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[PMID]:28452711
[Au] Autor:Scott JR; Sowerby LJ; Rotenberg BW
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
[Ti] Título:Office-based rhinologic surgery: A modern experience with operative techniques under local anesthetic.
[So] Source:Am J Rhinol Allergy;31(2):135-138, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Office-based rhinologic procedures have become popularized in recent years with the advent of several minimally invasive techniques. There is a paucity of literature, however, that supports more robust in-clinic procedures, e.g., true endoscopic sinus surgery (ESS). There is a high volume of this work being done at our center, and the objective of this article was to review the safety and tolerability of in-clinic surgeries. METHODS: A retrospective chart review was conducted. All the adult patients who underwent in-clinic sinonasal procedures and surgery with a minimum of 3 months of follow-up were included. Information regarding intra- and postoperative complications and revision procedures were recorded. For the ESS procedures, the indication, sinuses operated on, and type of revision were also collected. RESULTS: A total of 315 patients met the inclusion criteria. There were 166 turbinoplasties, 118 ESS, 35 septoplasties, 34 rhinoplasties, and 4 septorhinoplasties performed. For the ESS procedures, 74 (62.7%) were bilateral, and experience was had operating in all paranasal sinuses. All ESS work involved opening diseased ostia and was more than just polypectomies. The mean follow-up for the ESS cases was 13.4 months (range, 12-65 months). Complication rates and tolerability measures were comparable with those of other reported in-office sinonasal procedures performed with the patient under local anesthetic. CONCLUSION: Office-based rhinologic surgery was safe and well tolerated by the patients. The need for revision ESS in our series was low when considering the extent of surgery that was performed. An in-clinic procedure may avoid a general anesthetic in the operating room for appropriately selected patients.
[Mh] Termos MeSH primário: Anestésicos Locais/uso terapêutico
Endoscopia
Obstrução Nasal/epidemiologia
Dor/prevenção & controle
Seios Paranasais/cirurgia
Complicações Pós-Operatórias/prevenção & controle
Rinoplastia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Animais
Canadá/epidemiologia
Feminino
Seguimentos
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos
Obstrução Nasal/cirurgia
Dor/etiologia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anesthetics, Local)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4414


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[PMID]:28452709
[Au] Autor:Al-Asousi F; Okpaleke C; Dadgostar A; Javer A
[Ad] Endereço:Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, St. Paul's Sinus Centre, University of British Columbia, Vancouver, British Columbia, Canada.
[Ti] Título:The use of polydioxanone plates for endoscopic skull base repair.
[So] Source:Am J Rhinol Allergy;31(2):122-126, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many reconstructive techniques and materials have been reported for repair of skull base defects after sinonasal tumor excision, cerebrospinal fluid (CSF) leaks, and coverage of denuded bone. Synthetic materials have been developed for endoscopic skull base repair to avoid donor-site morbidity. Polydioxanone plate is a bioabsorbable implant designed for nasal septal reconstruction and has the ability to retain strength for at least 10 weeks and absorbs in 6 months. OBJECTIVES: This study aimed to describe the use of polydioxanone plates in endoscopic skull base defect and CSF leak repair, and to describe our experience with the surgical technique and postoperative management. METHODS: This was a retrospective case series of patients who, between May 2013 and December 2015, underwent endoscopic sinus surgery and skull base repair for CSF leak or after excision of a skull base tumor by using polydioxanone plates. Patients who presented with sinonasal inflammatory disease or skull base tumors underwent endoscopic skull base repair by using polydioxanone plates in an underlay fashion and mucosal membrane grafts with or without adjuvant materials in an overlay fashion. The patients were reviewed at 6 days, 6 weeks, and 3 months after surgery. Postoperative adverse events, including CSF leak, infection, bleeding, headache, and graft failure, were recorded. RESULTS: The cases of seven patients (five women, two men; mean age, 53.9 years) were reviewed. Five patients underwent sinonasal tumor resection and two underwent repair for CSF leak. The mean (standard deviation) defect size was 16.4 ± 11.4 mm. There was no evidence of postoperative CSF leak, and lumbar drains were not used. One patient reported transient headache and facial pressure at the 6-week follow-up visit. The surgeons' experience with polydioxanone plate placement, postoperative healing, and follow-up was satisfactory. CONCLUSION: Polydioxanone could be used to achieve rigid repair of endoscopic skull base defects. These early results, although promising, require validation in clinical trials.
