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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]:29350893
[Au] Autor:Jovancevic L; Canadanovic V; Savovic S; Zvezdin B; Komazec Z
[Ti] Título:Silent sinus syndrome: One more reason for an ophthalmologist to have a rhinologist as a good friend.
[So] Source:Vojnosanit Pregl;74(1):59-63, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Mh] Termos MeSH primário: Enoftalmia
Seio Maxilar
Oftalmologistas
Doenças dos Seios Paranasais
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Técnicas de Diagnóstico Oftalmológico
Enoftalmia/diagnóstico por imagem
Enoftalmia/cirurgia
Seres Humanos
Comunicação Interdisciplinar
Seio Maxilar/diagnóstico por imagem
Seio Maxilar/cirurgia
Procedimentos Cirúrgicos Otorrinolaringológicos
Doenças dos Seios Paranasais/diagnóstico por imagem
Doenças dos Seios Paranasais/cirurgia
Valor Preditivo dos Testes
Síndrome
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141118141J


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[PMID]:28468193
[Au] Autor:Jain A; Gupta G; Grover M
[Ad] Endereço:*Department of Otolaryngology (ENT), MAMC & Lok Nayak Hospital, New Delhi †Department of Otolaryngology (ENT), PBM Hospital, Bikaner ‡Department of Otolaryngology (ENT), SMS Hospital, Jaipur, Rajasthan, India.
[Ti] Título:Removal of an Unusual Neglected Foreign Body in Infratemporal Region Using Navigation.
[So] Source:J Craniofac Surg;28(3):e219-e221, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A 19-year-old male presented with complaint of a bluish mass in the hard palate since 3 months. The patient had a history of trauma 8 years back in the left zygomatic area with a pen. It was lodged in the wound and removed at that time. Computed tomography scan was revealed a linear heterogenous dense structure extending from left infratemporal fossa to oral cavity, traversing through left maxillary sinus, with bone defect seen in lateral and medial wall of maxilla, and in the hard palate, most likely a neglected foreign body. The foreign body was removed by navigation-assisted endoscopic surgery and the palatal perforation repaired using local rotation flap. There were no intraoperative or postoperative complications. Navigation-guided removal of foreign body in proximity to vital structures, in the infratemporal region, is a valuable option with minimal morbidity.
[Mh] Termos MeSH primário: Endoscopia/métodos
Migração de Corpo Estranho/cirurgia
Seio Maxilar/cirurgia
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
Palato Duro/cirurgia
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Migração de Corpo Estranho/diagnóstico
Seres Humanos
Masculino
Seio Maxilar/diagnóstico por imagem
Seio Maxilar/lesões
Palato Duro/diagnóstico por imagem
Palato Duro/lesões
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003402


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[PMID]:28807088
[Au] Autor:Dönmez D; Giotakis E; Hosemann WG; Kühnel TS; Hirt B; Weber RK
[Ad] Endereço:Department of Otorhinolaryngology,Municipal Hospital of Karlsruhe,Germany.
[Ti] Título:Posterior translacrimal approach to the maxillary sinus.
[So] Source:J Laryngol Otol;131(10):871-879, 2017 Oct.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to compare the view into the maxillary sinus using the posterior translacrimal approach compared with grade 3 antrostomy. METHODS: Grade 3 antrostomy followed by a posterior translacrimal approach was performed on four cadavers. The maximum intramaxillary view was documented endoscopically guided by electromagnetic navigation. Representative screenshots were evaluated in a blinded manner by three independent sinus surgeons. In addition, a prospective investigation of specific complications in the post-operative course of consecutive patients was performed. RESULTS: In the cadaver study, the posterior translacrimal approach provided a significantly better view into the maxillary sinus compared with grade 3 antrostomy. In the clinical study, only 1 out of 20 patients reported on a minor problem with lacrimal drainage at 6 months. CONCLUSION: The posterior translacrimal approach to visualising the maxillary sinus should be considered a strong alternative to more radical techniques.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
Doenças dos Seios Paranasais/diagnóstico por imagem
Doenças dos Seios Paranasais/cirurgia
[Mh] Termos MeSH secundário: Cadáver
Fenômenos Eletromagnéticos
Endoscopia
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117001621


