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1.
Ann R Coll Surg Engl ; 103(5): e144-e147, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33682425

RESUMO

The current global COVID-19 pandemic is caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, acquired tracheoesophageal fistulas are mainly iatrogenic lesions produced by prolonged tracheal intubation. We present a case of tracheoesophageal fistula with severe tracheal stenosis following tracheal intubation in a patient with SARS-CoV-2 infection.


Assuntos
/terapia , Intubação Intratraqueal/efeitos adversos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Estenose Traqueal/cirurgia , Fístula Traqueoesofágica/cirurgia , Adulto , Anastomose Cirúrgica/métodos , Broncoscopia/métodos , Humanos , Masculino , Salas Cirúrgicas , Isoladores de Pacientes , Respiração Artificial , Tomografia Computadorizada por Raios X , Estenose Traqueal/etiologia , Fístula Traqueoesofágica/etiologia
2.
J Laryngol Otol ; 135(2): 176-178, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33599574

RESUMO

BACKGROUND: Peritonsillar abscess, or quinsy, is one of the most common emergency presentations to ENT departments, and is the most common deep tissue infection of the head and neck. In the UK, junior members of the ENT team are regularly required to independently assess, diagnose and treat patients with peritonsillar aspiration or incision and drainage. ISSUE: Inexperienced practitioners can stumble at several obstacles: poor access due to trismus; poor lighting; difficulty in learning the therapeutic procedure; and difficulty in accurately documenting findings and treatment. SOLUTION: To counter these and other difficulties, the authors describe the routine use of video endoscopy as a training tool and therapeutic adjunct in the management of quinsy.


Assuntos
Drenagem/métodos , Laringoscópios , Laringoscopia/métodos , Abscesso Peritonsilar/cirurgia , Endoscopia/educação , Endoscopia/métodos , Humanos , Laringoscopia/educação , Orofaringe , Procedimentos Cirúrgicos Otorrinolaringológicos/educação , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
3.
Laryngoscope ; 131(1): E307-E313, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33405253

RESUMO

OBJECTIVE: To investigate whether modified uvulopalatopharyngoplasty (UPPP) for treatment of obstructive sleep apnea (OSA) remained effective after 8 years. METHODS: Prospective intervention study. Sixty-five patients with OSA were offered re-evaluation with polysomnography and the Epworth Sleepiness Scale (ESS) 8 years after UPPP. Results were compared with baseline and with a previous 2-year follow-up. Baseline predictors were analyzed with regression analyses. RESULTS: The dropout rate at the 8-year follow-up was 28%. The mean decrease in apnea-hypopnea index (AHI) between baseline and the 8-year follow-up was significant, 14.0 events/hour (from 52.9 to 38.9), 27% (P < .001). The mean increase in AHI between the 2-year and the 8-year follow-up was significant, 14.7 events/hour (from 24.2 to 38.9), 61% (P < .0001). Overweight at baseline predicted an AHI at the 8-year follow-up that was 22.9 events higher compared to patients with normal weight (P = .015). An increase in body mass index (BMI) of 1 kg/m2 between baseline and the 8-year follow-up predicted a mean AHI increase of 3.8 events/hour (P = .015). The median decrease in ESS between baseline and the 8-year follow-up was significant, 7 (from 13.0 to 6.0), 54% (P < .0001). The median increase in ESS between the 2-year and the 8-year follow-up was not significant, 1.0 (from 5.0 to 6.0), 20%. CONCLUSION: Modified UPPP was effective as a long-term treatment for OSA in selected patients, although the effect on AHI decreased over time. Daytime sleepiness remained improved even in the long term. High BMI at baseline and an increase in BMI predicted a reduced long-term respiratory outcome. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E307-E313, 2021.


