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1.
Arch. argent. pediatr ; 119(1): e36-e40, feb. 2021. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1147255

ABSTRACT

El hemangioma fusocelular es una neoplasia vascular benigna infrecuente. Afecta la dermis y la hipodermis de la parte distal de las extremidades; la afectación de la cabeza y el cuello es muy poco frecuente y nunca se informó compromiso de los senos paranasales. Este es el caso de un lactante de 4 meses con obstrucción nasal desde las 2 semanas debido a un tumor en los senos etmoidales que obstruía las fosas nasales. Se diagnosticó hemangioma fusocelular y se extirpó parcialmente el tumor. A los seis meses de seguimiento, se observó una regresión mínima con lesiones residuales. A los 30 meses, se observó que el tumor residual había desaparecido. El hemangioma fusocelular es infrecuente en cabeza y cuello y, a veces, la presentación no es indicativa del diagnóstico. El examen histopatológico ayuda con el diagnóstico diferencial y el tratamiento. La sensibilización sobre el hemangioma fusocelular podría aumentar los casos informados.


Spindle cell hemangioma (SCH) is a benign unusual vascular neoplasm. It does not have gender predilection and can occur at all ages. The disease affects dermis and subcutis of distal extremities predominantly; head and neck involvement is very rare, paranasal sinus involvement has not been reported before. Herein we present a 4-month-old infant with nasal obstruction since two weeks of age due to a mass in ethmoid sinus obliterating the nasal passage. After the histopathological diagnosis of SCH, the tumor was partially resected. In the sixth month follow-up, there was minimal regression of residual lesions. In the imaging studies performed 30 months after the surgery, the residual mass was found to be disappeared. SCH is not frequent in the head and neck, and presentation of some patients may not suggest the diagnosis. Histopathology is important for differential diagnosis and to orientate treatment. Awareness of SCH may increase the reported cases


Subject(s)
Humans , Male , Infant , Paranasal Sinuses , Head and Neck Neoplasms/surgery , Hemangioma/diagnosis , Nasal Obstruction
2.
Autops. Case Rep ; 11: e2020207, 2021. graf
Article in English | LILACS | ID: biblio-1142399

ABSTRACT

Renal cell carcinoma (RCC) is a malignant disease that is often diagnosed at a metastatic stage. The head and neck represent up to 3% of the metastatic RCC, and the paranasal sinus area is one of the least involved sites. Here, we introduce the case of a 74-year-old female patient who presented with a history of traumatic nasal bleed. A cranial computed tomography scan and magnetic resonance imaging showed a fronto-ethmoidal mass with pachymeningeal involvement. A nasal biopsy from the paranasal sinuses was taken. On histopathological examination, metastatic clear cell carcinoma was the main hypothesis, which later was confirmed to be RCC on immunohistochemistry. On further radiological examination, an exophytic mass was depicted in the kidney's upper and middle pole. The patient had no renal complaints and was asymptomatic. Fronto-ethmoidal sinus is a rare site for metastatic RCC, especially in cases where the patient is asymptomatic. Early detection by keeping RCC metastasis as the differential diagnosis in such cases can lead to early treatment and improve the overall survival of the patient.


Subject(s)
Humans , Female , Aged , Paranasal Sinuses , Carcinoma, Renal Cell/complications , Kidney Neoplasms/pathology , Epistaxis/pathology , Diagnosis, Differential
3.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(3): 297-306, set. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144893

ABSTRACT

Resumen La mucormicosis rino-órbito-cerebral (ROC) crónica es una patología poco frecuente, con un número reducido de casos publicados en la literatura, cuyas manifestaciones son muy diversas e inespecíficas. El tratamiento se basa en la experiencia de casos y series de casos. Las herramientas terapéuticas incluyen el uso de antifúngicos endovenosos y orales por tiempo prolongado, asociado o no a debridamiento quirúrgico amplio, pudiendo requerir incluso exenteración orbitaria. Presentamos a continuación un caso de mucormicosis ROC crónica, junto con las dificultades para su diagnóstico y manejo, en el que destaca el enfrentamiento multidisciplinario. Dada la poca frecuencia de esta enfermedad, nos parece relevante difundirlo.


Abstract Chronic rhino-orbital-cerebral mucormycosis is a rare condition with a small number of cases that have been published, whose manifestations are very diverse and nonspecific. The treatment is based on case series experiences. Therapeutic options include the use of long-term intravenous and oral antifungals, associated or not with extensive surgical debridement, and may even require orbital exenteration. We present below a case of chronic rhino-orbital-cerebral mucormycosis with the challenge of diagnosis and management in which multidisciplinary work is fundamental. Since it is an uncommon pathology, it seems relevant to share the information.


