ABSTRACT
Introduction: Focused lateral approach is widely accepted for the surgery of solitary parathyroid adenomas, because it is a minimally invasive approach and its aesthetic advantages. Notwithstanding, when the pathlogical gland is not easily recognized, this approach difficults the search and makes more susceptible for iatrogenic lesions. Sometimes, PTH levels do not decrease up to 75 percent of initial values 15 minutes after the gland resection; a smaller decreasement do not exelude that the pathological gland has been already resected. Case report: A 69-years old man underwent a minimally invasive parathyroidectomy. Surgical act is complex, because of a difficult identification of the gland. In the postoperative course, the patient developed a pharyngoesophageal fístula that was successfully managed with a conservative approach.
Introducción: El abordaje unilateral en la cirugía del adenoma solitario de paratiroides está ampliamente aceptado por sus ventajas estéticas y ser un procedimiento mínimamente invasivo. Sin embargo, cuando la glándula patológica no es fácilmente detectada, dificulta mucho su búsqueda y facilita la iatrogenia. En ocasiones, los niveles de PTH no descienden al 75 por ciento del valor inicial 15 minutos después de la paratiroidectomía; un descenso menor del 75 por ciento no excluye que la glándula patológica haya sido extirpada. Caso clínico: Varón de 69 años es sometido a paratiroidectomía a través de un abordaje mínimamente invasivo. La cirugía es compleja y prolongada al no identificarse fácilmente la glándula paratiroides. En el postoperatorio el paciente presenta una fístula faringoesofágica que se se maneja satisfactoriamente de forma conservadora.
Subject(s)
Humans , Male , Aged , Pharyngeal Diseases/etiology , Esophageal Fistula/etiology , Parathyroidectomy/adverse effects , Parathyroidectomy/methods , Drainage , Pharyngeal Diseases/therapy , Esophageal Fistula/therapy , Minimally Invasive Surgical Procedures/adverse effectsABSTRACT
We report a case of calcific tendinitis of the Longus Colli muscle. We reviewed the differencial diagnosis and performed a literature search. To our knowledge this is the first Chilean report on this unusual disease.
Nosotros reportamos un caso de Tendinitis cálcica del músculo Longus Colli. Se revisa la literatura y los diagnósticos diferenciales. Se trata de una enfermedad infrecuente, según nuestro conocimiento sería el primer caso reportado en la literatura chilena.
Subject(s)
Humans , Adult , Female , Calcinosis , Pharyngeal Diseases , Tendinopathy , Calcinosis/therapy , Diagnosis, Differential , Neck Pain/etiology , Pharyngeal Diseases/therapy , Tendinopathy/therapyABSTRACT
O refluxo gastro-esofágico (RGE) é definido como o fluxo retrógrado do conteúdo gástrico (ácido) ou biliar (alcalino) para o esôfago e apresenta-se, principalmente, com sintomas de queimação retro-esternal e regurgitação. Manifestações extra-esofágicas desse refluxo representam uma outra entidade, denominada doença do refluxo laringo-faríngeo (DRLF), e manifesta-se com alterações faríngeas, laríngeas e orais. O esofagograma, a pH-metria, a laringoscopia flexível e a endoscopia digestiva alta (EDA) são considerados os principais exames para o diagnóstico do RLF, cada um com suas vantagens e desvantagens e nenhum com 100% de acurácia isoladamente. O objetivo do tratamento da DRLF é o desaparecimento dos sintomas e a cicatrização das lesões laríngeas, que é realizado com a supressão ácida. Devido às semelhanças entre a DRLF e DRGE, o tratamento clínico baseia-se nos mesmos fundamentos: a instituição de medidas comportamentais e a administração de medicamentos que visam a supressão ácida.
Gastroesophageal reflux has been defined as the retrogradeflow of gastric contents into the esophagus and presents withclassic symptoms of heartburn and regurgitation. Extraesophageal symptoms of this reflux represent another disease named laryngopharyngeal reflux, presenting with laryngeal, pharyngeal and oral manifestations. The diagnosticmodalities frequently used to test for laryngopharyngeal refluxinclude esophagogram, ambulatory pH probe monitoring, flexible laryngoscopy, and upper endoscopy. Each examinationhas its advantages and disadvantages and none offer 100% accuracy. The purpose of the treatment is complete resolution of the symptoms and healing of the laryngeal damage, with isobtained with acid suppression. The standart treatment for laryngopharyngeal reflux is directed at lifestyle, behavioral anddietary modifications and proton pump inhibitors.