Assuntos
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Apneia Obstrutiva do Sono/cirurgia , Adulto , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Palato Mole/cirurgia , Faringe/cirurgia , Polissonografia , Estudos Prospectivos , Apneia Obstrutiva do Sono/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Úvula/cirurgia , Adulto Jovem
4.
J Laryngol Otol ; 135(1): 57-63, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33487190

RESUMO

OBJECTIVE: The incidence of recurrent stenosis after cricotracheal resection is 3-9.5 per cent. Management of such patients is challenging. This study aimed to review our experience in revision cricotracheal resection. METHODS: The study was conducted in the Otorhinolaryngology Department, Mansoura University Hospitals, Egypt, on nine patients with recurrent stenosis following cricotracheal resection. Revision cricotracheal resection was performed in all patients. Surgiflo was applied on the site of anastomosis to enhance healing. RESULTS: No intra-operative complications were recorded. Minor post-operative complications occurred in two patients (surgical emphysema and temporary choking); no major complications were reported. Re-stenosis occurred in one patient. Successful decannulation was achieved in eight of the nine patients. CONCLUSION: Revision cricotracheal resection is the definitive curative treatment for recurrent stenosis after previous unsuccessful resection. It has high success rates, provided that careful pre-operative assessment and meticulous operative technique are performed.


Assuntos
Cartilagem Cricoide/cirurgia , Traqueia/cirurgia , Estenose Traqueal/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Recidiva , Reoperação , Estudos Retrospectivos , Adulto Jovem
5.
Laryngoscope ; 131(6): E1950-E1956, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33459366

RESUMO

OBJECTIVE: Previous research has shown that effective application of angiolytic lasers in microlaryngeal surgery is determined by wavelength, pulse width (PW), and fluence. Recently, a 445-nm (blue) laser (BL) has been developed with a potentially greater hemoglobin absorption than previous lasers. The chick chorioallantoic membrane (CAM) represents a suitable model for testing various settings to find out the most optimal settings of this laser. This study used the CAM model to examine whether successful photoangiolytic effects could be obtained using BL. METHODS: Seven hundred and ninety three third-order vascular segments of viable CAM were irradiated using BL via 400-µm diameter fiber, 1 pulse/second, with PW and power varied systematically at standardized fiber-to-vessel distances of 1 and 3 mm. Outcome measures including vessel ablation rate (AR), rupture rate (RR), and visible tissue effects were analyzed using Chi-square test. RESULTS: Energy levels of 400, 540, and 600 mJ (per pulse) were most effective for vessel ablation. A working distance of 3 mm resulted in higher ablation and less vessel rupture compared with 1 mm at these optimal energy levels. At 3 mm, a longer PW resulted in higher AR. At 1 mm, AR increased with shorter PW and higher power. The 1-mm working distance resulted in lower tissue effects than 3 mm. CONCLUSION: Findings in this study showed that BL was effective in vessel ablation using relevant combination of working distance, PW, and energy levels. To obtain high AR, longer working distance plus longer PW was required and if working distance was reduced, shorter PW should be set. LEVEL OF EVIDENCE: NA Laryngoscope, 131:E1950-E1956, 2021.


Assuntos
Membrana Corioalantoide/irrigação sanguínea , Membrana Corioalantoide/efeitos da radiação , Terapia a Laser/métodos , Microcirurgia/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Animais , Embrião de Galinha , Galinhas , Modelos Animais , Ruptura , Prega Vocal/irrigação sanguínea , Prega Vocal/cirurgia
6.
Curr Opin Allergy Clin Immunol ; 21(1): 38-45, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33369568

RESUMO

PURPOSE OF REVIEW: The WHO announced the coronavirus disease 2019 (COVID-19) outbreak as a pandemic in February 2020 with over 15 million confirmed cases of COVID-19 globally to date. Otolaryngologists are at a high risk of contracting COVID-19 during this pandemic if there is inadequate and improper personal protective equipment provision, as we are dealing with diseases of the upper-aerodigestive tract and routinely engaged in aerosol-generating procedures. RECENT FINDINGS: This article discusses the background and transmission route for severe acute respiratory syndrome coronavirus 2, its viral load and temporal profile as well as precaution guidelines in outpatient and operative setting in otorhinolaryngology. SUMMARY: As it is evident that COVID-19 can be transmitted at presymptomatic or asymptomatic period of infections, it is essential to practice ear, nose, and throat surgery with high vigilance in a safe and up-to-standard protection level during the pandemic. This article provides a summary for guidelines and recommendations in otorhinolaryngology.


