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[PMID]:29390410
[Au] Autor:Kim JS; Kim EJ; Kwon SH
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery.
[Ti] Título:An ethmoid mucocele causing diplopia: A case report.
[So] Source:Medicine (Baltimore);96(50):e9353, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Mucocele is a disease lined primarily by epithelium, and occurs mainly when the sinus ostium is obstructed. PATIENT CONCERNS: We report a case of a 37-year-old man who presented with painless proptosis of the right eye and diplopia. DIAGNOSES: The preoperative finding was mucocele of the ethmoid sinus. INTERVENTIONS: We performed endoscopic sinus surgery, which included uncapping of the anterior and superior wall of the mucocele. OUTCOMES: The mucocele was treated safely and effectively without touching the medial orbital wall. LESSONS: Clinicians should note that minimally invasive surgery to remove ethmoid mucoceles is relatively straightforward and can prevent the various complications associated with these lesions.
[Mh] Termos MeSH primário: Diplopia/etiologia
Seio Etmoidal
Mucocele/complicações
Mucocele/cirurgia
Doenças dos Seios Paranasais/complicações
Doenças dos Seios Paranasais/cirurgia
[Mh] Termos MeSH secundário: Adulto
Endoscopia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009353


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[PMID]:29324798
[Au] Autor:Gookin JL; Mathews KG; Cullen J; Seiler G
[Ad] Endereço:Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America.
[Ti] Título:Qualitative metabolomics profiling of serum and bile from dogs with gallbladder mucocele formation.
[So] Source:PLoS One;13(1):e0191076, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Mucocele formation is characterized by secretion of abnormally thick mucus by the gallbladder epithelium of dogs that may cause obstruction of the bile duct or rupture of the gallbladder. The disease is increasingly recognized and is associated with a high morbidity and mortality. The cause of gallbladder mucocele formation in dogs is unknown. There is a strong breed predisposition and affected dogs have a high incidence of concurrent endocrinopathy or hyperlipidemia. These observations suggest a significant influence of both genetic and metabolic factors on disease pathogenesis. In this study, we investigated a theory that mucocele formation is associated with a syndrome of metabolic disruption. We surmised that a global, untargeted metabolomics approach could provide unique insight into the systemic pathogenesis of gallbladder mucocele formation and identify specific compounds as candidate biomarkers or treatment targets. Moreover, concurrent examination of the serum and hepatic duct bile metabolome would enable the construction of mechanism-based theories or identification of specific compounds responsible for altered function of the gallbladder epithelium. Abnormalities observed in dogs with gallbladder mucocele formation, including a 33-fold decrease in serum adenosine 5'-monophosphate (AMP), lower quantities of precursors required for synthesis of energy transporting nucleotides, and increases in citric acid cycle intermediates, suggest excess metabolic energy and a carbon surplus. Altered quantities of compounds involved in protein translation and RNA turnover, together with accumulation of gamma-glutamylated and N-acetylated amino acids in serum suggest abnormal regulation of protein and amino acid metabolism. Increases in lathosterol and 7α-hydroxycholesterol suggest a primary increase in cholesterol synthesis and diversion to bile acid formation. A number of specific biomarker compounds were identified for their ability to distinguish between control dogs and those that formed a gallbladder mucocele. Particularly noteworthy was a significant decrease in quantity of biologically active compounds that stimulate biliary ductal fluid secretion including adenosine, cAMP, taurolithocholic acid, and taurocholic acid. These findings support the presence of significant metabolic disruption in dogs with mucocele formation. A targeted, quantitative analysis of the identified serum biomarkers is warranted to determine their utility for diagnosis of this disease. Finally, repletion of compounds whose biological activity normally promotes biliary ductal secretion should be examined for any therapeutic impact for resolution or prevention of mucocele formation.
[Mh] Termos MeSH primário: Bile/metabolismo
Sangue
Doenças da Vesícula Biliar/metabolismo
Metabolômica
Mucocele/metabolismo
[Mh] Termos MeSH secundário: Animais
Cães
Feminino
Doenças da Vesícula Biliar/sangue
Masculino
Mucocele/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191076


