Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.909
Filtrar
1.
Artigo em Chinês | MEDLINE | ID: mdl-32086916

RESUMO

Objective:The aim of this study is to evaluate the efficacy of endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma. Method:Forty-three patients with olfactory neuroblastoma undergoing surgery combined with radiotherapy were retrospectively analyzed. The patients were divided into endoscopic surgery and conventional surgery. All patients received postoperative radiotherapy at a dose of 60-70 Gy, the 5-year survival rate and local recurrence time of the two groups were compared, and the therapeutic effects of endoscopic surgery and traditional surgery were compared. Result:Through survival analysis, the 5-year overall survival rates of the traditional surgery group and the endoscopic surgery group were 50% and 58% (P=0.560), the local recurrence rates were 44% and 48% (P=0.288), and the mean recurrence time was 5.6 months and 12.5 months (P=0.032). Conclusion:There was no difference between endoscopic surgery and conventional surgery combined with radiotherapy in the treatment of Neuroblastoma, and the time of local recurrence was significantly prolonged. In early Neuroblastoma, endoscopic sinus surgery may be superior to open surgery in terms of efficacy and patient survival.


Assuntos
Estesioneuroblastoma Olfatório/radioterapia , Estesioneuroblastoma Olfatório/cirurgia , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia , Terapia Combinada , Humanos , Cavidade Nasal/patologia , Cavidade Nasal/cirurgia , Recidiva Local de Neoplasia , Estudos Retrospectivos
2.
Harefuah ; 159(1): 113-116, 2020 Feb.
Artigo em Hebraico | MEDLINE | ID: mdl-32048491

RESUMO

INTRODUCTION: Tracheal intubation is a vital and common procedure during surgical care. The tracheal tube may be inserted orally or trans-nasally. Nasal intubation enables a non-restricted approach for oral and oropharyngeal regions. Thus, nasotracheal intubation is more suitable for surgeries such as uvulopalatopharyngoplasty treating obstructive sleep apnea. Obstructive sleep apnea is an independent risk factor for postoperative cardiorespiratory complications. Thus, meticulous treatment during and post-operatively is needed keeping the upper airway open including the nasal cavity. In several studies, nasotracheal intubation resulted in disruption of the nasal mucosa. OBJECTIVES: The objective of this study is evaluating the developing nasal resistance post nasotracheal intubation and comparing it to nasal resistance post-orotracheal intubation. To our knowledge, this is the first data on nasal obstruction following nasal intubation. METHODS: Forty-four candidates, for elective non-head and neck procedures were randomized into two groups: oral intubation group and nasal intubation group. The nasal resistance of all participants was measured by anterior rhinomanometry upon the recommendation of the standardization committee on objective assessment of the nasal airway. Statistical analysis with paired T test, Chi square and McNemar's test was performed. Statistical significance was evaluated at P≤0.05. RESULTS: There were no differences between the study groups regarding nasal resistance before and after intubation. However, nasotracheal intubation was found to disrupt the normal nasal cycle of the nasal mucosa. CONCLUSIONS: Nasotracheal intubation does not negatively affect nasal resistance in the early postoperative period. DISCUSSION: Nasotracheal intubation does not affect nasal resistance and it seems to be safe for OSA patients. More research has to be conducted to evaluate the nasal resistance in patients who undergo oral and nasal surgeries.


Assuntos
Intubação Intratraqueal , Cavidade Nasal , Procedimentos Cirúrgicos Eletivos , Humanos , Complicações Pós-Operatórias , Respiração Artificial
4.
J Comput Assist Tomogr ; 44(1): 70-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31939885

