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1.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(2): 237-246, jun. 2020.
Article in Spanish | LILACS | ID: biblio-1115840

ABSTRACT

La rinosinusitis crónica (RSC) en niños corresponde a la inflamación de la mucosa de la cavidad nasal y senos paranasales, presentando síntomas como obstrucción nasal, descarga nasal, presión o dolor facial y tos, presentes por más de 12 semanas. Conlleva una gran carga de morbilidad para quienes la padecen, y un alto costo económico. Su diagnóstico constituye un desafío debido a la sobreposición de síntomas con infecciones respiratorias altas y otras condiciones no infecciosas. En los últimos años se han dilucidado nuevos factores contribuyentes como los biofilms , disfunción del microbioma, y el creciente papel de mecanismos inflamatorios no infecciosos. El estudio imagenológico de elección es la tomografía computarizada, preferentemente en casos de duda diagnóstica, falta de respuesta a tratamiento o sospecha de complicaciones. El tratamiento de primera línea es el manejo médico, basado en irrigación nasal, posible uso de antibióticos prolongados y corticoides nasales. Para casos refractarios se plantean intervenciones quirúrgicas, siendo la adenoidectomía la primera elección, principalmente en niños menores; otras intervenciones incluyen la cirugía endoscópica de cavidades paranasales. Nuevas terapias biológicas están siendo estudiadas basadas en los mecanismos inflamatorios no infecciosos de la RSC y su relación con comorbilidades como el asma.


Chronic rhinosinusitis (CRS) in children is the inflammation of the nasal and sinus mucosa, presenting symptoms such as obstruction, nasal discharge, pressure or facial pain and cough, which extends for more than 12 weeks. It represents a great burden for those affected, with high economic cost. Its diagnosis constitutes a challenge due to the overlap of symptoms with other upper respiratory infections and other non-infectious conditions. In recent years, new contributing factors have been elucidated, such as biofilms, microbiome dysfunction, and the growing role of noninfectious inflammatory mechanisms. Diagnosis depends on the recognition of characteristic symptoms and their duration. The imaging study of choice is computed tomography, especially in cases of diagnostic doubt, lack of response to treatment or suspicion of complications. First-line treatment of is based on nasal irrigation, possible use of prolonged antibiotics and nasal corticosteroids. For refractory cases, surgical intervention is proposed, with adenoidectomy being the first choice, mainly in younger children; other interventions include endoscopic sinus surgery. New biological therapies are being studied based on noninfectious inflammatory mechanisms of CRS and its comorbidities such as asthma.


Subject(s)
Humans , Child , Sinusitis/diagnosis , Sinusitis/therapy , Rhinitis/diagnosis , Rhinitis/therapy , Sinusitis/etiology , Sinusitis/physiopathology , Rhinitis/etiology , Rhinitis/physiopathology , Chronic Disease
3.
Int. j interdiscip. dent. (Print) ; 13(1): 35-39, abr. 2020. graf
Article in Spanish | LILACS | ID: biblio-1114891

ABSTRACT

La cirugía de elevación de seno maxilar se considera como la técnica de aumento óseo más predecible. Sin embargo, no está exenta de complicaciones las cuales deben ser manejadas adecuadamente. Se presenta un caso clínico rehabilitado, con un seguimiento de 3 años, en el cual se realizó un manejo multidisciplinario y resolutivo de complicaciones asociadas a la técnica quirúrgica de elevación de membrana sinusal vía ventana lateral. Frente a una infección postoperatoria, como la presentada en el caso, hay que considerar iniciar un tratamiento antibiótico en el momento adecuado para impedir el agravamiento del cuadro clínico o un cambio de esquema en caso de resistencia antimicrobiana.


Maxillary sinus lift surgery is considered the most predictable bone augmentation technique. However, this procedure is not without complications, which must be handled properly. We present a rehabilitated clinical case, with a 3-year follow-up, in which a multidisciplinary and resolutive management of complications associated with the surgical technique of sinus lift procedure, using lateral window approach, was performed. In case of postoperative infection, such as the one presented in this report, it is necessary to consider starting an antibiotic treatment at the adequate moment to prevent the aggravation of the illness or change the pharmacological treatment in case of antimicrobial resistance.


Subject(s)
Humans , Female , Adult , Sinusitis/therapy , Bacterial Infections/therapy , Rhinitis/therapy , Sinus Floor Augmentation/adverse effects , Postoperative Complications/rehabilitation , Sinusitis/etiology , Sinusitis/microbiology , Bacterial Infections/etiology , Dental Implants , Rhinitis/etiology , Rhinitis/microbiology , Acute Disease , Follow-Up Studies , Treatment Outcome
5.
Braz. j. otorhinolaryngol. (Impr.) ; 85(3): 337-343, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011621

