Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 1.733
Filter
1.
Rev. cir. traumatol. buco-maxilo-fac ; 21(1): 21-26, jan.-mar. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1252367

ABSTRACT

A celulite orbital é uma complicação incomum após quadro de rinossinusite. O objetivo do presente trabalho é relatar um caso de um paciente do sexo masculino, adulto-jovem, 22 anos de idade, que compareceu ao serviço de emergência apresentando edema periorbitário direito, proptose, oftalmoplegia, cefaléia, obstrução nasal e febre. O diagnóstico foi realizado por uma equipe multidisciplinar. A tomografia computadorizada pré-operatória apresentou edema difuso em região periorbitária direita, velamento dos seios: maxilar, esfenoidal e frontal ipsilateral. O paciente foi internado para abordagem cirúrgica e antibioticoterapia. A celulite orbitária associada a rinossinusite é uma complicação rara, sendo comum em crianças, que necessita de um diagnóstico e abordagem multidisciplinar e precoce para evitar extensões cranianas... (AU)


Orbital cellulitis is an uncommon complication after rhinosinusitis. The aim of the present study is to report a case of a 22-year-old male patient, young, 22 years old, who attended the emergency department with right periorbital edema, proptosis, ophthalmoplegia, headache, nasal obstruction and fever. The diagnosis was made by a multidisciplinary team. Preoperative computed tomography showed diffuse edema in the right periorbital region, veiling of the sinuses: maxillary, sphenoidal and ipsilateral frontal. The patient was admitted for surgical approach and antibiotic therapy. Orbital cellulitis associated with rhinosinusitis is a rare complication, common in children, which requires a multidisciplinary and early diagnosis and approach to avoid cranial extensions... (AU)


Subject(s)
Humans , Male , Adult , Sinusitis , Coronavirus Infections , Orbital Cellulitis , Orbital Cellulitis/surgery , Orbital Cellulitis/complications
2.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 743-747, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1142588

ABSTRACT

Abstract Introduction: Chronic rhinosinusitis with nasal polyps, a prevalent disease affecting around 2% of the world population, is characterized by symptomatic inflammation of the nasal mucosa and impairment of quality of life. Chronic rhinosinusitis with nasal polyps has a multifactorial etiology, involving a dysfunctional host response to environmental factors. Thus, inflammatory models may be useful to shed light on the pathophysiology of this disease. Micronucleus count has been used to screen DNA damage in various tissues. Objective: To investigate the association between frequency of micronucleus in exfoliated cells from the nasal cavity of patients with chronic rhinosinusitis with nasal polyps and disease severity. Methods: This cross-sectional study included 21 patients with chronic rhinosinusitis with nasal polyps and 19 controls without disease. None of the participants were smokers. Results: Mean micronucleus count was 3.690 per 1000 cells (±2.165) in individuals with vs. 1.237 per 1000 cells (±0.806) in controls; (Student's t test = 4.653, p< 0.001). Nasal surgery in the past 5 years and aspirin-exacerbated respiratory disease were not associated with nicronucleus count (p= 0.251). Conclusion: Micronucleus count seems to be linked to chronic rhinosinusitis with nasal polyps, providing a new perspective for the evaluation of this disorder.


Resumo Introdução: A rinossinusite crônica com pólipos nasais, doença prevalente que afeta cerca de 2% da população mundial, é caracterizada por inflamação sintomática da mucosa nasal e comprometimento da qualidade de vida. A rinossinusite crônica com pólipos nasais tem etiologia multifatorial, envolvendo resposta disfuncional do hospedeiro a fatores ambientais. Assim, modelos inflamatórios podem ser úteis para esclarecer a fisiopatologia dessa doença. A contagem de micronúcleos tem sido usada para rastrear danos no DNA em vários tecidos. Objetivo: Investigar a associação entre a frequência de micronúcleos em células esfoliadas da cavidade nasal de pacientes com rinossinusite crônica com pólipos nasais e a gravidade da doença. Método: Estudo transversal que incluiu 21 pacientes com rinossinusite crônica com pólipos nasais e 19 controles sem doença. Nenhum dos participantes era fumante. Resultados: A contagem média de micronúcleos foi de 3,690 por 1.000 células (± 2,165) nos indivíduos doentes e 1,237 por 1.000 células (± 0,806) nos controles (teste t de Student = 4,653; p < 0,001). A cirurgia nasal nos últimos 5 anos e a doença respiratória exacerbada por aspirina não foram associadas à contagem de micronúcleos (p = 0,251). Conclusão: A contagem de micronúcleos parece estar ligada à rinossinusite crônica com pólipos nasais, proporcionando uma nova perspectiva para a avaliação dessa doença.