Subject(s)
Humans , Female , Middle Aged , Brain Diseases/diagnosis , Eye Diseases/diagnosis , Mucormycosis/surgery , Mucormycosis/diagnostic imaging , Orbital Diseases , Paranasal Sinuses/pathology , Exophthalmos , Orbit Evisceration , Diagnosis, Differential , Orbital Cellulitis/diagnostic imaging , Kidney Failure, Chronic/complications , Mucormycosis/drug therapy , Antifungal Agents
4.
Pesqui. vet. bras ; 40(8): 621-629, Aug. 2020. tab, ilus
Article in English | ID: biblio-1135666

ABSTRACT

This study aimed to quantify nasosinusal neoplasms diagnosed in dogs in 20 years (2000-2019) and characterize the main clinical, macroscopic, and histological aspects of these neoplasms. The sex, breed, age, skull conformation, the main clinical signs, and the anatomopathological characteristics (distribution, macroscopy, and histology) were computed. During this period, 49 dogs were affected by neoplasms in these regions, totaling 50 neoplasms (one dog had two neoplasms of different locations and histogenetic origins). Similar amounts of mixed-breed dogs (25/49) and purebred dogs (24/49) were affected, these distributed in 16 breeds. Among purebreds, it was noted that dogs with mesocephalic cranial conformation (12/24) were the most affected, followed by dolichocephalic (10/24) and brachycephalic (2/24). There were 22 cases in males and 27 in females, making a proportion of 1:1.23. There was an age variation from 11 months to 16 years old. The epithelial neoplasms have occurred in older dogs compared to those of other histogenic origins (mesenchymal and other origins/round cells). The main clinical signs were similar between the histogenetic categories, related to the involvement of the upper respiratory tract, sometimes accompanied by nervous signs (when there was brain invasion of nasal neoplasms or vice versa). The possible origin site was mostly in the nasal cavity concerning the paranasal sinuses (and other locations). Invasions occurred in different tissues adjacent to the nasal cavity and paranasal sinuses, resulting in cranial and facial deformities (21/49). The frequency was 48% of epithelial neoplasms, 32% of mesenchymal neoplasms, and 10% of neoplasms with other origins and round cells. The neoplasms most frequently observed, in decreasing order of frequency, were: adenocarcinoma (9/50), squamous cell carcinoma (9/50), transmissible venereal tumor (5/50), osteosarcoma (5/50), chondrosarcoma (4/50), and undifferentiated sarcoma (4/50). Through this study, it was possible to establish the frequency of these neoplasms in 20 years and their clinical, macroscopic, and histological characteristics.(AU)


Este estudo teve como objetivo quantificar os neoplasmas nasossinusais diagnosticados em cães em 20 anos (2000-2019) e caracterizar os principais aspectos clínicos, macroscópicos e histológicos desses neoplasmas. Foram computados sexo, raça, idade, conformação do crânio, principais sinais clínicos e características anatomopatológicas (distribuição, macroscopia e histologia). Nesse período, 49 cães foram acometidos por neoplasmas nessas regiões, totalizando 50 neoplasmas (um cão tinha dois neoplasmas de localização e origens histogenéticas distintas). Foram acometidas quantidades semelhantes de cães sem raça definida (25/49) e de cães com raça definida (24/49), estes distribuídos em 16 raças. Entre os cães com raça definida, notou-se que os cães com conformação craniana mesocefálica (12/24) foram os mais acometidos, seguidos pelos dolicocefálicos (10/24) e braquicefálicos (2/24). Foram observados 22 casos em machos e 27 em fêmeas, perfazendo a relação de 1:1,23. Ocorreu uma variação de idade de 11 meses a 16 anos; tendo os neoplasmas epiteliais ocorrido em cães mais velhos quando comparado aos de outras origens histogênicas (mesenquimais e outras origens/células redondas). Os principais sinais clínicos foram semelhantes entre as categorias histogenéticas, sendo relacionados ao comprometimento do trato respiratório superior, por vezes acompanhados de sinais nervosos (quando houve invasão encefálica de neoplasmas nasais ou vice-versa). O possível local de origem em sua maioria foi na cavidade nasal em relação aos seios nasais (e de outras localizações). Ocorreram invasões para diferentes tecidos adjacentes à cavidade nasal e seios paranasais, tendo como consequência deformidades cranianas e faciais (21/49). A frequência foi de 48% de neoplasmas epiteliais, 32% de neoplasmas mesenquimais e 10% de neoplasmas com outras origens e de células redondas. Os neoplasmas mais frequentemente observados, em ordem decrescente de frequência, foram: adenocarcinoma (9/50), carcinoma de células escamosas (9/50), tumor venéreo transmissível (5/50), osteossarcoma (5/50), condrossarcoma (4/50) e sarcoma indiferenciado (4/50). Com isso, pode-se estabelecer a frequência desses neoplasmas em 20 anos, bem como suas características clínicas, macroscópicas e histológicas.(AU)


Subject(s)
Animals , Dogs , Paranasal Sinuses/pathology , Paranasal Sinus Neoplasms/veterinary , Paranasal Sinus Neoplasms/epidemiology , Nose Neoplasms/pathology , Nose Neoplasms/veterinary , Nose Neoplasms/epidemiology , Dog Diseases/epidemiology , Nasal Cavity , Carcinoma/veterinary
6.
Rev. bras. cir. plást ; 35(2): 258-259, apr.-jun. 2020.
Article in English, Portuguese | LILACS | ID: biblio-1103844