Assuntos
/prevenção & controle , Otolaringologia/métodos , Pandemias , Aerossóis , Instituições de Assistência Ambulatorial , Infecções Assintomáticas , /transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Nasofaringe/virologia , Orofaringe/virologia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Equipamento de Proteção Individual , Exame Físico , Carga Viral
7.
Medicine (Baltimore) ; 99(42): e22835, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080763

RESUMO

Even being equipped with advanced surgical navigation systems, thorough analysis of patient's imaging diagnosis before procedures is still of great necessity for the operators. This study aimed to explore the morphological changes of sphenoid sinus lesions as observed on computed tomography (CT), and further carry out the fenestration of sphenoid sinus under guidance of the CT.A retrospective analysis of the characteristics of CT images was performed. The outcomes of three kinds of nasal endoscopic surgeries on benign lesions of sphenoid sinuses were investigated. For the 128 patients included, nasal-cavity-olfactory cleft pathway was performed in 64 patients, the Messerklinger pathway was adopted in 54 patients, while Wigand pathway was performed in the rest 10 patients.After follow-up visit, the drainage at the fenestration site of sphenoid sinus was found to be smooth, the symptoms were completely controlled, and no severe complication was reported during or after the surgery. No significant difference was observed in the curative effects among the 3 groups.CT of the paranasal sinus can guide the procedures of sphenoid sinus fenestration. No statistically significant differences were exhibited in terms of the amount of bleeding, surgical time and days of hospitalization among the 3 groups.


Assuntos
Endoscopia/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Seios Paranasais/diagnóstico por imagem , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/cirurgia , Cirurgia Assistida por Computador , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
8.
Otolaryngol Clin North Am ; 53(6): 1171-1174, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32951900

RESUMO

Although the majority of attention to the health care impact of COVID-19 has focused on adult first responders and critical care providers, the pandemic has had a profound effect on the entire health care industry, including the pediatric otolaryngology community. This article highlights the unique ramifications of COVID-19 on pediatric otolaryngology, with a focus on the immediate and potential long-term shifts in practice. Specifically, the article is divided into 3 sections (care for the patient, care for the practitioner, and care for the practice) and details the unique effects of the pandemic on the pediatric otolaryngology specialty.


Assuntos
Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Masculino , Saúde do Trabalhador , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Pandemias/estatística & dados numéricos , Segurança do Paciente , Pediatria/métodos , Pneumonia Viral/epidemiologia , Estados Unidos
9.
Dermatol Online J ; 26(8)2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32941709

RESUMO

Dermatologic surgeons are at increased risk of contracting SARS-COV-2. At time of writing, there is no published standard for the role of pre-operative testing or the use of smoke evacuators, and personal protective equipment (PPE) in dermatologic surgery. Risks and safety measures in otolaryngology, plastic surgery, and ophthalmology are discussed. In Mohs surgery, cases involving nasal or oral mucosa are highest risk for SARS-COV-2 transmission; pre-operative testing and N95 masks should be urgently prioritized for these cases. Other key safety recommendations include strict control of patient droplets and expanded pre-clinic screening. Dermatologic surgeons are encouraged to advocate for appropriate pre-operative tests, smoke evacuators, and PPE. Future directions would include national consensus guidelines with continued refinement of safety protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Dermatologistas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança/métodos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Procedimentos Cirúrgicos Eletivos , Humanos , Cirurgia de Mohs/efeitos adversos , Cirurgia de Mohs/métodos , Doenças Profissionais/epidemiologia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Cuidados Pré-Operatórios , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fumaça/prevenção & controle
10.
Plast Reconstr Surg ; 146(2): 205e-216e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740598