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[PMID]:28705330
[Au] Autor:Dash I; Dessauvagie B; Hardie M; Saunders C; Wylie E
[Ad] Endereço:Royal Perth Hospital, North Block, Wellington Street, Perth, Western Australia 6000, Australia. Electronic address: izzydash@hotmail.com.
[Ti] Título:Mucocoele-like lesions: is surgical excision still necessary?
[So] Source:Clin Radiol;72(11):992.e1-992.e6, 2017 Nov.
[Is] ISSN:1365-229X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To assess the rate of upgrade in our screening population to determine whether open excision biopsy of mucocoele-like lesions (MLL) is still required. MATERIALS AND METHODS: A retrospective review of the breast screening database from 1999-2014 was performed. RESULTS: MLL were identified on core biopsy in 113 women (0.6% of those recalled for a core biopsy). The majority (n=100, 88%) had a localised cluster of calcification prompting screening recall. Eighty-seven percent (n=99) underwent an excision biopsy; there was a 5% upgrade rate to malignancy (all low/intermediate ductal carcinoma in situ [DCIS]) and 15 women (15%) were found to have an additional "B3" lesion. Fourteen women did not undergo excision biopsy; none of these women had a subsequent cancer at an average of 5-years follow-up. Within the follow-up period, five additional cancers were identified, one of these was in the ipsilateral breast and location, albeit 9-years later. CONCLUSION: This is the largest study of MLL in the literature to date. The present findings show a 5% upgrade rate to DCIS. As long as the current management of low-risk DCIS remains surgical excision, the present results support continued excision of MLLs, either surgically or by vacuum-assisted biopsy.
[Mh] Termos MeSH primário: Neoplasias da Mama/diagnóstico
Mama/patologia
Mama/cirurgia
Carcinoma Intraductal não Infiltrante/diagnóstico
Mucocele/patologia
Mucocele/cirurgia
[Mh] Termos MeSH secundário: Idoso
Biópsia com Agulha de Grande Calibre
Neoplasias da Mama/patologia
Neoplasias da Mama/cirurgia
Carcinoma Intraductal não Infiltrante/patologia
Carcinoma Intraductal não Infiltrante/cirurgia
Feminino
Seguimentos
Seres Humanos
Meia-Idade
Mucocele/diagnóstico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE


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[PMID]:28695766
[Au] Autor:Zukin LM; Hink EM; Liao S; Getz AE; Kingdom TT; Ramakrishnan VR
[Ad] Endereço:1 University of Colorado School of Medicine, Aurora, Colorado, USA.
[Ti] Título:Endoscopic Management of Paranasal Sinus Mucoceles: Meta-analysis of Visual Outcomes.
[So] Source:Otolaryngol Head Neck Surg;157(5):760-766, 2017 Nov.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective Paranasal sinus mucoceles are benign cystic lesions originating from sinus mucosa that can impinge on adjacent orbital structures, causing ophthalmic sequelae such as decreased visual acuity. Definitive treatment requires surgery. We present the first meta-analysis quantifying the effect of preoperative visual function and time to surgery on postoperative visual acuity outcomes. Data Sources PubMed, Ovid, Embase, Web of Science, and the Cochrane Library. Methods Two independent authors systematically reviewed articles describing outcomes after endoscopic sinus surgery for paranasal sinus mucoceles presenting with visual loss. Available data from case reports and series were combined to analyze the associations among preoperative visual acuity, time to surgery, and postoperative outcomes. Results Eighty-five studies were included that provided data on 207 patients. The average presenting visual acuity was 1.57 logMAR (logarithm of the minimum angle of resolution), and the average postoperative visual acuity was 0.21 logMAR, with visual improvement in 71.5% of cases. Preoperative visual acuity ≥1.52 logMAR correlated with postoperative improvement >1 logMAR ( R = 0.4887, P < .0001). A correlation was found between a time to surgery <6 days and postoperative improvement ( R = 0.297, P < .0001). Receiver operator curve analysis of these thresholds demonstrated a moderately accurate prognostic ability (area under the curve: 75.1 for preoperative visual acuity and 73.1 for time to surgery). Conclusion Visual loss resulting from paranasal sinus mucoceles is potentially reversible in most cases, even those presenting with poor vision. When possible, surgery should be performed promptly after diagnosis, but emergency surgery does not appear to be necessary for vision restoration.
[Mh] Termos MeSH primário: Endoscopia
Mucocele/complicações
Mucocele/cirurgia
Doenças dos Seios Paranasais/complicações
Doenças dos Seios Paranasais/cirurgia
Transtornos da Visão/etiologia
Transtornos da Visão/cirurgia
[Mh] Termos MeSH secundário: Descompressão Cirúrgica
Seres Humanos
Acuidade Visual
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817717674