ABSTRACT

Introdução: O aumento da projeção da ponta nasal às vezes se torna necessário para a obtenção de uma boa proporção entre ela e o dorso. Inúmeras técnicas e táticas são descritas com essa finalidade utilizando enxertos cartilaginosos obtidos do septo nasal, concha auricular e cartilagem costal. Quando esse aumento deve ser discreto é proposto o uso dos excedentes de cartilagens alares laterais em forma de "pseudo-retalhos". Métodos: Em rinoplastias abertas primárias os excedentes das cartilagens alares, geralmente removidas, são utilizados como "pseudo-retalhos", dobrados sobre si mesmos, em forma de "suspensório de soldado francês", sobre o domus das cartilagens alares, tendo como acolchoamento de apoio os tecidos moles delas próprias, e o tecido mole interdomal, geralmente desprezado, que é liberado, e elevado para sobre os domus. Ele é mantido, descolado e deslocado para a ponta nasal, e fica contido pelos "pseudo-retalhos" das cartilagens alares ali suturados ou cobrindo o extremo do enxerto estrutural da columela. Foram operados com essa tática 36 pacientes. Resultados: 35 com bons resultados e um apresentou um abcesso de ponta nasal, provocado pela exposição endonasal de um fio de sutura não absorvível, que foi removido. Houve necessidade de uma segunda intervenção, utilizando novo enxerto auricular, ainda com resultado insatisfatório. O método é relativamente simples para quem opera narizes. Conclusão: A ponta nasal pode ser discretamente mais projetada utilizando os excessos de cartilagens alares, "pediculadas" no domus.


Introduction: An increased nasal tip projection is sometimes necessary to achieve an appropriate proportion between nasal tip and dorsum. Numerous techniques and tactics have been described for this purpose using cartilaginous grafts obtained from the nasal septum, auricular concha, and costal cartilage. When this increased projection must be discrete, the use of excess lateral alar cartilage in the form of "pseudo-flaps" is proposed. Methods: In primary open rhinoplasty, excess alar cartilage, which is generally removed, was used to produce "pseudo-flaps". The cartilages were folded over themselves in the form of a "French soldier's suspender" over the domes of the alar cartilage and supported by interdomal soft tissue padding raised over the domus. It was kept detached, and relocated to the nasal tip and was contained by "pseudoflaps" of the alar cartilages sutured there or covering the columella's structural graft. Thirty-six patients underwent surgery using this technique. Results: Thirty-five had good results and one had a nasal tip abscess, caused by endonasal exposure to a non-absorbable suture, which was removed. A second intervention was then performed using a new auricular graft, but the result was still unsatisfactory. The "pseudoflaps" method is relatively simple for those performing nasal surgery. Conclusion: The nasal tip can be projected discretely using the excess of alar cartilage "pedicled" in the domus.


Subject(s)
Humans , Male , Female , Middle Aged , History, 21st Century , Paranasal Sinuses , Rhinoplasty , Case Reports , Nose , Retrospective Studies , Evaluation Study , Nasal Cartilages , Nasal Mucosa , Paranasal Sinuses/surgery , Rhinoplasty/adverse effects , Rhinoplasty/methods , Nose/surgery , Nasal Cartilages/surgery , Nasal Mucosa/surgery
7.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 376-382, May-June 2020. graf
Article in English | LILACS | ID: biblio-1132586

ABSTRACT

Abstract Introduction: Packing of the nasal cavity has traditionally been used for postoperative bleeding control and decreasing synechia formation in patients undergoing nasal surgeries. Although absorbable nasal packing has been gaining popularity in the recent years, nonabsorbable nasal packing is still often used in nasal surgeries in various parts of the world. It is known to be associated with pain and discomfort especially upon and during removal, and previous reviews have only evaluated the effects of local anesthetic infiltration of nasal packing in septal surgeries. Objective: To evaluate the effect of infiltrating nasal packing with local anesthetics in postoperative pain and anxiety following sinonasal surgeries Materials and methods: We searched the PubMed and Embase databases from their earliest record to April 27, 2019, randomized controlled trials and prospective controlled trials for review, and included only randomized controlled trials for data analysis. We included studies using topical anesthetics-infiltrated nasal packing following sinonasal surgeries and evaluated the effectiveness compared to placebo packing in pain reduction during postoperative follow up, as well as the effectiveness in anxiety reduction. Results: Among 15 studies included for review, 9 studies involving 765 participants contributed to the meta-analysis. In terms of pain reduction, our analysis showed significant standard mean differences regarding effectiveness at postoperative 1, 12, 24 h interval for all surgical groups combined, in the sinus surgery group, as well as during nasal packing removal. There was no consistent evidence to support the effectiveness in anxiety reduction. Conclusions: Our study supports anesthetics infiltration of nasal packing as an effective method in managing pain in patients with nasal packing after sinonasal surgeries. However, the level of evidence is low. More high-quality randomized controlled trials are needed to establish its effectiveness in reducing anxiety. We believe this review is of great clinical significance due to the vast patient population undergoing sinonasal surgeries. Postoperative local hemorrhage remains the greatest concern for ear nose and throat surgeons due to the rich vasculature of the nose and sinuses. Sinonasal packing provides structural support and serves as an important measure for hemostasis and synechia formation. Although absorbable packing has been gaining popularity in the recent years, nonabsorable packing materials are still used in many countries due to lower cost. Infiltration of nasal packing with local anesthetic provides a solution to the discomfort, nasal pressure and nasal pain experienced commonly by the patients as evidenced by our analysis.


