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1.
Am J Otolaryngol ; 41(2): 102371, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31917022

RESUMO

PURPOSE: The aim of this study was to illustrate and confirm that the complete intraoral excision of the sublingual gland alone, is anatomically the most rational approach, for the management of plunging ranula. MATERIAL AND METHODS: We retrospectively reviewed clinical charts of diagnosed HIV-infected patients presenting with plunging ranula. The intraoral approach was used for the complete excision of the sublingual gland with evacuation of the pseudocystic content only. Neither extra oral approach, nor ranula dissection / drainage was performed. The surgical procedure was performed using local anesthesia. Pre- and postoperative MRI-scan investigations were recorded. Histological reports were documented to confirm the diagnosis of oral mucocele. Patients were clinically monitored. RESULTS: We identified 90 adults presenting with oral mucocele, type ranula. Seventy (77%) of them were diagnosed with HIV infection. Plunging ranula was recorded in 35 (50%) patients from the latter group. The study enrolled 11 operated patients whose files contained useable data, including an acceptable follow-up period. The postoperative follow-up period ranged from three to 15 months. The clinical and postoperative MRI-scans of operated patients demonstrated satisfactory results. There were neither postoperative complications nor recurrence of ranula reported. CONCLUSION: The location of the sublingual gland in the floor of the mouth coupled with the physio-pathogenesis of the plunging ranula, makes the transoral complete excision of the offending gland, with the intraoral evacuation of the pseudocyst, anatomically the most rational approach for plunging ranula management. There is no need for cervical approach, ranula dissection and/or postoperative placement of drainage.


Assuntos
Mucocele/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Rânula/cirurgia , Glândulas Salivares/anatomia & histologia , Glândulas Salivares/cirurgia , Seguimentos , Infecções por HIV/complicações , Humanos , Imagem por Ressonância Magnética , Mucosa Bucal , Mucocele/diagnóstico , Mucocele/etiologia , Mucocele/patologia , Rânula/diagnóstico , Rânula/etiologia , Rânula/patologia , Estudos Retrospectivos , Glândulas Salivares/diagnóstico por imagem
2.
Pan Afr Med J ; 34: 3, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762872

RESUMO

Mucoceles are slow-growing paranasal sinus cystic masses whose clinical presentation varies according to the affected sinus. Diagnosis is often radiological, based essentially on CT scan. The aim of this work was to study the radiologic characteristics of mucoceles on CT scan and MRI. We conducted a retrospective study of patients with mucoceles explored by imaging and operated on in our department. In our series, fronto-ethmoidal sinuses were the most frequently affected (81%). Facial scan confirmed the diagnosis in the majority of cases. Magnetic resonance imaging (MRI) was performed in 4 cases. Eleven patients were operated on by endonasal approach, three by external approach and one by combined surgical approach. Recurrence was observed in two patients after an average delay of 24 months. CT scan is considered the method of choice in the investigation of mucoceles. MRI is indicated in some cases to assess any orbital or intracranial extension.


Assuntos
Imagem por Ressonância Magnética/métodos , Mucocele/diagnóstico por imagem , Doenças dos Seios Paranasais/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucocele/cirurgia , Doenças dos Seios Paranasais/cirurgia , Recidiva , Estudos Retrospectivos , Adulto Jovem
3.
Cir Cir ; 87(6): 630-635, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31631175

RESUMO

Background: The tumors of the cecal appendix are a rare and heterogeneous group of neoplasms with variable prognosis and evolution, its incidence is very low. Mucinous tumors are defined as a dilated cecal appendix due to an abnormal accumulation of mucin, which may be benign or malign. Within these we find the mucoceles, which according to the latest consensus and classifications no longer include them. In this article we describe our experience in these tumors, we also propose a group to include the mucoceles and we review the literature. Method: Descriptive and retrospective study, analyzing all the surgical pieces of cecal appendix during the last 17 years. Results: We analyzed 4910 surgical pieces. 36 were included in the group of non-carcinoid benign epithelial neoplasms (NEBNC), in this group 16 were low-grade mucinous neoplasms, 14 mucoceles and 6 tubular adenomas. The most frequent presentation's form was simulating an acute appendicitis. Surgical treatment was performed by open approach in 22 cases and by laparoscopic approach in 14 cases. Conclusions: Symptomatic NEBNC can simulate acute appendicitis but in people with a higher mean age, so this diagnostic should be considered in older patients with nonspecific imaging tests. The recommended treatment is always surgical and it can be possible by laparoscopic approach.


Assuntos
Adenoma/cirurgia , Neoplasias do Apêndice/cirurgia , Mucocele/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária , Fatores de Tempo
4.
Ophthalmic Plast Reconstr Surg ; 35(6): e136-e138, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31567913

RESUMO

The development of orbit-eroding mucocele associated with inverted papilloma has been rarely reported., Here, the authors present a case and surgical management of a patient with orbit-eroding mucocele associated with inverted papilloma who declined craniotomy. A combined approach utilizing frontal endoscopic sinus surgery and external sub-brow anterior orbitotomy was used to explore, drain, and excise the mucocele and inverted papilloma. Gelatin sponges soaked in gentamicin were used to cover the exposed dura and to protect the orbital content from the frontal sinus cavity.A fronto-ethmoidal sinus inverted papilloma associated with recurrent orbit-eroding mucocele was excised by combined transnasal endoscopic and external sub-brow anterior orbitotomy approach using stereotactic navigation.


Assuntos
Seio Etmoidal/patologia , Mucocele/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Doenças Orbitárias/cirurgia , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Idoso , Humanos , Masculino , Papiloma Invertido/complicações , Neoplasias dos Seios Paranasais/complicações , Resultado do Tratamento
5.
Vet J ; 251: 105350, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31492387

RESUMO

Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7 to 45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14-8.23; P<0.001). The multivariable model indicated that categorical variables including owner recognition of jaundice (OR, 2.12; 95% CI, 1.19-3.77; P=0.011), concurrent hyperadrenocorticism (OR 1.94; 95% CI, 1.08-3.47; P=0.026), and Pomeranian breed (OR, 2.46; 95% CI 1.10-5.50; P=0.029) were associated with increased odds of death, and vomiting was associated with decreased odds of death (OR, 0.48; 95% CI, 0.30-0.72; P=0.001). Continuous variables in the multivariable model, total serum/plasma bilirubin concentration (OR, 1.03; 95% CI, 1.01-1.04; P<0.001) and age (OR, 1.17; 95% CI, 1.08-1.26; P<0.001), were associated with increased odds of death. The clinical utility of total serum/plasma bilirubin concentration as a biomarker to predict death was poor with a sensitivity of 0.61 (95% CI, 0.54-0.69) and a specificity of 0.63 (95% CI, 0.59-0.66). This study identified several prognostic variables in dogs with GBM including total serum/plasma bilirubin concentration, age, clinical signs, concurrent hyperadrenocorticism, and the Pomeranian breed. The presence of hypothyroidism or diabetes mellitus did not impact outcome in this study.


Assuntos
Doenças do Cão/diagnóstico , Doenças da Vesícula Biliar/veterinária , Hiperbilirrubinemia/veterinária , Mucocele/veterinária , Hiperfunção Adrenocortical/veterinária , Animais , Bilirrubina/sangue , Biomarcadores , Doenças do Cão/mortalidade , Doenças do Cão/cirurgia , Cães , Doenças da Vesícula Biliar/diagnóstico , Doenças da Vesícula Biliar/mortalidade , Doenças da Vesícula Biliar/cirurgia , Predisposição Genética para Doença , Hiperlipidemias/veterinária , Mucocele/diagnóstico , Mucocele/mortalidade , Mucocele/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
6.
J Vet Intern Med ; 33(5): 2057-2066, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31490022

RESUMO

BACKGROUND: Gallbladder mucoceles (GBM) typically are treated by cholecystectomy. Medical management rarely has been reported and medical and surgical management have not been compared. HYPOTHESIS/OBJECTIVES: To compare survival of dogs treated for GBM by medical management or cholecystectomy or both. ANIMALS: Eighty-nine client-owned dogs diagnosed with GBM that received cholecystectomy or medical treatment or both from 2011 to 2017. METHODS: Potential cases were identified by searching the medical records database. Data collected included signalment, clinicopathologic results, treatments, and ultrasonographic images and reports. Dogs were grouped according to the treatment received (medical management, surgical treatment, or both) that was chosen at the discretion of the attending veterinarian. Survival analysis was performed and prognostic variables identified and compared between treatment groups. RESULTS: Of dogs surviving at least 14 days after diagnosis, median survival times were 1802 (95% confidence interval [CI], 855-not reached) days, 1340 (95% CI, 444-1340) days, and 203 (95% CI, 18-525) days, for the surgical, medical, and medical then surgical treatment groups, respectively, and differed significantly (P < .0001). Gallbladder mucocele type (P = .05), serum alkaline phosphatase activity (P = .0001), and serum creatinine (P = .002) and phosphorus (P = .04) concentrations were associated with decreased survival across groups. Suspicion of biliary rupture on abdominal ultrasound (AUS) examination was correlated with increased survival in the surgical group (P = .02). CONCLUSIONS AND CLINICAL IMPORTANCE: Cholecystectomy for the treatment of GBM results in the best long-term survival in dogs surviving the immediate postoperative period (14 days) compared to medical management. Although medical management is associated with shorter survival compared to surgical treatment, it is a reasonable alternative when surgery cannot be pursued.


Assuntos
Colecistectomia/veterinária , Doenças do Cão/cirurgia , Doenças do Cão/terapia , Doenças da Vesícula Biliar/veterinária , Mucocele/veterinária , Abdome/diagnóstico por imagem , Fosfatase Alcalina/sangue , Animais , Doenças dos Ductos Biliares/veterinária , Creatinina/sangue , Cães , Feminino , Doenças da Vesícula Biliar/cirurgia , Doenças da Vesícula Biliar/terapia , Masculino , Mucocele/cirurgia , Mucocele/terapia , Fósforo/sangue , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Ultrassonografia/veterinária
7.
J Laryngol Otol ; 133(8): 674-677, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31378208

RESUMO

OBJECTIVE: Transnasal inferior meatal antrostomy is increasingly used for the treatment of post-Caldwell-Luc mucoceles in maxillary sinus. This study aimed to report the outcomes after inferior meatal antrostomy with a mucosal flap for recurrent mucoceles. METHOD: The records of patients who had undergone transnasal inferior meatal antrostomy with or without a mucosal flap were reviewed. RESULTS: Transnasal endoscopic inferior meatal antrostomy with or without a mucosal flap was performed in 21 and 49 patients, respectively. No complications were observed. A closing of the antrostomy was found in 9 (18.4 per cent) of the 49 patients who underwent antrostomy without a mucosal flap. No closings were observed in the 21 patients who underwent antrostomy with a mucosal flap. There was a significant difference in the rate of closing for surgery with and without the mucosal flap. CONCLUSION: Transnasal endoscopic inferior meatal antrostomy with a mucosal flap is a safe method for the treatment of post-Caldwell-Luc maxillary mucoceles that effectively prevents recurrence.


Assuntos
Mucocele/cirurgia , Doenças dos Seios Paranasais/cirurgia , Seios Paranasais/cirurgia , Retalhos Cirúrgicos , Idoso , Idoso de 80 Anos ou mais , Endoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
10.
Trop Doct ; 49(4): 316-318, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31311462

RESUMO

Mucocoeles are slow-growing, locally aggressive, mucus-containing cysts, lined by epithelium, which, when infected, are called pyomucocoeles. We present the case of a five-year-old girl who presented with a frontal pyomucocoele requiring decompression and adequate antibiotics.


Assuntos
Testa/patologia , Seio Frontal/patologia , Mucocele/patologia , Antibacterianos/uso terapêutico , Pré-Escolar , Descompressão Cirúrgica , Feminino , Seio Frontal/cirurgia , Humanos , Mucocele/tratamento farmacológico , Mucocele/cirurgia , Resultado do Tratamento
12.
BMC Vet Res ; 15(1): 215, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238989

RESUMO

BACKGROUND: Leptin has been shown to have various physiological and pathological roles in the canine gallbladder. In this study, we performed pre- and postoperative short-term follow-up analyses to confirm changes in serum leptin levels before and after cholecystectomy due to gallbladder mucocele (GBM) or cholelithiasis in dogs. RESULTS: Twenty-six cholecystectomized dogs (GBM: n = 14; cholelithiasis: n = 12) for prophylactic or clinical symptom relief were enrolled in the present study. Dogs were subgrouped according to clinical symptoms and prognosis after surgery as follows: 1) asymptomatic group (n = 13), 2) recovery group (n = 8), and 3) death group (n = 5). Liver enzymes, total bilirubin, lipid profiles, and leptin concentrations were determined from sera on the pre-operative day and at 1, 3, and 7 days postoperation. Serum leptin concentrations were gradually but significantly decreased in the asymptomatic group (p = 0.008, 0.004, and 0.004 on days 1, 3, and 7, respectively, compared with that before surgery) and the recovery group (p = 0.048 and 0.048 on days 3 and 7, respectively, compared with that before surgery). However, in the death group, leptin concentrations did not differ significantly over time (p = 0.564). Additionally, serum leptin levels in the recovery group (p = 0.006) and death group (p = 0.021) were significantly higher than those in the asymptomatic group. Liver enzymes and total bilirubin (T-Bil) were significantly decreased only in the recovery group, particularly on day 7. In the asymptomatic group, liver enzymes and T-Bil were not changed significantly over time, and in the death group, only T-Bil was significantly decreased on day 7. Total cholesterol and triglyceride levels were not significantly decreased over time in all groups. CONCLUSIONS: These results indicate that leptin is a potential biomarker reflecting the severity and prognosis of GBM and cholelithiasis both before and after cholecystectomy in dogs.


Assuntos
Colecistectomia/veterinária , Colelitíase/veterinária , Doenças do Cão/cirurgia , Doenças da Vesícula Biliar/veterinária , Leptina/sangue , Mucocele/veterinária , Animais , Colelitíase/sangue , Colelitíase/cirurgia , Doenças do Cão/sangue , Cães , Feminino , Doenças da Vesícula Biliar/sangue , Doenças da Vesícula Biliar/cirurgia , Masculino , Mucocele/sangue , Mucocele/cirurgia , Período Pós-Operatório , Período Pré-Operatório , Prognóstico
13.
Ann Surg Oncol ; 26(11): 3478-3488, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31187364

RESUMO

PURPOSE: Mucocele-like lesions of the breast identified on core biopsy are rare high-risk lesions associated with variable upgrade rates to carcinoma on excision. We aimed to identify the clinicoradiopathological features that can help optimize management of this lesion. METHODS: We evaluated 50 mucocele-like lesions identified on core biopsies from two institutions, including 36 with no atypia and 14 with limited atypia. Outcome data from excision or clinicoradiological follow-up were reviewed with core biopsy results. RESULTS: Radiological targets were calcifications in 74% of cases, calcifications with associated mass or density in 16%, and mass in 10%. One of the 16 excised lesions without atypia on core biopsy, which was a mass lesion, was upgraded to mucinous carcinoma on excision. Of the 12 excised lesions with limited atypia, none were upgraded on excision. Among the lesions not excised, 20 without atypia had a median follow-up of 61 months, and 2 with limited atypia had follow-up of 97 and 109 months. None of these 22 patients had new development of their lesions on follow-up. The upgrade rate was 2% in our entire cohort, 3% for lesions without atypia, and 0% for lesions with limited atypia. CONCLUSIONS: Clinicoradiological surveillance can be appropriate when a mucocele-like lesion without atypia is identified on core biopsy for a non-mass lesion with pathological-radiological concordance. For mucocele-like lesions with limited atypia, a nonsurgical approach could be considered if the atypia by itself does not warrant excision. The latter recommendation requires careful clinicopathological correlation and support from additional studies.


Assuntos
Adenocarcinoma Mucinoso/patologia , Neoplasias da Mama/patologia , Calcinose/patologia , Carcinoma Ductal de Mama/patologia , Mucocele/patologia , Adenocarcinoma Mucinoso/cirurgia , Adulto , Idoso , Biópsia com Agulha de Grande Calibre , Neoplasias da Mama/cirurgia , Calcinose/cirurgia , Carcinoma Ductal de Mama/cirurgia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Mucocele/cirurgia , Prognóstico , Estudos Retrospectivos
14.
Medicine (Baltimore) ; 98(21): e15674, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124945

RESUMO

RATIONALE: A postoperative maxillary mucocele (POMM) is a delayed complication of maxillary sinus surgery. Although transoral enucleation is a conventional approach for its treatment, the intraoperative risk of injury to the inferior rectus muscle increases when there is an orbital floor defect. The transnasal endoscopic marsupialization has also been used widely for treatment. However, it has a potential risk of postoperative stenosis of the meatal antrostomy site, especially when the medial wall of the maxillary sinus is thick. PATIENT CONCERNS: A 60-year-old man who underwent a right Caldwell-Luc operation about 30 years ago came to the emergency room with pain and swelling in the right periorbital region. DIAGNOSIS: He was diagnosed with a POMM accompanied by an orbital floor defect and a thick medial wall of the maxillary sinus. INTERVENTIONS: Transnasal endoscopic marsupialization was performed, and a cylindrical penrose drain was placed at the antrostomy site for one month. OUTCOMES: The patient's periorbital pain disappeared after surgery. After 3 months, the postoperative computed tomography scan showed good opening at the meatal antrostomy site. LESSONS: In a patient with POMM with an orbital floor defect and a thick medial wall of the maxillary sinus, transnasal endoscopic marsupialization with penrose drain insertion could prevent both injury of the inferior rectus muscle and postoperative stenosis.


Assuntos
Drenagem/métodos , Seio Maxilar/cirurgia , Mucocele/cirurgia , Órbita/patologia , Complicações Pós-Operatórias/cirurgia , Endoscopia/métodos , Humanos , Masculino , Pessoa de Meia-Idade
15.
HNO ; 67(6): 458-462, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31065761

RESUMO

BACKGROUND: Pediatric acute dacryocystitis typically develops due to persistence of Hasner's membrane. Pediatric paranasal mucoceles are rare entities. In contrast, chronic dacryocystitis in cases of congenital dacryostenosis is one of the most frequent pediatric ophthalmologic issues. METHODS: The case report of a 10-year-old girl suffering acute dacryocystitis is presented. RESULTS: The area around the left lacrimal sac showed a painful swelling with edema and hyperemia. Systemic and local antibiotic therapy resulted in only slight improvement. Dacryoendoscopy detected acute dacryocystitis with significant stenosis of the nasolacrimal duct. The nasolacrimal duct was widened dacryoendoscopically and autostable bicanalicular nasolacrimal intubation was performed. Nevertheless, the lacrimal ducts were blocked subtotally and a widening of the ethmoid on the left side was shown by rhinoscopy. Magnetic resonance imaging confirmed a frontoethmoidal mucocele which was treated by marsupialization. During the 24-month follow-up there was no recurrence of acute dacryocystitis. There were no signs of sinusitis. CONCLUSION: Paranasal mucoceles, e. g., ethmoidal mucoceles, can compress the lacrimal pathways and cause acute lacrimal inflammation in childhood. Paranasal mucoceles should thus be excluded in cases of unclear masses in the lacrimal region.


Assuntos
Dacriocistite , Dacriocistorinostomia , Obstrução dos Ductos Lacrimais , Mucocele , Ducto Nasolacrimal , Criança , Dacriocistite/diagnóstico , Dacriocistite/etiologia , Dacriocistite/cirurgia , Feminino , Humanos , Obstrução dos Ductos Lacrimais/etiologia , Mucocele/complicações , Mucocele/cirurgia , Ducto Nasolacrimal/patologia
16.
Rev. Odontol. Araçatuba (Impr.) ; 40(2): 54-58, maio/ago. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1006572

RESUMO

O termo mucocele pode ser definido como ''cavidade patológica contendo muco'', sendo este conteúdo proveniente das glândulas salivares menores. Enquadrando-se como um processo patológico destas glândulas. A mucocele pode ser caracterizada pelo fenômeno de extravasamento ou de retenção de muco, dando-se o diagnóstico somente através da análise microscópica. Clinicamente apresenta-se como um nódulo indolor, circunscrito, normocrômico ou azulado e flutuante à palpação, localiza-se predominantemente no lábio inferior. A escolha do tratamento partirá da análise de alguns fatores, como o tamanho da lesão, a sua localização, profundidade e a idade do paciente, sendo a excisão cirúrgica juntamente com as glândulas acessórias da lesão a mais indicada. Há várias técnicas para realização de tal procedimento e a técnica de Shira foi a opção para o referido relato de caso. Esta técnica se dá a partir da injeção cuidadosa de material hidrocolóide irreversível (alginato) dentro da lesão previamente esvaziada de seu conteúdo com o objetivo de delimitar a mesma e facilitar a remoção cirúrgica. Utilizar esta técnica reduz as chances de recidiva da lesão, pois com a utilização do alginato a lesão fica bem delimitada facilitando a excisão cirúrgica, mas mesmo com esta técnica deve-se orientar o paciente para a remoção dos fatores etiológicos envolvidos, pois sua permanência acarretará na recidiva da lesão(AU)


The term mucocele can be defined as a 'pathological cavity containing mucus', and this content comes from the minor salivary glands, fitting in as a pathological process of these glands. Mucocele can be characterized by the mucous extravasation or retention phenomena, giving the diagnosis only through microscopic analysis. Clinically it is presented as a painless, circumscribed, normochromic or bluish nodule floating on palpation. It is predominantly located on the lower lip. The choice of treatment will depend on the analysis of some factors, such as the size of the lesion, its location, depth and the age of the patient. Surgical excision together with the accessory glands of the lesion is the most indicated. There are several techniques for performing such a procedure and the Shira technique was the option for this case report. This technique is based on the careful injection of irreversible hydrocolloid material (alginate) into the lesion previously emptied of its mucoid content in order to delimit it and facilitate surgical removal. Using this technique reduces the chances of recurrence of the lesion, because with the use of alginate the lesion is well delimited facilitating surgical excision, but even with this technique the patient should be guided to remove the etiological factors involved, since its permanence will lead to recurrence of the lesion(AU)


Assuntos
Humanos , Feminino , Adulto , Mucocele/cirurgia , Mucocele/terapia , Doenças das Glândulas Salivares , Cirurgia Bucal , Mucocele
18.
Eur Ann Otorhinolaryngol Head Neck Dis ; 136(4): 321-323, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31023591

RESUMO

INTRODUCTION: The open frontal intersinus septum takedown (FISST) technique was first described in 1976. We describe our experience with an endoscopic transnasal approach to manage a frontal sinus pyocele arising from an obstructed frontal sinus outflow tract due to anterolateral thigh flap reconstruction of a maxillectomy defect. CASE REPORT: A 40-year-old lady experienced upper eyelid swelling and purulent nasal discharge 3 weeks after undergoing a left extended medial maxillectomy with free anterolateral thigh flap reconstruction. A computed tomography (CT) scan revealed total opacification of the left frontal sinus. There was no improvement with intravenous antibiotics and she underwent a surgery, whenshe was found intraoperatively to have a frontal sinus pyocele, which was then drained. She then underwent an endoscopic transnasal FISST to ventilate the left frontal sinus via the contralateral frontal recess with good results. A CT scan performed 3 months postoperatively showed a widely patent interfrontal sinus septal window and right frontal outflow tract with no disease recurrence. DISCUSSION: The FISST is a useful technique to manage unilateral frontal sinus disease by taking advantage of the contralateral outflow tract when the ipsilateral frontal recess is obstructed.


Assuntos
Seio Frontal/cirurgia , Mucocele/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Adulto , Feminino , Seio Frontal/diagnóstico por imagem , Humanos , Mucocele/diagnóstico por imagem , Tomografia Computadorizada por Raios X
19.
Ear Nose Throat J ; 98(7): 425-430, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31012343

RESUMO

In this article, we explore the disease spectrum and clinical characteristics of and the diagnosis and endoscopic approach to treating isolated sphenoid sinus disease (ISSD) in children. To these ends, we review a case series of 19 patients (mean age: 8.1 ± 4.9 years, range: 1.1-15 years, median age: 6.7 years, 13 males, 6 females) who underwent surgical treatment at our hospital for ISSD during the 4 years between 2012 and 2016. The symptoms of pediatric sphenoid sinus disease tend to be variable and nonspecific and include atypical headache, nasal congestion, epistaxis, postnasal drip, snoring, and impaired vision. Headache is the presenting symptom in 42% of patients, but headaches occurred in no specific or typical location. Ten patients underwent preoperative endoscopic examination, and abnormalities in the sphenoethmoidal recess were found in 6 (60%) of these 10 patients. All 19 patients underwent ultra-low-dose paranasal sinus computed tomography (CT) imaging, and 9 patients with suspected tumors or sphenoid mucoceles were further examined by magnetic resonance imaging (MRI). The endoscopic transostial approach was performed in all 19 patients: 16 patients received excision of inflammatory sphenoid sinus disorders and benign tumors, including sphenoid sinusitis, sphenoid sinus mucocele, sphenoid sinus polyp, and ossifying fibroma; 3 patients with suspected tumors received biopsies to detect rhabdomyosarcoma, Langerhans cell histiocytosis, and juvenile xanthogranuloma. No intraoperative or immediate postoperative complications were observed. Children with opacified sphenoid sinus identified by radiographic imaging presented a variety of pathologies. The most common lesions were associated with inflammatory disease. Because the symptoms of pediatric sphenoid sinus disease tend to be variable and nonspecific, CT remains the standard for evaluating sphenoid sinus disease, and ultra-low-dose paranasal sinus CT imaging is recommended and can provide images of equal or better quality compared with those obtained by standard dose CT. In addition, MRI is an essential adjunct in the diagnosis and selection of treatment for suspected tumors of the sphenoid sinus. The endoscopic transostial approach was especially suitable for the management of pediatric benign isolated sphenoid sinus lesions.


Assuntos
Endoscopia/métodos , Doenças dos Seios Paranasais/cirurgia , Seio Esfenoidal/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Mucocele/diagnóstico por imagem , Mucocele/cirurgia , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/cirurgia , Seio Esfenoidal/diagnóstico por imagem , Sinusite Esfenoidal/diagnóstico por imagem , Sinusite Esfenoidal/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
20.
Cient. dent. (Ed. impr.) ; 16(1): 55-58, ene.-abr. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-183382

RESUMO

El objetivo de este trabajo es conocer las principales técnicas para el tratamiento de la ránula sublingual, llevando a cabo una revisión de la literatura existente a propósito de un caso clínico. Con respecto al caso clínico se trata de una paciente mujer de 20 años que acude a consulta por aumento de tamaño del suelo de la boca de unos 3x5 cm. Al realizar la resonancia magnética, se observa una lesión quística en la región sublingual derecha. Se planifica cirugía de escisión radical, extirpando la glándula sublingual derecha y la lesión. Se pauta como tratamiento antibiótico amoxicilina-ác. clavulánico 875/125 mg y antiinflamatorio metilprednisolona 40 mg y dexketoprofeno 50 mg. Como conclusión la técnica más utilizada, hoy en día, es la cirugía radical, seguida de la micromarsupialización y técnicas modernas mínimamente invasivas


The objective of this study is to know the main techniques for the treatment of the sublingual ranula, through a literature review about a clinical case. With regard to the clinical case, this is a 20 year old female patient present at medical clinic for an increase size of the floor of the mouth of about 3x5cm. When performing a magnetic resonance, observe a cystic lesion in the right sublingual region. Radical excision surgery planned, removing the right sublingual gland and the lesion. It is prescribed as antibiotic treatment amoxicillin-clavulanic acid 875/125 mg and anti-inflammatory methylprednisolone 40 mg and dexketoprofene 50 mg. In conclusion, the most used technique, nowadays, is the radical surgery, followed by the micromarsupialisation and minimally invasive modern technique


Assuntos
Humanos , Feminino , Adulto Jovem , Rânula/diagnóstico por imagem , Rânula/cirurgia , Mucocele/diagnóstico , Mucocele/cirurgia , Imagem por Ressonância Magnética
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