  5 / 3083 MEDLINE  
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[PMID]:28683957
[Au] Autor:Ballivet de Régloix S; Maurin O; Crambert A; Genestier L; Bonfort G; Pons Y
[Ad] Endereço:Hôpital d'instruction des Armées-Percy, service d'ORL et de chirurgie cervico-faciale, 101, avenue Henri-Barbusse, 92140 Clamart, France. Electronic address: stanbdr@msn.com.
[Ti] Título:[Complications of sinusitis].
[Ti] Título:Complications des sinusites..
[So] Source:Presse Med;46(7-8 Pt 1):655-659, 2017 Jul - Aug.
[Is] ISSN:2213-0276
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:The complications of sinusitis are essentially secondary to ethmoidal and frontal sinusitis, occurring in patients weakened, particularly in case of immunodeficiency or anatomical defects. The gravity is due to the risk of spreading infection in intracranial tissues and orbital cavity. The diagnosis is always to discuss any symptomatology resistant to treatment and the appearance of orbital or neurological signs. The scanner and MRI contribute greatly to the orientation and diagnostic evaluation of the extent of the lesions. Treatment is based on prolonged antibiotic therapy and surgery and requires a multidisciplinary approach involving ENT, ophthalmologist, neurosurgeon and anesthesiologist resuscitator.
[Mh] Termos MeSH primário: Sinusite/complicações
[Mh] Termos MeSH secundário: Abscesso Encefálico/etiologia
Empiema/etiologia
Seres Humanos
Meningite/etiologia
Mucocele/etiologia
Celulite Orbitária/etiologia
Osteomielite/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE


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[PMID]:28397948
[Au] Autor:Saleh SM; Idris AM; Vani NV; Tubaigy FM; Alharbi FA; Sharwani AA; Mikhail NT; Warnakulasuriya S
[Ad] Endereço:Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia. E-mail. Sanaasaleh54@gmail.com.
[Ti] Título:Retrospective analysis of biopsied oral and maxillofacial lesions in South-Western Saudi Arabia.
[So] Source:Saudi Med J;38(4):405-412, 2017 Apr.
[Is] ISSN:0379-5284
[Cp] País de publicação:Saudi Arabia
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To report the prevalence and types of biopsied oral and maxillofacial lesions (OMLs) in South-Western (Jazan Province) region, , Kingdom of Saudi Arabia (KSA). Methods: This retrospective study was based on the retrieval of clinicopathological data for a period of 6 years between January 2009 and December 2014. These  data were obtained between October 2014 and June 2015 from the histopathology records of King Fahad Central Hospital, Jazan, KSA, which is the only referral center for biopsy services. Results: Out of the 32149 biopsies received, 714 (2.2%) were OMLs. The age ranged from 0 (neonatal) to 100 years, with a mean age of 46.8±23.4 and a male-to-female ratio of 1:1.3. The tongue was the most common site for OMLs and for malignant neoplasms, in particular. The most common category was malignant neoplasm (38.7%), followed by inflammatory lesions (16.5%). Oral malignancies accounted for 15.8% of all malignancies. Oral squamous cell carcinoma (OSCC) (36.1%) was the most frequent type, followed by pyogenic granuloma and mucocele (7% each). Shammah-associated OSCC and epithelial dysplasia were twice as common in females. Conclusion: The number of non-malignant OMLs was much lower than expected in comparison to oral malignancies. This difference can likely be explained by the fact that the biopsies were taken only when malignancy was suspected. The higher rate of OSCC reported from this region is attributed to shammah usage. This study emphasizes the importance of biopsy services for all OMLs and the prevention of shammah use.
[Mh] Termos MeSH primário: Doenças da Boca/epidemiologia
Doenças da Boca/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Biópsia
Carcinoma de Células Escamosas/epidemiologia
Carcinoma de Células Escamosas/patologia
Criança
Pré-Escolar
Feminino
Granuloma Piogênico/epidemiologia
Granuloma Piogênico/patologia
Promoção da Saúde
Seres Humanos
Incidência
Lactente
Recém-Nascido
Masculino
Meia-Idade
Neoplasias Bucais/epidemiologia
Neoplasias Bucais/patologia
Mucocele/epidemiologia
Mucocele/patologia
Úlceras Orais
Prevalência
Estudos Retrospectivos
Arábia Saudita/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE
[do] DOI:10.15537/smj.2017.4.18760


