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1.
J Laryngol Otol ; 134(4): 323-327, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32241312

RESUMO

OBJECTIVE: The nasal septal swell body is a normal anatomical structure located in the superior nasal septum anterior to the middle turbinate. However, the impact of the septal swell body in nasal breathing during normal function and disease remains unclear. This study aimed to establish that the septal swell body varies in size over time and correlates this with the natural variation of the inferior turbinates. METHOD: Consecutive patients who underwent at least two computed tomography scans were identified. The width and height of the septal swell body and the inferior turbinates was recorded. A correlation between the difference in septal swell body and turbinates between the two scans was performed using a Pearson's coefficient. RESULTS: A total of 34 patients (53 per cent female with a mean age of 58.3 ± 20.2 years) were included. The mean and mean difference in septal swell body width between scans for the same patient was 1.57 ± 1.00 mm. The mean difference in turbinate width between scans was 2.23 ± 2.52 mm. A statistically significant correlation was identified between the difference in septal swell body and total turbinate width (r = 0.35, p = 0.04). CONCLUSION: The septal swell body is a dynamic structure that varies in width over time in close correlation to the inferior turbinates. Further research is required to quantify its relevance as a surgical area of interest.


Assuntos
Obstrução Nasal/patologia , Septo Nasal/diagnóstico por imagem , Rinite/patologia , Conchas Nasais/diagnóstico por imagem , Adulto , Idoso , Austrália/epidemiologia , Feminino , Humanos , Hipertrofia , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Obstrução Nasal/terapia , Septo Nasal/patologia , Seios Paranasais/diagnóstico por imagem , Osso Petroso/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Conchas Nasais/patologia
2.
J Laryngol Otol ; 134(3): 270-271, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32122421

RESUMO

BACKGROUND: Endoscopic frontal sinus surgery is frequently complicated by post-operative stenosis and obstruction of the frontal sinus outflow tract, resulting in recurrent disease. Frontal sinus stents may help prevent re-occlusion of the frontal neo-ostia. OBJECTIVE: This paper presents a simple and cost-effective approach to frontal sinus stenting using modified Silastic nasal splints. RESULTS AND CONCLUSION: The current technique provides an effective, reliable and inexpensive method for achieving post-operative frontal sinus outflow tract patency.


Assuntos
Endoscopia/instrumentação , Seio Frontal/cirurgia , Procedimentos Cirúrgicos Nasais/instrumentação , Doenças dos Seios Paranasais/cirurgia , Stents , Constrição Patológica/etiologia , Constrição Patológica/prevenção & controle , Endoscopia/métodos , Seio Frontal/patologia , Humanos , Obstrução Nasal/etiologia , Obstrução Nasal/prevenção & controle , Procedimentos Cirúrgicos Nasais/métodos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Recidiva , Resultado do Tratamento
3.
Ann R Coll Surg Engl ; 102(2): e20-e22, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31219307

RESUMO

We present the case of a 33-year-old man with right-sided facial pain. Clinical examination revealed an isolated mass attached to the right inferior turbinate. This was confirmed with computed tomography. Excision was achieved endoscopically and histology revealed an angioleiomyoma. Full symptomatic relief was achieved after surgical excision. Less than 1% of angioleiomyoma lesions are found within the sinonasal cavity. We describe the first documented presentation of angioleiomyoma as a cause of isolated, unilateral facial pain; a very common presentation to the otorhinolaryngology clinic. We promote consideration of angioleiomyoma as a different diagnosis in the presence of facial pain and a unilateral sinonasal lesion. Endoscopic resection provides complete symptomatic resolution.