Resumo Introdução: O tamponamento da cavidade nasal tem sido usado tradicionalmente para controle do sangramento pós-operatório e diminuição da formação de sinéquia em pacientes submetidos a cirurgias nasais. Embora o tamponamento nasal absorvível tenha ganhado popularidade nos últimos anos, o tampão nasal não absorvível ainda é frequentemente usado em várias partes do mundo. Sabe-se que o tamponamento está associado a dor e desconforto, especialmente na sua remoção, e revisões anteriores avaliaram apenas os efeitos do tampão com anestésico local em cirurgias do septo nasal. Objetivo: Avaliar o efeito do tamponamento nasal infiltrado com anestésicos locais na dor e ansiedade pós-operatórias após cirurgias nasosinusais. Material e métodos: Para a revisão, pesquisamos nos bancos de dados PubMed e Embase desde o registro mais antigo até 27 de abril de 2019, incluímos ensaios clínicos controlados e randomizados, a ensaios clínicos prospectivos controlados e apenas ensaios clínicos controlados e randomizados para análise de dados. Incluímos estudos que usaram tamponamento nasal infiltrado com anestésicos tópicos após cirurgias nasosinusais e avaliamos a eficácia em comparação com o tamponamento com placebo na redução da dor durante o acompanhamento pós-operatório, bem como os efeitos na redução da ansiedade. Resultados: Entre os 15 estudos incluídos, 9, que envolveram 765 participantes, contribuíram para a metanálise. Em termos de redução da dor, nossa análise mostrou diferenças médias padrão significantes em relação à eficácia no pós-operatório nos intervalos de 1, 12, 24 horas para todos os grupos cirúrgicos combinados, no grupo da cirurgia sinusal e durante a remoção do tamponamento nasal. Não houve evidências consistentes para apoiar a eficácia na redução da ansiedade. Conclusões: Nosso estudo apoia o uso de tamponamentos nasais infiltrados com anestésicos locais como um método eficaz no tratamento da dor em pacientes após cirurgias nasosinusais. No entanto, o nível de evidência é baixo. São necessários mais ensaios clínicos randomizados de alta qualidade para estabelecer sua eficácia na redução da ansiedade. Acreditamos que esta revisão seja de grande significado clínico devido à vasta população submetida a cirurgias nasosinusais. A hemorragia local pós-operatória continua a ser a maior preocupação para os cirurgiões otorrinolaringológicos devido à rica vasculatura do nariz e seios nasais. O tamponamento nasosinusal fornece suporte estrutural e serve como uma medida importante para a hemostasia e formação de sinéquias. Embora o tamponamento absorvível tenha ganhado popularidade nos últimos anos, os materiais de tamponamento não absorvíveis ainda são usados em muitos países devido ao menor custo. A infiltração do tamponamento nasal com anestésicos locais fornece uma solução para desconforto, pressão e dor nasal comumente referida pelos pacientes, como evidenciado por nossa análise.


Subject(s)
Humans , Anxiety/psychology , Pain, Postoperative/prevention & control , Paranasal Sinuses/surgery , Postoperative Hemorrhage/prevention & control , Nasal Surgical Procedures/methods , Anesthetics, Local/administration & dosage , Pain, Postoperative/psychology , Bandages , Clinical Trials as Topic , Postoperative Hemorrhage/psychology
8.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(1): 91-96, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1099208

ABSTRACT

Los leiomiosarcomas de la cavidad nasal y senos paranasales son neoplasias malignas de baja frecuencia, localmente agresivas. Presentan una alta tendencia a la recurrencia de aproximadamente 55% en nariz y senos paranasales. Están conformados por células musculares lisas. Según diversos autores, aproximadamente el 50% de los pacientes mueren antes del primer año y la supervivencia a los 5 años es del 20%. Anteriormente se pensaba que no poseían potencial metastásico, sin embargo, en series actuales se ha visto que presentan un alto poder metastásico de hasta el 50%. Las metástasis se presentan de forma tardía. El tratamiento recomendado consiste en la resección radical del tumor primario con un amplio margen de tejido normal y la radioterapia es de uso controversial en el manejo.


Leiomyosarcoma of the nasal cavity and paranasal sinuses are malignant, low frequency, locally aggressive neoplasm. They present a high tendency to recurrence of approximately 55% in the nose and paranasal sinuses. They are made up of smooth muscle cells. According to different authors, approximately 50% of patients die before the first year and survival at 5 years is 20%. Previously it was thought that they did not possess metastatic potential, however in current series it has been seen that they have a high metastatic power of up to 50%. Metastases present late. The recommended treatment consists of radical resection of the primary tumor with a wide margin of normal tissue.


Subject(s)
Humans , Female , Middle Aged , Nose Neoplasms/surgery , Nose Neoplasms/diagnostic imaging , Leiomyosarcoma/surgery , Leiomyosarcoma/diagnostic imaging , Paranasal Sinuses , Magnetic Resonance Imaging , Nose Neoplasms/pathology , Endoscopy , Leiomyosarcoma/pathology , Nasal Cavity/surgery , Nasal Cavity/diagnostic imaging
9.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(1): 107-112, mar. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1099210

ABSTRACT

Los mucoceles son quistes expansivos e indolentes de las cavidades paranasales. A pesar de ser lesiones benignas, tienen potencial destructivo local por su expansión crónica y cambios óseos. Su ubicación más frecuente es frontoetmoidal. Se postula que su origen es por alteración de la vía de drenaje de los senos. La clínica es dependiente de su ubicación: los mucoceles frontoetmoidales presentan aumento de volumen, cefalea o proptosis. Las imágenes juegan un rol importante en el diagnóstico, siendo la tomografía computarizada y la resonancia magnética los exámenes que detectan patrones sugerentes de mucoceles. El tratamiento es quirúrgico, donde el abordaje endoscópico ha desplazado al abierto por ser mínimamente invasivo, presentar menos comorbilidades y tener menor tasa de recurrencia.