ABSTRACT

Abstract Introduction: Burnt sugarcane harvesting requires intense physical exertion in an environment of high temperature and exposure to particulate matter. Objective: To evaluate the effects of burnt sugarcane harvesting on rhinitis symptoms and inflammatory markers in sugarcane workers. Methods: A total of 32 male sugarcane workers were evaluated with questionnaire for rhinitis symptoms, and for inflammatory markers on peripheral blood and nasal lavage, in the non-harvesting, and 3 and 6 months into the sugarcane harvesting period. Weather data and particulate matter fine concentrations were measured in the same day. Results: The particulate matter concentrations in sugarcane harvesting were 27 (23-33 µg/m3), 112 (96-122 µg/m3), and 63 (17-263 µg/m3); 24 h temperatures were 32.6 (25.4-37.4 ºC), 32.3 (26.7-36.7 ºC) and 29.7 (24.1-34.0 ºC) and relative humidities were 45.4 (35.0-59.7%), 47.9 (39.1-63.0%), and 59.9 (34.7-63.2%) in the non-harvesting period, three and 6 months of the harvesting period. The age was 37.4 ± 10.9 years. The prevalence of rhinitis symptoms was significantly higher at 3 months of the harvesting period (53.4%), compared to non-harvesting period (26.7%; p = 0.039) and at 6 months into the harvesting period (20%; p = 0.006). Concentrations of interleukin 6 (IL-6) in nasal lavage increased after 3 months of the harvesting period compared to the non-harvesting period (p = 0.012). The presence of rhinitis symptoms, after 3 months of the harvesting period, was directly associated with blood eosinophils and inversely associated with neutrophils. Conclusions: After 3 months of work in burnt sugarcane harvesting the prevalence of rhinitis symptoms and IL-6 in nasal lavage increased. Furthermore, eosinophil counts were directly associated with the rhinitis symptoms in the period of higher concentration of particulate matter.


Resumo Introdução: A colheita de cana-de-açúcar queimada requer esforço físico intenso em um ambiente com altas temperaturas e exposição a material particulado. Objetivo: Avaliar os efeitos da colheita de cana-de-açúcar queimada nos sintomas de rinite e marcadores inflamatórios de cortadores de cana-de-açúcar. Método: Foram avaliados 32 cortadores de cana-de-açúcar do sexo masculino por meio de um questionário para sintomas de rinite, e marcadores inflamatórios em sangue periférico e lavado nasal, no período de entressafra, e em 3 e 6 meses após o início da colheita da cana-de-açúcar. Os dados climáticos e as concentrações de material particulado fino foram medidos no mesmo dia. Resultados: O material particulado fino na entressafra e em 3 e 6 meses de safra foi 27 (23-33 µg/m3), 112 (96-122 µg/m3) e 63 (17-263 µg/m3), respectivamente; a temperatura de 24 horas foi 32,6 (25,4º-37,4ºC), 32,3 (26,7º-36,7ºC) e 29,7 (24,1º-340ºC) e a umidade relativa do ar foi 45,4 (35,0%-59,7%), 47,9 (39,1%-63,0%), e 59,9 (34,7%-63,2%), na entressafra, 3 e 6 meses após o início da colheita. A idade foi de 37,4 ± 10,9 anos. A prevalência de sintomas de rinite foi significativamente maior em 3 meses da S (53,4%), comparado com a entressafra (26,7%; p = 0,039) e 6 meses da safra (20%; p = 0,006). As concentrações de interleucina 6 (IL-6) no lavado nasal aumentaram após 3 meses do início da colheita comparado com a entressafra (p = 0,012). A presença de sintomas de rinite, após 3 meses do início da colheita, foi diretamente associada com eosinófilos e inversamente associada com neutrófilos. Conclusões: Após 3 meses do início da colheita da cana-de-açúcar queimada, houve aumento na prevalência de sintomas de rinite e IL-6 em LN. Além disso, as contagens de eosinófilos foram diretamente associadas aos sintomas de rinite no período de maior concentração de material particulado.


Subject(s)
Humans , Male , Adult , Rhinitis/etiology , Saccharum , Air Pollutants, Occupational/adverse effects , Particulate Matter/adverse effects , Occupational Diseases/etiology , Biomarkers/blood , Rhinitis/blood , Prevalence , Interleukin-4/blood , Interleukin-6/blood , Agriculture , Occupational Diseases/blood
6.
Rev. otorrinolaringol. cir. cabeza cuello ; 78(4): 451-462, dic. 2018.
Article in Spanish | LILACS | ID: biblio-985753

ABSTRACT

RESUMEN La rinosinusitis crónica (RSC) se define como una inflamación sintomática de las cavidades nasales y paranasales. Es una enfermedad altamente prevalente, que conlleva una gran carga económica asociada y cuyo tratamiento médico actual consigue un alivio sintomático en aproximadamente 50% de los pacientes. Tradicionalmente se ha clasificado de acuerdo a la presencia o ausencia de pólipos nasales, sin embargo, no se conoce con total claridad los mecanismos que llevan a la diferenciación de ambos fenotipos. Se estima que existirían tanto factores exógenos como endógenos involucrados que configurarían un origen multifactorial de la enfermedad. La RSC es motivo de intensa investigación científica actual dado su impacto y prevalencia, de manera de determinar con mejor precisión los objetivos de un eventual tratamiento de mayor efectividad. Es por ello que presentamos una revisión actualizada en relación a los mecanismos fisiopatológicos subyacentes en RSC.