  7 / 3083 MEDLINE  
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[PMID]:28366182
[Au] Autor:Andratschke M; Hagedorn H
[Ad] Endereço:Department of Otorhinolaryngology,Head and Neck Surgery,HELIOS Amper-Klinikum Dachau,Teaching Hospital of the Ludwig Maximilian University of Munich,Germany.
[Ti] Título:First results of frontal sinus obliteration with a synthetic, resorbable and osteoconductive bone graft of ß-tricalcium phosphate.
[So] Source:J Laryngol Otol;131(6):534-540, 2017 Jun.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite advances in endoscopic sinus surgery, frontal sinus obliteration is still indicated in some cases. Current options for obliteration include autologous and synthetic materials. The use of ß-tricalcium phosphate as a resorbable bone graft substitute is a good alternative for frontal sinus obliteration. This study aimed to report our experience with this material. METHODS: A retrospective chart review of patients who underwent frontal sinus obliteration at our clinic between 2008 and 2013 was performed. Demographic data, indications, previous surgery, and immediate and late complications were examined. Information on persisting symptoms and patient outcomes was collected using a telephone questionnaire in February 2016. RESULTS: None of the patients underwent further surgery for frontal sinus disease. All of them reported a good cosmetic result and symptom improvement. CONCLUSION: ß-tricalcium phosphate is a good, safe and cost-effective material for frontal sinus obliteration.
[Mh] Termos MeSH primário: Substitutos Ósseos/uso terapêutico
Fosfatos de Cálcio/uso terapêutico
Seio Frontal/cirurgia
Mucocele/cirurgia
Doenças dos Seios Paranasais/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Regeneração Óssea
Feminino
Osso Frontal/cirurgia
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Terapia de Salvação/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Substitutes); 0 (Calcium Phosphates); 0 (beta-tricalcium phosphate)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117000706


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[PMID]:28241001
[Au] Autor:Carrillo Andrades VA; Carrillo Venezian BC
[Ad] Endereço:Facultad de Medicina, Universidad de Valparaíso, Región de Valparaíso, Chile. Address: 2 Norte 550 Departamento 112-b, Viña del Mar, Región de Valparaíso, Chile. Email: bernarditacarrillov@gmail.com.
[Ti] Título:[Maxillary mucocele after an orthognathic surgery: case report].
[Ti] Título:Mucocele maxilar secundario a cirugía ortognática: reporte de un caso..
[So] Source:Medwave;17(1):e6841, 2017 Jan 16.
[Is] ISSN:0717-6384
[Cp] País de publicação:Chile
[La] Idioma:spa
[Ab] Resumo:Mucoceles are not often found in the maxillary sinus, and is a rare surgery complication, in this case, orthognathic. This review describes a mucocele that partially occupies the right maxillary sinus, causing a chronic nasal obstruction. This is the case of a 44 year-old female patient, which after 12 years of several orthognathic surgeries, presents facial pain and right nasal obstruction. The paranasal sinus computed tomography reveals a mass with liquid content that occupies the lower part of the right maxillary sinus and compromises the right nasal cavity. The patient was treated with an intranasal marsupialization and a middle meatotomy with endoscopic nasal approach. Evolution was satisfactory two years after the intervention.
[Mh] Termos MeSH primário: Seio Maxilar/diagnóstico por imagem
Mucocele/diagnóstico por imagem
Procedimentos Cirúrgicos Ortognáticos/efeitos adversos
Doenças dos Seios Paranasais/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Dor Facial/etiologia
Feminino
Seres Humanos
Seio Maxilar/patologia
Mucocele/etiologia
Mucocele/cirurgia
Obstrução Nasal/etiologia
Doenças dos Seios Paranasais/etiologia
Doenças dos Seios Paranasais/cirurgia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170228
[St] Status:MEDLINE
[do] DOI:10.5867/medwave.2017.01.6841