RESUMO

PURPOSE: The aim of this study was to determine the valuable magnetic resonance imaging (MRI) features of sinonasal metastatic clear-cell renal cell carcinoma (cc-RCC), especially focusing on its dynamic-enhanced characteristics. METHODS: The conventional and dynamic-enhanced MRI findings of 8 patients with histopathologically confirmed sinonasal metastatic cc-RCC were reviewed by 2 radiologists. The control group of 8 patients with capillary hemangioma underwent the same MRI protocol. RESULTS: Metastatic cc-RCCs arose from the nasoethmoid region, maxillary sinus, posterior ethmoid and sphenoid sinus, and nasal cavity in 2 patients in each. These lesions were well circumscribed and the mean maximum dimension was 42 mm. The signal intensity of these lesions was isointense to brain stem on both MR T1- and T2-weighted images. All metastatic tumors showed vivid enhancement on enhanced T1-weighted image. Multiple flow voids within these metastatic lesions were identified in 6 patients. Peripheral cyst was detected around the metastatic tumor in 4 patients. Metastatic cc-RCCs exhibited a characteristic type 4 time intensity curve (TIC) similar to that of the internal carotid artery, whereas capillary hemangiomas showed a type 3 TIC on dynamic-enhanced MRI. CONCLUSIONS: A hypervascular mass with the characteristic type 4 TIC in the sinonasal region is highly suggestive of a metastatic cc-RCC.


Assuntos
Carcinoma de Células Renais/diagnóstico por imagem , Neoplasias Renais/diagnóstico por imagem , Cavidade Nasal/patologia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/secundário , Idoso , Carcinoma de Células Renais/patologia , Detecção Precoce de Câncer , Feminino , Humanos , Neoplasias Renais/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/diagnóstico por imagem , Neoplasias dos Seios Paranasais/patologia , Período Pré-Operatório , Intensificação de Imagem Radiográfica
5.
World Neurosurg ; 133: e275-e280, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31518747

RESUMO

BACKGROUND: The acellular dermal matrix (ADM) and turbinate flap (TF) have been widely used in the reconstruction of skull base defects. However, owing to the lack of reported data, the therapeutic effects have been controversial. The purpose of the present study was to compare the effect of the ADM and TF on cerebrospinal fluid (CSF) rhinorrhea after nasal endoscopic resection of a skull base tumor. METHODS: The data from 46 patients who had undergone nasal endoscopic resection of a skull base tumor and repair of CSF rhinorrhea were retrospectively analyzed. The patients were divided into ADM and TF groups according to the difference in repair materials used. We compared and analyzed the intraoperative information and postoperative outcomes. RESULTS: The operation time, blood loss, defect area, and need for blood transfusion were not significantly different between the ALT and TF groups. The postoperative length of hospital stay (14.33 ± 3.66 vs. 16.76 ± 5.51 days; P = 0.669) and the incidence of complications, including wound infection (1 vs. 0; P = 0.270), intracranial infection (1 vs. 1; P = 0.900), hemorrhage (2 vs. 3; P = 0.788), 15-day CSF leak (1 vs. 2; P = 0.658), and respiratory infection (2 vs. 1; P = 0.450) were comparable between the 2 groups. The 6-month (0 vs. 0; P = 1.000) and 12-month (0 vs. 0; P = 1.000) incidence of recurrence also showed no significant differences. CONCLUSION: The use of the ADM for patients with CSF rhinorrhea showed comparable results in terms of postoperative outcomes compared with the use of TF. ADM could serve as a safe and feasible alternative for endoscopic repair of CSF rhinorrhea after nasal endoscopic resection of skull base tumors.


Assuntos
Derme Acelular , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Complicações Intraoperatórias/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Neoplasias da Base do Crânio/cirurgia , Retalhos Cirúrgicos , Conchas Nasais/transplante , Adulto , Idoso , Perda Sanguínea Cirúrgica , Rinorreia de Líquido Cefalorraquidiano/etiologia , Feminino , Humanos , Complicações Intraoperatórias/etiologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cavidade Nasal , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Neuroimagem , Duração da Cirurgia , Estudos Retrospectivos
6.
World Neurosurg ; 133: e293-e302, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31520764

RESUMO

OBJECTIVE: Interest in endoscopic transnasal access has increased with continued technological advances in endoscopic technology. The goals of this study were to review the normal anatomy in transnasal endoscopic neurosurgery and outline the anatomical basis for an expanded surgical approach. Defining anatomical aspects of surgical endoscopy helps guide the surgeon by defining normal anatomy of the access vector. METHODS: This anatomic study was conducted on 15 adult male cadaver specimens using various microsurgical tools and endoscopic instruments and 1 intraoperative case. The vasculature was injected with colored silicone to aid visualization. Different transnasal approach techniques were used, with angles of endoscope access at 0°, 30°, 45°, and 70° accordingly for extensive anatomical mapping. RESULTS: The proximity of critical structures is different in each approach degree. A full understanding of the possible structures to be met during transnasal access is described. As a result of the study, anatomical aspects and important structures were outlined, and a surgical protocol was defined for minimal risk access in respect to normal anatomy of the area. CONCLUSIONS: Thorough knowledge of topographic anatomy of the craniovertebral junction is required for performing minimal-risk surgical intervention in this region. It is important to know all anatomical aspects of the transnasal approach in order to reduce the risk of damage to vital structures. Transnasal endoscopic surgery of the craniovertebral junction is a relatively new direction in neurosurgery; therefore, anatomical studies such as the one described in this article are extremely important for the development of this access method.