ABSTRACT Chronic rhinosinusitis (CRS) is defined as a symptomatic inflammation of the nasal and paranasal cavities. It is a highly prevalent disease carrying a large associated economic burden, and its current medical treatment achieves symptomatic relief in approximately 50% of patients. Traditionally, it has been classified according to the presence or absence of nasal polyps. However, the mechanisms that lead to the differentiation of both phenotypes are not fully understood. It has been estimated that there are both exogenous and endogenous factors involved that would configure a multifactorial origin of the disease. Given its impact and prevalence, CRS is currently a subject of intense scientific research, in order to accurately determine the targets for a more effective treatment. For this reason, we present an updated review in relation to the underlying pathophysiological mechanisms in CRS.


Subject(s)
Humans , Sinusitis/etiology , Sinusitis/physiopathology , Rhinitis/etiology , Rhinitis/physiopathology , Nasal Polyps , Chronic Disease , Allergy and Immunology , Immune System
7.
Rev. otorrinolaringol. cir. cabeza cuello ; 77(2): 207-213, jun. 2017. ilus
Article in Spanish | LILACS | ID: biblio-902765

ABSTRACT

Presentamos un caso de fístula oroantral y rinosinusitis maxilar, resuelto por abordaje combinado endoscópico, nasal e intraoral en el cual se utilizó colgajo de mucosa palatina y hueso vómer para el cierre de la misma. Describimos el caso de una paciente femenina de 66 años de edad, que consultó por presentar cacosmia, algia facial izquierda y rinorrea posterior purulenta, 3 semanas posterior a extracción de segundo molar superior izquierdo, la tomograffa axial computarizada (TC) de senos paranasales evidenció velamiento total maxilar izquierdo, parcial etmoidal izquierdo y defecto óseo en reborde alveolar superior izquierdo. Se realizó toma de fragmento de hueso vómer. Seguidamente abordaje de cavidad antral izquierda por vía endoscópica; e intraoral, se concluyó disección, cierre óseo y mucoso de la fístula.


We report a case of an oroantral fistula and maxillary rhinosinusitis, that was resolved by combined approach, in which palatal mucosa flap and vomer bone was used for its closure. We describe the case of a female patient of 66 years old, who consulted for having cacosmia, left facial pain and purulent rhinorrhea, after left second molar extraction. CT-scan sinus showed the total left maxillary sinus, partial left ethmoid opacity and bone defect in left alveolar ridge. A vomer bone graft was taken from the nasal septum; left maxillary sinus surgerywas done by endoscopic approach and intraoral closure of bony and mucosa fístula was concluded.


Subject(s)
Humans , Female , Aged , Maxillary Sinusitis/surgery , Rhinitis/surgery , Oroantral Fistula/surgery , Vomer/transplantation , Tooth Extraction/adverse effects , Maxillary Sinusitis/etiology , Rhinitis/etiology , Bone Transplantation , Oroantral Fistula/etiology , Endoscopy/methods
8.
Rev. paul. pediatr ; 34(2): 184-188, Apr.-June 2016. tab, graf
Article in English | LILACS | ID: lil-784339

ABSTRACT

Objective: To describe the frequency and etiology of rhinitis, oral breathing, types of malocclusion and orofacial disorders in patients treated for dental malocclusion. Methods: Patients with poor dental occlusion (n=89, 8-15 years) undergoing orthodontic treatment at the Postgraduate Orthodontics Center (São Paulo, Brazil) participated in the study. Rhinitis and oral breathing were diagnosed by anamnesis, clinical assessment and allergic etiology of rhinitis through immediate hypersensitivity skin prick test with airborne allergens. The association between types of breathing (oral or nasal), rhinitis and types of dental malocclusion, bruxism and cephalometric alterations (increased Y axis of facial growth) compared to standard cephalometric tracing (Escola de Odontologia da Universidade de São Paulo) were assessed. Results: The frequency of rhinitis in patients with dental malocclusion was 76.4% (68), and, of these, 81.7% were allergic (49/60 positive skin prick test), whereas the frequency of oral breathing was 62.9%. There was a significant association between an increased Y axis of facial growth and oral breathing (p<0.001), as well as between oral breathing and rhinitis (p=0.009). There was no association between rhinitis and bruxism. Conclusions: The frequency of rhinitis in children with dental malocclusion is higher than that in the general population, which is approximately 30%. Patients with oral breathing have a tendency to a dolichofacial growth pattern (increased Y axis of facial growth). In patients with rhinitis, regardless of the presence of oral breathing, the dolichofacial growth tendency was not observed.


