RESUMO
Acinic cell carcinoma (ACC) is a low grade malignant tumor of the salivary glands. Primary ACC affects most frequently the parotid gland and can rarely arise in the minor salivary glands of the oral cavity, pharynx and larynx. It is extremely rare in the nasal cavity; to our knowledge only 18 cases of primary ACC of the nasal cavity are reported in the English-written literature. Herein we report a case of acinic cell carcinoma of the nasal cavity, describe the clinical, radiological and microscopic features of this uncommon presentation and finally provide a discussion in the light of relevant literature.
Assuntos
Carcinoma de Células Acinares , Cavidade Nasal , Septo Nasal , Neoplasias Nasais , Neoplasias das Glândulas Salivares , Adulto , Biópsia , Carcinoma de Células Acinares/diagnóstico por imagem , Carcinoma de Células Acinares/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Septo Nasal/diagnóstico por imagem , Septo Nasal/patologia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/patologia , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Neoplasias das Glândulas Salivares/patologiaAssuntos
Anticorpos Monoclonais Humanizados , Asma , Humanos , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Asma/tratamento farmacológico , Asma/induzido quimicamente , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Rinite/induzido quimicamente , Rinite/tratamento farmacológico , Índice de Gravidade de Doença , Antiasmáticos/efeitos adversos , Antiasmáticos/uso terapêutico , IdosoRESUMO
Surgeons conventionally use electrocautery dissection and surgical clip appliers to harvest free flaps. The ultrasonic Harmonic Scalpel is a new surgical instrument that provides high-quality dissection and hemostasis and minimizes tissue injury. The aim of this study was to evaluate the effectiveness and advantages of the ultrasonic Harmonic Scalpel compared to conventional surgical instruments in free flap surgery. This prospective study included 20 patients who underwent head and neck reconstructive surgery between March 2009 and May 2010. A forearm free flap was used for reconstruction in 12 patients, and a fibular flap was used in 8 patients. In half of the patients, electrocautery and surgical clips were used for free flap harvesting (the EC group), and in the other half of the patients, ultrasonic dissection was performed using the Harmonic Scalpel (the HS group). The following parameters were significantly lower in the HS group compared to the EC group: the operative time of flap dissection (35% lower in the HS group), blood loss, number of surgical clips and cost of surgical materials. This study demonstrated the effectiveness of the Harmonic Scalpel in forearm and fibular free flap dissections that may be extended to other free flaps.