Assuntos
Cirurgia Endoscópica por Orifício Natural/métodos , Neuroendoscopia/métodos , Adulto , Cadáver , Vértebras Cervicais/anatomia & histologia , Humanos , Masculino , Cavidade Nasal , Crânio/anatomia & histologia
7.
World Neurosurg ; 133: e356-e368, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31521759

RESUMO

BACKGROUND: Intracranial aneurysms (IAs) located in the midline region represent formidable challenge owing to their deep location. The objective of this study was to assess feasibility and identify the limitations of endoscopic endonasal clipping of IAs. We further aimed to describe the locations and characteristics of aneurysms that may be amenable for endoscopic endonasal clipping; thus outlining the indications of these approaches. METHODS: Fifteen latex-injected cadaveric heads were used for endoscopic endonasal exposure of anterior and posterior cerebral circulations. An aneurysm simulator model with 2 different sizes was used at the common sites for IAs to emulate a real surgery. Key measured parameters included "exposure of vessels and their respective perforators," "ability to gain proximal/distal control," and "possibility of clip placement" according to the size, direction, and location of the aneurysm model. Maneuverability of instruments and the need for pituitary gland transposition were assessed and recorded as well. RESULTS: Exposure of the anterior communicating artery complex and the common sites of posterior circulation aneurysms were feasible. The size, location, and direction of the aneurysm model had an impact on obtaining proximal and/or distal control, and the ability of clip placement. CONCLUSIONS: Clipping of midline aneurysms of the posterior circulation is feasible via endoscopic endonasal approach. Small-sized ventrally and medially directed aneurysm models carried a better probability of getting proximal and/or distal control, as well as better overall ability to place a clip. The endonasal route seems to provide a limited condition for proper management of anterior circulation aneurysms.


Assuntos
Artérias Cerebrais/anatomia & histologia , Aneurisma Intracraniano/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Neuroendoscopia/métodos , Cadáver , Circulação Cerebrovascular , Estudos de Viabilidade , Humanos , Modelos Anatômicos , Cavidade Nasal , Cirurgia Endoscópica por Orifício Natural/instrumentação , Neuroendoscopia/instrumentação
8.
Ann R Coll Surg Engl ; 102(2): e45-e47, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31538802

RESUMO

Parapharyngeal infections carry a significant risk of extensive suppuration and airway compromise. We report the case of a patient presenting with a right paranasopharyngeal abscess, featuring atypical symptoms that made diagnosis particularly challenging. Complications included evidence of right vocal cord paralysis, likely secondary to involvement of the vagus nerve. Notably, this paralysis occurred in isolation, without involvement of cranial nerves IX or XI, which would be expected from jugular foramen encroachment. Imaging demonstrated the presence of a collection extending towards the skull base, which was drained using a transnasal endoscopic approach, avoiding the use of external incisions. Tissue biopsies from the abscess wall suggest that the underlying aetiology was minor salivary gland sialadenitis, which has not been previously reported in the literature.


Assuntos
Abscesso/etiologia , Doenças Faríngeas/etiologia , Sialadenite/complicações , Paralisia das Pregas Vocais/etiologia , Abscesso/diagnóstico , Abscesso/cirurgia , Adolescente , Biópsia , Drenagem , Endoscopia , Feminino , Humanos , Imagem por Ressonância Magnética , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Nasofaringe/diagnóstico por imagem , Nasofaringe/patologia , Doenças Faríngeas/diagnóstico , Doenças Faríngeas/cirurgia , Nervo Laríngeo Recorrente/diagnóstico por imagem , Glândulas Salivares Menores/patologia , Sialadenite/diagnóstico , Sialadenite/patologia , Base do Crânio/diagnóstico por imagem , Base do Crânio/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Paralisia das Pregas Vocais/diagnóstico
9.
World Neurosurg ; 133: e241-e251, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31505289