Objetivo: Descrever a frequência e etiologia da rinite, da respiração oral, os tipos de má oclusão e as alterações orofaciais em pacientes tratados por má oclusão dentária. Métodos: Pacientes com má oclusão dentária (n=89, oito a 15 anos) em tratamento ortodôntico em centro de pós-graduação em ortodontia (São Paulo, Brasil) participaram do estudo. Rinite e respiração oral foram diagnosticadas por anamnese e exame clínico e a etiologia alérgica dessa por teste cutâneo de hipersensibilidade imediata (TCHI) com aeroalérgenos. Avaliou-se a relação entre tipos de respiração (oral ou nasal), rinite e tipos de má oclusão dentária, bruxismo e alterações cefalométricas (aumento do eixo Y de crescimento facial) em comparação com o traçado cefalométrico padrão (Escola de Odontologia da Universidade de São Paulo). Resultados: A frequência de rinite nos pacientes com má oclusão dentária foi de 76,4% (68), desses 81,7% eram alérgicos (49/60 TCHI positivo) e a frequência de respiração oral foi de 62,9%. Houve associação significativa entre ter o eixo Y de crescimento facial aumentado e respiração oral (p<0,001), o mesmo entre respiração oral e rinite (p=0,009). Não houve associação entre rinite e bruxismo. Conclusões: A frequência de rinite em crianças com má oclusão dentária é superior à da população geral, que gira ao redor de 30%. Os pacientes com respiração oral têm tendência de crescimento dólico facial (eixo Y de crescimento aumentado). Nos pacientes com rinite, independentemente da presença da respiração oral, a tendência dólico facial não foi observada.


Subject(s)
Humans , Child , Adolescent , Cephalometry , Malocclusion/complications , Mouth Breathing/complications , Rhinitis/epidemiology , Rhinitis/etiology , Bruxism
9.
Braz. j. otorhinolaryngol. (Impr.) ; 82(1): 105-111, Jan.-Feb. 2016. tab
Article in Portuguese | LILACS | ID: lil-775705

ABSTRACT

ABSTRACT INTRODUCTION: There is a controversy concerning the terminology and definition of rhinitis in pregnancy. Gestational rhinitis is a relatively common condition, which has drawn increasing interest in recent years due to a possible association with maternal obstructive sleep apnea syndrome (OSAS) and unfavorable fetal outcomes. OBJECTIVE: To review the current knowledge on gestacional rhinitis, and to assess its evidence. METHODS: Structured literature search. RESULTS: Gestational rhinitis and rhinitis "during pregnancy" are somewhat similar conditions regarding their physiopathology and treatment, but differ regarding definition and prognosis. Hormonal changes have a presumed etiological role, but knowledge about the physiopathology of gestational rhinitis is still lacking. Management of rhinitis during pregnancy focuses on the minimal intervention required for symptom relief. CONCLUSION: As it has a great impact on maternal quality of life, both the otorhinolaryngologist and the obstetrician must be careful concerning the early diagnosis and treatment of gestational rhinitis, considering the safety of treatment measures and drugs and their current level of evidence.


RESUMO INTRODUÇÃO: Há grande confusão quanto à terminologia e definição da rinite na gestação. A rinite gestacional é uma condição relativamente comum que vem ganhando importância nos últimos anos pela descoberta de sua associação com a SAOS materna e possíveis desfechos desfavoráveis ao feto. Há pouca evidência na literatura nacional sobre o tema. OBJETIVO: Revisar o conhecimento científico atual sobre a rinite na gestação e suas evidências disponíveis. MÉTODO: Revisão de literatura estruturada. RESULTADOS: A rinite gestacional e a rinite "durante a gestação" são condições com alguns pontos de fisiopatologia e tratamento semelhantes, mas com definições e prognósticos diferentes. O papel dos hormônios nessas condições vem sendo sugerido por muitos trabalhos, mas o conhecimento sobre a fisiopatogenia da rinite gestacional ainda é escasso. O manejo da rinite na gestação requer o mínimo de intervenção com o maior alívio sintomático possível. CONCLUSÃO: Dado o grande impacto na qualidade de vida da gestante, tanto o otorrinolaringologista quanto o obstetra devem estar atentos para o diagnóstico precoce e manejo desta entidade, considerando o perfil de segurança e o nível de evidência das medidas e medicamentos disponíveis atualmente.


Subject(s)
Female , Humans , Pregnancy , Pregnancy Complications/diagnosis , Rhinitis/diagnosis , Diagnosis, Differential , Pregnancy Complications/etiology , Pregnancy Complications/therapy , Risk Factors , Rhinitis/etiology , Rhinitis/therapy , Terminology as Topic
10.
Rev. otorrinolaringol. cir. cabeza cuello ; 75(3): 295-300, dic. 2015.
Article in Spanish | LILACS | ID: lil-771704

ABSTRACT

La rinosinusitis crónica es una patología que se presenta en pacientes con fibrosis quística y se asocia a la expresión de numerosos genes que determinan una alteración en la secreción de cloro del canal CFTR e hiperplasia de las glándulas submucosas del epitelio sinusal. En este artículo se efectúa una revisión acerca de las indicaciones y distintas alternativas de cirugía endoscópica nasal para la rinosinusitis crónica en pacientes con fibrosis quística. Se realizó una búsqueda de artículos en PubMed, la biblioteca de Cochrane y en SciELO con fecha de publicación hasta el año 2014, en los que se trata específicamente la rinosinusitis crónica asociada a fibrosis quística.


Chronic sinusitis is a condition that occurs in patients with cystic fibrosis and is associated with the expression of numerous genes that determine an alteration in the secretion of chloride channel CFTR and hyperplasia of submucosal glands sinus epithelium. This article reviews about the indications and alternatives of endoscopic nasal surgery for chronic rhinosinusitis in patients with cystic fibrosis. Searches were performed in PubMed, Cochrane Library, and SciELO with a publication date until 2014, specifically chronic rhinosinusitis associated with cystic fibrosis.