RESUMO

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe normal ear anatomy and development, and evaluate the patient's ears for differences in shape, size, prominence, and symmetry. 2. Identify common congenital ear deformities, including prominent ear, macrotia, Stahl ear, cryptotia, constricted ear, and lobule anomalies. 3. Describe both early nonoperative management and operative techniques for correction of these ear deformities. 4. Be aware of advantages and disadvantages of common and emerging techniques for correction of pediatric ear deformities. SUMMARY: Whereas severe ear malformations such as microtia/anotia are rare, other ear deformities, such as prominent ear, Stahl ear, and cryptotia, are common. Although these ear deformities result in minimal physiologic morbidity, their psychological and cosmetic impact can be significant. Identifying these common deformities and understanding how they differ from normal ear anatomy is critical to their management. In cases where a deformity is identified in neonatal life, ear molding may obviate the need for surgery. Although various surgical techniques have been described for correction of common ear deformities, the surgeon should follow a careful stepwise approach to address the auricular deformity or deformities present. By using such an approach, complications may be minimized and predictable aesthetic outcomes achieved.


Assuntos
Orelha Externa/anormalidades , Estética , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fatores Etários , Criança , Desenvolvimento Infantil , Pré-Escolar , Orelha Externa/crescimento & desenvolvimento , Orelha Externa/cirurgia , Humanos , Lactente , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Tempo para o Tratamento , Adesivos Teciduais , Resultado do Tratamento
11.
Saudi Med J ; 41(7): 715-719, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32601639

RESUMO

OBJECTIVES: To analyze the data of patients with otorhinolaryngological foreign bodies and to evaluate the management and outcomes of foreign bodies to prevent complications. METHODS: A retrospective study was conducted over 8 years at Aseer Central Hospital to examine all admitted cases with foreign bodies in the ear, nose, throat, esophagus and bronchus during the period from January 2011 to January 2019. Patient demographic data, type of foreign body, and most common site were analyzed. RESULTS: A total of 184 patients were admitted, including 72 (39.1%) males and 112 (60.9%) females. The age range was from one year old to 70 years old; the mean±standard deviation of age was 10.6±12.55 years. Foreign bodies were most commonly located in the esophagus (n=97, 52.7%), followed by the bronchus (n=55, 29.9%). A statistically significant difference was found, with a p-value of 0.00001. The most common site in children was the bronchus (n=39, 21%); the most common site in adults was the esophagus (n=18, 72%). CONCLUSION: Otorhinolaryngological foreign bodies are found most frequently in preschool-aged children. The most common site in children was the bronchus, and the most common site in adults was the esophagus. Prevention measures are essential to reduce the risk of ingestion and admission, which can be challenging.


Assuntos
Brônquios , Orelha , Endoscopia/métodos , Esôfago , Corpos Estranhos/cirurgia , Nariz , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Faringe , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Corpos Estranhos/prevenção & controle , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
12.
BMC Oral Health ; 20(1): 184, 2020 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-32615964

RESUMO

BACKGROUND: Late diagnosis of a salivary fistula increases the risk of wound infection and scarring. The purpose of the present study was to identify a quantitative predictor of postoperative salivary fistula for cases treated with surgery. METHODS: Demographic, intraoperative and postoperative parameters for 57 cases that received surgery for benign parotid tumours were recorded from June 2017 to June 2018, of which 18 cases developed salivary fistulas. These data were analysed using univariate and binary logistic regression analyses as well as receiver operating curve analysis. RESULTS: Drain fluid amylase concentration was positively correlated with salivary fistula development (p <  0.001), with an odds ratio of 1.14 for a 1 KU/L increase in concentration and an optimal receiver operating curve cut-off value of 51,100 U/L for predicting salivary fistula development. Cases wherein the parotid-masseteric fascia remained intact were associated with a lower risk of salivary fistula development (p = 0.006). CONCLUSION: Drain fluid amylase concentration may be a valuable predictor of postoperative salivary fistula in cases with benign parotid tumours.