Assuntos
Angiomioma/diagnóstico , Dor Facial/etiologia , Obstrução Nasal/etiologia , Neoplasias Nasais/diagnóstico , Adulto , Angiomioma/complicações , Angiomioma/cirurgia , Biópsia , Endoscopia , Dor Facial/cirurgia , Humanos , Masculino , Obstrução Nasal/diagnóstico por imagem , Obstrução Nasal/cirurgia , Neoplasias Nasais/complicações , Neoplasias Nasais/cirurgia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Conchas Nasais/diagnóstico por imagem , Conchas Nasais/patologia
4.
Ann Otol Rhinol Laryngol ; 129(5): 482-488, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31868005

RESUMO

OBJECTIVE: To assess the value of lateral neck radiographs in quantifying adenoid hypertrophy to help guide treatment decisions in patients with symptoms of nasal obstruction. STUDY DESIGN: Retrospective review. METHODS: Quantitative radiologic grading of adenoids was correlated with the intraoperative grading to select cases in agreement between the two methods. The percent airway obstruction was calculated as a ratio of adenoid size to the size of the nasopharyngeal airway near the level of the choanae on the lateral neck radiographs for adenoidectomy cases in which radiographic and intraoperative grading of adenoid size were in agreement. RESULTS: A total of 426 adenoidectomy cases with preoperative lateral neck radiographs were reviewed (M:F = 254:172 for age range 9 months to 16 years), and only cases in agreement between radiographic and intraoperative adenoid grading were included in radiographic analysis (N = 234). The percent airway obstruction values were significantly different between "severely obstructive" (N = 137, mean = 94.71, SD = 6.55, range [72.00; 100.00]) and "moderately obstructive" adenoid categories (N = 97, mean = 78.53, SD = 6.91, range [63.67; 98.08]), not only within clinically relevant age groups (1-3 years, 4-7 years, 8-15 years), but also for the entire data set (95% CI [14.41; 17.95], P < .0001). "Mildly obstructive" category was omitted due to small sample size (N = 4). CONCLUSION: Lateral neck radiographs can provide useful supplemental information on the degree of nasopharyngeal airway obstruction when other clinical findings do not clearly point toward adenoid hypertrophy as a primary cause of nasal obstruction. In our data set, a 65% nasopharyngeal airway obstruction represents a value two standard deviations below the mean for "moderately" obstructive adenoid category, and can be viewed as a simplified cut-off to indicate that the degree of adenoid enlargement is clinically relevant. This cut-off value can assist in evaluation of patients with symptoms of nasal obstruction. LEVEL OF EVIDENCE: 4.


Assuntos
Adenoidectomia/métodos , Tonsila Faríngea/diagnóstico por imagem , Obstrução Nasal/etiologia , Pescoço/diagnóstico por imagem , Radiografia/métodos , Tonsila Faríngea/cirurgia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Hipertrofia/complicações , Hipertrofia/diagnóstico , Hipertrofia/cirurgia , Lactente , Masculino , Obstrução Nasal/diagnóstico , Obstrução Nasal/cirurgia , Período Pré-Operatório , Estudos Retrospectivos
5.
Pan Afr Med J ; 34: 71, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31819787

RESUMO

Introduction: Inverted Papilloma (IP) is a rare benign tumour of the nose and paranasal sinuses histologically characterized by invagination of the outer layer of the epithelium in the underlying chorion. Its most distinctive feature is a strong local aggressiveness, a tendency to recur and an unpredictable risk of association with epidermoid carcinoma. The purpose of this study was to report the epidemiological, clinical, paraclinical data as well as to assess the outcomes of endoscopic endonasal surgery. Methods: We conducted a retrospective study on a series of 13 patients whose data were collected in the Oto-Rhino-Laryngology at the National University Hospital Center of Fann, from 1st January 2012 to 31st December 2017. All patients followed up for inverted papilloma confirmed by anathomopathological examination were included in the study. Results: The average age of patients was 44 years, the sex-ratio was 2.25. All patients had nasal obstruction; 53% of them had rhinorrhea followed by epistaxis in 30% of cases. Right-sided symptoms were reported by 69% of patients, left-sided symptoms by 23% and bilateral symptoms by 7% of patients. Anterior rhinoscopy showed endonasal mass in all patients. All patients underwent CT scan; the MRI was performed in a single patient. Endoscopic resection of IP was performed in 10 patients (76.9%) while external approach was used in 23% of cases. Surgery helped to clarify where the tumor had originated: in 46% of cases in the maxillary sinus, in 15% in the lower nasal turbinate, in 15% in the mid-turbinate, in 7% in the ethmoid bulla and in 7% in the lateral wall of the nasal fossa. One patient had recurrence after an average period of 26 months. Malignant transformation to squamous cell carcinoma occurred in one patient. Conclusion: Inverted papilloma is a very aggressive tumor. CT scan is essential to highlight its spread, especially to bone. The advent of endoscopic surgery has revolutionised treatment, providing excellent results. But, there is nevertheless a risk of recurrence after surgery which motivates an indication for long term monitoring.