[Mh] Termos MeSH primário: Implantes Absorvíveis/utilização
Vazamento de Líquido Cefalorraquidiano/cirurgia
Endoscopia
Seios Paranasais/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Neoplasias da Base do Crânio/cirurgia
Base do Crânio/cirurgia
[Mh] Termos MeSH secundário: Materiais Biocompatíveis/química
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Seios Paranasais/patologia
Polidioxanona/química
Complicações Pós-Operatórias
Estudos Retrospectivos
Base do Crânio/anormalidades
Base do Crânio/patologia
Neoplasias da Base do Crânio/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); 31621-87-1 (Polydioxanone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4411


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[PMID]:28452707
[Au] Autor:Roxbury CR; Smith DF; Higgins TS; Lee SE; Gallia GL; Ishii M; Lane AP; Reh DD
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
[Ti] Título:Complete surgical resection and short-term survival in acute invasive fungal rhinosinusitis.
[So] Source:Am J Rhinol Allergy;31(2):109-116, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acute invasive fungal rhinosinusitis (AIFR) is a fulminant fungal infection seen in patients who are immunocompromised. Due to its rarity, there is little evidence regarding the appropriate antifungal treatment regimen, especially the degree of surgical intervention. OBJECTIVE: To assess factors that impact short-term survival in AIFR as defined by survival to hospital discharge and to develop a staging system to predict survival and complete surgical resection. METHODS: Fifty-four patients with histopathologically diagnosed AIFR who met inclusion criteria were identified between 1984 and 2014. Patient characteristics, disease extent, treatment modality, and short-term survival data were collected. Univariate analysis was performed to assess for factors associated with survival and increased likelihood of surgical resection. RESULTS: Of 52 patients with adequate documentation, 36 (69.2%) survived their hospital stay. Complete surgical resection was the only factor associated with improved survival (survival, 95.5%; p < 0.01). A surgical staging system was proposed to guide probability of complete resection and overall prognosis, with stage I disease limited to the nasal cavity, stage II involving the paranasal sinuses, stage III involving the orbit, and stage IV with skull base or intracranial extension. The χ2 analyses showed a decreased likelihood of complete surgical resection with stage III or IV disease compared with stage I (resection, 90.9%) (stage III resection, 37.5% [p = 0.01]; stage IV resection, 16.7% [p = 0.002]). There was a decreased likelihood of survival associated with increasing disease stage compared with stage I (survival, 100%) (stage II survival, 60% [p = 0.009]; stage III survival, 62.5% [p = 0.02]; stage IV survival, 54.6%, [p = 0.006]). CONCLUSION: Although further studies are needed to define specific treatment protocols, analysis of these data indicated that endoscopic sinus surgery with the goal of complete surgical resection may provide the best survival outcomes in select patients when complete surgical resection can be performed. Our staging system represents the first attempt to predict surgical success and prognosis in patients with AIFR.
[Mh] Termos MeSH primário: Aspergilose Pulmonar Invasiva/cirurgia
Cavidade Nasal/cirurgia
Órbita/cirurgia
Procedimentos Cirúrgicos Otorrinolaringológicos
Seios Paranasais/cirurgia
Rinite/cirurgia
Sinusite/cirurgia
[Mh] Termos MeSH secundário: Doença Aguda
Adolescente
Adulto
Idoso
Criança
Feminino
Seres Humanos
Hospedeiro Imunocomprometido
Aspergilose Pulmonar Invasiva/mortalidade
Masculino
Meia-Idade
Cavidade Nasal/microbiologia
Órbita/microbiologia
Seios Paranasais/microbiologia
Prognóstico
Rinite/mortalidade
Sinusite/mortalidade
Análise de Sobrevida
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4420


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[PMID]:28452708
[Au] Autor:Chaudhry S; Chaudhry S; Qureshi T; Batra PS
[Ad] Endereço:Rush Medical College, Rush University, Chicago, Illinois, USA.
[Ti] Título:Evolution of sinonasal symptoms and mucosal healing after minimally invasive pituitary surgery.