Assuntos
Amilases , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Complicações Pós-Operatórias , Fístula das Glândulas Salivares/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amilases/sangue , Drenagem , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Pancreaticoduodenectomia/efeitos adversos , Glândula Parótida/patologia , Valor Preditivo dos Testes , Resultado do Tratamento , Adulto Jovem
13.
J Laryngol Otol ; 134(8): 696-702, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32723403

RESUMO

BACKGROUND: The coronavirus disease 2019 pandemic has resulted in various changes in knowledge, attitude and practice among doctors. A survey was conducted of otolaryngologists in India regarding these aspects in relation to the coronavirus disease 2019 pandemic. METHOD: Otolaryngologists from West Bengal (India) were invited to participate in an online self-administered survey. Data were collected and analysed using appropriate methods. RESULTS: Responses from 133 participants, grouped into 4 groups by their career stage, were collected and analysed. Of the participants, 36.8 per cent were directly involved in treating a known or suspected coronavirus disease 2019 patient, although 66.2 per cent considered the personal protective equipment inadequate. Ninety-four per cent indicated that their willingness to perform procedures depended on personal protective equipment availability. Of the respondents, 83.5 per cent revealed additional mental stress due to the pandemic. Of the participants, 41.4 per cent took hydroxychloroquine as coronavirus disease 2019 prophylaxis. CONCLUSION: This study provides an insight into which issues may need attention, to help ENT surgeons tackle the coronavirus disease 2019 pandemic more effectively based on analysis of responses in the survey.


Assuntos
Infecções por Coronavirus/epidemiologia , Otorrinolaringologistas/psicologia , Pneumonia Viral/epidemiologia , Inquéritos e Questionários/normas , Atitude do Pessoal de Saúde , Conscientização , Betacoronavirus/isolamento & purificação , Escolha da Profissão , Tomada de Decisão Clínica/ética , Infecções por Coronavirus/virologia , Humanos , Índia/epidemiologia , Conhecimento , Saúde Mental/estatística & dados numéricos , Otorrinolaringologistas/educação , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Pandemias , Equipamento de Proteção Individual/estatística & dados numéricos , Equipamento de Proteção Individual/provisão & distribuição , Pneumonia Viral/virologia , Padrões de Prática Médica/tendências , Medição de Risco , Cirurgiões/educação , Cirurgiões/estatística & dados numéricos
14.
J Laryngol Otol ; 134(8): 732-734, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32605665

RESUMO

BACKGROUND: Robust personal protective equipment is essential in preventing the transmission of coronavirus disease 2019 to head and neck surgeons who are routinely involved in aerosol generating procedures. OBJECTIVE: This paper describes the collective experience, across 3 institutes, of using a reusable half-face respirator in 72 head and neck surgery cases. METHOD: Cost analysis was performed to demonstrate the financial implications of using a reusable respirator compared to single-use filtering facepiece code 3 masks. CONCLUSION: The reusable respirator is a cost-effective alternative to disposable filtering facepiece code 3 respirators. Supplying reusable respirators to individual staff members may increase the likelihood of them having appropriate personal protective equipment during their clinical duties.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Reutilização de Equipamento/economia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/economia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Aerossóis , Betacoronavirus/isolamento & purificação , Líquidos Corporais/virologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Análise Custo-Benefício/métodos , Desenho de Equipamento , Feminino , Humanos , Masculino , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Otolaringologia/estatística & dados numéricos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/normas , Equipamento de Proteção Individual/provisão & distribuição , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Cirurgiões/estatística & dados numéricos , Ventiladores Mecânicos/efeitos adversos , Ventiladores Mecânicos/virologia
15.
J Laryngol Otol ; 134(7): 636-641, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32686629