Subject(s)
Humans , Endoscopy , Rhinitis/surgery , Sinusitis/surgery , Chronic Disease , Cystic Fibrosis/complications , Rhinitis/etiology , Sinusitis/etiology
11.
Biomédica (Bogotá) ; 35(3): 357-362, jul.-sep. 2015. graf, tab
Article in English | LILACS | ID: lil-765464

ABSTRACT

Introduction: Among allergic patients, pet avoidance is commonly recommended. It is difficult for patients to accomplish this because of their emotional attachment to the pets, and its effectiveness is controversial. Objective: To explore the applicability and effectiveness of pet avoidance measures among sensitized patients. Materials and methods: We evaluated 288 patients with asthma, rhinitis, conjunctivitis and/or dermatitis using skin prick test to measure their sensitization to cats, dogs and other animals to which they were exposed. Exposure to animals was evaluated in each patient (pets at home, frequent indirect exposure or no exposure). In those patients sensitized to animals some avoidance measures, such as removing pets from home and preventing indirect exposure, were recommended. On the following two appointments, we evaluated patients' fulfillment of these recommendations. Results: Sensitization to cats, dogs and birds was high (9%, 48%, 14%, respectively), as well as direct and indirect exposure (30%, 46%, 24%, respectively). Most patients denied contact with other animals (horses, hamsters, rabbits or cows), and sensitization to them was low. During the follow-up of patients sensitized to their pets at home (n=50), most of them refused to remove them from their house due to emotional attachment, and only two followed this recommendation. Conclusions: High exposure to animals could explain the frequency of sensitization to pets in this population. However, emotional attachment and prevalent indirect exposure to animals among sensitized patients make avoidance recommendations impractical or impossible to achieve.


Introducción. Entre los pacientes alérgicos se recomienda comúnmente la evitación de mascotas; sin embargo, es difícil que los pacientes cumplan con esta recomendación debido al apego emocional y, además, su efecto clínico no es claro. Objetivo. Explorar la aplicabilidad de las medidas de evitación entre pacientes sensibilizados a mascotas . Materiales y métodos. En 284 pacientes con asma, rinitis, conjuntivitis y dermatitis, se evaluó la sensibilización a gatos, perros y otros animales mediante pruebas de punción epidérmica. Se evaluó, igualmente, el nivel de exposición a animales (mascotas en la casa y exposición indirecta frecuente). A aquellos pacientes sensibilizados a los animales, se les recomendaron medidas de evitación como retirar la mascota de la casa y evitar la exposición indirecta. En las dos citas médicas siguientes se evaluó el cumplimiento de estas recomendaciones. Resultados. La sensibilización a gatos, perros y aves fue alta (9, 48, y 14 %, respectivamente), al igual que la exposición directa o indirecta a estos animales (30, 46, 24 %, respectivamente). La mayoría de los pacientes negó el contacto frecuente con otros animales (caballos, hámsteres, conejos, vacas) y la sensibilización a estos fue baja. La mayoría de los pacientes sensibilizados a su propia mascota (n= 50) se rehusó a retirar la mascota de la casa y solo dos de ellos siguieron la recomendación de hacerlo. Conclusiones. La exposición frecuente a los animales podría explicar la gran frecuencia de sensibilización a las mascotas en esta población. Sin embargo, el apego emocional y la exposición indirecta frecuente, hacen que las recomendaciones de evitación sean imprácticas o casi imposibles de lograr.


Subject(s)
Adolescent , Adult , Aged , Animals , Cats , Child , Child, Preschool , Dogs , Female , Humans , Infant , Male , Middle Aged , Young Adult , Patient Compliance , Pets , Hypersensitivity/prevention & control , Asthma/etiology , Asthma/prevention & control , Species Specificity , Birds/immunology , Skin Tests , Allergens/immunology , Rhinitis/etiology , Rhinitis/prevention & control , Prospective Studies , Dermatitis, Atopic/etiology , Dermatitis, Atopic/prevention & control , Emotions , Environmental Exposure , Pets/immunology , Hypersensitivity/etiology
12.
Rev. otorrinolaringol. cir. cabeza cuello ; 75(1): 44-48, abr. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-745618

ABSTRACT

El síndrome de Tolosa Hunt es un cuadro inflamatorio del seno cavernoso, idiopático y caracterizado por uno o más episodios de dolor orbital unilateral asociado o seguido de paresia oculomotora (afección del III, IV y VI nervio craneal) y en ocasiones con compromiso de la rama maxilar del nervio trigémino. Nosotros presentamos un hombre de 27 años con episodios de oftalmoparesia dolorosa derecha concomitantes a cuadros de rinosinusitis agudas. Su estudio fue negativo y en una de sus recurrencias se encontró en la RM de alta resolución de senos cavernosos, compromiso inflamatorio con captación de gadolinio de los nervios III, IV, V2 y VI derechos. Dado los hallazgos, se planteó el diagnóstico de STH exacerbado por la rinosinusitis e inició tratamiento corticoidal prolongado.