RESUMO

BACKGROUND: Cystic sellar masses (CSMs) pose diagnostic and therapeutic challenges associated with subtotal cyst wall resection, cerebrospinal fluid (CSF) leak repair, and disease recurrence. Current magnetic resonance imaging (MRI) interpretation often cannot reliably differentiate CSMs, mandating adaptable intraoperative strategies. We reviewed our diagnostic and therapeutic experience after endoscopic endonasal approaches (EEAs) for CSMs. METHODS: A retrospective record review of patients with CSM managed via EEA at the University of Southern California from 2011 to 2018 was conducted. Patient demographics, preoperative characteristics, surgical details, pathologic findings, and postoperative outcomes were assessed. RESULTS: Analysis included 47 patients (mean age, 43.2 years); of these, 78.7% were women. Preoperative symptoms included headache (76.6%) and vision loss (42.6%). Histologically verified sellar pathology included 27 Rathke cleft cysts (RCCs) (57.4%), 17 cystic pituitary adenomas (CPAs) (36.2%), 2 arachnoid cysts (4.3%), and 1 xanthogranuloma (2.1%). Twelve patients (70.6%) with CPAs underwent complete resection and 5 (29.4%) underwent subtotal resection. All 27 patients with RCC and 2 patients with arachnoid cyst underwent complete fenestration and drainage. One xanthogranuloma was completely resected. There were 14 intraoperative (29.8%) and 4 postoperative CSF leaks (8.5%). Headaches, vision, and endocrinopathy improved in 69.2%, 80.0%, and 33.3% of patients with CPA and 73.9%, 71.4%, and 40.9% of patients with RCC, respectively. There were 2 RCC recurrences and 1 CPA recurrence over the follow-up period. CONCLUSIONS: Surgeons must prepare for versatile management strategies of CSMs based on pretest probability associated with MRI and intraoperative findings. Outcomes after EEA for CSMs show low complication profiles and excellent rates of headache and visual improvement, albeit lower rates of endocrine normalization.


Assuntos
Cistos do Sistema Nervoso Central/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Neuroimagem/métodos , Sela Túrcica , Adenoma/complicações , Adenoma/diagnóstico , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , Adulto , Cistos do Sistema Nervoso Central/complicações , Cistos do Sistema Nervoso Central/diagnóstico , Cistos do Sistema Nervoso Central/diagnóstico por imagem , Vazamento de Líquido Cefalorraquidiano/etiologia , Drenagem , Fadiga/etiologia , Feminino , Cefaleia/etiologia , Humanos , Hipopituitarismo/etiologia , Complicações Intraoperatórias/etiologia , Masculino , Pessoa de Meia-Idade , Cavidade Nasal , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/diagnóstico por imagem , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Sela Túrcica/diagnóstico por imagem , Sela Túrcica/cirurgia , Transtornos da Visão/etiologia , Xantomatose/complicações , Xantomatose/diagnóstico , Xantomatose/diagnóstico por imagem , Xantomatose/cirurgia
11.
Ann Otol Rhinol Laryngol ; 129(1): 5-11, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31390881

RESUMO

OBJECTIVES: Intranasal septal splints are often used in nasal septal surgeries. Routine use of postoperative antibiotics is an accepted practice, although data regarding its efficacy in preventing postsurgical complications are limited. This study aimed to examine bacterial colonization on septal splints following prophylactic antibiotic therapy and the association with postoperative infections. METHODS: Fifty-five patients underwent septoplasty by a single surgeon between March 2015 and April 2016. All had intranasal septal splints and were given antibiotic prophylaxis for 7 days until removal of splints. Nasal cultures were taken before surgery, and septal splints were examined for bacterial colonization following their removal. RESULTS: Thirty-six patients (65%) had positive nasal culture prior to surgery. The most common isolates were Staphylococcus aureus (30%) and Enterobacteriaceae species (66%). All these patients had postoperative bacterial colonization on septal splints. In 15 patients with negative preoperative cultures, bacteria were isolated postoperatively. An increased resistance profile was documented postoperatively in 9 patients (16%), including two with multidrug resistance. In two of these patients preoperative wild-type strains acquired antibiotic resistance postoperatively. No adverse drug reactions to antibiotics were reported. CONCLUSIONS: Increased bacterial growth and emergence of resistant strains were observed on intranasal septal splints despite prophylactic antibiotic treatment. Nonetheless, this did not translate into clinical infection. Thus, considering antibiotics overuse and increasing bacterial resistance, further research is needed to determine the role of antibiotic prophylaxis in the setting of intranasal splints.