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[PMID]:28140636
[Au] Autor:Kakimoto T; Kanemoto H; Fukushima K; Ohno K; Tsujimoto H
[Ti] Título:Bile acid composition of gallbladder contents in dogs with gallbladder mucocele and biliary sludge.
[So] Source:Am J Vet Res;78(2):223-229, 2017 Feb.
[Is] ISSN:1943-5681
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE To examine bile acid composition of gallbladder contents in dogs with gallbladder mucocele and biliary sludge. ANIMALS 18 dogs with gallbladder mucocele (GBM group), 8 dogs with immobile biliary sludge (i-BS group), 17 dogs with mobile biliary sludge (m-BS group), and 14 healthy dogs (control group). PROCEDURES Samples of gallbladder contents were obtained by use of percutaneous ultrasound-guided cholecystocentesis or during cholecystectomy or necropsy. Concentrations of 15 bile acids were determined by use of highperformance liquid chromatography, and a bile acid compositional ratio was calculated for each group. RESULTS Concentrations of most bile acids in the GBM group were significantly lower than those in the control and m-BS groups. Compositional ratio of taurodeoxycholic acid, which is 1 of 3 major bile acids in dogs, was significantly lower in the GBM and i-BS groups, compared with ratios for the control and m-BS groups. The compositional ratio of taurocholic acid was significantly higher and that of taurochenodeoxycholic acid significantly lower in the i-BS group than in the control group. CONCLUSIONS AND CLINICAL RELEVANCE In this study, concentrations and fractions of bile acids in gallbladder contents were significantly different in dogs with gallbladder mucocele or immobile biliary sludge, compared with results for healthy control dogs. Studies are needed to determine whether changes in bile acid composition are primary or secondary events of gallbladder abnormalities.
[Mh] Termos MeSH primário: Bile/química
Doenças do Cão/fisiopatologia
Doenças da Vesícula Biliar/veterinária
[Mh] Termos MeSH secundário: Animais
Estudos de Casos e Controles
Cães
Doenças da Vesícula Biliar/fisiopatologia
Mucocele/fisiopatologia
Mucocele/veterinária
Ultrassonografia de Intervenção/veterinária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.2460/ajvr.78.2.223


  10 / 3083 MEDLINE  
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[PMID]:28122112
[Au] Autor:Ata N; Erkiliç S
[Ad] Endereço:Department of Otorhinolaryngology, 25 Aralik State Hospital, Gaziantep, Turkey.
[Ti] Título:Mucous retention cyst of mastoid bone mimicking cholesteatoma.
[So] Source:Ear Nose Throat J;96(1):E41-E42, 2017 Jan.
[Is] ISSN:1942-7522
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Colesteatoma da Orelha Média/diagnóstico
Processo Mastoide/diagnóstico por imagem
Mucocele/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Doença Crônica
Diagnóstico Diferencial
Seres Humanos
Masculino
Processo Mastoide/cirurgia
Mucocele/complicações
Mucocele/cirurgia
Miringoplastia
Otite Média/complicações
Otite Média/cirurgia
Tomografia Computadorizada por Raios X
Perfuração da Membrana Timpânica/complicações
Perfuração da Membrana Timpânica/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170614
[Lr] Data última revisão:
170614
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170126
[St] Status:MEDLINE



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