Tolosa Hunt Syndrome is the idiopathic inflammation of cavernous sinus, characterized by one or more episodes of unilateral orbital pain followed by ophtalmoparesis (III, IV o VI nerve palsy) and sometimes the affection of maxillary branch of the trigeminal nerve. We describe the case of a 27 years old man with episodes of painful right ophtalmoparesis associated with acute rhinosinusitis. On high resolution MRI there was inflammation of the III, IV, V2 and VI right nerves with gadolinium enhancement. We propose the THS diagnosis exacerbated by rhinosinusitis and started on chronic steroid therapy.


Subject(s)
Humans , Male , Adult , Rhinitis/etiology , Sinusitis/etiology , Tolosa-Hunt Syndrome/diagnosis , Tolosa-Hunt Syndrome/drug therapy , Administration, Oral , Adrenal Cortex Hormones/therapeutic use , Recurrence
13.
J. bras. pneumol ; 41(1): 65-76, Jan-Feb/2015. tab, graf
Article in English | LILACS | ID: lil-741555

ABSTRACT

Although cystic fibrosis (CF) is an irreversible genetic disease, advances in treatment have increased the life expectancy of CF patients. Upper airway involvement, which is mainly due to pathological changes in the paranasal sinuses, is prevalent in CF patients, although many are only mildly symptomatic (with few symptoms). The objective of this literature review was to discuss the pathophysiology and current therapeutic management of chronic rhinosinusitis (CRS) in CF patients. The review was based on current evidence, which was classified in accordance with the Oxford Centre for Evidence-Based Medicine criteria. When symptomatic, CRS with nasal polyps can affect quality of life and can lead to pulmonary exacerbations, given that the paranasal sinuses can be colonized with pathogenic bacteria, especially Pseudomonas aeruginosa. Infection with P. aeruginosa plays a crucial role in morbidity and mortality after lung transplantation in CF patients. Although clinical treatment of the upper airways is recommended as initial management, this recommendation is often extrapolated from studies of CRS in the general population. When sinonasal disease is refractory to noninvasive therapy, surgery is indicated. Further studies are needed in order to gain a better understanding of upper airway involvement and improve the management of CRS in CF patients, with the objective of preserving lung function and avoiding unnecessary invasive procedures.


A fibrose cística (FC) é uma doença genética irreversível, mas os avanços no tratamento têm aumentado a expectativa de vida dos pacientes. O acometimento das vias aéreas superiores, principalmente por alterações patológicas dos seios paranasais, é prevalente nesses pacientes, embora muitos apresentem poucos sintomas. O objetivo desta revisão é discutir a fisiopatologia e o manejo terapêutico atual da rinossinusite crônica (RSC) na FC. A revisão fundamentou-se nas evidências mais recentes, classificadas em conformidade com os critérios do Oxford Centre for Evidence-Based Medicine. Quando sintomática, a RSC com pólipos nasais pode afetar a qualidade de vida e as exacerbações pulmonares, já que os seios paranasais podem ser colonizados por bactérias patogênicas, principalmente a Pseudomonas aeruginosa. Essa bactéria tem papel crucial na morbidade e mortalidade após o transplante pulmonar em pacientes com FC. Embora o tratamento clínico das vias aéreas superiores seja indicado no manejo inicial, a indicação é muitas vezes extrapolada de estudos sobre RSC na população geral. A cirurgia é a alternativa quando o quadro nasossinusal é refratário à terapia não invasiva. Mais estudos são necessários para compreender melhor o acometimento das vias aéreas superiores e melhorar o manejo da RSC na FC, a fim de preservar a função pulmonar e evitar procedimentos invasivos desnecessários.


Subject(s)
Humans , Cystic Fibrosis/complications , Nasal Polyps/diagnosis , Nasal Polyps/therapy , Rhinitis/diagnosis , Rhinitis/therapy , Sinusitis/diagnosis , Sinusitis/therapy , Chronic Disease , Evidence-Based Medicine , Nasal Polyps/etiology , Paranasal Sinuses , Rhinitis/etiology , Tomography, X-Ray Computed
14.
Article in Portuguese | LILACS | ID: lil-724267

ABSTRACT

JUSTIFICATIVA E OBJETIVOS: A associação entre cesariana,asma e rinite ainda é uma questão controversa com dadosconflitantes na literatura. Esta revisão tem como objetivo reuniros resultados dos trabalhos mais importantes acerca do tema.MÉTODOS: Base de dados Medline, Lilacs e SciELO foramconsultadas no período de janeiro de 2000 a julho de 2013 utilizandoas palavras chaves delivery cesarean and asthma; deliverycesarean and rhinitis. Foram incluídos artigos escritos em línguainglesa, portuguesa e espanhola e estudos epidemiológicosanalíticos em seres humanos em qualquer faixa etária. Foramexcluídos os artigos publicados em outras línguas e não relacionadosao tema estudado. RESULTADOS: Foram identificados33 artigos, de acordo o delineamento, 25 estudos foram longitudinais,5 foram transversais e 3 estudos de caso-controle.A cesariana esteve associada à asma em 18 estudos e 1 estudoesteve associado a sibilância recorrente. Dez estudos avaliaramos sintomas de rinite com cesariana, nove avaliaram conjuntamentea asma, 4 encontraram associação entre cesariana e rinitee 6 estudos não demonstraram associação. CONCLUSÃO: Aassociação entre cesariana, asma e rinite permanece ainda controversadevido ao potencial de confundimento de vários outrosfatores determinantes da asma. Cesariana de emergência esteveassociada à asma em alguns estudos e esta associação não podeser explicada pela hipótese da higiene.(AU)


