alto volume com solução de budesonida em rinossinusite crônica de difícil tratamento

ABSTRACT INTRODUCTION: Chronic rhinosinusitis (CRS) is termed difficult-to-treat when patients do not reach acceptable level of control despite adequate surgery, intranasal corticosteroid treatment and up to 2 short courses of systemic antibiotics or corticosteroids in the preceding year. Recently, high-volume corticosteroid nasal irrigations have been recommended for CRS treatment. OBJECTIVE: To assess high-volume budesonide nasal irrigations for difficult-to-treat CRS. METHODS: Prospective uncontrolled intervention trial. Participants were assessed before- and 3 months after nasal irrigation with 1 mg of budesonide in 500 mL of saline solution daily for 2 days. Subjective (satisfactory clinical improvement) and objective (SNOT-22 questionnaire and Lund-Kennedy endoscopic scores) assessments were performed. RESULTS: Sixteen patients were included, and 13 (81.3%) described satisfactory clinical improvement. SNOT-22 mean scores (50.2-29.6; p = 0.006) and Lund-Kennedy mean scores (8.8-5.1; p = 0.01) improved significantly. Individually, 75% of patients improved SNOT-22 scores, and 75% improved Lund-Kennedy scores after high volume budesonide nasal irrigations. CONCLUSION: High-volume corticosteroid nasal irrigations are a good option in difficult-to-treat CRS control of disease, reaching 81.3% success control and significant improvement of SNOT-22 and Lund-Kennedy scores.

RESUMO INTRODUÇÃO: A rinossinusite crônica (RSC) de difícil tratamento é aquela inadequadamente controlada com cirurgia, corticosteroides tópicos em spray e até dois ciclos de medicação sistêmica em um ano. Atualmente, tem sido preconizado o uso de irrigações nasais de corticosteroides em alto volume para seu tratamento. OBJETIVO: Avaliar o uso da terapia tópica de irrigações nasais com budesonida em alto volume nos pacientes com RSC de difícil tratamento. MÉTODO: Estudo prospectivo de intervenção não controlado em RSC de difícil tratamento com 3 meses de terapia tópica de irrigação (1 mg de budesonida diluído em 500 mL de soro fisiológico para ser utilizado em dois dias). Realizada avaliação subjetiva (melhora clínica satisfatória) e objetiva (questionário SNOT-22 e classificação endoscópica de Lund-Kennedy). RESULTADOS: Foram incluídos 16 pacientes, sendo que 13 (81,3%) consideraram sua melhora clínica satisfatória. Houve melhora significante das médias de SNOT-22 (50,2 a 29,6; p = 0,006) e de Lund-Kennedy (8,8 a 5,1; p = 0,01). Individualmente, 75% dos pacientes apresentaram melhora do SNOT-22 e 75%, do Lund-Kennedy. CONCLUSÃO: A terapia tópica de irrigação de alto volume de corticosteroide é uma boa opção no controle clínico dos pacientes com rinossinusite crônica de difícil tratamento, com controle adequado de 81,3% destes pacientes e melhora significante do SNOT-22 e do Lund-Kennedy.

Topical therapy with high-volume budesonide nasal irrigations in difficult-to-treat chronic rhinosinusitis.

INTRODUCTION: Chronic rhinosinusitis (CRS) is termed difficult-to-treat when patients do not reach acceptable level of control despite adequate surgery, intranasal corticosteroid treatment and up to 2 short courses of systemic antibiotics or corticosteroids in the preceding year. Recently, high-volume corticosteroid nasal irrigations have been recommended for CRS treatment. OBJECTIVE: To assess high-volume budesonide nasal irrigations for difficult-to-treat CRS. METHODS: Prospective uncontrolled intervention trial. Participants were assessed before- and 3 months after nasal irrigation with 1mg of budesonide in 500 mL of saline solution daily for 2 days. Subjective (satisfactory clinical improvement) and objective (SNOT-22 questionnaire and Lund-Kennedy endoscopic scores) assessments were performed. RESULTS: Sixteen patients were included, and 13 (81.3%) described satisfactory clinical improvement. SNOT-22 mean scores (50.2-29.6; p=0.006) and Lund-Kennedy mean scores (8.8-5.1; p=0.01) improved significantly. Individually, 75% of patients improved SNOT-22 scores, and 75% improved Lund-Kennedy scores after high volume budesonide nasal irrigations. CONCLUSION: High-volume corticosteroid nasal irrigations are a good option in difficult-to-treat CRS control of disease, reaching 81.3% success control and significant improvement of SNOT-22 and Lund-Kennedy scores.