Mucoceles are expansive and indolent cyst of the paranasal cavities. Despite being benign lesions, they have local destructive potential because of its chronic expansion and bony changes. Its most common location is frontoethmoidal. Alterations in the drainage pathway of sinus is thought to be the origin of mucoceles. The clinical features depend on the location. Frontoethmoidal often presents frontal swelling, headache or proptosis. Imaging plays an important part of diagnosis. Tomography and magnetic resonance have patterns that can suggest the presence of a mucocele. Paranasal sinus mucoceles are primarily treated surgically. The endoscopic surgical management has replaced the open resection because of its minimally invasive treatment, less morbidity and low recurrence rates.


Subject(s)
Humans , Paranasal Sinuses/surgery , Paranasal Sinuses/diagnostic imaging , Mucocele/surgery , Mucocele/diagnostic imaging , Paranasal Sinuses/physiopathology , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Endoscopy , Mucocele/physiopathology
11.
Article in Chinese | WPRIM | ID: wpr-826368

ABSTRACT

Nuclear protein of the testis midline carcinoma (NMC) is a rare malignant tumor that is mostly located in the upper trachea,mediastinal midline,and paravertebral midline,and few literature has described the imaging features of NMC in the nasal cavity and paranasal sinuses. In this article we summarize the clinical,radiologic,and pathologic data of one case of pathologically confirmed NMC in the nasal cavity and paranasal sinus by focusing on its CT and magnetic resonance imaging features.


Subject(s)
Humans , Magnetic Resonance Imaging , Nasal Cavity , Pathology , Nose Neoplasms , Diagnostic Imaging , Nuclear Proteins , Paranasal Sinus Neoplasms , Diagnostic Imaging , Paranasal Sinuses , Pathology , Tomography, X-Ray Computed
12.
Acta otorrinolaringol. cir. cabeza cuello ; 48(1): 53-61, 20200000. ilus, graf, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1097449

ABSTRACT

Objetivos: La cirugía endoscópica del seno frontal es quizá uno de los procedimientos más complejos en el manejo endoscópico de los senos paranasales debido a su localización y a las múltiples variantes anatómicas que pueden encontrarse durante su disección. Es indispensable conocer al detalle la anatomía quirúrgica de esta región en nuestra población, para optimizar la planeación quirúrgica de los pacientes. Actualmente en nuestro país se desconoce la frecuencia de estas variaciones. El objetivo del proyecto es evaluar la frecuencia de las variables anatómicas del seno frontal y realizar un estudio radio-anatómico en una muestra de pacientes en Colombia. Diseño del estudio: Observacional, descriptivo de tipo transversal. Métodos: Muestra aleatorizada de 406 tomografías computarizadas de senos paranasales que incluyeron 812 senos frontales recolectados durante el año 2018 Resultados: La celdilla suprabular fue la más comúnmente reportada con una frecuencia de 59.61%. La segunda celdilla fue la supra agger nasi con una frecuencia de 57.88%, seguido de la celdilla supra agger frontal (25.12%), celdilla suprabular frontal (22.17%), celdillas supraorbitarias (34.98%) y las celdilla frontal intersinusal (24,14%). La arteria etmoidal anterior se reportó colgante en un 31.28% y el diámetro AP más frecuente fue entre 5 -10 milímetros. Conclusiones: Para realizar una sinusotomía frontal endoscópica de forma adecuada es necesario conocer al detalle la anatomía del receso del seno frontal. Las diferentes variantes radio-anatómicas son muy frecuentes en el grupo poblacional estudiado. Creemos que este trabajo permitirá a los cirujanos un mejor entendimiento de esta región de difícil acceso quirúrgico en nuestra población. Palabras clave: Seno frontal, senos paranasales, seno clasificación frontal, cirugia endoscopica nasosinusal


Objectives: Endoscopic frontal sinus surgery is perhaps, one of the most complex procedures in the endoscopic sinus surgery, due to its anatomical location and the multiple anatomical variants that can be found. It is essential to know in detail the anatomy of this region in order to obtain a better understanding for the surgical planning. Currently, the frequency of these anatomical variations remains unknown in our country. Therefore, the objective of the study is to evaluate the frequency of the anatomical variants of the frontal sinus and to carry out a radio-anatomic study in a sample of patients from Colombia. Study design: Observational, cross-sectional descriptive. Methods: Randomized sample of 406 CT scan of the paranasal sinuses that included 812 frontal sinuses collected during the year 2018. Results: The supra bulla cell was the most frequently reported with a frequency of 59.61%. The second cell was the supra agger (57.88%) followed by supra agger frontal cell (25.12%), supra bulla frontal cell (22.17%), supraorbital ethmoid cells (34,98%) and frontal septal cell (24,14%) . The anterior ethmoidal artery was found hanging in 31.28% and the most frequent AP diameter was between 5 -10 mm. Conclusions: To perform an appropriate endoscopic frontal sinusotomy, it is necessary to know in detail the anatomy of the frontal sinus recess. The different radio-anatomical variants of the frontal sinus are very frequent in the population group studied. We believe that this study will allow surgeons to obtain a better understanding of this anatomical region of difficult surgical access.