Assuntos
Neoplasias do Seio Maxilar/epidemiologia , Neoplasias Nasais/epidemiologia , Papiloma Invertido/epidemiologia , Neoplasias dos Seios Paranasais/epidemiologia , Adulto , Idoso , Carcinoma de Células Escamosas/diagnóstico , Feminino , Hospitais Universitários , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias do Seio Maxilar/patologia , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/patologia , Papiloma Invertido/diagnóstico , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/patologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
6.
Medicine (Baltimore) ; 98(52): e17802, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876702

RESUMO

RATIONALE: Epistaxis is a common otorhinolaryngological emergency, but septal abscess has not been reported before as a complication of epistaxis. PATIENT CONCERNS: We report a case of a 51-year-old man complaining of nasal obstruction and facial numbness for 3 weeks. He had a history of epistaxis, and had been treated with electrocauterization of the left nasal septum at a local clinic 1 month earlier. DIAGNOSES: On nasal endoscopy, swelling of the septum was noticed; computed tomography (CT) was performed, and revealed a septal abscess. INTERVENTIONS: The patient was treated with incision and drainage under local anesthesia. A left vertical hemitransfixion incision was made and 4 mL of purulent material was drained. There was no quadrangular septal cartilage. OUTCOMES: On the 5th postoperative day, the patient complained of blurred vision in his right eye. Visual acuity of the left eye was 0.5, but acuity of the right eye was finger count at 50 cm. Examination of the right eye revealed a whitish fan-shaped corneal opacity on the medial side with neovascularization, diagnostic of lipid keratopathy. CONCLUSION: Electrocautery of epistaxis should be performed carefully during hemostasis, and there should be careful follow-up after the procedure to detect the occurrence of septal hematoma or septal abscess. These conditions should be treated as early as possible to avoid further serious complications. Since lipid keratopathy is difficult to treat once it occurs, care should be taken to avoid a septal abscess.


Assuntos
Abscesso/diagnóstico , Doenças da Córnea/diagnóstico , Septo Nasal , Doenças Nasais/diagnóstico , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Abscesso/terapia , Doenças da Córnea/etiologia , Drenagem , Eletrocoagulação/efeitos adversos , Epistaxe/complicações , Epistaxe/terapia , Humanos , Lipídeos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Septo Nasal/diagnóstico por imagem , Doenças Nasais/etiologia , Tomografia Computadorizada por Raios X
7.
Niger J Clin Pract ; 22(10): 1372-1377, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607726

RESUMO

Objectives: The aim of the study is to compare the pre- and post-operative symptomatology, endoscopic findings, and nasal patency and to evaluate the postoperative outcomes of conventional compared to endoscopic septoplasty (ES). Materials and Methods: This prospective study was conducted at Rajindra Hospital, Patiala, Punjab, India, on 50 patients aged between 18 and 60 years having symptomatic deviated nasal septum and refractory to medical treatment. The patients were divided into two groups: Group A, which included 25 patients in whom conventional septoplasty (CS) was performed, and Group B, which included 25 patients in whom ES was conducted. The postoperative assessment was carried out at once weekly for 1 month and twice weekly for another 2 months. Results: Nasal obstruction was relieved in 79.1% cases belonging to Group A and 91.3% cases to Group B. Headache was relieved in 62.5% cases belonging to Group A and 93.3% cases to Group B. Postnasal drip was relieved in 73.3% cases in Group A and 94.1% cases in Group B. The results were found to be statistically significant. An improvement in visual analog scale score was observed in both groups, but statistically significant difference was seen at 2nd and 4th week. Postoperative nasal patency improvement was observed in both groups by the Gertner plate, and the results were found to be statistically significant. Postoperative hemorrhage was observed in 24% cases in Group A and 12% cases in Group B. Septal perforation, septal hematoma, and mucosal tear were observed in 4%, 4%, and 8% of cases, respectively, in Group A. No such complication was reported in Group B. Conclusion: ES is more effective in terms of relief of symptoms and improvement of nasal patency. It is best for isolated spur, posterior deviation, and revision surgery, but anterior caudal dislocation is best handled with CS. Both these techniques should be taken as an adjuvant to each other.