Epistaxe: diagnóstico e tratamento / Epistaxis: diagnosis and treatment

A epistaxe é a principal urgência Otorrinolaringológica, com grande incidência e impacto social, porém a grande maioria dos episódios é autolimitada. A característica principal da vascularização nasal é a presença de anastomoses entre os sistemas carotídeos externo e interno, que determinam correlação clínico-anatômica, que devem ser consideradas na investigação diagnóstica e conduta terapêutica da epistaxe. O objetivo deste artigo é revisar os principais pontos do diagnóstico e do tratamento da epistaxe...

The role of maxillary sinus puncture on the diagnosis and treatment of patients with hospital-acquired rhinosinusitis.

UNLABELLED: Rhinosinusitis is one of the most common causes of fever of unknown origin in critically ill patients and should be systematically searched. OBJECTIVE: This study aims to evaluate the diagnostic and therapeutic effect of maxillary sinus puncture performed at the bedside in patients with infective rhinosinusitis hospitalized in an Intensive Care Unit of a high complexity care hospital. MATERIALS AND METHODS: This retrospective study looks into patients on mechanical ventilation with fever of unknown origin and signs of rhinosinusitis on CT images who were submitted to inferior meatus maxillary sinus puncture. RESULTS: The total study sample consisted of 27 patients (70.3% male; mean age 45.3 years). The most common Intensive Care Unit admission diagnoses were head trauma and stroke. CT scans revealed the maxillary (85.2%) and sphenoid (74.1%) sinuses were the most involved paranasal sinuses. Middle meatus purulent drainage was seen in 30.7% of the nasal cavities. Fever was reduced in 70.4% of the patients after puncture (p < 0.001). The most commonly found organisms in sinus aspirates were Pseudomonas aeruginosa and Acinetobacter baumannii. CONCLUSION: Maxillary sinus puncture performed at the bedside of the patients is an important diagnostic and therapeutic tool for critically ill patients.

Papel da punção do seio maxilar no diagnóstico e no tratamento de pacientes com rinossinusite hospitalar / The role of maxillary sinus puncture on the diagnosis and treatment of patients with hospital-acquired rhinosinusitis

A rinossinusite é uma das principais causas de febre em pacientes críticos e deve ser sistematicamente pesquisada. OBJETIVO: Avaliar o impacto da punção do seio maxilar à beira leito, no diagnóstico e no tratamento dos pacientes com rinossinusite infecciosa internados em Unidade de Terapia Intensiva de um hospital universitário de alta complexidade. MATERIAIS E MÉTODOS: Estudo retrospectivo que avaliou os pacientes em ventilação mecânica com febre de origem indeterminada e sinais tomográficos de rinossinusite submetidos à punção do seio maxilar pelo meato inferior. RESULTADOS: A amostra total do estudo consistiu de 27 pacientes (70,3% do sexo masculino com média de idade 45,3 anos). Os diagnósticos de admissão mais frequentes na Unidade de Terapia Intensiva foram Trauma Crânio Encefálico e Acidente Vascular Cerebral. No exame tomográfico, os seios paranasais mais acometidos foram o maxilar, em 85,2%, e esfenoidal, em 74,1%. A secreção purulenta foi visualizada no meato médio em 30,7% das fossas nasais. Os microrganismos mais frequentes nos aspirados dos seios foram Pseudomonas aeruginosa e Acinetobacter baumannii. CONCLUSÃO: A punção do seio maxilar à beira leito demonstrou-se uma importante ferramenta diagnóstica e terapêutica nos pacientes de UTI com rinossinusite hospitalar, submetidos à ventilação mecânica invasiva.

Rhinosinusitis is one of the most commom causes of fever of unknown origin in critically ill patients and should be systematically searched. OBJECTIVE: This study aims to evaluate the diagnostic and therapeutic effect of maxillary sinus puncture performed at the bedside in patients with infective rhinosinusitis hospitalized in an Intensive Care Unit of a high complexity care hospital. MATERIALS AND METHODS: This retrospective study looks into patients on mechanical ventilation with fever of unknown origin and signs of rhinosinusitis on CT images who were submitted to inferior meatus maxillary sinus puncture. RESULTS: The total study sample consisted of 27 patients (70.3% male; mean age 45.3 years). The most common Intensive Care Unit admission diagnoses were head trauma and stroke. CT scans revealed the maxillary (85.2%) and sphenoid (74.1%) sinuses were the most involved paranasal sinuses. Middle meatus purulent drainage was seen in 30.7% of the nasal cavities. Fever was reduced in 70.4% of the patients after puncture (p < 0.001). The most commonly found organisms in sinus aspirates were Pseudomonas aeruginosa and Acinetobacter baumannii. CONCLUSION: Maxillary sinus puncture performed at the bedside of the patients is an important diagnostic and theraupetic tool for critically ill patients.