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[PMID]:28790259
[Au] Autor:Tanaka S; Tomifuji M; Araki K; Shiotani A
[Ad] Endereço:Dept. of Otolaryngology-Head and Neck Surgery, National Defense Medical College.
[Ti] Título:[II. Organ Preserving Transoral Surgery for Locally Advanced Laryngo-Pharyngeal Cancer].
[So] Source:Gan To Kagaku Ryoho;44(7):569-574, 2017 Jul.
[Is] ISSN:0385-0684
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Mh] Termos MeSH primário: Neoplasias Laríngeas/cirurgia
Procedimentos Cirúrgicos Otorrinolaringológicos
Neoplasias Faríngeas/cirurgia
[Mh] Termos MeSH secundário: Endoscopia
Seres Humanos
Guias de Prática Clínica como Assunto
[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:170810
[St] Status:MEDLINE


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[PMID]:28770621
[Au] Autor:Buchakjian MR; Davis AB; Sciegienka SJ; Pagedar NA; Sperry SM
[Ad] Endereço:1 Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA.
[Ti] Título:Longitudinal Perioperative Pain Assessment in Head and Neck Cancer Surgery.
[So] Source:Ann Otol Rhinol Laryngol;126(9):646-653, 2017 Sep.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate perioperative pain in patients undergoing major head and neck cancer surgery and identify associations between preoperative and postoperative pain characteristics. METHODS: Patients undergoing head and neck surgery with regional/free tissue transfer were enrolled. Preoperative pain and validated screens for symptoms (neuropathic pain, anxiety, depression, fibromyalgia) were assessed. Postoperatively, patients completed a pain diary for 4 weeks. RESULTS: Twenty-seven patients were enrolled. Seventy-eight percent had pain prior to surgery, and for 38%, the pain had neuropathic characteristics. Thirteen patients (48%) completed at least 2 weeks of the postoperative pain diary. Patients with moderate/severe preoperative pain report significantly greater pain scores postoperatively, though daily pain decreased at a similar linear rate for all patients. Patients with more severe preoperative pain consumed greater amounts of opioids postoperatively, and this correlated with daily postoperative pain scores. Patients who screened positive for neuropathic pain also reported worse postoperative pain. CONCLUSION: Longitudinal perioperative pain assessment in head and neck patients undergoing surgery suggests that patients with worse preoperative pain continue to endorse worse pain postoperatively and require more narcotics. Patients with preoperative neuropathic pain also report poor pain control postoperatively, suggesting an opportunity to identify these patients and intervene with empiric neuropathic pain treatment.
[Mh] Termos MeSH primário: Dor do Câncer/fisiopatologia
Carcinoma de Células Escamosas/cirurgia
Neoplasias de Cabeça e Pescoço/cirurgia
Neuralgia/fisiopatologia
Procedimentos Cirúrgicos Otorrinolaringológicos
Dor Pós-Operatória/fisiopatologia
Neoplasias Cutâneas/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Ameloblastoma/complicações
Ameloblastoma/cirurgia
Analgésicos Opioides/uso terapêutico
Ansiedade/psicologia
Dor do Câncer/etiologia
Dor do Câncer/psicologia
Carcinoma Adenoide Cístico/complicações
Carcinoma Adenoide Cístico/cirurgia
Carcinoma de Células Escamosas/complicações
Depressão/psicologia
Feminino
Neoplasias de Cabeça e Pescoço/complicações
Seres Humanos
Modelos Lineares
Estudos Longitudinais
Masculino
Melanoma/complicações
Melanoma/secundário
Melanoma/cirurgia
Meia-Idade
Neuralgia/etiologia
Neuralgia/psicologia
Medição da Dor
Dor Pós-Operatória/tratamento farmacológico
Dor Pós-Operatória/epidemiologia
Dor Pós-Operatória/psicologia
Neoplasias Parotídeas/complicações
Neoplasias Parotídeas/cirurgia
Período Perioperatório
Período Pré-Operatório
Índice de Gravidade de Doença
Neoplasias Cutâneas/complicações
Neoplasias Cutâneas/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171121
[Lr] Data última revisão:
171121
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417723034