[So] Source:Am J Rhinol Allergy;31(2):117-121, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Minimally invasive pituitary surgery (MIPS) via endoscopy has become widely accepted as the surgical paradigm of choice for pituitary pathology. The objective of the current study was to analyze the evolution of symptom scores and mucosal healing after MIPS. METHODS: The 22-item Sino-Nasal Outcome Test (SNOT-22) scores and objective endoscopic data of 52 patients were reviewed in a longitudinal manner. Scaled averages of the SNOT-22 and endoscopic scores from different time points were compared with baseline scores by using nonparametric testing. The time to baseline for endoscopic examinations was also analyzed by using Kaplan-Meier curves. RESULTS: The rhinologic symptoms subdomain of the SNOT-22 scores showed statistically significant worsening between baseline and 2 weeks after surgery (p = 0.03). Follow-up SNOT-22 scores after 2 weeks showed no significant differences compared with baseline scores, with an overall trend toward improvement in patient symptoms during the subsequent period. Similar analysis for the endoscopic data illustrated statistically significant differences from the baseline scores up to 16 weeks after surgery. The overall trend showed a worsened endoscopic examination, initially with a spike at ∼8 to 10 weeks (p = 0.03) and with a subsequent return to baseline. The Kaplan-Meier estimate curve demonstrated a median time to return to baseline endoscopy at 18.9 weeks (95% confidence interval, 14.9-38.3 weeks). CONCLUSION: The longitudinal data exhibited subjective improvement of patient outcomes based on SNOT-22 scores within 2-4 weeks after MIPS. However, the objective endoscopic data revealed a lag in improvement of the examination, typically at 16-20 weeks, which underscores ongoing careful endoscopic assessment and management to ensure proper mucosal healing beyond just subjective symptoms as the gauge to postoperative recovery.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Minimamente Invasivos
Seios Paranasais/cirurgia
Hipófise/cirurgia
Neoplasias Hipofisárias/cirurgia
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Endoscopia
Feminino
Seres Humanos
Masculino
Meia-Idade
Membrana Mucosa/patologia
Seios Paranasais/patologia
Hipófise/patologia
Neoplasias Hipofisárias/patologia
Período Pós-Operatório
Qualidade de Vida
Estudos Retrospectivos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4407


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[PMID]:28452704
[Au] Autor:Yan CH; Hahn S; McMahon D; Bonislawski D; Kennedy DW; Adappa ND; Palmer JN; Jiang P; Lee RJ; Cohen NA
[Ad] Endereço:Department of Otorhinolaryngology-Head and Neck Surgery, Division of Rhinology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
[Ti] Título:Nitric oxide production is stimulated by bitter taste receptors ubiquitously expressed in the sinonasal cavity.
[So] Source:Am J Rhinol Allergy;31(2):85-92, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bitter taste receptors (T2R) have recently been demonstrated to contribute to sinonasal innate immunity. One T2R, T2R38, regulates mucosal defense against gram-negative organisms through nitric oxide (NO) production, which enhances mucociliary clearance and directly kills bacteria. To determine whether additional T2Rs contribute to this innate defense, we evaluated two other sinonasal T2Rs (T2R4 and T2R16) for regulation of NO production and expression within the human sinonasal cavity. METHODS: Primary human sinonasal cultures were stimulated with ligands specific to T2R4 and T2R16, colchicine and D-salicin, respectively. Cellular NO production was measured by intracellular 4-amino-5-methylamino-2',7'-difluorofluorescein diacetate fluorescence. For T2R expression mapping, sinonasal tissue was obtained from patients who underwent sinus surgery of the middle turbinate, maxillary sinus, ethmoid sinus, or sphenoid sinus. The expression of T2R4, T2R16, and T2R38 was evaluated by using immunofluorescence with validated antibodies. RESULTS: Similar to T2R38, T2R4 and T2R16 trigger NO production in a dose-dependent manner by using the canonical taste signaling pathway in response to stimulation with their respective ligands. All three receptors were expressed in the cilia of human epithelial cells of all regions in the sinonasal cavity. CONCLUSION: These three T2Rs signaled through the same NO-mediated antimicrobial pathway and were ubiquitously expressed in the sinonasal epithelium. Additional T2Rs besides T2R38 may play a role in sinonasal immune defense. Mapping of T2R expression demonstrated the potential widespread role of T2Rs in sinonasal defense, whereas the genetics of these T2Rs may contribute to our understanding of specific endotypes of chronic rhinosinusitis and develop into novel therapeutic targets.