RESUMO

OBJECTIVE: This study aimed to assess the outcomes of a prelacrimal recess approach assisted middle meatal antrostomy in the management of hard to reach maxillary sinus pathologies. METHOD: Twenty-five patients with maxillary sinus pathology underwent prelacrimal recess approach assisted middle meatal antrostomy (with a prelacrimal recess width of more than 3 mm). Patients were prospectively evaluated using both the Arabic version of the Sino-Nasal Outcome Test-22 and nasal endoscopy at least 6 months post-operatively. RESULTS: Our study included 25 maxillary sinuses (13 with antrochoanal polyps, 10 with maxillary fungal ball and 2 with a migrated part of a tooth). At a mean follow-up period of 10.9 months, all patients showed significant improvement in total mean Sino-Nasal Outcome Test-22 score. There was recurrence of one case with antrochoanal polyp and two cases with asymptomatic synechia. Injury to the nasolacrimal duct was not reported. CONCLUSION: A prelacrimal recess approach assisted middle meatal antrostomy is a reliable and safe technique to manage pathologies in hard to reach regions within the maxillary sinus.


Assuntos
Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Doenças dos Seios Paranasais/cirurgia , Adolescente , Adulto , Idoso , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Cavidade Nasal , Ducto Nasolacrimal/diagnóstico por imagem , Ducto Nasolacrimal/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Estudos Prospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto Jovem
16.
Am J Otolaryngol ; 41(5): 102610, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32580067

RESUMO

OBJECTIVE: To evaluate surgical approaches and outcomes associated with accessory parotid gland neoplasms. DATA SOURCES: MEDLINE, SCOPUS, and the Cochrane Central Register of Controlled Trials. REVIEW METHODS: A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed. Studies were included if they reported surgical management and outcomes of patients with accessory parotid gland neoplasms. RESULTS: After screening 3532 records, 15 studies were included with a total of 187 patients. Benign tumors consisted of 61.5% of cases. External open, transoral, and preauricular endoscopic approaches were used for 82.3%, 11.3%, and 6.5% of cases, respectively. Accessory lobe resection alone, concurrent with partial parotidectomy, and concurrent with total parotidectomy were used in 54.8%, 43.0%, and 2.2% of cases, respectively. Complication rates were similar between histology groups (7.8% benign vs. 8.3% malignant, p = 0.82). Accessory lobe resection with concurrent partial parotidectomy had the lowest overall complication rate (6.3%). Resections limited to the accessory lobe were found to have an overall complication rate of 8.7%. CONCLUSION: The results offer an overview of the surgical management and complications for accessory parotid gland tumors. Overall surgical complication rates found in these case series may be lower for management of accessory gland tumors than rates available in the literature for tumors within the main parotid gland.


Assuntos
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Endoscopia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Resultado do Tratamento , Adulto Jovem
17.
Am J Otolaryngol ; 41(5): 102554, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32521299

RESUMO

PURPOSE: Nasal douching is commonly used as a postoperative management strategy for chronic rhinosinusitis with nasal polyps (CRSwNP). Few studies to date have compared the effectiveness of nasal douching in CRSwNP phenotypes after endoscopic sinus surgery (ESS). We evaluated the efficacy of seawater types in eosinophilic CRSwNP (ECRSwNP) and noneosinophilic CRSwNP (nonECRSwNP) after ESS. METHODS: Patients with bilateral CRSwNP who had undergone ESS were blindly randomized to receive buffered hypertonic seawater (BHS) (n = 48) or physiological seawater (PS) (n = 45). CRSwNP patients were stratified by phenotypes (ECRSwNP and nonECRSwNP) retrospectively according to whether tissue eosinophils exceeded 10%. Follow-up evaluations were conducted at 2, 8, 16, and 24 weeks after surgery. Evaluations included the 22-item Sino-Nasal Outcome Test (SNOT-22), visual analog scale (VAS), Lund-Kennedy endoscopic score (LKES), saccharine clearance time (SCT), and adverse events. RESULTS: All of the patients experienced significant improvements in SNOT-22 scores, VAS scores, and LKES over time. BHS resulted in better improvement of LEKS and SCT relative to PS at 8 weeks postoperatively. Mucosal edema formation was significantly reduced with less crusting among HBS recipients at 8 weeks. After stratification, only patients in the nonECRSwNP + BHS subgroup showed a significant improvement in LEKS and SCT at 8 weeks postoperatively. Side effect profiles were not significantly different among the groups. CONCLUSIONS: BHS has a better inhibitory effect on mucosal edema and crusting during the early postoperative care period of CRSwNP. Among all of the patients, nonECRSwNP patients showed a significant improvement in LEKS and SCT at 8 weeks.