Subject(s)
Humans , Sinusitis/complications , Rhinitis/complications , Nasal Polyps/complications , Quality of Life , Chronic Disease , Cross-Sectional Studies , Epithelial Cells
3.
Rev. Assoc. Med. Bras. (1992) ; 66(11): 1503-1508, Nov. 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1143639

ABSTRACT

SUMMARY OBJECTIVE: To characterize the effects of nasal aspiration with Proetz® in peak nasal inspiratory flow (PNIF) in pediatric sinusitis (PS) patients with nasal obstruction. METHODS: This is a non-randomized descriptive-analytical clinical trial with a quantitative approach. The sample comprised 30 children. Initially, the PNIF was measured and the Visual Analogical Scale (VAS) was used for nasal obstruction, followed by the nasal aspiration procedure. The SNOT-22 questionnaire was applied to the legal guardian of each child, and one week later, it was reapplied for the sake of follow-up. RESULTS: 16 (53.3%) patients were females and 14 (46.7%) were males, with an average age of 6.4±1.8 years (between 4 and 10 years of age). Analyses of the VAS for obstruction before the intervention revealed that 10 of the participants (33.3%) presented moderate levels, and 20 of them (66.7%) severe levels. However, after the Proetz® method was applied, all the samples (n=30) had mild levels. The PNIF significantly increased after the technique was used, with an improvement of 23.4% in mean values. There was no significant correlation between the VAS and the PNIF. CONCLUSION: Nasal aspiration with the Proetz® method significantly improved the clinical condition of sinusitis patients with nasal obstruction according to the visual analogical scale, the PNIF, and the SNOT-22 questionnaire. No correlation between the VAS and the PNIF could be found. The study confirms the importance of non-pharmacological interventions in the treatment of sinusitis in children, thus resulting in an improvement in their quality of life.


RESUMO OBJETIVO: Caracterizar os efeitos da aspiração nasal com Proetz® no pico do fluxo inspiratório nasal (Pnif) em pacientes com sinusite pediátrica (SP) com obstrução nasal. MÉTODOS: Trata-se de um ensaio clínico analítico descritivo, não randomizado, com abordagem quantitativa. A amostra foi composta por 30 crianças. Inicialmente, o Pnif foi medido e a escala visual analógica (EVA) foi utilizada para obstrução nasal, seguida do procedimento de aspiração nasal. O questionário Snot-22 foi aplicado ao responsável legal de cada criança e, uma semana depois, foi reaplicado para fins de acompanhamento. RESULTADOS: Dezesseis (53,3%) pacientes eram do sexo feminino e 14 (46,7%) do sexo masculino, com idade média de 6,4±1,8 anos (entre 4 e 10 anos). A análise da EVA para obstrução antes da intervenção revelou que dez dos participantes (33,3%) apresentaram níveis moderados e 20 deles (66,7%), níveis graves. No entanto, após a aplicação do método Proetz®, todas as amostras (n=30) apresentaram níveis leves. O Pnif aumentou significativamente após a utilização da técnica, com uma melhoria de 23,4% nos valores médios. Não houve correlação significativa entre EVA e Pnif. CONCLUSÃO: A aspiração nasal com o método Proetz® melhorou significativamente o quadro clínico de pacientes com sinusite com obstrução nasal, de acordo com a escala visual analógica, o Pnif e o questionário Snot-22. Não foi encontrada correlação entre EVA e Pnif. O estudo confirma a importância de intervenções não farmacológicas no tratamento da sinusite em crianças, resultando em melhoria na sua qualidade de vida.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Sinusitis/therapy , Quality of Life , Nasal Obstruction , Surveys and Questionnaires , Visual Analog Scale
4.
Braz. j. otorhinolaryngol. (Impr.) ; 86(5): 639-646, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1132645

ABSTRACT

Abstract Introduction: Currently, several different concentrations of saline are recommended for use in nasal irrigation. Increasing studies show that nasal irrigation with hypertonic saline is more effective than traditional saline in the treatment of rhinosinusitis, but there have been few systematic analyses of the effect of nasal irrigation with hypertonic saline on chronic rhinosinusitis. Objective: We sought to compare the effects of hypertonic saline and isotonic saline in the treatment of rhinosinusitis in order to provide a reference for clinical nasal irrigation for chronic rhinosinusitis treatment. Methods: Medline, cochrane library, EMBASE, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database, and other databases were searched, and the searching was supplemented by manual searches for relevant references to treatment of rhinosinusitis by saline nasal irrigation. The last retrieval date was March 2018. The included studies were evaluated for quality, and data were extracted for meta-analysis using RevMan 5.3. Results: Seven studies were included. Effects favoring hypertonic saline on nasal symptoms were greater in 4 subgroups. These were (1) patients with nasal secretion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (2) patients with congestion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (3) patients with headache (SMD = 0.82; 95% CI: 0.38, 1.26; p < 0.01), (4) patients with overall symptomatic relief (SMD = 1.63; 95% CI: 0.83, 2.44; p < 0.01). However, no difference was shown in smell improvement (SMD = 0.47; 95% CI: −0.65, 1.59; p = 0.41) and radiologic scores improvement (SMD = 2.44; 95% CI: -3.14, 8.02; p < 0.01). Besides, hypertonic saline showed greater improvement in mucociliary clearance time scores than did the isotonic saline group (SMD = 1.19; 95% CI: 0.78, 1.60; p < 0.01). Hypertonic saline brought greater minor adverse effects. Conclusion: Compared with isotonic saline, hypertonic saline nasal irrigation for the treatment of chronic rhinosinusitis is significantly more effective and has mild side effects in improving nasal symptoms and ciliary movement, but there is no significant difference in imaging findings and smell improvement. Although hypertonic saline is worthy of widespread use in clinical practice, it is still necessary to further study the exact manner and concentration of nasal irrigation.