Subject(s)
Humans , Laryngeal Diseases/diagnosis , Laryngeal Diseases/therapy , Pharyngeal Diseases/diagnosis , Pharyngeal Diseases/therapy , Hypopharynx , Laryngitis , Otorhinolaryngologic Diseases , Gastroesophageal Reflux/pathology , Gastroesophageal Reflux/therapyABSTRACT
EL síndrome de Eagle es un trastorno causado por la elongación del proceso estiloides o calcificación del ligamento estilohioide de cuerpo extraño, disfagia u odinofagia. El diagnóstico se puede hacer al examen físico con la palpación del proceo estiloides en la fosa amigdalina, provocando dolor o exacerbación de este. Presentamos el caso de un paciente masculino de 54 años con cuadro de sensación de cuerpo extraño seguido por dolor en faringe, que al examen físico presentaba leve dolor a la palpación en región submandibular izquierda. El estudio de laringoscopía endoscópica fue normal, y estudio de TAC helicoidal de cuello demostró proceso estiloides izquierdo elongado. El paciente mejoró con tratamiento medicamentoso. Los autores informan el primer caso de Síndrome de Eagle en la literatura Hondureña
Subject(s)
Pharynx , Pharyngeal Diseases/diagnosis , Pharyngeal Diseases/pathology , Pharyngeal Diseases/therapy , Deglutition Disorders/diagnosis , Deglutition Disorders , Deglutition Disorders/therapy , Foreign Bodies , Foreign Bodies/diagnosis , Foreign Bodies/therapyABSTRACT
As tonsilites säo doenças freqüêntes, principalmente na faixa etária pediátrica, e muitas vezes geram dúvidas diagnósticas.Esta revisäo tem como objetivo classificar as tonsilites quanto à sua etiopatogenia, basendo-se no quadro clínico e achados de exame físico, permitindo, assim, Diagnóstico e tratamento específicos para cada caso.(au)
Subject(s)
Humans , Pharyngeal Diseases/classification , Pharyngeal Diseases/diagnosis , Pharyngeal Diseases/etiology , Pharyngeal Diseases/pathology , Pharyngeal Diseases/therapy , Ludwig's AnginaABSTRACT
Se realizó un estudio abierto para evaluar la eficacia y tolerabilidad de levofloxacina a dosis de 500 mg oral cada 24 horas por siete días, en el tratamiento de faringoamigdalitis aguda en 50 pacientes. Se evaluaron clínica y microbiológicamente antes y después del tratamiento. Se encontraron diferencias estadísticamente significativas entre las evaluaciones inicial y final de signos y síntomas relacionados con la infección aguda, y en la temperatura inicial y final. En la evaluación microbiológica se observó cultivo inicial positivo (germen patógeno identificado) en 35 pacientes, y cultivo final positivo en dos pacientes lo que indica 94.2 por ciento de eficacia bacteriológica. Se evaluó como curación a 44 (83 por ciento) pacientes (sin síntomas ni signos, cultivo negativo) y mejoría (disminución de signos y síntomas, cultivo positivo o negativo) en seis pacientes (12 por ciento). No se observaron efectos adversos, lo que indica 100 por ciento de tolerabidad. Por tanto, se concluye que la levofloxacina es una quinolona eficaz y segura para el tratamiento de faringoamigdalitis aguda en adultos, y una nueva herramienta contra patógenos de las vías respiratorias
Subject(s)
Humans , Male , Female , Adult , Culture Media , Culture Media/analysis , Diagnosis, Differential , Drug Tolerance , Pharyngeal Diseases/microbiology , Pharyngeal Diseases/therapy , Epidemiology, Descriptive , Longitudinal Studies , Ofloxacin/administration & dosage , Ofloxacin/therapeutic use , Pharyngitis/diagnosis , Pharyngitis/therapy , Prospective Studies , Signs and Symptoms , Tonsillitis/diagnosis , Tonsillitis/therapy , Treatment OutcomeABSTRACT
Realizamos uma revisäo sobre as principais doenças granulomatosas que podem acometer a laringe, devido à grande ocorrência dessas afecçöes no Brasil e em outros países de clima tropical e subtropical. Ressaltamos os aspectos histopatológicos para o seu diagnóstico, assim como o seu tratamento.