Assuntos
Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Cavidade Nasal/microbiologia , Septo Nasal/cirurgia , Procedimentos Cirúrgicos Nasais/métodos , Contenções/microbiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Adolescente , Adulto , Idoso , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Cefalexina/uso terapêutico , Técnicas de Cultura , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla , Enterobacteriaceae/isolamento & purificação , Infecções por Enterobacteriaceae/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Infecção da Ferida Cirúrgica/epidemiologia , Adulto Jovem
12.
Clin Implant Dent Relat Res ; 22(1): 105-111, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31849199

RESUMO

BACKGROUND: There is limited information about inferior meatus pneumatization in terms of implant treatment for the posterior maxilla. PURPOSE: To demonstrate the clinical, radiologic, and nasal endoscopic outcomes of implants accidentally protruding into the nasal cavities with inferior meatus pneumatization in the posterior maxilla. MATERIALS AND METHODS: A total of 560 implants (324 patients) with transcrestal sinus augmentation in the posterior maxilla were screened. On panoramic radiographs, 132 implants (78 patients) appear to penetrate the sinus floor, but cone-beam computed tomography demonstrated that 26 implants (13 patients) penetrated the nasal floor due to inferior meatus pneumatization. Width of nasal and sinus cavities and extent of penetration were radiographically measured. Nasal endoscopy was performed. RESULTS: Two implants were lost during 13.81 ± 5.40 years due to peri-implantitis. However, no nasosinusal problem occurred in any patient. The nasal cavity was significantly larger in patients with implants penetrating the pneumatized inferior meatus than in those with implants penetrating the sinus floor (P< .05). Nasal endoscopy demonstrated that the apical portion of the implants was covered with thin mucosa without inflammation. CONCLUSION: Implants accidentally penetrating the pneumatized inferior meatus demonstrated high survival with no specific nasosinusal complications. Inferior meatus pneumatization should be considered for implant treatment in the posterior maxilla.


Assuntos
Implantes Dentários , Levantamento do Assoalho do Seio Maxilar , Implantação Dentária Endo-Óssea , Falha de Restauração Dentária , Seguimentos , Humanos , Maxila , Seio Maxilar , Cavidade Nasal
14.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 37(5): 533-536, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31721503

RESUMO

OBJECTIVE: This study aims to compare the effects of fast and slow expansion on nasal cavity structure. METHODS: A total of 40 patients were selected and randomly divided into two groups. Cone-beam computer tomography (CBCT) was obtained before and after surgery and used for comparing the changes in nasal structure before and after treatment. RESULTS: Fast expansion had resulted in greater changes in the basilar and nasal bone arch extension structures than slow expansion. No significant difference at maxillary width and nasal parenchyma. CONCLUSIONS: Rapid expansion therapy has more beneficial effects on nasal function.


Assuntos
Maxila , Técnica de Expansão Palatina , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila/diagnóstico por imagem , Cavidade Nasal , Nariz
18.
BMC Infect Dis ; 19(1): 899, 2019 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-31660878

RESUMO

BACKGROUND: Several reports designate the recent increase in community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal carriage. Because of the scanty information regarding the nasal carriage sate of MRSA in the west of Iran, the purpose of the present study was to determine the frequency of CA-MRSA in Sanandaj city. METHODS: Swabs collected from anterior nares of 600 volunteers were analyzed for the presence of S. aureus. The isolates were further investigated for methicillin resistance by using the cefoxitin disk diffusion test, followed by PCR-amplification of the mecA gene. SCCmec types and the presence of the Panton-Valentine Leukocidin (pvl) encoding genes were determined through PCR. Finally, the antimicrobial susceptibility of the isolates was determined by the agar diffusion method. RESULTS: Nasal screening identified 181 S. aureus, of which 55 isolates were MRSA. SCCmec types IV and V were detected in MRSA at frequencies of 80 and 20%, respectively. The overall frequency of pvl genes among the MRSA isolates was 14.54%. MRSA isolates were highly susceptible (98.18%) to mupirocin, gentamicin, and fusidic acid. CONCLUSIONS: The high prevalence of CA-MRSA carriage in the population could pose a serious public health concern for the region. Additionally, advent of drug-resistant pvl-positive strains demands continuous surveillance on the colonization state of CA-MRSA in order to prevent dissemination of the bacterium in the community.