Resumo Introdução: Atualmente, o uso de várias concentrações diferentes de solução salina é recomendado na irrigação nasal. Um número crescente de estudos mostra que a irrigação nasal com solução salina hipertônica é mais eficaz do que a solução salina tradicional no tratamento de rinossinusite, mas existem poucas análises sistemáticas do efeito da irrigação nasal com solução salina hipertônica em rinossinusite crônica. Objetivo: Comparar os efeitos da solução salina hipertônica com a solução salina isotônica no tratamento da rinossinusite, para fornecer uma referência clínica de irrigação nasal no tratamento da rinossinusite crônica. Método: Foram pesquisados os bancos de dados Medline, Cochrane Library, Embase, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database e outros, e a pesquisa foi complementada por pesquisas manuais de referências relevantes ao tratamento da rinossinusite por irrigação nasal com solução salina. A data da última recuperação de dados foi março de 2018. Os estudos incluídos foram avaliados quanto à qualidade e os dados foram extraídos para a metanálise com o software RevMan 5.3. Resultados: Sete estudos foram incluídos. Os efeitos favoráveis à solução salina hipertônica nos sintomas nasais foram maiores em quatro subgrupos. Esses foram (1) pacientes com secreção nasal (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (2) pacientes com congestão (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (3) Pacientes com dor de cabeça (DMP = 0,82; IC95%: 0,38, 1,26; p ˂ 0,01); (4) Pacientes com alívio sintomático geral (DMP = 1,63; IC95%: 0,83, 2,44; p ˂ 0,01). Entretanto, não houve diferença na melhoria do olfato (DMP = 0,47; IC95%: -0,65, 1,59; p = 0,41) e na melhoria dos escores radiológicos (DMP = 2,44; IC95%: -3,14, 8,02; p < 0,01). Além disso, o grupo solução salina hipertônica mostrou maior melhoria nos escores do tempo de clearence mucociliar do que o grupo solução salina isotônica (DMP = 1,19; IC95%: 0,78, 1,60; p ˂ 0,01). A solução salina hipertônica causou efeitos adversos menores. Conclusão: Em comparação com a solução salina isotônica, a irrigação nasal com solução salina hipertônica para o tratamento da rinossinusite crônica é significantemente mais eficaz e apresenta efeitos colaterais mais leves, melhoria mais acentuada dos sintomas nasais e no movimento ciliar, mas não há diferença significante nos achados de imagem e na melhoria do olfato. Embora a solução salina hipertônica seja digna de uso generalizado na prática clínica, ainda são necessários mais estudos sobre a forma de uso e a concentração ideal da solução nasal.


Subject(s)
Humans , Sinusitis , Rhinitis , Saline Solution, Hypertonic , Sodium Chloride , Chronic Disease , Nasal Lavage
5.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(3): 352-359, set. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144900

ABSTRACT

Resumen Los pacientes trasplantados presentan mayor vulnerabilidad a complicaciones infecciosas, no solo debido al uso de drogas inmunosupresoras, sino que también, a las enfermedades subyacentes que presentan y a la falla de órganos primarios. A pesar de que las infecciones otorrinolaringológicas no son frecuentes en estos pacientes, es importante establecer un adecuado estudio y tratamiento de ellas. A través del siguiente artículo se aportan directrices en el estudio pretrasplante desde un enfoque otorrinolaringológico, generando recomendaciones de acuerdo a la patología del paciente y el órgano a trasplantar. Si bien, las recomendaciones se realizan según evaluación rinosinusal, otológica y faringoamigdalina, una adecuada anamnesis y examen físico son los pilares de la evaluación pretrasplante en otorrinolaringología, reservándose el estudio con imágenes para aquellos pacientes con alteraciones sospechosas.


Abstract Transplanted patients have higher frequency of infectious complications, not only due to the use of immunosuppressive drugs, but also the underlying diseases that present and the failure of primary organs. Although ear, nose and throat (ENT) infections are not frequent in these patients, it is important to establish an adequate study and treatment of them. Through the following article, guidelines are provided in the pretransplant study from an ENT approach, generating recommendations according to the pathology of the patient and the organ to be transplanted. Although, the recommendations are made according to rhinosinusal, otological and pharyngotonsiline evaluation, adequate anamnesis and physical examination are the pillars of the pretransplant evaluation in otolaryngology, reserving the study with images for patients with suspicious alterations.


Subject(s)
Humans , Otorhinolaryngologic Diseases/surgery , Organ Transplantation , Transplantation Conditioning/methods , Otitis Media/therapy , Sinusitis/therapy , Rhinitis/therapy , Surgical Clearance/methods , Infections
6.
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
7.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 281-286, May-June 2020. tab
Article in English | LILACS | ID: biblio-1132589

ABSTRACT

Abstract Introduction: Clinicians rely on clinical presentations to select therapeutic agents for acute bacterial rhinosinusitis. Streptococcus pneumoniae and Haemophilus influenzae are common in acute bacterial rhinosinusitis. Drug resistant Streptococcus pneumoniae and Haemophilus influenzae require different antibiotics. Objective: This study aimed to evaluate the associations between clinical features of acute bacterial rhinosinusitis and pathogenic bacteria. Methods: Sixty-four patients with acute bacterial rhinosinusitis were enrolled. Clinical features including nasal obstruction, discolored discharge, facial pain, smell disturbance, fever and laboratory findings of patients with acute bacterial rhinosinusitis were collected. The bacterial cultures of endoscopic middle meatal swabs were used as a reference. Results: Serum C-reactive protein level elevation correlated with the bacterial species (p = 0.03), by which was increased in 80.0% of Haemophilus influenzae rhinosinusitis and 57.1% of Streptococcus pneumoniae rhinosinusitis. The elevated C-reactive protein was the significant predictor for Haemophilus influenzae rhinosinusitis with the Odds Ratio of 18.06 (95% CI 2.36-138.20). The sensitivity of serum C-reactive protein level elevation for diagnosing Haemophilus influenzae rhinosinusitis was 0.80 (95% CI 0.49-0.94). Conclusion: Elevation of serum C-reactive protein level was associated with and predicted acute bacterial rhinosinusitis caused by Haemophilus influenzae.