Subject(s)
Humans , Frontal Sinus , Paranasal Sinuses
13.
Acta otorrinolaringol. cir. cabeza cuello ; 48(e-Boletín): 72-78, 2020. ilus, graf, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1095912

ABSTRACT

En el mundo de la pandemia por SARS-CoV-2 (COVID-19), definir pautas durante la fase a la que nos enfrentamos es un gran reto, ya que los criterios pueden cambiar, así como las medias de protección y aislamiento. Esta publicación pretende orientar los procedimientos, patologías y procesos relacionados con el área de rinología, senos paranasales y cirugía de base de cráneo en el contexto de consulta externa, procedimientos ambulatorios, cirugía relacionada y controles postquirúrgicos.


In the world of the SARS-CoV-2 pandemic (COVID-19), defining guidelines during the current phase is a real challenge since those criteria can change as well as the protection and isolation measures. This publication is intended to guide the procedures, pathologies and processes related to the area of Rhinology, Paranasal Sinuses and Skull Base Surgery, in the context of Outpatient Consultation, Outpatient Procedures, Related Surgery and Post-surgical controls.


Subject(s)
Humans , Betacoronavirus , Otolaryngology , Paranasal Sinuses , Coronavirus , Personal Protective Equipment , Infections
14.
Braz. j. otorhinolaryngol. (Impr.) ; 85(5): 551-559, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1039282

ABSTRACT

Abstract Introduction: Radiologic evaluation is mandatory to assess the type of endoscopic approach concerning sinonasal pathology and reconstruction of fractured defects before any treatment modalities are instituted related to medial wall of the orbit. Objective: The goal was to provide improved understanding of the lamina papyracea variations and the relationship with the orbital morphometry. Methods: This retrospective study was performed using computed tomography scans of 200 orbits and results were compared with respect to age, sex, laterality and LP variations. Results: Lamina papyracea variations were categorized as type A, 80.5% (161/200); type B, 16% (32/200); type C, 3.5% (7/200). For medial wall the anterior and posterior lamina papyracea heights and angles were found as 17.14 mm, 147.88º and 9.6 mm, 152.72º, respectively. Also, the length of the lamina papyracea, the mean area of the orbital floor, medial wall, lamina papyracea and orbital entrance were 33.3 mm, 7.2 cm2, 6.89 cm2, 4.51 cm2 and 12.46 cm2 respectively. The orbital height and width were measured as 35.9 mm and 39.2 mm respectively. The mean orbital cavity depth was 46.3 mm from optic foramen to the orbital entrance and the orbital volume was 19.29 cm3. We analyzed the morphometric measurements tending to increase with aging and greater in men and the relationship of them with lamina papyracea types. Conclusion: Precise knowledge of the lamina papyracea anatomy using computed tomography is essential for safer and more effective surgery and preforming the dimensions of an implant. In this way, the postoperative complications can be decreased and the best outcome can be provided.


Resumo Introdução: A avaliação radiológica é mandatória para avaliar o tipo de abordagem endoscópica no tratamento cirúrgico de doença nasossinusal e na reconstrução de fraturas antes de quaisquer modalidades de tratamento relacionadas à parede medial orbital. Objetivo: O objetivo foi proporcionar uma melhor compreensão das variações da lâmina papirácea e a relação com a morfometria orbital. Método: Este estudo retrospectivo foi realizado por meio de tomografia computadorizada de 200 órbitas, e os resultados foram comparados em relação à idade, sexo, lateralidade e variações da lâmina pairácea. Resultados: As variações da lâmina papirácea foram categorizadas como tipo A, 80,5% (161/200); tipo B, 16% (32/200); tipo C, 3,5% (7/200). Para a parede medial, as medidas das alturas anteriores e posteriores da lâmina papirácea e ângulos foram de 17,14 mm, 147,88º e 9,6 mm, 152,72º, respectivamente. Além disso, as medidas do seu comprimento da, da área média do assoalho orbital, e da parede medial, lâmina papyracea e entrada orbital foram: 33,3 mm, 7,2 cm2, 6,89 cm2, 4,51 cm2 e 12,46 cm2, respectivamente. As medidas da altura e da largura orbitais foram 35,9 mm e 39,2 mm, respectivamente. A profundidade média da cavidade orbital foi de 46,3 mm, do forame óptico até a entrada orbital, e o volume orbital foi de 19,29 cm3. Analisamos as medidas morfométricas com tendência a aumentar com o envelhecimento e nos indivíduos do sexo masculino, e a relação das mesmas com os tipos de lâmina. Conclusões: O conhecimento preciso da anatomia da lâmina papirácea por meio de tomografia computadorizada é essencial para uma cirurgia mais segura e eficaz, além de permitir pré-moldar as dimensões do implante. Assim, as complicações pós-operatórias podem ser minimizadas, obtendo-se melhores resultados.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Orbit/anatomy & histology , Orbit/diagnostic imaging , Tomography, X-Ray Computed/methods , Endoscopy/methods , Orbit/injuries , Paranasal Sinuses/surgery , Paranasal Sinuses/injuries , Paranasal Sinuses/diagnostic imaging , Postoperative Complications/prevention & control , Retrospective Studies , Ethmoid Bone/injuries , Ethmoid Bone/diagnostic imaging
15.
Article in Spanish | LILACS | ID: biblio-1020668

