ABSTRACT
O objetivo deste trabalho é relatar um caso de reconstrução nasal precoce em um paciente com síndrome do Warfarin fetal, onde um paciente de 23 dias com apresentava hipoplasia nasal isolada. O ganho ponderal estava estagnado e não havia possibilidade de introdução de sonda nasoentérica devido à deformidade. Foi realizada rinoplastia aberta com incisão transcolumelar. Dois enxertos de cartilagem tragal foram confeccionados e introduzidos na região da ponta, porção cranial do septo cartilaginoso e alares. O paciente apresentou melhoria da permeabilidade ventilatória, diminuição do ruído inspiratório, ganho de peso e também da forma. Após um ano de seguimento o resultado continuava satisfatório. Concluímos que a intervenção precoce é satisfatória e pode minimizar ou mesmo prevenir procedimentos futuros.
The aim of this work is to report a case of early nasal reconstruction in a 23-day-old patient with fetal Warfarin syndrome and isolated nasal hypoplasia. Weight gain was arrested and the deformity precluded the use of a nasogastric tube. An open rhinoplasty with transcolumellar incision was performed. Two grafts of tragal cartilage were made and introduced in the tip area, cranial portion of the cartilaginous septum, and alar cartilages. The patient presented improved ventilatory permeability, decrease of inspiratory noise, and weight and shape gains. At the one-year follow-up the result was still satisfactory. We concluded that early intervention is satisfactory and may minimize or even prevent future procedures.
Subject(s)
Humans , Abnormalities, Drug-Induced/genetics , Abnormalities, Drug-Induced/pathology , Rhinoplasty , Warfarin , Warfarin/adverse effects , Maxillofacial Abnormalities , Anticoagulants/adverse effects , Fetal Diseases/surgery , Fetal Diseases/genetics , Fetal Diseases/chemically induced , Prenatal Exposure Delayed Effects/surgery , Prenatal Exposure Delayed Effects/genetics , Prenatal Exposure Delayed Effects/chemically inducedABSTRACT
Several types of limb deformities were induced by vitamin A in B. melanostictus. These ranged from total suppression of all the limbs (ectromelia) to partial development of either the forelimb or the hindlimb or both (mesomelia) to reduction or absence of digits in either the forelimbs or hindlimbs or both and absence of long bones in either the forelimbs or hindlimbs or both (phocomelia) or duplication of the hindlimbs (polymelia). All the limb abnormalities were induced in the developing limbs of the tail amputated tadpoles of B. melanostictus following vitamin A treatment, which is all the more interesting. The results suggest that vitamin A induces the above mentioned abnormalities by either switching on or over-expressing or disrupting the limb-specific hox genes by yet unknown mechanisms.