BACKGROUND AND OBJECTIVES: The association betweencaesarean, asthma and rhinitis is still a controversial issue withconflicting data in the literature. This review aims to bringtogether the results of the most important studies about thesubject published in recent years. METHODS: Medline,LILACS and Scielo databases were consulted from January 2000to July 2013 using the keywords asthma and cesarean delivery,cesarean delivery and rhinitis. We included articles written inEnglish, Portuguese and Spanish and analytical epidemiologicalstudies in humans at any age. We excluded studies published inother languages and not related to the theme. RESULTS: 33articles were identified. 25 studies were prospective cohorts; 5were sectional studies; 3 were case-control studies. Caesareanwas associated with asthma in 18 studies. One study foundassociation between recurrent wheezing and Caesarean. Tenstudies evaluated the symptoms of rhinitis with caesarean.Nine evaluated the association between asthma, rhinitis andcaesarean. Four studies found an association between Caesareanand rhinitis. Six studies did not find an association betweencaesarean and rhinitis. CONCLUSION: The association betweencaesarean, rhinitis and asthma remains controversial due topotential confounding of several other determinants of asthma.Emergency caesarean was associated with asthma in somestudies and this association can not be explained by the hygienehypothesis.(AU)


Subject(s)
Humans , Female , Pregnancy , Asthma/etiology , Cesarean Section , Rhinitis/etiology
15.
Braz. j. otorhinolaryngol. (Impr.) ; 80(4): 285-289, Jul-Aug/2014. tab, graf
Article in English | LILACS | ID: lil-721411

ABSTRACT

INTRODUCTION: hematopoietic stem cell transplantation (HSCT) is associated with more respiratory infections due to immunosuppression. OBJECTIVE: this study aimed to verify the frequency of rhinosinusitis after HSCT, and the association between rhinosinusitis and chronic graft vs. host disease (GVHD) and type of transplantation, clinical treatment, surgical treatment, and survival. METHODS: this was a retrospective study in a tertiary university hospital. A total of 95 patients with hematological diseases undergoing HSCT between 1996 and 2011 were selected. RESULTS: chronic myeloid leukemia was the most prevalent disease. The type of transplant most often performed was the allogenic type (85.26%). The frequency of rhinosinusitis was 36%, with no difference between the autologous and the allogenic types. Chronic GVHD occurred in 30% of patients. Patients with GVHD had a higher frequency and recurrence of rhinosinusitis, in addition to more frequent need for endoscopic sinusectomy and decreased overall survival. CONCLUSION: there was a higher frequency of rhinosinusitis in HSCT and GVHD. The type of transplant does not appear to predispose to the occurrence of rhinosinusitis. GVHD seems to be an aggravating factor and requires a more stringent treatment. .


INTRODUÇÃO: O transplante de células troncas hematopoiéticas (TCTH) associa-se a mais infecções respiratórias devido a imunossupressão. OBJETIVO: Este trabalho tem o objetivo de verificar a frequência das rinossinusites pós-TCTH, a associação entre a rinossinusite e a doença do enxerto contra hospedeiro (DECH) crônico e o tipo de transplante e o tratamento clinico e o tratamento cirúrgico e a sobrevida. MÉTODO: Estudo retrospectivo em hospital universitário terciário. Foram selecionados 95 pacientes com doença hematológica submetidos a TCTH entre 1996 a 2011. RESULTADOS: A leucemia mieloide crônica foi a doença mais prevalente. O tipo de transplante mais realizado foi o alogênico (85,26%). A frequência de rinossinusite foi de 36%, sem diferença entre os tipos de transplante autólogo e alogênico. A DECH crônica ocorreu em 30% dos pacientes. Os pacientes com DECH tiveram maior frequência e recorrência de rinossinusite, além de mais necessidade de sinusectomia endoscópica e de diminuição da sobrevida global. CONCLUSÃO: Houve maior frequência de rinossinusite no TCTH e DECH. O tipo de transplante não parece predispor a ocorrência da rinossinusite. A DECH parece ser um fator agravante e necessita de tratamento mais rigoroso. .