Assuntos
Endoscopia/métodos , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Rinoplastia/métodos , Adolescente , Adulto , Endoscopia/efeitos adversos , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Septo Nasal/anormalidades , Deformidades Adquiridas Nasais/epidemiologia , Deformidades Adquiridas Nasais/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Hemorragia Pós-Operatória/etiologia , Período Pós-Operatório , Estudos Prospectivos , Rinoplastia/efeitos adversos , Inquéritos e Questionários , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
8.
Acta otorrinolaringol. esp ; 70(5): 279-285, sept.-oct. 2019. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-186371

RESUMO

Introducción y objetivos: El nasoangiofibroma juvenil es una neoplasia benigna sumamente vascularizada de tratamiento complejo, tanto en su preparación quirúrgica como en la cirugía a realizar, los riesgos y las recurrencias. El objetivo es analizar el manejo y tratamiento quirúrgico para el nasoangiofibroma juvenil. Materiales y métodos: Se revisaron las historias clínicas e imágenes de los pacientes intervenidos por la especialidad de cirugía de cabeza, cuello y maxilofacial con resultado de proceso patológico compatible con nasoangiofibroma juvenil, en el periodo comprendido entre enero de 2008 a diciembre de 2016. Resultados: Se intervinieron 61 casos, todos ellos tratados con el mismo acceso quirúrgico por medio de una osteotomía Le Fort I. La totalidad de los pacientes fue de sexo masculino, con un promedio de edad de 13,3 años. Se utilizó la clasificación de Andrew-Fish para la estadificación de los casos, obteniendo los grados ii y i la mayor cantidad de casos. Conclusiones: El abordaje descrito provee un acceso quirúrgico extenso, el cual es adecuado para los diferentes estadios de la tumoración. Requiere de experiencia para poder llevar a cabo la resección de la tumoración con el menor sangrado posible


Introduction and objectives: The juvenile nasopharyngeal angiofibroma is a highly vascularised benign neoplasm of complex treatment in its surgical preparation, surgery to be performed, risks and recurrences. The aim of the study was to analyze the management and surgical treatment for the pathology of juvenile nasoangiofibroma. Materials and methods: We reviewed the clinical histories and images of the patients who underwent surgery with a pathology result of juvenile nasoangiofibroma in the period from January 2008 to December 2016. Results: Sixty-one cases were treated; all of them treated using the same surgical access by means of a Le Fort I osteotomy. All of the patients were male, with an average age of 13.3 years. The Andrew-Fish classification was used for staging the cases, most were staged as grade II and I. Conclusions: The described approach provided extensive surgical access, which was adequate for the different stages of the tumour. It requires experience to be able to resect the tumour with the least possible bleeding


Assuntos
Humanos , Masculino , Criança , Adolescente , Angiofibroma/cirurgia , Neoplasias Nasofaríngeas/cirurgia , Angiofibroma/complicações , Angiofibroma/terapia , Perda Sanguínea Cirúrgica , Transfusão de Sangue , Terapia Combinada , Embolização Terapêutica , Endoscopia , Epistaxe/etiologia , Obstrução Nasal/etiologia , Neoplasias Nasofaríngeas/complicações , Neoplasias Nasofaríngeas/terapia , Terapia Neoadjuvante , Osteotomia de Le Fort , Estudos Retrospectivos , Transtornos da Visão/etiologia
9.
Eur Arch Otorhinolaryngol ; 276(11): 3147-3151, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31486935