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[PMID]:28766959
[Au] Autor:Beswick DM; Messner AH; Hwang PH
[Ad] Endereço:1 Stanford University School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Stanford, California, USA.
[Ti] Título:Pediatric Chronic Rhinosinusitis Management in Rhinologists and Pediatric Otolaryngologists.
[So] Source:Ann Otol Rhinol Laryngol;126(9):634-639, 2017 Sep.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the management of pediatric chronic rhinosinusitis (PCRS) between members of the American Rhinologic Society (ARS) and the American Society of Pediatric Otolaryngology (ASPO). STUDY DESIGN: Comparison of surveys. METHODS: A web-based survey was distributed to ASPO membership twice in September-October 2016. Data were compared to previously published data from ARS membership in March-April 2016. RESULTS: ASPO survey completion rate was 22%. ARS members were more likely to employ oral steroids in initial ( P = .025) and maximal medical management ( P = .001). ASPO members more commonly performed adenoidectomy before computed tomography (CT) ( P < .001). Both groups commonly included adenoidectomy as part of initial surgical management (90% vs 94%, P = .316), while ASPO members more frequently performed adenoidectomy alone (70% vs 43%, P = .001). If initial surgical treatment failed, both groups commonly performed endoscopic sinus surgery (ESS; 81% vs 88%, P = .56) with a similar extent including frontal ( P ≥ .207) and sphenoid ( P ≥ .304) surgery. CONCLUSIONS: Pediatric chronic rhinosinusitis management is similar between groups, yet there are differences including oral steroid use, relative order of CT versus adenoidectomy, and performing concomitant procedures with adenoidectomy. Both groups commonly perform ESS with similar surgical extent if prior surgical treatment fails. Management by both groups is largely in agreement with published consensus statements.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Glucocorticoides/uso terapêutico
Antagonistas dos Receptores Histamínicos/uso terapêutico
Otorrinolaringologistas
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
Pediatras
Rinite/terapia
Sinusite/terapia
[Mh] Termos MeSH secundário: Adenoidectomia/métodos
Adenoidectomia/utilização
Administração Oral
Criança
Doença Crônica
Gerenciamento Clínico
Endoscopia
Seres Humanos
Sprays Nasais
Otolaringologia
Procedimentos Cirúrgicos Otorrinolaringológicos/utilização
Pediatria
Guias de Prática Clínica como Assunto
Padrões de Prática Médica
Rinite/diagnóstico por imagem
Sinusite/diagnóstico por imagem
Sociedades Médicas
Inquéritos e Questionários
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Glucocorticoids); 0 (Histamine Antagonists); 0 (Nasal Sprays)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417719717


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[PMID]:28675096
[Au] Autor:Cheng J; Liu B; Farjat AE; Jang DW
[Ad] Endereço:1 Pediatric Otolaryngology, Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
[Ti] Título:Adverse Events in Endoscopic Sinus Surgery for Infectious Orbital Complications of Sinusitis: 30-Day NSQIP Pediatric Outcomes.
[So] Source:Otolaryngol Head Neck Surg;157(4):716-721, 2017 Oct.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective Identify predictors of adverse events for children who underwent endoscopic sinus surgery for treatment of orbital complications associated with sinusitis. Study Design Cross-sectional analysis of a US national database. Setting American College of Surgeons National Surgical Quality Improvement Program (NSQIP), pediatric version (2012-2015). Subjects and Methods Patients were identified with a combination of codes from the International Classification of Diseases, Ninth Revision and 2014 Current Procedural Terminology. Our primary outcome measure was adverse events, which were compared with clinical risk factors to examine for any associations. Results A total of 57 patients were included for analysis. No significant relationship was identified between 30-day postoperative adverse events and age, sex, race, body mass index, prematurity, history of asthma, steroid use (within 30 days), and preoperative white blood cell count. There was a statistically significant increase in adverse events for those patients who underwent delayed surgery ( P < .0001). No serious adverse events related to death, sepsis, nerve injury (eg, visual loss), or other organ space infections (eg, intracranial infection) were identified. After controlling for age group and race, delayed operative intervention was a significant clinical predictor of adverse events (odds ratio = 25.65; 95% CI, 3.86-170.45; P = .0008). We observed unplanned reoperation and readmission rates of 5.3% and 7%, respectively. Conclusions Endoscopic surgical drainage for infectious orbital complications of sinusitis in children appears to be safe. Serious or significant adverse events were uncommon. Areas for improvement include limiting and reducing unplanned reoperations and readmissions.
[Mh] Termos MeSH primário: Endoscopia/efeitos adversos
Infecções Oculares Bacterianas/etiologia
Doenças Orbitárias/etiologia
Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos
Melhoria de Qualidade
Sinusite/cirurgia
Infecção da Ferida Cirúrgica/etiologia
[Mh] Termos MeSH secundário: Criança
Estudos Transversais
Infecções Oculares Bacterianas/epidemiologia
Feminino
Seguimentos
Inquéritos Epidemiológicos
Seres Humanos
Incidência
Masculino
Razão de Chances
Doenças Orbitárias/epidemiologia
Estudos Retrospectivos
Infecção da Ferida Cirúrgica/epidemiologia
Fatores de Tempo
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[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:170705
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817717675