Resumo: Introdução: Os médicos se baseiam nas características clínicas para a escolha dos agentes terapêuticos para o tratamento da rinossinusite bacteriana aguda. Streptococcus pneumoniae e Haemophilus influenzae são agentes comuns na rinossinusite bacteriana aguda. Streptococcus pneumoniae e Haemophilus influenzae resistentes a antibióticos requerem medicamentos diferentes. Objetivo: Avaliar as associações entre as características clínicas da rinossinusite bacteriana aguda e bactérias patogênicas. Método: O estudo incluiu 64 pacientes com rinossinusite bacteriana aguda. Foram coletadas e registradas as características clínicas, inclusive obstrução nasal, secreção com cor alterada, dor facial, distúrbios do olfato, febre e achados laboratoriais de pacientes com rinossinusite bacteriana aguda. As culturas bacterianas obtidas por swab endoscópico do meato médio foram usadas como referência. Resultados: A elevação do nível sérico de proteína C-reativa estava correlacionada com a espécie bacteriana (p = 0,03); ela estava aumentada em 80,0% das rinossinusites por Haemophilus influenzae e em 57,1% das rinossinusites por Streptococcus pneumoniae. A proteína C-reativa elevada foi um significativo fator preditor de rinossinusite por Haemophilus influenzae, com razão de probabilidade de 18,06 (IC 95% 2,36-138,20). A sensibilidade da elevação dos níveis séricos de proteína C-reativa para o diagnóstico de rinossinusite por Haemophilus influenzae foi de 0,80 (IC 95% 0,49 ± 0,94). Conclusão: A elevação dos níveis séricos de proteína C-reativa é um preditor de rinossinusite bacteriana aguda causada por Haemophilus influenzae.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Sinusitis/microbiology , Rhinitis/microbiology , Gram-Positive Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/microbiology , Acute Disease , Cross-Sectional Studies
8.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(2): 147-156, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1115829

ABSTRACT

INTRODUCCIÓN: La rinosinusitis crónica odontogénica (RSCO) es un proceso inflamatorio/infeccioso de la mucosa nasal y senos paranasales (SPN) de origen dental. Corresponde a una patología subdiagnosticada en la actualidad. El gold standard diagnóstico es la tomografia computarizada. Los tratamientos difieren, desde tratamiento médico aislado hasta médico-quirúrgico de SPN o combinados. OBJETIVO: Caracterizar los resultados clinicos e imagenológicos de pacientes con RSCO en función del tratamiento recibido, para establecer recomendaciones terapéuticas. Describir la frecuencia de subdiagnóstico de esta patología. MATERIAL Y MÉTODO: Estudio descriptivo, retrospectivo. Se incluyeron pacientes con diagnóstico clínico e imagenológico de RSCO entre los años 2013-2017 en un centro de atención médico privado, a los que se realizó una tomografía computarizada cone beam de control. Fueron excluidos aquellos con rinosinusitis crónica, cirugía endoscópica funcional (CEF) previa, cáncer, embarazadas, rechazo a tomografía computarizada cone beam, ausencia de imágenes preoperatorias y menores de 18 años. RESULTADOS: De un total de 27 pacientes, en los operados de CEF (n =24; 89%) la resolución total de los síntomas se logró en 20/24 (83%), resolución parcial 3/24 (12,5%) y persistencia de los síntomas 1/24 (4%). Discusión: De los pacientes con RSCO 22/27 (81%) no tenían reportado el foco dental en el informe radiológico a pesar de ser visible. Aquellos pacientes con sintomatologia postratamiento, hubo factores identificados como la bilateralidad, mala dentadura general, falta de combinación de tratamiento dental y CEF. CONCLUSIONES: La CEF combinada con tratamiento dental concomitante, tiene un alto grado de éxito radiológico y clínico en esta patología. No fue posible demostrar si siempre es requerida la exodoncia con cierre de fístula oro-antral o si se pueden seleccionar pacientes para un tratamiento más conservador.


INTRODUCTION: Chronic odontogenic rhinosinusitis (CORS) is an inflammatory/infectious process of the nasal mucosa and sinuses of dental origin. Actually, it corresponds to an underdiagnosed pathology. The gold standard diagnosis is computed tomography. The treatments differ, from isolated medical treatment to medical-surgical sinuses or combined. AIM: To characterize the clinical and imaging results of patients with CORS according to the treatment received, to establish therapeutic recommendations. In addition to describing the frequency of subdiagnosis of this pathology. MATERIAL AND METHOD: Descriptive, retrospective study. Patients with clinical and imaging diagnosis of CORS between 2013-2017 were included in a private medical care center, to whom a cone beam computed tomography control was performed. Those with chronic rhinosinusitis, previous functional endoscopic sinus surgery (FESS), cancer, pregnant women, rejection of cone beam computed tomography, absence of preoperative images and those under 18 years were excluded. RESULTS: Of all patients operated on FESS (n =24; 89%) the total resolution of the symptoms was 20/24 (83%), partial resolution 3/24 (12.5%) and persistence of the symptoms a 1/24 (4%). Discussion: 22/27 (81%) of patients with CORS had not reported the dental focus in the radiological report despite being visible. Those patients with post-treatment symptoms had identified factors such as bilaterality, general bad teeth, lack of combination of dental treatment and FESS. CONCLUSION: The FESS combined with concomitant dental treatment, has a high degree of radiological and clinical success in this pathology. It was not possible to demonstrate whether exodontia with closure of oroantral fistula is always required or if patients can be selected for a more conservative treatment.