Subject(s)
Humans , Graft vs Host Disease , Hematologic Diseases/surgery , Hematopoietic Stem Cell Transplantation/adverse effects , Rhinitis/etiology , Sinusitis/etiology , Chronic Disease , Retrospective Studies , Rhinitis/diagnosis , Sinusitis/diagnosis
16.
Acta cir. bras ; 29(5): 313-319, 05/2014. tab, graf
Article in English | LILACS | ID: lil-709233

ABSTRACT

PURPOSE: Evaluate and compare two different experimental techniques of maxillary sinus ostium occlusion using N-butyl cyanoacrylate in developing chronic histological findings without the inoculation of pathogenic bacteria among rabbits. METHODS: In a randomized study, sixteen New Zealand rabbits were assigned for occlusion of the right maxillary sinus through a transmaxillary approach or through the roof of the nasal cavity. The contralateral sinus served as a control. After 12 weeks, the animals were sacrificed for blinded histopathological analysis of the maxillary sinus mucosa. RESULTS: Histopathological changes consistent with CRS were found in eight (100%) of the maxillary sinuses approached transmaxillary and three of those through the roof of the nasal cavity (37.5%), p 0.008 and 0.250, respectively, comparing with the control side. Chronic mucosal changes were significantly better induced using the transmaxillary approach (p 0.026). CONCLUSION: It is possible to induce a model of chronic sinusitis among rabbits with transmaxillary sinus occlusion without bacterial inoculation. This model can be replicated for future cellular studies. .


Subject(s)
Animals , Male , Rabbits , Disease Models, Animal , Maxillary Sinus/pathology , Nasal Cavity/pathology , Rhinitis/pathology , Sinusitis/pathology , Biopsy , Chronic Disease , Enbucrilate , Maxillary Sinus/surgery , Nasal Cavity/surgery , Nasal Mucosa/pathology , Reference Values , Reproducibility of Results , Rhinitis/etiology , Sinusitis/etiology , Time Factors
18.
Full dent. sci ; 3(10): 217-220, jan.-mar. 2012. tab
Article in English | LILACS, BBO | ID: lil-642922

ABSTRACT

Purpose: The study assessed the occurrence ofallergic rhinitis and bruxism, and the associationbetween these variables from a sample of childrenranging from 1 to 12 years of age in thecity of Santa Maria, RS, Brazil. Study design:This was a retrospective study and data wereanalyzed from 465 records belonging to the PediatricDentistry Clinic at the Federal Universityof Santa Maria from January 1997 to December2008. In a questionnaire applied to the children’sparents, questions about bruxism and allergicrhinitis occurrence were included. The chi-squaretest was used to assess data. Girls made up 51%of the sample and boys 49%. Results: The resultsshowed a 53.1% allergic rhinitis occurrenceand a 23.9% bruxism occurrence. Of the childrenshowing bruxism, 63% also showed allergicrhinitis. Conclusion: Therefore, the associationbetween bruxism and allergic rhinitis was significant.It was concluded that bruxism-bearing childrenare likely to develop allergic rhinitis.


Subject(s)
Infant , Child, Preschool , Child , Bruxism/diagnosis , Bruxism/etiology , Rhinitis/diagnosis , Rhinitis/etiology , Age and Sex Distribution , Chi-Square Distribution
19.
Rev. bras. alergia imunopatol ; 34(1): 12-18, jan.-fev. 2011. ilus
Article in Portuguese | LILACS | ID: lil-596662

ABSTRACT

A maior parte dos pacientes com asma tem rinite, e esta é consideradaum fator de risco independente para a asma. Esta inter-relaçãopode ser vista como manifestação de uma mesma doença em compartimentos distintos. Apesar das inúmeras evidências desta associação, seu mecanismo ainda não está por completo elucidado, abrindo possibilidades e perspectivas para novos estudos, principalmente no que tange aaspectos etiopatogênicos e terapêuticos. Além dos estudos de avaliação clínico-epidemiológica, os estudos experimentais são fundamentais para um melhor entendimento destes mecanismos. Descrevemos as diversas técnicas que têm sido utilizadas para a melhor compreensão destacomplexa interação.


Most asthmatic patients present rhinitis, the latter being anindependent risk factor for asthma. This interrelation could be seenas manifestation of one disease in different compartments. Howeveruncountable evidences for this association have been shown, themechanisms are not completely elucidated, opening possibilities fornew trials, mainly in etiopathogenesis and therapeutics. Besides that, experimental studies are extremely important to explain these mechanisms. We describe those different techniques being used for a better understanding of this complex interaction.


Subject(s)
Asthma/diagnosis , Rhinitis/etiology , Diagnostic Techniques, Respiratory System , Spirometry
20.
RBM rev. bras. med ; 67(supl.2)mar. 2010.
Article in Portuguese | LILACS | ID: lil-545632

ABSTRACT

A rinossinusite é uma doença frequente na prática diária de clínicos gerais, pediatras, alergologistas, pneumologistas e otorrinolaringologistas. Embora tenha baixa mortalidade e alta morbidade, há situações específicas que precisam ser reconhecidas, em que as complicações podem colocar a vida do paciente em risco. Por ser abordada por diversas especialidades e ter formas variadas de apresentações, é importante definir uma classificação comum a fim de estabelecer diagnósticos mais precisos, racionalizar a solicitação de exames complementares e instituir tratamentos adequados. Dessa forma, haverá uma redução nos custos do tratamento, nas complicações e nas formas crônicas da doença, garantindo uma melhor qualidade de vida para o paciente.


Subject(s)
Humans , Male , Female , Child , Adult , Pharmaceutical Preparations , Rhinitis/diagnosis , Rhinitis/etiology , Rhinitis/pathology , Rhinitis/therapy , Sinusitis/etiology , Sinusitis/pathology , Sinusitis/therapy , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/physiopathology , Respiratory Tract Diseases/therapy
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