[Mh] Termos MeSH primário: Infecções Bacterianas/imunologia
Mucosa Nasal/imunologia
Seios Paranasais/metabolismo
Receptores Acoplados a Proteínas-G/metabolismo
Rinite/imunologia
Sinusite/imunologia
Paladar
[Mh] Termos MeSH secundário: Bacteriólise
Células Cultivadas
Doença Crônica
Seres Humanos
Imunidade Inata
Depuração Mucociliar
Mucosa Nasal/microbiologia
Óxido Nítrico/metabolismo
Cultura Primária de Células
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Receptors, G-Protein-Coupled); 0 (taste receptors, type 2); 31C4KY9ESH (Nitric Oxide)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4424


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[PMID]:28452706
[Au] Autor:Rowan NR; Wang EW; Kanaan A; Sahu N; Williams JV; Phillips CD; Lee SE
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
[Ti] Título:Respiratory viral detection in the paranasal sinuses of patients with cystic fibrosis.
[So] Source:Am J Rhinol Allergy;31(2):105-108, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pulmonary colonization with antibiotic-resistant organisms in patients with cystic fibrosis (CF) is often preceded by upper-airway infections. Although there is a well-described relationship between pulmonary respiratory viral infections and overall disease progression of CF, the pathogenicity of respiratory viral infections in the paranasal sinuses of patients with CF remains unknown. With recent advances in respiratory virus detection techniques, this study sought to detect the presence of respiratory viruses in the paranasal sinuses of patients with CF in comparison with healthy controls and to correlate the viral presence with clinical measures of sinonasal disease. METHODS: This prospective individual cohort study compared 24 patients with CF with 14 healthy controls. Basic demographics, clinical measures of disease and respiratory viral screens (commercial multiplex) obtained directly from the paranasal sinuses were compared between the two groups. RESULTS: Respiratory viruses were detected in 33% of patients with CF (8/24) compared with 0% of the healthy controls (0/14) (p = 0.017). Respiratory viruses were only detected during the winter months, and the most commonly identified were influenza A and human rhinovirus strains. There was no statistical difference in the 22-Item Sino-Nasal Outcome Test (SNOT-22) scores (p = 0.93) or modified Lund-Kennedy scores (p = 0.74) between patients with CF with a positive viral test and those without a positive result. CONCLUSIONS: Respiratory viral detection is more commonly detected in the paranasal sinuses of patients with CF compared with healthy controls. Although respiratory viral presence did not correlate with a worse clinical severity of sinonasal disease, these findings may provide insight into the pathophysiology of CF and open new avenues for potential targeted therapy.
[Mh] Termos MeSH primário: Fibrose Cística/epidemiologia
Fibrose Cística/virologia
Vírus da Influenza A/fisiologia
Influenza Humana/epidemiologia
Seios Paranasais/virologia
Infecções por Picornaviridae/epidemiologia
Rhinovirus/fisiologia
[Mh] Termos MeSH secundário: Adulto
Estudos de Coortes
Progressão da Doença
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Estações do Ano
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4422


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[PMID]:28452705
[Au] Autor:Lin L; Chen Z; Cao Y; Sun G
[Ad] Endereço:Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai, China.
[Ti] Título:Normal saline solution nasal-pharyngeal irrigation improves chronic cough associated with allergic rhinitis.
[So] Source:Am J Rhinol Allergy;31(2):96-104, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Upper airway inflammation is one of the most commonly identified causes of chronic cough, although the underlying mechanism is not clear. This study compared normal saline solution nasal-pharyngeal irrigation (NSNPI) and fluticasone propionate nasal spray (FPNS) treatment for chronic cough associated with allergic rhinitis (AR). METHODS: Patients with suspected AR to house-dust mite were enrolled, and the symptom of cough was assessed by a cough symptom score and the Leicester Cough Questionnaire, and cough response to capsaicin was evaluated. AR was assessed by using the visual analog scale (VAS) and the Mini Juniper Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ). Mediators, including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein from nasal lavage fluid (NLF) were examined. The patients were treated with NSNPI (the NSNPI group) or FPNS (the FPNS group) for 30 days, after which they were reassessed. RESULTS: Forty-five of 50 patients completed this study. The scores of the cough symptom and the Leicester Cough Questionnaire, and the capsaicin cough threshold all improved statistically after NSNPI but did not change after FPNS. There were statistically significant changes in the evaluations of the MiniRQLQ and the mediators, including histamine and leukotriene C4, in the NLF in the NSNPI group. However, significant changes were found in the assessments of VAS, MiniRQLQ, and all above mediators including histamine, leukotriene C4, and prostaglandin D2, and the major basic protein in the NLF of the FPNS group. Furthermore, the assessments of VAS and all the mediators were reduced more in the FPNS group compared with those in the NSNPI group. CONCLUSION: The patients with suspected AR to house-dust mite reported a better relief of the cough symptom after 30 days of treatment with NSNPI compared with that after nasal corticosteroid.