Subject(s)
Humans , Male , Female , Sinusitis/surgery , Rhinitis/surgery , Sinusitis/diagnostic imaging , Rhinitis/diagnostic imaging , Retrospective Studies , Treatment Outcome , Endoscopy , Cone-Beam Computed Tomography , Focal Infection, Dental/complications
9.
Rev. cir. traumatol. buco-maxilo-fac ; 20(1): 34-38, jan.-mar. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1253593

ABSTRACT

Introdução: O seio maxilar possui íntima relação com os molares e, por esse motivo, após a extração desses elementos, pode ocorrer comunicação entre as cavidades bucais e sinusais. Quando o canal que possibilita a comunicação entre as cavidades é revestido por epitélio, chamamos de fístula buço-sinusal. O diagnóstico se dá por meio dos aspectos clínicos e radiográficos. O tratamento deve ser imediato, para que ocorra fechamento espontâneo. O objetivo deste trabalho é discutir um fechamento de Fístula Buco-Sinusal com tratamento expectante do seio maxilar e manejo cirúrgico associado à sinusite. Relato de caso: Homem, 33 anos, compareceu à FOP-UPE relatando incômodo ao ingerir alimentos e história de exodontia traumática do elemento 17 há 1 ano. Ao exame intra-oral, observou-se a presença da fístula na região da exodontia e, ao exame tomográfico, foi observada radiopacidade em seio maxilar, sugerindo fenestração óssea e sinusite, respectivamente. Iniciou-se antibioticoterapia e descongestionante nasal para sinusite e posterior cirurgia de fechamento da fístula buco-sinusal com uso da bola de Bichat. O manejo adequado é essencial no sucesso terapêutico da fístula. Além disso, a avaliação clínica e a radiográfica auxiliam na sua prevenção. Considerações Finais: Nosso caso concordou com a literatura, demonstrando que o uso da bola de Bichat é um método simples, conveniente e confiável para a reconstrução de defeitos intraorais de pequeno a médio porte... (AU)


Introduction: The maxillary sinus has a relation with the molars, for this reason, after extraction of these teeth can occur communication between buccal and sinus cavities. When the channel that allows the communication between the cavities is coated epithelium, we diagnose oroantral fistula. The diagnosis is made through clinical and radiographic aspects. Treatment should be immediate so that spontaneous closure occurs. The objective of this study is to discuss a closure of Buco-Sinus Fistula with expectant treatment of the maxillary sinus and surgical management associated with sinusitis. Case report: Man, 33 years old, attended FOP-UPE reporting discomfort when eating food and history of traumatic exodontia of element 17, 1 year ago. The intra-oral examination revealed the presence of the fistula in the region of the exodontia and at the tomographic examination radiopacity was observed in the maxillary sinus, suggesting bone fenestration and sinusitis, respectively. Antibiotic therapy and nasal decongestant for sinusitis and subsequent closure of the bucosinus fistula with Buccal Fat were started. Adequate management is essential for the therapeutic success of the fistula. In addition, clinical and radiographic evaluation helps to prevent. Final considerations: Our case corroborates the literature, showing that the use of the bichat ball is a simple, convenient and reliable method for the reconstruction of small to medium sized intraoral defects... (AU)


Subject(s)
Humans , Male , Adult , Surgery, Oral , Maxillary Sinusitis , Oroantral Fistula , Antibiotic Prophylaxis , Diagnosis, Oral , Maxillary Sinus , Anti-Bacterial Agents , Sinusitis , Therapeutics , Bone and Bones , Eating
10.
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
12.
Braz. j. otorhinolaryngol. (Impr.) ; 86(1): 56-62, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1089365

ABSTRACT

Abstract Introduction Chronic rhinosinusitis is a broad clinical syndrome characterized by mucosal inflammation of the nose and paranasal sinuses. In order for the paranasal sinuses to maintain their physiological functions; the ostiomeatal complex drainage pathways must be open. Surgical procedures are an important treatment option in patients who do not respond adequately to medical treatment. Although the methods and instruments used in functional endoscopic sinus surgery have continued to improve in recent years, the scar tissue formed during operation disrupts the drainage of the sinuses and reduces postoperative success. The natural ostiodilatation method, which is performed by balloon sinoplasty method, has become more and more popular in recent years. Objectives To compare the technique of balloon sinoplasty with the classical functional endoscopic sinus surgery method by considering the severity of chronic sinusitis on the same patient. Methods Total of 61 chronic sinusitis patients was included in the study. Paranasal sinus tomography of the patients was taken and according to the Lund-Mackay scoring, chronic sinusitis levels were determined. Cases were divided into two groups: Group 1 (severe chronic sinusitis group) and Group 2 (mild chronic sinusitis). Results There was no statistically significant difference in the results of comparison of sinuses which underwent balloon sinoplasty and classical functional endoscopic sinus surgery in Group 2 after Lund-Mackay scores. However in Group 1, the results of the comparison of postoperative Lund-Mackay scores of the balloon sinoplasty and the classical endoscopic operation were statistically significantly lower than those of the face half operated with the classical functional endoscopic sinus surgery. Conclusion The success of balloon sinoplasty in patients with mild sinusitis is the same as in classic functional endoscopic sinus surgery. However, as the severity of sinusitis increases, the efficacy of balloon sinoplasty decreases.