Translation, cross-cultural adaptation and validation of SinoNasal Outcome Test (SNOT): 22 to Brazilian Portuguese.

UNLABELLED: Quality of life questionnaires have been increasingly used in clinical trials to help establish the impact of medical intervention or to assess the outcome of health care services. Among disease-specific outcome measures, SNOT-22 was considered the most suitable tool for assessing chronic rhinosinusitis and patients with nasal polyps. AIMS: To perform translation, cross-cultural adaptation and validation of the SNOT-22 to Brazilian Portuguese. METHODS: Prospective study involving eighty-nine patients with chronic rhinosinusitis or nasal polyps submitted to functional endoscopic sinus surgery, who answered the questionnaire before and after surgery. Furthermore, 113 volunteers without sinonasal disease also answered the questionnaire. Internal consistency, test-retest reliability, measure validity, responsiveness and clinical interpretability were assessed. RESULTS: Mean preoperative, postoperative and no sinonasal disease scores were 62.39, 23.09 and 11.42, respectively (p<0.0001); showing validity and responsiveness. Internal consistency was high (Cronbach's alpha = 0.9276). Reliability was sufficiently good, considering inter-interviewers (r=0.81) and intra-interviewers within a 10 to 14 day-interval (r=0.72). Surgery effect size was 1.55. Minimally important difference was 14 points; and scores up to 10 points were considered normal. CONCLUSION: The Brazilian Portuguese SNOT-22 version is a valid instrument to assess patients with chronic rhinosinusitis and nasal polyps.

Translation, cross-cultural adaptation and validation of SinoNasal Outcome Test (SNOT): 22 to Brazilian Portuguese / Tradução, adaptação cultural e validação do questionário Sinonasal Outcome Test (SNOT): 22 para a Língua Portuguesa (BR)

Quality of life questionnaires have been increasingly used in clinical trials to help establish the impact of medical intervention or to assess the outcome of health care services. Among disease-specific outcome measures, SNOT-22 was considered the most suitable tool for assessing chronic rhinosinusitis and patients with nasal polyps. AIMS: To perform translation, cross-cultural adaptation and validation of the SNOT-22 to Brazilian Portuguese. METHODS: Prospective study involving eighty-nine patients with chronic rhinosinusitis or nasal polyps submitted to functional endoscopic sinus surgery, who answered the questionnaire before and after surgery. Furthermore, 113 volunteers without sinonasal disease also answered the questionnaire. Internal consistency, test-retest reliability, measure validity, responsiveness and clinical interpretability were assessed. RESULTS: Mean preoperative, postoperative and no sinonasal disease scores were 62.39, 23.09 and 11.42, respectively (p<0.0001); showing validity and responsiveness. Internal consistency was high (Cronbach's alpha = 0.9276). Reliability was sufficiently good, considering inter-interviewers (r=0.81) and intra-interviewers within a 10 to 14 day-interval (r=0.72). Surgery effect size was 1.55. Minimally important difference was 14 points; and scores up to 10 points were considered normal. CONCLUSION: The Brazilian Portuguese SNOT-22 version is a valid instrument to assess patients with chronic rhinosinusitis and nasal polyps.

Os questionários de qualidade de vida têm sido utilizados para determinar o impacto promovido por uma intervenção ou avaliar os resultados dos serviços de saúde. Dentre os questionários específicos, o SNOT-22 foi considerado o mais adequado para avaliar pacientes com rinossinusite crônica (RSC) e polipose nasossinusal (PNS). OBJETIVO: Realizar a tradução, adaptação cultural e validação do SNOT-22 para o Português Brasileiro (BR). MATERIAL E MÉTODO: Estudo prospectivo com 89 pacientes no pré e pós-operatório de cirurgia endoscópica nasossinusal por RSC ou PNS e 113 voluntários sem doença nasossinusal. RESULTADOS: O escore médio no pré-operatório foi de 62,39 pontos; no pós-operatório, de 23,09 e dos sem doença nasossinusal, de 11,42 (p<0,0001), mostrando a validade e responsividade. A consistência interna foi alta (alfa de Cronbach de 0,9276). A reprodutibilidade foi suficiente na aplicação interentrevistadores (r=0,81) e intraentrevistadores com 10 a 14 dias de intervalo (r=0,72). O tamanho de efeito da cirurgia foi de 1,55. A diferença minimamente importante foi de 14 pontos e escores até 10 pontos foram considerados como normais. CONCLUSÃO: A versão para Português Brasileiro do questionário SNOT-22 é um instrumento válido para avaliar pacientes com RSC e PNS.