[Mh] Termos MeSH primário: Tonsila Faríngea/patologia
Tosse/prevenção & controle
Fluticasona/uso terapêutico
Seios Paranasais/patologia
Rinite Alérgica/terapia
Cloreto de Sódio/uso terapêutico
Irrigação Terapêutica
[Mh] Termos MeSH secundário: Tonsila Faríngea/efeitos dos fármacos
Adolescente
Adulto
Idoso
Animais
Antígenos de Dermatophagoides/imunologia
Doença Crônica
Tosse/etiologia
Seres Humanos
Meia-Idade
Sprays Nasais
Seios Paranasais/efeitos dos fármacos
Pyroglyphidae/imunologia
Rinite Alérgica/complicações
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antigens, Dermatophagoides); 0 (Nasal Sprays); 451W47IQ8X (Sodium Chloride); CUT2W21N7U (Fluticasone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4418


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[PMID]:28452700
[Au] Autor:Ghadersohi S; Ference EH; Detwiller K; Kern RC
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
[Ti] Título:Presentation, workup, and management of penetrating transorbital and transnasal injuries: A case report and systematic review.
[So] Source:Am J Rhinol Allergy;31(2):29-34, 2017 Mar 01.
[Is] ISSN:1945-8932
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A foreign body (FB) penetrating intracranially after passing transorbitally or transnasally is a rare occurrence. However, otolaryngologists are increasingly being asked to participate in the care of these patients for both endoscopic removal of the object and repair of any skull base defects. OBJECTIVE: To assess the presentation, workup, and management of transnasal or transorbital penetrating FB injury. METHODS: Systematic review of the presentation, workup, and management of transnasal or transorbital penetrating FB injury; plus, a case report of a 53-year-old woman with a transorbital penetrating rose bush branch. We searched medical literature data bases, which resulted in 215 total titles, which were then narrowed based on inclusion and exclusion criteria. RESULTS: Thirty-five cases of transorbital or transnasal low-velocity trauma that involved the paranasal sinuses were reviewed from 33 articles. The average age was 30 years, 40% of the objects were made of wood. Fifty-seven percent of the cases were transorbital, whereas 43% were transnasal. Forty-six percent of the surgical interventions were completed endoscopically or with endoscopic assistance. Complications of injury were common, with 66% of patients experiencing cerebrospinal fluid leaks; 23%, permanent blindness; 17%, meningitis; 14%, ophthalmoplegia; 9%, decreased visual acuity; and 3%, brain abscess. Our patient presented with a traumatic cerebrospinal fluid leak, and recovered well after transorbital and endoscopic removal of the branch, skull base repair, and a prolonged course of antibiotics and antifungal medications. CONCLUSIONS: Transnasal and transorbital penetrating FB injuries are a relatively uncommon occurrence but when they do occur require rapid workup and interdisciplinary management to prevent acute and delayed complications.
[Mh] Termos MeSH primário: Vazamento de Líquido Cefalorraquidiano/epidemiologia
Traumatismos Craniocerebrais/epidemiologia
Endoscopia
Traumatismos Oculares/epidemiologia
Traumatismos Cranianos Penetrantes/epidemiologia
Órbita/cirurgia
Seios Paranasais/cirurgia
Complicações Pós-Operatórias/epidemiologia
[Mh] Termos MeSH secundário: Vazamento de Líquido Cefalorraquidiano/etiologia
Traumatismos Craniocerebrais/cirurgia
Traumatismos Oculares/cirurgia
Feminino
Corpos Estranhos
Traumatismos Cranianos Penetrantes/cirurgia
Seres Humanos
Meia-Idade
Base do Crânio/cirurgia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.2500/ajra.2017.31.4421


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[PMID]:28470359
[Au] Autor:Topuz MF; Sari M; Binnetoglu A; Dogrul R; Bugdayci O; Seker A
[Ad] Endereço:Department of Otorhinolaryngology, Dumlupinar University School of Medicine, Istiklal Parish Okmeydani st. No: 10 Merkez, Kütahya, Turkey. drfatihtopuz@yahoo.com.
[Ti] Título:Is endoscopic endonasal transsphenoidal surgery increases the susceptibility to rhinosinusitis.