ABSTRACT

RESUMEN: La Pansinusitis aguda odontogénica es un cuadro infeccioso infrecuente que afecta a todos los senos paranasales, en el cual se hace necesario un diagnóstico precoz para obtener una menor morbilidad. Un correcto diagnóstico requiere una evaluación dental exhaustiva, apoyándose con imágenes apropiadas. El presente caso clínico reporta paciente femenino de 17 años, sin enfermedades crónicas de base, diagnosticada con pansinusitis aguda odontogénica a través de examen de tomografía axial computarizada. Fue manejada de forma intrahospitalaria con un equipo multidisciplinario para su recuperación. Tratada con antibioterapia de amplio espectro vía parenteral y manejo del dolor, posterior al alta médica se realizó endodoncia del diente afectado y rehabilitación con prótesis fija unitaria.


ABSTRACT: Acute Odontogenic Pansinusitis is an infrequent infectious disease that affects all the paranasal sinuses. It requires an early diagnosis to obtain a lower morbidity. A correct diagnosis requires thorough dental evaluation, supported by appropriate images. The present clinical case reports a 17-year-old female patient, without chronic underlying diseases, with anacute Odontogenic Pansinusitis diagnosed through a computerized axial tomography scan. She was treated by a multidisciplinary team for recovery, through parenteral wide spectrum antibiotic therapy and pain management. After medical discharge, root canal of the affected tooth and rehabilitation with fixed unitary prosthesis were performed.


Subject(s)
Humans , Female , Adolescent , Paranasal Sinuses , Tooth , Endodontics , Pain Management
16.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(2): 207-212, jun. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1014439

ABSTRACT

RESUMEN El lipoma intraóseo es un tumor mesenquimatoso poco frecuente que se presenta principalmente en el esqueleto apendicular. La localización dentro del cráneo, es aún más rara, y hasta la fecha solo se han descrito 6 casos en la literatura de lipomas intraóseos que comprometen la región esfenoclival. Por lo general, no presenta ningún síntoma y es un hallazgo incidental en el estudio de imágenes. Presentamos el caso de un paciente de 22 años de edad que consulta por obstrucción nasal y rinorrea mucosa de tres semanas de evolución. La tomografía computarizada y resonancia nuclear magnética evidenciaron una lesión en la región esfenoclival con características sugerentes de lipoma intraóseo. No se realiza estudio histopatológico. Con respecto al manejo, se decide hacer seguimiento radiológico. Se realizó una segunda resonancia magnética 4 meses después, sin cambios significativos.


ABSTRACT Intraosseous lipoma are a rare mesenchymal tumor that occurs primarily in the appendicular skeleton. Skull presentation is a rare finding, and only 6 cases have been described in literature so far of lipomas that compromise the sphenoclival region. In general, they are asymptomatic and occur as incidental findings in imaging studies. We present the case of a 22-year-old patient who consulted for nasal obstruction and mucous rhinorrhea of three weeks of evolution. Computed tomography and magnetic resonance imaging showed a lesion in the sphenoclival region suggestive of intraosseous lipoma. Histopathological study was not performed. Regarding management, radiological follow-up was decided. A second MRI was taken 4 months later, with no significant changes.


Subject(s)
Humans , Male , Adult , Young Adult , Brain Neoplasms/diagnostic imaging , Skull Base/diagnostic imaging , Lipoma/diagnostic imaging , Paranasal Sinuses/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Diagnosis, Differential
17.
Int. j. morphol ; 37(2): 735-738, June 2019. graf
Article in English | LILACS | ID: biblio-1002286

ABSTRACT

The pneumatization area in the crista galli region of the ethmoid bone can be called Sinus Crista Galli (SCG). The authors would like to recommend the terminology as sinus crista galli for pneumatized crista galli. Our aims in this study are to determine SCG on three dimensional Computerized Tomography (CT) images, to investigate its frequency, dimension and to emphasize their clinical significance in children and adults. A total of 360 adult images (160 female, 200 male) and 68(43 female, 25 male) pediatric images were examined. The presence SCG was recorded with axial and coronal paranasal sinus CT images. The height, width, anterposterior diameter of the sinus was measured. All the data we obtained from this study were analyzed using the SPSS 18.0 program. Descriptive statistics are shown as mean ± Sdt. Sinus crista galli was found in 17 examined images of the 360 (4.72 %) in adult group. Chronic pansinusitis was detected in 7 of 17 cases. Frontal sinusitis findings were detected in 7 cases. Sinusitis was not observed in 3 cases. The incidence of SCG was found in 4 pediatric images out of 68 (5.88 %). In 1 out of 4 cases, infection was detected in SCG. We did not observe SCG in the pediatric group with 0-7 years of age. Sinus crista galli was found at low rates in adult and pediatric age group. However; relationship was found between these variation and chronic rhinosinusitis. Additionally, detection of SCG in paranasal sinus CT can be provided better results and reduce complications in anterior cranial fossa surgery.


