Effect of application of fibrin glue on vocal fold healing after surgical manipulation in rabbits / Efeito da aplicação de cola de fibrina na cicatrização de pregas vocais após manipulação cirúrgica em coelhos

Abstract Introduction A challenge in phonosurgery is achieving good vocal quality with minimal vocal fold fibrosis. Fibrin glue can be applied to minimize fibrosis; however, its use in the larynx is based primarily on clinical experience, particularly in extensive lesions. Objective The objective of this study was to evaluate the effect of application of fibrin glue on collagen concentration at the late phase of the healing process after detaching a pedicled flap of the vocal fold cover in rabbits. Methods In this prospective animal study, twelve adult male rabbits underwent laryngeal microsurgery, in which an incision was made along the entire length of both vocal folds, followed by extensive mucosal detachment and section of the incision ends. Fibrin glue was applied in the left vocal fold, and the mucosa was repositioned. In the right vocal fold, the mucosa was repositioned without treatment with fibrin glue. After 3-months, the rabbits were euthanized. Histological analyses were performed, and the data collected were subjected to statistical analysis. Results Vocal folds treated with fibrin glue presented higher collagen concentration in Masson trichrome staining and significantly higher (p< 0.05) collagen concentration in picrosirius red staining compared to control vocal folds. Conclusion Treatment with fibrin glue led to greater vocal fold fibrogenesis in the present study. Nonetheless, further studies are necessary to determine the prophylactic effect of sealants in laryngeal surgeries that require extensive detachment of the vocal fold cover.

Resumo Introdução Um desafio na fonocirurgia é conseguir uma boa qualidade vocal com o mínimo de fibrose das pregas vocais. A cola de fibrina pode ser aplicada para minimizar a fibrose; porém, seu uso na laringe é baseado principalmente na experiência clínica, particularmente em lesões extensas. Objetivo Avaliar o efeito da aplicação da cola de fibrina na concentração de colágeno na fase tardia do processo de cicatrização, após o descolamento do retalho pediculado da cobertura da prega vocal em coelhos. Método Neste estudo prospectivo com animais, 12 coelhos adultos machos foram submetidos à microcirurgia de laringe, na qual uma incisão foi feita em toda a extensão de ambas as pregas vocais, seguida de extenso descolamento da mucosa e secção das extremidades da incisão. A cola de fibrina foi aplicada na prega vocal esquerda e a mucosa foi reposicionada. Na prega vocal direita, a mucosa foi reposicionada sem tratamento com cola de fibrina. Após três meses, os coelhos foram sacrificados. Análises histológicas foram feitas e os dados coletados foram submetidos à análise estatística. Resultados As pregas vocais tratadas com cola de fibrina apresentaram maior concentração de colágeno na coloração tricrômica de Masson e concentração significativamente maior de colágeno (p < 0,05) na coloração com picrosirius red comparadas às pregas vocais controle. Conclusão O tratamento com cola de fibrina resultou em maior fibrogênese das pregas vocais no presente estudo. Contudo, novos estudos são necessários para determinar o efeito profilático dos selantes em cirurgias de laringe que requerem extenso descolamento da cobertura das pregas vocais.

Extramedullary nasal plasmacytoma: literature review and a rare case report

INTRODUCTION: Extramedullary plasmacytoma is a plasma cell tumor that grows within any of the soft tissues of the organism. Similar to all plasmacytic dyscrasia, the disease is extremely rare. AIM: This study reports a case of an extramedullary plasmacytoma of the nasal cavity and provides a literature review on the topic. CASE REPORT: A 51-year-old woman presented at our tertiary university hospital with a 6-month history of progressive nasal obstruction, predominantly to the right side, and self-limiting epistaxis. Examination revealed a large pale-reddish tumor within the right nasal cavity. Anatomopathological analysis showed features consistent with a plasmacytoma diagnosis, which was subsequently confirmed by immunohistochemical techniques. Further assessment revealed the solitary nature of the condition, consistent with extramedullary plasmacytoma. Radiotherapy was initiated, which led to partial regression of the symptoms. The tumor was surgically removed by using a mid-facial degloving approach. The patient evolved with a naso-oral fistula and underwent 3 corrective surgeries. No evidence of associated systemic disease was found after 5 years of follow-up. CONCLUSIONS: This case report, which describes a rare tumor of the nasal cavity, is expected to improve the recognition and referral of this condition by ear, nose, and throat (ENT) specialists for multidisciplinary management and long-term follow-up.

Avaliação do desempenho intelectual e escolar de crianças submetidas à tonsilectomia e adenoamigdalectomia no pré e pós-operatório / Intellectual and school performance evaluation of children submitted to tonsillectomy and adenotonsillectomy before and after surgery

Vários estudos demonstram o impacto dos distúrbios obstrutivos do sono na qualidade de vida de crianças. No entanto, poucos tratam do desempenho escolar e intelectual em crianças que passaram por tonsilectomia ou adenoamigdalectomia, indicando benefícios destas cirurgias. OBJETIVO: Avaliar e comparar o desempenho intelectual e de aprendizado de crianças submetidas a cirurgias de tonsilectomia ou adenoamigdalectomia no pré e pós-operatório. MATERIAL E MÉTODO: Por meio de um estudo longitudinal e descritivo, 83 crianças entre 7 e 11 anos foram avaliadas pela Psicologia no pré e pós-operatório. A primeira avaliação ocorreu antes da cirurgia, a segunda e a terceira avaliações ocorreram com um e seis meses após esta. Foram utilizados Ficha Sociodemográfica, Teste das Matrizes Progressivas Coloridas de Raven e o Teste de Desempenho Escolar. RESULTADOS: O grupo de crianças do estudo apresentou evolução estatisticamente significante nas avaliações de desempenho intelectual (p < 0,05) e também nas avaliações de desempenho escolar nos subtestes escrita, aritmética e leitura (p < 0,001) ao longo do tempo. CONCLUSÃO: Baseados em nossas descobertas, concluímos que a tonsilectomia ou adenoamigdalectomia realizadas em crianças com distúrbios respiratórios obstrutivos produzem impacto positivo no desenvolvimento da aprendizagem escolar e intelectual.

Several studies have demonstrated the impact of obstructive sleep disorders on the quality of life of children. However, few studies address school and intellectual performances of children who have undergone tonsillectomy or adenotonsillectomy, indicating the benefits of these surgeries. OBJECTIVE: To evaluate and compare the learning and intellectual performances of children submitted to tonsillectomy or adenotonsillectomy, before and after surgery. MATERIALS AND METHODS: 83 children between the ages of 7 and 11 were evaluated by a psychologist employing a longitudinal and descriptive study in the pre and post-surgery groups. The first evaluation was performed just before surgery, and the second and third evaluations one and six months after the surgical procedure. The social-demographic form, Raven's Colored Progressive Matrices Test and the School Performance Test were used. RESULTS: The group of children in this study presented a statistically significant evolution in their intellectual performance evaluations (p < 0.05) and also school performance evaluations in writing, mathematics and reading sub-tests (p < 0.001). CONCLUSION: Based on our findings we concluded that tonsillectomy or adenotonsillectomy performed in children with obstructive respiratory disorders produce a positive impact on intellectual and school learning development.