Assuntos
Seio Etmoidal/cirurgia , Soluções Isotônicas/administração & dosagem , Pólipos Nasais/cirurgia , Pólipos Nasais/terapia , Cuidados Pós-Operatórios/métodos , Rinite/cirurgia , Rinite/terapia , Solução Salina Hipertônica/administração & dosagem , Sinusite/cirurgia , Sinusite/terapia , Irrigação Terapêutica/métodos , Adulto , Tampões (Química) , Doença Crônica , Método Duplo-Cego , Edema/prevenção & controle , Endoscopia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Nasal , Pólipos Nasais/complicações , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Doenças dos Seios Paranasais/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Rinite/complicações , Sinusite/complicações , Resultado do Tratamento
19.
Auris Nasus Larynx ; 47(4): 544-558, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32540054

RESUMO

INTRODUCTION: Otolaryngologists are at very high risk of COVID-19 infection while performing examination or surgery. Strict guidelines for these specialists have not already been provided, while currently available recommendations could presumably change in course of COVID-19 pandemic as the new data increases. OBJECTIVES: This study aimed to synthesize evidence concerning otolaryngology during COVID-19 pandemic. It presents a review of currently existing guidelines and recommendations concerning otolaryngological procedures and surgeries during COVID-19 pandemic, and provides a collective summary of all crucial information for otolaryngologists. It summarizes data concerning COVID-19 transmission, diagnosis, and clinical presentation highlighting the information significant for otolaryngologists. METHODS: The Medline and Web of Science databases were searched without time limit using terms ''COVID-19", "SARS-CoV-2" in conjunction with "head and neck surgery", "otorhinolaryngological manifestations". RESULTS: Patients in stable condition should be consulted using telemedicine options. Only emergency consultations and procedures should be performed during COVID-19 pandemic. Mucosa-involving otolaryngologic procedures are considered high risk procedures and should be performed using enhanced PPE (N95 respirator and full face shield or powered air-purifying respirator, disposable gloves, surgical cap, gown, shoe covers). Urgent surgeries for which there is not enough time for SARS-CoV-2 screening are also considered high risk procedures. These operations should be performed in a negative pressure operating room with high-efficiency particulate air filtration. Less urgent cases should be tested for COVID-19 twice, 48 h preoperatively in 24 h interval. CONCLUSIONS: This review serves as a collection of current recommendations for otolaryngologists for how to deal with their patients during COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Telemedicina , Betacoronavirus , Infecções por Coronavirus/transmissão , Humanos , Otorrinolaringologistas , Otolaringologia , Pneumonia Viral/transmissão
20.
Ann Otol Rhinol Laryngol ; 129(12): 1239-1242, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32560593

RESUMO

OBJECTIVE: Thyroglossal duct cysts (TGDCs) are relatively common congenital midline neck masses that are treated with surgical excision. Traditionally these are removed along with any associated tract and the central portion of the hyoid bone through an anterior neck incision. Some patients with TGDCs want to avoid an external neck scar. METHODS: We describe the details of a transoral endoscopic vestibular excision of a TGDC and the associated hyoid bone in an adolescent patient. RESULTS: This novel approach was successful and there were no complications. CONCLUSION: We propose that cervical TGDCs can be safely and completely removed with this approach in appropriately selected patients while avoiding a neck scar.


Assuntos
Osso Hioide/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Cisto Tireoglosso/cirurgia , Adolescente , Endoscopia/métodos , Humanos , Osso Hioide/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Boca , Cisto Tireoglosso/diagnóstico por imagem
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