[So] Source:Eur Arch Otorhinolaryngol;274(8):3065-3069, 2017 Aug.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The aim of the study was to analyze whether the measurement of changes in the anatomical position and volume of middle concha, the volume changes in the area between the middle concha and lamina papyracea, the evaluation of opacification in major paranasal sinuses, and osteomeatal complex occlusion in cases with middle concha by out-fracture technique during endoscopic endonasal transsphenoidal approach is a minimally invasive surgery, and also to find out whether these changes lead to the development of tendency to rhinosinusitis. It was a retrospective clinical study. Forty-five cases, between 2013 and 2015, planned for endoscopic endonasal transsphenoidal surgery due to hypophyseal pathology at the Neurosurgery Departments of Marmara University Hospital were evaluated retrospectively. The patients were evaluated for the changes in the anatomy of the middle concha and the effects of these changes to paranasal sinuses by paranasal computed tomographies were studied at the preoperative second week and postoperative 12 month. The Lund-Mackay scoring system was used for the evaluation of opacification in the five major paranasal sinuses and occlusion of the osteomeatal complex in the pre- and postoperative period. The Lund-Mackay scoring system was used to analyze the paranasal computed tomography of the patients at the preoperative 2 weeks and postoperative first year. According to the Lund-Mackay scoring system, no significant difference was detected between the preoperative and postoperative opacification of paranasal sinuses (p > 0.05). Besides, there was also no significant difference between the preoperative and postoperative osteomeatal complex occlusion (p > 0.05). Considering the distance between middle concha and lamina papyracea following the out-fracture of the middle concha, a significant lateralization of 0.5 mm between the preoperative and postoperative period was observed (p < 0.05). In addition, a significant change was also detected in the volume of middle concha (p < 0.05). The volume of the area between the middle concha and lamina papyracea was decreased with a statistical significance (p < 0.05). The endoscopic endonasal transsphenoidal surgery causes some variations in the structures of the middle concha, paranasal sinuses, and OMC, but these changes do not lead to significant rhinologic pathologies.
[Mh] Termos MeSH primário: Cirurgia Endoscópica por Orifício Natural
Rinite/etiologia
Sinusite/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Suscetibilidade a Doenças
Feminino
Seres Humanos
Masculino
Meia-Idade
Cirurgia Endoscópica por Orifício Natural/efeitos adversos
Nariz
Seios Paranasais/diagnóstico por imagem
Doenças da Hipófise/cirurgia
Estudos Retrospectivos
Osso Esfenoide
Conchas Nasais/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-017-4598-4


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Fotocópia
[PMID]:28458494
[Au] Autor:Sahota R; Gambhir R; Anand S; Dixit A
[Ad] Endereço:Department of Oral Pathology, Rayat and Bahra Dental College and Hospital, Mohali.
[Ti] Título:Rhinocerebral Mucormycosis: Report of a Rare Case.
[So] Source:Ethiop J Health Sci;27(1):85-90, 2017 Jan.
[Is] ISSN:2413-7170
[Cp] País de publicação:Ethiopia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mucormycosis is one of the rapidly progressing and lethal form of fungal infection which involves the nose and paranasal sinuses of the head and the neck regions. Mucormycosis also remains a threat to patients with uncontrolled diabetes or other predisposing systemic conditions. It manifests as rhinocerebral, pulmonary, gastrointestinal, cutaneous or disseminated form. The underlying conditions can influence clinical presentation and often delay diagnosis, with resultant poor outcomes. CASE DETAILS: We report a case of rhinocerebral mucormycosis in a 75 year-old diabetic patient with emphasise on diagnosis, treatment and survival options of patient from this potentially fatal fungal infection. Extra oral examination revealed mild non-tender swelling on the face, unable to see from left eye, impaired sense of smell, difficulty in speech and nasal stuffiness. Intra-oral examination showed necrosis of mucosa and underlying bone in relation to canine to the tuberosity area of the left vestibular region of the maxilla. CONCLUSION: Timely diagnosis is critical to survival and minimization of morbidity. Institution of surgical and medical therapy is critical in maximizing the likelihood of good outcome.
[Mh] Termos MeSH primário: Antifúngicos/uso terapêutico
Mucormicose/diagnóstico por imagem
Mucormicose/tratamento farmacológico
Seios Paranasais/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Anfotericina B/uso terapêutico
Seres Humanos
Masculino
Mucormicose/cirurgia
Necrose
Seios Paranasais/patologia
Seios Paranasais/cirurgia
Tomografia Computadorizada por Raios X/métodos
Triazóis/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Triazoles); 6TK1G07BHZ (posaconazole); 7XU7A7DROE (Amphotericin B)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE



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