El área de neumatización en la crista galli del etmoides se puede denominar sinus crista galli (SCG). Los autores recomiendan incluir en la terminología anatómica el término sinus crista galli para la crista galli neumatizada. Los objetivos del estudio fueron determinar la SCG en imágenes tridimensionales de tomografía computarizada (TC), investigar su frecuencia, dimensión y enfatizar su importancia clínica en niños y adultos. Se examinaron un total de 360 imágenes de adultos (160 mujeres, 200 hombres) y 68 (43 mujeres, 25 hombres) en imágenes pediátricas. La presencia de SCG se registró con imágenes de tomografía axial y axial del seno paranasal. Se midió la altura, anchura y diámetro anteroposterior del seno del proceso crista galli. Todos los datos obtenidos se analizaron mediante el programa SPSS 18.0. Las estadísticas descriptivas se muestran como media ± DS. El seno crista galli se encontró en 17/360 (4,72 %) de las imágenes examinadas en el grupo de adultos. Se detectó pansinusitis crónica en 7 de 17 casos. Se detectaron hallazgos de sinusitis frontal en 7 casos. Sinusitis no se observó en 3 casos. La incidencia de SCG se encontró en 4 imágenes pediátricas de 68 (5,88 %). En 1 de cada 4 casos, se detectó infección en SCG. No observamos SCG en el grupo pediátrico con 0-7 años de edad. El seno crista galli se encontró en bajas tasas en adultos y en niños. Sin embargo, se encontró relación entre estas variaciones y la rinosinusitis crónica. Además, la detección de SCG en la tomografía computarizada del seno paranasal puede proporcionar mejores resultados y reducir las complicaciones en la cirugía de la fosa craneal anterior.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Ethmoid Bone/abnormalities , Ethmoid Bone/diagnostic imaging , Frontal Sinus/abnormalities , Frontal Sinus/diagnostic imaging , Paranasal Sinuses/abnormalities , Paranasal Sinuses/diagnostic imaging , Tomography, X-Ray Computed
18.
Rev. Cient. CRO-RJ (Online) ; 4(1): 102-106, Jan.-Apr. 2019.
Article in English | LILACS, BBO | ID: biblio-1024336

ABSTRACT

Introduction: Exostoses in the paranasal sinuses have been reported in a greater number in the dental radiological literature, despite the extensive citation in the otorhinolaryngology literature. Objective: This case report was a rare idiopathic expression that grew in the maxillary sinus. Case report: A 68-year-old black patient, BGS, followed up by the Odontology Service of Cancer Hospital for treating oral lesions (Mucositis) and other conditions resulting from radiation therapy and hormone therapy (Tamoxifen), presented malignant neoplasm at the right breast in 2015; an exostosis biopsy was not performed, since the patient is being treated and followed up by the hospital service. Panoramic radiography and clinical examination were performed. By analyzing the tests, it was possible to notice an image with double radiodensity, more radiopaque in the external portion and less radiopaque in the internal portion, with an aspect of trabecular bone, circumscribed, unilocular, in the region of pedunculated premolar, inside the left maxillary sinus. In order to have a better assessment and diagnostic hypothesis of the case, a CT scan was performed, a tool was applied to measure the density of the profile of the lesion, thus evidencing that the supposed injury invaginates to the interior of the maxillary sinus and had bone density similar to the alveolar crest bone. Conclusion: Simultaneously to other lesions, exostoses are benign lesions, present low aggression and rare symptomatology; exeresis is indicated only when it prevents functioning, or for aesthetics reasons, or when it is not possible to make prostheses. Many cases are incidentally diagnosed from routine radiographic review in medical or dental offices and should be followed up for analysis and verification of their growth.


Introdução: Exostoses nos seios paranasais têm sido muito mais relatados na literatura radiológica odontológica, apesar da extensa citação na literatura otorrinolaringológica. Objetivo: Neste relato de caso, encontramos uma exostose idiopática rara, que cresceu no seio maxilar. Relato de caso: Paciente negra de 68 anos, BGS, acompanhada pelo Serviço de Odontologia do Hospital do Câncer para tratamento de lesões orais (mucosite) e outras condições decorrentes da radioterapia e terapia hormonal (Tamoxifeno), apresentou neoplasia maligna da mama direita em 2015. Não foi realizada biopsia da exostose, pois a paciente está em tratamento e está sendo acompanhada pelo serviço do hospital. Realizaram-se radiografia panorâmica e exame clínico. Ao examinar os exames, foi possível notar uma imagem com dupla radiodensidade, mais radiopaca numa parte externa e menos radiopaca na parte interna, com aspecto de osso trabecular, circunscrito, unilocular, na região do ré-molar pediculado, no interior do seio maxilar esquerdo. Para melhor avaliação e hipótese diagnóstica, foi realizada uma tomografia computadorizada, aplicou-se uma ferramenta para mensuração da densidade do perfil da lesão, evidenciando-se que a suposta lesão invagina para o interior do seio maxilar e tinha densidade óssea semelhante ao osso da crista alveolar. Conclusão: Simultaneamente a outras lesões, as exostoses são lesões benignas, apresentam baixa agressividade e rara sintomatologia, sendo indicada exérese somente quando acomete a função, ou por motivos estéticos, ou quando não é possível a confecção de próteses. Muitos dos casos são diagnosticados de modo incidental e a partir de exames radiográficos de rotina em consultórios médicos ou odontológicos e devem ser acompanhados para análise e verificação de seu crescimento.


Subject(s)
Exostoses , Paranasal Sinuses , Radiography, Dental , Radiography, Panoramic
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