Assuntos
Resistência a Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/genética , Cavidade Nasal/microbiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adolescente , Adulto , Idoso , Toxinas Bacterianas/genética , Criança , Pré-Escolar , Estudos Transversais , Exotoxinas/genética , Feminino , Frequência do Gene , Humanos , Lactente , Irã (Geográfico)/epidemiologia , Leucocidinas/genética , Masculino , Programas de Rastreamento , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Saúde Pública , Fatores de Risco , Adulto Jovem
19.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(10): 741-747, 2019 Oct 07.
Artigo em Chinês | MEDLINE | ID: mdl-31606986

RESUMO

Objective: To investigate the deposition rate of Artemisia pollen in different nasal cavity regions and its influence factors in residents of northwest China. Methods: Thirty healthy adults from northwest China were enrolled. The computational fluid dynamics (CFD) and discrete phase model (DPM) were used for numerical simulation of nasal structures. The pollen deposition fraction in each anatomical part was counted and the effects of pollen density and breathing rate on deposition were analyzed. SPSS 19.0 software was used for statistical analysis. Results: The hottest deposition parts of Artemisia pollen were nasal septum (30.70%±12.27%), vestibule (27.45%±8.21%), middle turbinate area (13.59%±8.98%) and nasopharynx (7.14%±5.90%). When the inspiratory flow rate increased to 30 L/min, the deposition rates of pollen in nasal vestibule and nasal septum were significantly higher than that at the rate of 15 L/min (43.20%±11.14% vs 27.45%±8.21%, 51.48%±9.77% vs 30.70%±12.27%, t value was -8.126,-5.264, respectively, all P<0.05), which indicated that with the increase of the inspiratory flow rate, the deposition hotspot moved forward. Compared with the wet Artemisia pollen, the deposition rate of the dry pollen in nasal vestibule and nasal septum decreased significantly (16.55%±4.33% vs 27.45%±8.21%, 7.09%±3.69% vs 30.70%±12.27%, t value was 8.669, 9.173, respectively, all P<0.05). The escape rate at outlet increased from 17.00%±9.57% to 43.48%±13.43% (t=-9.282, P<0.05). Conclusions: The deposition of Artemisia pollen in nasal cavity is highly concentrated. The inhalation velocity and the dry-wet degree of pollen are the main determinants of the deposition site.


Assuntos
Alérgenos/análise , Artemisia , Cavidade Nasal , Pólen , Adulto , China , Simulação por Computador , Humanos , Cavidade Nasal/química
20.
Vestn Otorinolaringol ; 84(4): 6-12, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31579049

RESUMO

PURPOSE: To describe the principles of medical navigation systems in head and neck surgery, the possibility of their application and the existing limitations. MATERIAL AND METHODS: The article presents the generalized experience of image-guidance equipment using in the ENT Department of First Pavlov State Medical University. 298 operations, mostly FESS, were performed from 2013 to 2018 under the control of navigation system. The majority of cases consisted of surgical treatment of chronic sinusitis, tumors of the nasal cavity and paranasal sinuses; also, navigation control was useful in the case of altered intranasal anatomy after previous surgical treatment or due to chronic polyposis. A case report of frontal sinus inverted papilloma surgical treatment, controlled by an electromagnetic navigation system, is presented. RESULTS: The use of navigation systems in head and neck surgery can improve surgery accuracy and safety, as well as providing a unique opportunity to learn FESS in real time.


Assuntos
Neoplasias dos Seios Paranasais , Sinusite , Cirurgia Assistida por Computador , Endoscopia , Humanos , Cavidade Nasal , Neoplasias dos Seios Paranasais/cirurgia , Seios Paranasais , Sinusite/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA