ABSTRACT
Abstract Objective: The present study aimed to perform a morphological and morphometric analysis of cochlear structures of C57BL/6J mice receiving oral melatonin for a 12-month period. Methods: 32 male C57BL/6J were divided into control and melatonin groups. Control received saline and ethanol solution and melatonin group, 50 μL of 10 mg of melatonin/kg/day orally for a 12-month period. After de experiment the animals were sacrificed into a 40% concentration of CO2 chamber, and the blades were morphological and morphometrically analyzed. Results: The melatonin group revealed a higher median density of viable cells (45 ± 10.28 cells/100 μm2, 31-73, vs. 32 ± 7.47 cells/100 μm2, 25-48). The median area of stria vascularis was 55.0 ± 12.27 cells/100 μm2 (38-80) in the control, and 59.0 ± 16.13 cells/100 μm2 (40-134) in the melatonin group. The morphometric analysis of the spiral ligament reveals a higher median of total viable neurons in the melatonin (41 ± 7.47 cells/100 μm2, 27-60) than in the control group (31 ± 5.68 cells/100 μm2, 21-44). Conclusion: Although melatonin is a potent antioxidant, it does not completely neutralize the occurrence of presbycusis; however, it may delay the onset of this condition. Level of evidence: 3.
ABSTRACT
Abstract Introduction: Endoscopic access to the sellar region by videoendoscopy shows a low rate of surgical complications, with findings that indicate risk factors for reducing morbidities during and after the postoperative period. Objective: To evaluate, over a nine-year period, the acquisition of skills by the anterior skull base surgical team, according to the time of elimination of nasal crusts and/or the presence of morbidities in the postoperative follow-up of individuals treated in a tertiary public hospital. Methods: After confirming the diagnosis of skull base pathologies, the individuals in this study underwent endoscopic surgery according to the rostrocaudal or coronal axis. For the skull base reconstruction, the nasoseptal flap (associated or not with fascia lata with thigh fat) or free graft was used; clinical follow-up of individuals occurred for a minimum period of 12 months. To assess the impact of the surgical approach on patient clinical evolution, qualitative data related to smoking, post-nasal discharge, nasal flow, smell, taste, clinical symptoms of headache, cranial paresthesia, comorbidities and postoperative morbidities were obtained. Results: The most frequent diagnosis was pituitary macroadenoma (84.14%). The mean absence of crusts in this cohort was 124.45 days (confidence interval 95% = 119.50-129.39). There was a low cerebrospinal fluid fistula rate (3%). Reconstruction with the nasoseptal flap with a fat graft was an independent variable that recorded the highest mean time for the elimination of nasal crusts (=145 days, confidence interval 95% = 127.32-162.68). Allergic rhinitis and smoking were shown to be the most important and independent variables that increased the mean time to eliminate nasal crusts. Conclusion: The mean time to eliminate nasal crusts did not change over the years during which the procedures were performed, demonstrating the adequate training of the surgical team. Debridement and nasal irrigation with saline solutions should be performed more frequently and effectively in patients with allergic rhinitis, smokers and those who received the nasoseptal flap and fascia lata graft with autologous fat.
Resumo Introdução: O acesso endoscópico à região selar por videoendoscopia demonstra baixo índice de complicações cirúrgicas, com achados que apontam fatores risco para reduzir as morbidades durante e após o período pósoperatório. Objetivo: Avaliar fatores morbidades no seguimento pós-operatório de indivíduos atendidos em um hospital público terciário. Método: Depois de confirmado o diagnóstico de doenças da base do crânio, os indivíduos deste estudo foram submetidos a cirurgia endoscópica conforme o eixo rostrocaudal ou coronal. Para a reconstrução da base do crânio usava-se o retalho nasoseptal (associado ou não à fáscia lata com gordura de coxa) ou enxerto livre; o seguimento clínico dos indivíduos ocorreu por um período mínimo de 12 meses. Para avaliar o impacto da abordagem cirúrgica na evolução clínica dos pacientes foram obtidos os dados qualitativos relativos ao tabagismo, descarga pós-nasal, fluxo nasal, olfato, paladar, sintomas clínicos de dor de cabeça, parestesia craniana, comorbidades e morbidades pós-operatórias. Resultados: O diagnóstico mais frequente foi o macroadenoma hipofisário (84,14%). A média da ausência de crostas nesta coorte foi de 124,45 dias (intervalo de confiança [95% CI] 119,50-129,39). Baixo índice de fístula liquórica (3%). A reconstrução com o retalho nasoseptal com enxerto de gordura apresentou-se com variável independente que necessitou de maior tempo médio para a eliminação de crostas nasais (=145 dias, 95% CI 127,32-162,68). A rinite alérgica e o tabagismo se demonstraram como as variáveis mais importantes e independentes para aumentar o tempo médio de eliminação de crostas nasais. Conclusão: O tempo médio de eliminação de crostas nasais não se alterou ao longo dos anos em que os procedimentos foram feitos. Deve-se fazer com maior frequência e eficácia o debridamento e as irrigações nasais com soluções salinas nos pacientes com rinite alérgica, tabagistas e os que usaram o retalho nasoseptal e enxerto de fáscia lata com gordura autóloga.