Comparação entre a telelaringoscopia e a laringoscopia de suspensão no diagnóstico das lesões benignas das pregas vocais / Comparison between telelaryngoscopy and suspension laryngoscopy in the diagnosis of benign vocal fold lesions

O correto diagnóstico das lesões benignas da laringe ainda causa dúvida em laringologistas experientes, apesar dos avanços diagnósticos. OBJETIVO: O objetivo desse estudo foi comparar a telelaringoscopia (pré-operatória) com a laringoscopia de suspensão (intra-operatória) no diagnóstico das lesões benignas das pregas vocais. MATERIAL E MÉTODO: Foi realizado um estudo retrospectivo através da análise de 79 prontuários de pacientes acompanhados em um hospital universitário. Em todos os prontuários havia pelo menos uma hipótese diagnóstica ambulatorial sugerida pela telelaringoscopia, que posteriormente foi comparada aos achados intra-operatórios da laringoscopia de suspensão. RESULTADOS: Quase dois terços dos pacientes eram do gênero feminino, com idade variando de 12 aos 66 anos (média de 37 anos). Dos 79 pacientes estudados, foram diagnosticadas 95 lesões com a telelaringoscopia e 124 com a laringoscopia de suspensão. A lesão benigna mais freqüente foi pólipo vocal em ambos os métodos. Em 64,5 por cento dos casos, o diagnóstico das lesões feito no ambulatório foi o mesmo dos achados cirúrgicos. CONCLUSÃO: O laringologista deve estar preparado para alterar seu planejamento cirúrgico e abordagens terapêuticas devido às mudanças diagnósticas que ocorrem no intra-operatório.

Proper diagnosis of laryngeal benign lesions still brings doubts among experienced laryngologists, despite current diagnostic progress. AIM: the goal of this study was to compare telelaryngoscopy (preoperative) with suspension laryngoscopy (intraoperative) on the diagnosis of vocal fold benign lesions. MATERIALS AND METHODS: We carried out a restrospective study analyzing 79 charts from patients followed up in a University Hospital. In all the charts there was at least diagnostic hypothesis suggested by telelaryngoscopy, which was later on compared to intraoperative findings of suspension laryngoscopy. RESULTS: Almost two-thirds of the patients were females, with ages varying between 12 and 66 years (mean of 37 years). Of the 79 patients studied, we diagnosed 95 lesions with telelaryngoscopy and 124 with suspension laryngoscopy. The most frequently found benign lesion was the vocal polyp in both methods. In 64.5 percent of the cases the diagnosis of the lesions in the outpatient ward was the same as those in the surgical findings. CONCLUSION: Laryngologists must be prepared to alter their surgical planning and treatment approaches because of diagnostic changes that may happen during surgery.

Timpanoplastia com plugue de cartilagem na infância / Plug cartilage tympanoplasty in children

O tratamento das perfurações da membrana timpânica na população pediátrica com seqüelas de Otite Média Crônica representa um desafio ao Otorrinolaringologista. OBJETIVO: Avaliar os resultados clínicos e audiométricos da técnica "inlay" com colocação de plugue de cartilagem do trago. MATERIAL E MÉTODOS: Foram analisados 23 pacientes (idade 1-15 anos) submetidos à timpanoplastia com plugue. FORMA DE ESTUDO: Clínico retrospectivo. RESULTADOS: A taxa de sucesso de fechamento foi de 82,6 por cento, com melhora dos parâmetros audiométricos em 87,5 por cento dos pacientes. As complicações foram mínimas. CONCLUSÃO: Em face dos resultados obtidos, este método de timpanoplastia deve ser considerado uma boa opção para o tratamento das perfurações da membrana timpânica na infância.

The treatment of tympanic membrane perforations in the pediatric population with sequelae of chronic otitis media represents a challenge to otolaryngologists. AIM: to assess the clinical and audiometric results of the inlay technique with a tragus cartilage plug. MATERIALS AND METHODS: we assessed 23 patients (ages between 1 and 15 years) who underwent plug tympanoplasty. Study design: clinical retrospective. RESULTS: repair success rate was of 82.6 percent, with audiometric parameters improvement in 87.5 percent of the patients. Complications were minimum. CONCLUSION: considering the results attained, this method of tympanoplasty should be considered a good treatment option for tympanic membrane perforation in children.