RESUMO

INTRODUCTION: While most people believe the nasal septum to have intrinsic deviation and overgrowth in patients seeking rhinoplasty, an alternative concept is that a mal-oriented premaxilla causes extrinsic septal buckling and external extrusion of the septal cartilage. In this sense, the premaxillary bone plays a significant role in the pathogenesis of septal deviation. This study was performed to determine if non-traumatically acquired septal/nasal functional and aesthetic pathology or septal deviation may be related to the orientation of the premaxilla relative to the skullbase. METHODS: A retrospective, single-center study of patients in the general population who underwent maxillofacial CT scans and presented for the evaluation of nasal obstruction. CT scans were used to measure features of both pathologic and non-pathologic nasal septums. RESULTS: A total of 68 subjects were evaluated. When comparing patients with a premaxillary-skullbase angle of greater than 81° (the mean of the study group) to those of less than 81°, and a more obtuse nasolabial angle was observed (p = 0.0269). When comparing the extremes of premaxillary rotation, specifically, greater than 87° (mean 91.7°, SD 5.1) and less than 77° (mean 70.7°, SD 3.6), the differences were more pronounced with regard to caudal septal excess (p = 0.0451) and septal deviation in the axial plane (p = 0.0150). CONCLUSION: Septal developmental changes may involve an overly rotated or more vertically oriented premaxillary bone relative to the skull base. An understanding of the cause of septal deformity may provide insight into the design of improved treatments.


Assuntos
Maxila/diagnóstico por imagem , Obstrução Nasal , Septo Nasal , Deformidades Adquiridas Nasais , Rinoplastia/métodos , Base do Crânio/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Desenvolvimento Maxilofacial , Obstrução Nasal/diagnóstico , Obstrução Nasal/etiologia , Septo Nasal/diagnóstico por imagem , Septo Nasal/patologia , Deformidades Adquiridas Nasais/diagnóstico , Deformidades Adquiridas Nasais/etiologia , Deformidades Adquiridas Nasais/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
10.
Otolaryngol Pol ; 73(4): 8-13, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-31474619

RESUMO

Nasal obstruction caused by adenoid hypertrophy can lead to malocclusion. The research material consisted of children aged 7-12 years with adenoid hypertrophy qualified for adenoidectomy. On the basis of the conducted tests (laryngological, orthodontic, pediatric), the occurrence of open frontal bite in children with pharyngeal tonsil hypertrophy, in particular in boys, was confirmed in comparison to children without hypertrophy correctly breathing through the nose.


Assuntos
Tonsila Faríngea/patologia , Hipertrofia/cirurgia , Obstrução Nasal/cirurgia , Adenoidectomia/métodos , Tonsila Faríngea/cirurgia , Criança , Feminino , Humanos , Hipertrofia/complicações , Masculino , Obstrução Nasal/etiologia
11.
Rhinology ; 57(6): 469-476, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31502597

RESUMO

BACKGROUND: Empty nose syndrome (ENS) is a debilitating disorder characterised by paradoxical nasal obstruction after excessive surgical excision of nasal tissues. ENS negatively impacts the quality of life (QOL) and psychological status of patients. This study aimed to determine the associations among disease-specific QOL impairments and the severity of anxiety and depression before and after surgery in ENS patients. METHODS: A total of 68 ENS patients were prospectively recruited and underwent submucosal Medpor implantation. QOL impairments and the severity of anxiety and depression were evaluated using the Sinonasal Outcome Test-25 (SNOT-25), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) 1 day before and 6 months after surgery. RESULTS: The BDI-II and BAI scores were significantly associated with the total score and ear/facial symptoms, psychological dysfunction, sleep dysfunction, and empty nose symptoms domains of the SNOT-25. Surgery improved disease-specific and psychological symptoms. Post-operative changes in the BDI-II score were correlated with changes in the total score and sleep dysfunction and empty nose symptoms domains of the SNOT-25. A SNOT-25 total score of greater than 60, sleep dysfunction domain score of greater than 18, and empty nose symptoms domain score of greater than 14 were good predictors of moderate-to-severe depression. CONCLUSIONS: ENS symptoms are associated with psychological burden and could be good predictors of moderate-to-severe depression. Targeted symptom improvement could reduce the psychological burden.


Assuntos
Depressão/diagnóstico , Obstrução Nasal/diagnóstico , Obstrução Nasal/psicologia , Procedimentos Cirúrgicos Nasais/efeitos adversos , Ansiedade/diagnóstico , Ansiedade/etiologia , Depressão/etiologia , Humanos , Obstrução Nasal/etiologia , Doenças Nasais/etiologia , Doenças Nasais/cirurgia , Qualidade de Vida , Síndrome
14.
Eur Arch Otorhinolaryngol ; 276(11): 3247-3249, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31363902

RESUMO

PURPOSE: The pathogenesis of persistent allergic rhinitis with chronic and refractory nasal obstruction is still unknown. Inflammation and tissue remodeling are known to play a role, but this has not been studied thoroughly. The purpose of this study is to identify the profile of gene expression of inflammatory and remodeling markers in nasal mucosa of patients with PAR and chronic obstruction. METHODS: After informed consent, we obtained nasal mucosa tissue from five aeroallergen-sensitized PAR patients undergoing anterior turbinectomy, and control non-sensitized individuals undergoing cerebrospinal fluid fistula repair or rhinoplasty. We assessed the expression of 34 genes related to inflammation and tissue remodeling using the real-time polymerase chain reaction (qPCR) to quantify each mRNA. RESULTS: IL-4 mRNA was upregulated in nasal mucosa of all five patients; CCR3, CCR8 and Eotaxin-2 were upregulated in four out of five patient samples; while IL-5 and IL-13 were upregulated in two of them. TGF-ß1 was not upregulated in PAR samples. mRNA from metalloproteinases MMP-7, MMP13 and MMP15 were upregulated in three out of five samples. Our results indicate a typical mRNA expression profile of the infiltrating inflammatory Th2 cells and eosinophils, combined with altered gene expression of remodeling-related proteins in stromal cells from the mucosa. CONCLUSION: Prolonged allergen challenge can lead to persistent upregulation of genes for inflammatory mediators such as IL-4 Th2/eosinophil cytokines, chemokines and receptors, which may play an important role in maintaining PAR with chronic nasal obstruction. Our findings may have therapeutic implications, including the use of anti-IL4, -CCR3 or -MMP therapy to ameliorate the condition.


Assuntos
Mediadores da Inflamação , Interleucina-4/análise , Metaloproteases/análise , Mucosa Nasal/imunologia , Obstrução Nasal , Receptores CCR3/análise , Rinite Alérgica/imunologia , Adulto , Biomarcadores/análise , Feminino , Perfilação da Expressão Gênica , Humanos , Mediadores da Inflamação/análise , Mediadores da Inflamação/classificação , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Obstrução Nasal/imunologia , Rinite Alérgica/complicações , Rinite Alérgica/patologia , Tempo , Regulação para Cima
15.
Ann Otol Rhinol Laryngol ; 128(12): 1158-1164, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31387359

RESUMO

BACKGROUND: Correction of caudal septal deviation is a challenging task that may require multiple surgical approaches. OBJECTIVE: To introduce a novel technique - caudal septal division and interposition batten graft - and evaluate its surgical outcomes in patients undergoing correction of caudal septal deviation. METHOD: The surgical procedure includes a division of the deviated caudal L-strut preserved after resection of the deviated quadrangular septal cartilage at the central portion. A batten graft made of septal cartilage or bone is interposed between the cut ends of the caudal L-strut, the upper part of which mobilized toward the more concave side of the nasal cavity, and then sutured. The medical records of 29 patients with caudal septal deviation who underwent septoplasty using caudal L-strut division and interposition batten graft technique between January 2016 and March 2018 were retrospectively reviewed. Patient satisfaction and symptom improvement were evaluated by using the Nasal Obstruction Symptoms Evaluation scores. Endoscopic assessment of deviation correction was performed and postoperative complications were analyzed. RESULTS: Of the 29 patients, 19 (65.5%) answered the telephonic interview. Mean Nasal Obstruction Symptoms Evaluation scores were 62.1 preoperatively and 9.2 postoperatively, exhibiting significant improvement (P < .001). Satisfaction was rated as much improved in 9 (32.0%) patients, improved in 16 (57.0%), unchanged in 2 (7%), and worse in 1 (4%). Records of endoscopic examinations showed that 26 (82.9%) patients had a straight septum, 4 (11.4%) had improved but persisting caudal deviation, and 2 (5.7%) had no available data. Four patients had postoperative complications: 2 had septal abscesses, 1 had wound dehiscence, and 1 had synechia. All of these complications were managed without persistent problems. CONCLUSIONS: Caudal septal division and interposition batten graft can serve as an alternative surgical approach with acceptable surgical outcomes for managing severely deviated caudal septum. LEVEL OF EVIDENCE: 4.