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[PMID]:28670951
[Au] Autor:Yeo NK; Park WJ; Ryu IS; Lim HW; Song YJ
[Ad] Endereço:1 Department of Otorhinolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.
[Ti] Título:Is Facial or Head Pain Related to the Location of Lesions on Computed Tomography in Chronic Rhinosinusitis?
[So] Source:Ann Otol Rhinol Laryngol;126(8):589-596, 2017 Aug.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Facial or head pain is not an infrequent symptom among patients diagnosed with chronic rhinosinusitis (CRS), but few reports have investigated the pain in CRS, including the relationship between pain and sites of CRS. The aim of this study was to investigate whether pain is related to the location of lesions on computed tomography (CT) in CRS. METHODS: We analyzed 203 patients who underwent endoscopic sinus surgery (ESS) for 2 years. Patients were assessed using the questionnaires on pain, provided 1 day prior to the operation and 6 months post operation. Sites of CRS were evaluated using CT. We analyzed whether the degree of inflammation in each sinus had an effect on the location of pain. RESULTS: Seventy-eight patients (38.4%) had preoperative facial or head pain. There was no difference in the sinus inflammation scores in CT findings, based on the presence of pain. Pain was most commonly located in the periorbital area, followed by the frontal, vertex, occipital, and facial areas. No significant correlation was found between the sinuses and the location of pain. CONCLUSIONS: This study indicates that in CRS patients, several sites of pain are involved, particularly in the periorbital area; these sites were not found to be related to the location of CRS.
[Mh] Termos MeSH primário: Dor Facial/diagnóstico por imagem
Cefaleia/diagnóstico por imagem
Rinite/diagnóstico por imagem
Sinusite/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Doença Crônica
Endoscopia
Feminino
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Otorrinolaringológicos
Medição da Dor
Rinite/cirurgia
Sinusite/cirurgia
Inquéritos e Questionários
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417717268


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[PMID]:28608764
[Au] Autor:Ayoub N; Thamboo A; Hwang PH; Walgama ES
[Ad] Endereço:1 Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
[Ti] Título:Radioanatomic Study of the Greater Palatine Canal Relevant to Endoscopic Endonasal Surgical Landmarks.
[So] Source:Otolaryngol Head Neck Surg;157(4):731-736, 2017 Oct.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective A radioanatomic study of surgically relevant variations in the greater palatine canal (GPC) on computed tomography (CT) was performed to determine susceptibility during endoscopic endonasal procedures. Study Design Blinded radioanatomic analysis. Setting Tertiary university hospital. Subjects and Methods Fifty consecutive paranasal CT scans (100 sides) were analyzed. Measurements were standardized to landmarks such as the inferior turbinate (IT) and floor of the nasal cavity (FNC) to assess variability and vulnerability of the nerve. Measurements included (1) incidence of maxillary sinus pneumatization posterior to the GPC, (2) distance from the posterior wall of the maxillary sinus to the GPC at the IT and FNC, (3) width of bone containing the GPC, (4) incidence of medial GPC dehiscence, and (5) angle of the GPC extending from the IT to FNC. Results Ninety-one percent of maxillary sinuses were pneumatized posterior to the GPC. The distance from the posterior wall of the maxillary sinus to the GPC was 2.8 ± 1.7 mm (range, -2.3 to 5.9) at the posterior attachment of the IT and 4.1 ± 3.1 mm (range, -6.3 to 11.9) at the FNC. The width of bone containing the GPC was 3.3 ± 1.3 mm (range, 1-8.9), and the medial bony GPC was dehiscent in 38% of cases. In the sagittal plane, the angle of the GPC between the IT and the FNC was 31.9 ± 6.9 degrees (range, 10.8-45). Conclusion The GPC has considerable anatomic variability relative to important surgical landmarks in endoscopic procedures. Preoperative review of CTs to assess vulnerability may prevent postoperative complications.
[Mh] Termos MeSH primário: Pontos de Referência Anatômicos
Seio Maxilar/diagnóstico por imagem
Sinusite Maxilar/cirurgia
Cirurgia Endoscópica por Orifício Natural/métodos
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
Palato Duro/diagnóstico por imagem
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Seio Maxilar/cirurgia
Sinusite Maxilar/diagnóstico
Meia-Idade
Nariz
[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:170614
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817711883



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