Resumo Introdução A rinossinusite crônica é uma síndrome clínica ampla, caracterizada por inflamação da mucosa nasal e seios paranasais. Para que os seios paranasais mantenham suas funções fisiológicas, as vias de drenagem do complexo ostiomeatal devem estar abertas. Os procedimentos cirúrgicos são uma importante opção de tratamento em pacientes que não respondem adequadamente ao tratamento clínico. Embora os métodos e instrumentos utilizados na cirurgia endoscópica funcional dos seios paranasais tenham melhorado continuamente, o tecido cicatricial formado durante a cirurgia interrompe a drenagem dos seios nasais e reduz o sucesso pós-operatório. O método natural de dilatação ostial, que é aplicado por meio da técnica de sinuplastia com balão, tem se tornado cada vez mais popular nos últimos anos. Objetivos Comparar a técnica de sinuplastia com balão com o método convencional de cirurgia endoscópica, no mesmo paciente, considerando a gravidade da rinossinusite crônica. Método Foram incluídos no estudo 61 pacientes com rinossinusite crônica. Por meio de tomografia dos seios paranasais e de acordo a escala de Lund-Mackay foram determinados os graus da rinossinusite crônica. Os casos foram divididos em dois grupos: Grupo 1 (grupo com rinossinusite crônica grave) e Grupo 2 (rinossinusite crônica leve). Resultados No Grupo 2 não houve diferença estatisticamente significante, segundo a escala de Lund-Mackay, no resultado da comparação dos seios paranasais nos quais foram realizadas a sinuplastia com balão e por cirurgia endoscópica convencional. No entanto, no Grupo 1, os resultados da comparação dos escores pós-operatórios de Lund-Mackay mostraram-se estatística e significativamente melhores naqueles submetidos à cirurgia endoscópica funcional dos seios paranasais. Conclusão O sucesso da sinuplastia com balão em pacientes com rinossinusite leve é o mesmo da cirurgia endoscópica funcional dos seios da face tradicional. No entanto, à medida que a gravidade da rinossinusite aumenta, a eficácia da sinuplastia com balão diminui.


Subject(s)
Humans , Male , Female , Middle Aged , Sinusitis/surgery , Rhinitis/surgery , Dilatation/methods , Endoscopy/methods , Nasal Surgical Procedures/methods , Postoperative Period , Otorhinolaryngologic Surgical Procedures , Severity of Illness Index , Tomography, X-Ray Computed , Chronic Disease , Treatment Outcome
13.
Rev. chil. infectol ; 37(1): 77-81, feb. 2020. graf
Article in Spanish | LILACS | ID: biblio-1092725

ABSTRACT

Resumen Los episodios de neutropenia febril son cuadros graves, que requieren un estudio etiológico exhaustivo y un inicio rápido de antimicrobianos. Dentro de los posibles microorganismos causales se encuentran los de origen fúngico, los que, dependiendo de su grado de invasión tisular, pueden llegar a presentar una alta mortalidad. Presentamos el caso de un niño con una leucemia mieloide aguda, que tras su quimioterapia de inducción, presentó un episodio de neutropenia febril, con una infección rino-sinusal por Exserohilum rostratum, hongo filamentoso que raramente se asocia a cuadros patológicos. Se inició rápidamente terapia antifúngica, lo cual, asociado a un aseo quirúrgico precoz, lograron una respuesta clínica favorable, sin complicaciones. Luego del seguimiento, y tras recibir profilaxis secundaria durante los episodios de neutropenia, no ha vuelto a presentar nuevas lesiones ni compromiso rino-sinusal.


Abstract The episodes of febrile neutropenia are severe cases that require an exhaustive etiological study and a quick start of antimicrobial agents. Within the possible microorganisms, fungal origins are also found, and depending on its tissue invasion, they can reach a high mortality rate. A case of a pediatric patient who suffered from acute myeloid leukemia is reported, and after his induction chemotherapy, the patient showed an episode of febrile neutropenia, which matches a rhinosinusal infection caused by Exserohilum rostratum, a filamentous fungi that is uncommonly associated with pathological cases. An antifungal therapy and an early surgical treatment were started, which lead to a positive response, without complications to the patient. After the monitoring and receiving secondary prophylaxis during the episodes of neutropenia, the patient hasn't presented new injuries nor rhinosinusal damage.