Assuntos
Obstrução Nasal/cirurgia , Septo Nasal/anormalidades , Septo Nasal/cirurgia , Rinoplastia/métodos , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Satisfação do Paciente , Estudos Retrospectivos , Técnicas de Sutura , Avaliação de Sintomas , Resultado do Tratamento , Adulto Jovem
16.
Artigo em Chinês | MEDLINE | ID: mdl-31446742

RESUMO

SummaryNasal obstruction is one of the main symptoms of allergic rhinitis(AR) as well as one of the most common complains in the otolaryngology department. Among the many causes of nasal congestion, such as inflammation and anatomy, the most common clinical cause is the nasal mucosal inflammatory response that caused by AR. The nasal congestion caused by AR can induce nighttime sleep disturbance and mental-psychological burden. Nasal congestion has a greater impact on children, which can directly affect growth and development due to affecting nighttime sleep, and may even affect maxillofacial development, which should be paid special attention by physicians. According to the particularity of AR nasal congestion, this review summarizes how to carry out clinical consultation, select specialist examination and objective examination methods, and develop the optimal treatment strategy.


Assuntos
Obstrução Nasal/etiologia , Obstrução Nasal/terapia , Rinite Alérgica/complicações , Humanos , Sono
17.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451469

RESUMO

We present a rare and unusual case of a 16-year-old girl, with no significant medical history, presenting with right nasal obstruction and suspected sinusitis with occasional epistaxis and haemoptysis. On examination, she had a mass lesion in the right nasal cavity, with no evidence of other pathology on assessment of the ears, nose, throat or head and neck. A CT scan revealed an opacified right maxillary sinus with polypoidal mucosa, extending and passing through the accessory ostium into the right nasal cavity. Examination under anaesthesia with functional endoscopic sinus surgery and excision of the lesion was subsequently undertaken. Histological analysis confirmed the mass lesion as a haemangioma. This case report is the first to present a maxillary haemangioma presenting as nasal obstruction with intermittent sinusitis symptoms in a child. The authors discuss the incidence, presentation and management of maxillary haemangiomas in the paediatric population.


Assuntos
Hemangioma , Neoplasias do Seio Maxilar , Sinusite Maxilar , Obstrução Nasal/diagnóstico , Cirurgia Endoscópica por Orifício Natural/métodos , Adolescente , Diagnóstico Diferencial , Feminino , Hemangioma/patologia , Hemangioma/fisiopatologia , Hemangioma/cirurgia , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Neoplasias do Seio Maxilar/patologia , Neoplasias do Seio Maxilar/fisiopatologia , Sinusite Maxilar/diagnóstico , Sinusite Maxilar/etiologia , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Obstrução Nasal/etiologia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
18.
Acta otorrinolaringol. esp ; 70(4): 192-199, jul.-ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185395

RESUMO

Introduction and objectives: Children up to 2 years old are at high risk of respiratory infections and nasal irrigation is often prescribed. Yet, to date there is no sufficient knowledge about its immediate effects on the nasopharynx and middle ear. Therefore, this study aimed to analyze the effect of a rhino-pharyngeal clearance intervention protocol on nasal obstruction and middle ear condition in children under 3 years of age with URTI. Materials and methods: Randomized controlled trial in a day-care centre of Porto, including 44 children randomized to Intervention Group (IG) and Control Group (CG). Nasal auscultation and tympanometry were performed at baseline (M0) as well as after the intervention (M1), which consisted of nasal irrigation (NaCl .9%) followed by a forced nasal inspiration in the IG, and after 30 min of normal activities, in the CG. Results: In M1 there was a lower frequency of children classified as having an obstructed nasal sound in the IG when compared to the CG (IG = 33.3%; CG = 68.4%; p = 0.042). We also observed an improvement of mean peak pressure (PP) in the IG (Left ear: M0 = -124daPa; M1 = -92daPa; p = 0.022. Right ear: M0 = -102daPa; M1 = -77daPa; p = 0.021), which was not observed in the CG (Left ear: M0 = -105daPa; M1 = -115daPa; p = 0.485. Right ear: M0 = -105daPa; M1 = -131daPa; p = 0.105). There were no significant results concerning the compliance of the tympanic membrane. Conclusions: The rhino-pharyngeal clearance improved the nasal obstruction and PP of the middle ear of children under 3 years of age with URTI