Subject(s)
Humans , Actinomycosis/physiopathology , Amyloidosis/physiopathology , Blastomycosis/physiopathology , Pharyngeal Diseases/physiopathology , Granulomatosis with Polyangiitis/physiopathology , Leprosy/physiopathology , Histoplasmosis/physiopathology , Leishmaniasis/physiopathology , Rhinoscleroma/physiopathology , Sarcoidosis/physiopathology , Syphilis/physiopathology , Tuberculosis/physiopathology , Actinomycosis/diagnosis , Actinomycosis/drug therapy , Amyloidosis/diagnosis , Amyloidosis/therapy , Blastomycosis/diagnosis , Blastomycosis/drug therapy , Pharyngeal Diseases/diagnosis , Pharyngeal Diseases/drug therapy , Pharyngeal Diseases/therapy , Granulomatosis with Polyangiitis/diagnosis , Granulomatosis with Polyangiitis/drug therapy , Leprosy/diagnosis , Leprosy/drug therapy , Histoplasmosis/diagnosis , Histoplasmosis/drug therapy , Leishmaniasis/diagnosis , Leishmaniasis/drug therapy , Rhinoscleroma/diagnosis , Rhinoscleroma/drug therapy , Sarcoidosis/diagnosis , Sarcoidosis/drug therapy , Syphilis/diagnosis , Syphilis/drug therapy , Tuberculosis/diagnosis , Tuberculosis/drug therapySubject(s)
Actinomycosis/diagnosis , Actinomycosis/physiopathology , Actinomycosis/drug therapy , Amyloidosis/diagnosis , Amyloidosis/physiopathology , Amyloidosis/drug therapy , Blastomycosis/diagnosis , Blastomycosis/physiopathology , Blastomycosis/drug therapy , Pharyngeal Diseases/diagnosis , Pharyngeal Diseases/physiopathology , Pharyngeal Diseases/therapy , Pharyngeal Diseases/drug therapy , Granulomatosis with Polyangiitis/diagnosis , Granulomatosis with Polyangiitis/physiopathology , Granulomatosis with Polyangiitis/drug therapy , Leprosy/diagnosis , Leprosy/physiopathology , Leprosy/drug therapy , Histoplasmosis/diagnosis , Histoplasmosis/physiopathology , Histoplasmosis/drug therapy , Leishmaniasis/diagnosis , Leishmaniasis/physiopathology , Leishmaniasis/drug therapy , Rhinoscleroma/diagnosis , Rhinoscleroma/physiopathology , Rhinoscleroma/drug therapy , Sarcoidosis/diagnosis , Sarcoidosis/physiopathology , Sarcoidosis/drug therapy , Syphilis/diagnosis , Syphilis/physiopathology , Syphilis/drug therapy , Tuberculosis/diagnosis , Tuberculosis/physiopathology , Tuberculosis/drug therapyABSTRACT
Este artigo apresenta as emergências mais comuns em vias aéreas superiores, bem como seus tratamentos e opções terapêuticas
Subject(s)
Humans , Laryngeal Diseases/therapy , Pharyngeal Diseases/therapy , EmergenciesABSTRACT
Intractable pharyngeal haemorrhage as a result of trauma or neoplastic erosion of a blood vessel in the neck is sometimes difficult to control. Considering the fact that the management has to be tailored according to the prevailing circumstances, surgical airway is established by tracheostomy using midline incision and then pharynx is packed with roll gauze using McIntosh Laryngoscope and McGill Forceps. The pack is left in the pharynx until proximal or distal control has been achieved. Decannulation is done after physiological, airways are normal. This method has been successfully used in two patients