Subject(s)
Humans , Child , Ascomycota/isolation & purification , Sinusitis/complications , Sinusitis/microbiology , Sinusitis/drug therapy , Leukemia, Myeloid, Acute/complications , Mycoses/complications , Mycoses/drug therapy , Antifungal Agents/therapeutic use , Treatment Outcome , Neutropenia/etiology
14.
Braz. dent. sci ; 23(2): 1-10, 2020. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1095374

ABSTRACT

Background and aim: Endoscopic sinus surgery owing to its satisfactory prognosis and low complication is considered as the first line of surgical procedure. Implant failure is often reported despite efforts in recent years. The purpose of this study was to review the factors leading to side effects in dental implantation of the maxillary sinus. Material and Methods: The systematic search was performed on electronic databases of MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google scholar to find corresponding articles regarding dental literature during 2010 to 2019. Electronic title management was carried out by Endnote X9 software. Searches were based on the keywords of "dental implants", "Implants"," dental"," maxilla", "sinusitis". Results: The searched potentially relevant titles and abstracts were related to 294 articles, 104 of which were excluded due to lack of study inclusion criteria. At last, 11 articles were included into the final analysis. Postoperative sinusitis was found in 78 patients within 9 articles among 1195 patients. The implant failure was reported in 136 cases and the sinus membrane perforation in 185 sinuses within 11 articles among 1372 sinus lift procedures. Conclusion: The findings showed that the risk factors of sinusitis after implant surgery were Schneiderian membrane rupture and preoperative sinusitis, as well as smoking and residual bone height were the parameters elevating the dental implant failure risk. (AU)


Justificativa e objetivo: A cirurgia endoscópica do seio maxilar, devido ao seu prognóstico satisfatório e baixa complicação, é considerada a primeira opção cirúrgica. A falha do implante é frequentemente relatada, apesar dos esforços realizados nos últimos anos. O objetivo deste estudo foi revisar os fatores que levaram a efeitos colaterais no implante dentário do seio maxilar. Material e Métodos: A busca sistemática foi realizada nas bases de dados eletrônicas do MEDLINE, PubMed, Cochrane Library, Embase, ISI, Google Scholar para encontrar artigos correspondentes sobre literatura odontológica no período de 2010 a 2019. O gerenciamento eletrônico de títulos foi realizado pelo software Endnote X9. As pesquisas foram baseadas nas palavras-chave "implantes dentários", "implantes", "dentário", "maxila", "sinusite". Resultados: Os títulos e resumos potencialmente relevantes pesquisados foram relacionados a 294 artigos, 104 dos quais foram excluídos por falta de critérios de inclusão no estudo. Por fim, 11 artigos foram incluídos na análise final. Sinusite pós-operatória foi encontrada em 78 pacientes em 9 artigos entre 1195 pacientes. A falha do implante foi relatada em 136 casos e a perfuração da membrana sinusal em 185 seios, em 11 artigos, entre 1372 procedimentos de elevação sinusal. Conclusão: Os achados mostraram que os fatores de risco para sinusite após cirurgia de implante foram ruptura da membrana Schneideriana e sinusite pré-operatória, assim como tabagismo e altura óssea residual, os quais foram considerados parâmetros que elevaram o risco de falha do implante dentário. (AU)


Subject(s)
Sinusitis , Dental Implants , Dental Restoration Failure
15.
Article in Spanish | LILACS, COLNAL | ID: biblio-1102963

ABSTRACT

Introducción: la rinosinusitis crónica (RSC) es una de las enfermedades más prevalentes a nivel mundial. Los eosinófilos desempeñan un papel importante en la generación del proceso inflamatorio nasosinusal crónico secundario a la generación de una respuesta maladaptativa Th2 y cambios en la microbiota nasal. El objetivo del estudio es determinar si la eosinofilia periférica puede usarse como factor predictor de severidad tomográfica en pacientes que cursan con rinosinusitis crónica. Métodos: se realizó un estudio observacional de corte transversal con componente analítico en pacientes con diagnóstico de RSC quienes dispusieran en su registro de historia clínica un hemograma con recuento de eosinófilos. El tamaño de la muestra fue de 74 individuos. Resultados: la eosinofilia periférica se estableció como factor de severidad tomográfica, ya que se encontró que por cada incremento de 100 eosinófilos en sangre, aumentaría en un punto el puntaje total de la escala tomográfica Lund-Mackay. Este patrón fue similar en pacientes con pólipos y asma, en los que se encontró un incremento en los puntajes totales de 4 y 5 puntos, respectivamente, con respecto a los pacientes que no presentan estas patologías. Conclusión: la utilización de la eosinofilia periférica como predictor de severidad podría ser de gran utilidad para la comunidad médica. Este biomarcador puede resultar en un ahorro potencial de costos al eliminar la necesidad de tratamientos médicos repetidos en pacientes que de entrada tienen un riesgo incrementado de enfermedad nasosinusal severa.


Introduction: chronic rhinosinusitis (CRS) is one of the most prevalent diseases worldwide. Eosinophils play an important role in the generation of a chronic nasosinusal inflammatory process secondary to the generation of a Th2 maladaptive response and changes in the nasal microbiota. The objective of the study is to determine if peripheral eosinophilia can be used as a predictor of tomographic severity in patients with chronic rhinosinusitis. Methods: an observational cross-sectional study with an analytical component was performed in patients with a diagnosis of CSR who had an eosinophil count in their clinical record. The sample size was 74 individuals. Results: peripheral eosinophilia was established as a tomographic severity factor, finding that for each increase of 100 eosinophils in blood, the total score of the Lund-Mackay tomographic scale would increase by 1 point. This pattern was equally concordant in patients with polyps and asthma, with increases in total scores of 4 and 5 points respectively, with respect to patients who do not present these pathologies. Conclusion: the uses of peripheral eosinophilia as a predictor of severity could be very useful for the medical community. This biomarker can result in potential cost savings by eliminating the need for repeated medical treatments in patients who initially have an increased risk of severe nasosinusal disease.