Introducción y objetivos: Los niños corren un alto riesgo de infecciones respiratorias superiores (IRS) y con frecuencia se prescriben irrigaciones nasales. Hasta hoy no hay suficiente conocimiento sobre sus efectos inmediatos en la nasofaringe y el oído medio. Por lo tanto, este estudio tuvo como objetivo analizar el efecto de un protocolo de intervención de limpieza nasal en la obstrucción y en el estado del oído medio de niños menores de 3 años con IRS. Material y métodos: Ensayo controlado aleatorizado en una guardería de Oporto, incluidos 44 niños asignados al Grupo de intervención (IG) y al Grupo de control (CG). La auscultación nasal y la timpanometría se realizaron al inicio (M0) y después de la intervención (M1), que consistió en irrigación nasal (NaCl 0,9%) seguido de una inspiración nasal forzada en IG, y después de 30 min de actividades normales en CG. Resultados: En M1 hubo una menor frecuencia de niños clasificados como con un sonido nasal obstruido en IG en comparación con CG (IG = 33,3%; CG = 68,4%; p = 0,042). También se observó una mejora de la presión máxima media (PP) en IG (oído izquierdo: M0 = -124daPa; M1 = -92daPa; p = 0,022; oído derecho: M0 = -102daPa; M1 = -77daPa; p = 0,021), que no se observó en CG (oído izquierdo: M0 = -105daPa; M1 = -115daPa; p = 0,485; oído derecho: M0 = -105daPa; M1 = -131daPa; p = 0,105). No hubo resultados significativos con respecto al cumplimiento de la membrana timpánica. Conclusiones: La limpieza nasal mejoró la obstrucción y la PP del oído medio de niños menores de 3 años con IRS


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Lavagem Nasal/métodos , Obstrução Nasal/terapia , Otite Média/terapia , Testes de Impedância Acústica , Lavagem Nasal/instrumentação , Obstrução Nasal/etiologia , Otite Média/diagnóstico , Otite Média/etiologia , Projetos Piloto , Infecções Respiratórias/complicações , Solução Salina/administração & dosagem , Índice de Gravidade de Doença , Resultado do Tratamento
19.
J Otolaryngol Head Neck Surg ; 48(1): 30, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277707

RESUMO

INTRODUCTION: Ectopic sinonasal teeth are uncommon. The classic approach to removal of such foreign bodies was the Caldwell-Luc. In recent years however, endoscopic approaches have become increasingly utilized. Despite this, there is a dearth of literature and consensus regarding the endoscopic removal of ectopic sinonasal teeth. As such, we conducted a systematic review on all cases of endoscopic removal of ectopic sinonasal teeth in the literature. With an understanding of the literature, clinical and technical decision making for patients with this pathology may be elucidated. METHODS: Systematic review of the Ovid Medline, EMBASE Classic and Pubmed databases were conducted using PRISMA guidelines. RESULTS: Our search identified 100 articles. Final inclusion consisted of 23 studies with a total of 27 patient cases. The majority of the patients included were male (70.4%) with a mean age of 27.06 years. Patients presented with a multitude of symptoms, with nasal obstruction (48.14%), rhinorrhea (22.2%), facial pain (22.2%) and epistaxis (22.2%) being most common. Surgeons mostly reported using a 0° endoscope (22.2%) and performing a maxillary antrostomy/uncinectomy (37%) and simple extraction under general anesthetic (41%). CONCLUSIONS: This systematic review analyzed important epidemiological, clinical and technical information regarding patients with endoscopic removal of sinonasal ectopic teeth. Further research is needed to promote implementation of such data into clinical practice.


Assuntos
Endoscopia , Seio Maxilar/cirurgia , Cavidade Nasal/cirurgia , Doenças dos Seios Paranasais/cirurgia , Erupção Ectópica de Dente/cirurgia , Adulto , Feminino , Humanos , Masculino , Obstrução Nasal/etiologia , Obstrução Nasal/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Sinusite/etiologia , Sinusite/cirurgia , Erupção Ectópica de Dente/complicações
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