Subject(s)
Humans , Sinusitis , Nasal Polyps , Eosinophilia , Eosinophils
16.
Article in English | WPRIM | ID: wpr-785339

ABSTRACT

PURPOSE: Osteitis refers to the development of new bone formation and remodeling of bone in chronic rhinosinusitis (CRS) patients; it is typically associated with eosinophilia, nasal polyps (NPs), and recalcitrant CRS. However, the roles of ossification in CRS with or without NPs remain unclear due to the lack of appropriate animal models. Thus, it is necessary to have a suitable animal model for greater advances in the understanding of CRS pathogenesis.METHODS: BALB/c mice were administered ovalbumin (OVA) and staphylococcal enterotoxin B (SEB). The numbers of osteoclasts and osteoblasts and bony changes were assessed. Micro computed tomography (micro-CT) scans were conducted to measure bone thickness. Immunofluorescence, immunohistochemistry, and quantitative polymerase chain reaction were performed to evaluate runt-related transcription factor 2 (RUNX2), osteonectin, interleukin (IL)-13, and RUNX2 downstream gene expression. Gene set enrichment analysis was performed in mucosal tissues from control and CRS patients. The effect of resveratrol was evaluated in terms of osteogenesis in a murine eosinophilic CRS NP model.RESULTS: The histopathologic changes showed markedly thickened bones with significant increase in osteoblast numbers in OVA/SEB-treated mice compared to the phosphate-buffered saline-treated mice. The structural changes in bone on micro-CT were consistent with the histopathological features. The expression of RUNX2 and IL-13 was increased by the administration of OVA/SEB and showed a positive correlation. RUNX2 expression mainly co-localized with osteoblasts. Bioinformatic analysis using human CRS transcriptome revealed that IL-13-induced bony changes via RUNX2. Treatment with resveratrol, a candidate drug against osteitis, diminished the expression of IL-13 and RUNX2, and the number of osteoblasts in OVA/SEB-treated mice.CONCLUSIONS: In the present study, we found the histopathological and radiographic evidence of osteogenesis using a previously established murine eosinophilic CRS NP model. This animal model could provide new insights into the pathophysiology of neo-osteogenesis and provide a basis for developing new therapeutics.


Subject(s)
Animals , Computational Biology , Core Binding Factor Alpha 1 Subunit , Enterotoxins , Eosinophilia , Eosinophils , Fluorescent Antibody Technique , Gene Expression , Humans , Immunohistochemistry , Interleukin-13 , Interleukins , Mice , Models, Animal , Mucous Membrane , Nasal Polyps , Nose , Osteitis , Osteoblasts , Osteoclasts , Osteogenesis , Osteonectin , Ovalbumin , Polymerase Chain Reaction , Sinusitis , Transcription Factors , Transcriptome
18.
Article in English | WPRIM | ID: wpr-762184

ABSTRACT

PURPOSE: Various immune cells, including eosinophils and neutrophils, are known to contribute to the development of chronic rhinosinusitis with nasal polyps (CRSwNP). However, the current understanding of the role of neutrophils in the development of CRSwNP still remains unclear. Therefore, we investigated risk factors for refractoriness of CRSwNP in an Asian population. METHODS: Protein levels of 17 neutrophil-related mediators in nasal polyps (NPs) were determined by multiplex immunoassay, and exploratory factor analysis using principal component analysis was performed. Immunofluorescence analysis was conducted to detect human neutrophil elastase (HNE) or myeloperoxidase (MPO)-positive cells. Tissue eosinophilic nasal polyp (ENP) and tissue neutrophilia (Neu(high)) were defined as greater than 70 eosinophils and 20 HNE-positive cells, otherwise was classified into non-eosinophilic nasal polyp (NENP) and absence of tissue neutrophilia (Neu(low)). RESULTS: In terms of disease control status, NENP-Neu(low) patients showed the higher rate of disease control than NENP-Neu(high) and ENP-Neu(high) patients. Linear by linear association demonstrated the trend in refractoriness from NENP-Neu(low) to NENP-Neu(high) or ENP-Neu(low) to ENP-Neu(high). When multiple logistic regression was performed, tissue neutrophilia (hazard ratio, 4.38; 95% confidence interval, 1.76-10.85) was found as the strongest risk factor for CRSwNP refractoriness. Additionally, exploratory factor analysis revealed that interleukin (IL)-18, interferon-γ, IL-1Ra, tumor necrosis factor-α, oncostatin M, and MPO were associated with good disease control status, whereas IL-36α and IL-1α were associated with refractory disease control status. In subgroup analysis, HNE-positive cells and IL-36α were significantly upregulated in the refractory group (P = 0.0132 and P = 0.0395, respectively), whereas MPO and IL-18 showed higher expression in the controlled group (P = 0.0002 and P = 0.0009, respectively). Moreover, immunofluorescence analysis revealed that IL-36R⁺HNE⁺-double positive cells were significantly increased in the refractory group compared to the control group. We also found that the ratio of HNE-positive cells to α1 anti-trypsin was increased in the refractory group. CONCLUSIONS: Tissue neutrophilia had an influence on treatment outcomes in the Asian CRSwNP patients. HNE-positive cells and IL-36α may be biomarkers for predicting refractoriness in Asians with CRSwNP. Additionally, imbalances in HNE and α1 anti-trypsin may be associated with pathophysiology of neutrophilic chronic rhinosinusitis.


Subject(s)
Asian Continental Ancestry Group , Biomarkers , Eosinophils , Fluorescent Antibody Technique , Humans , Immunoassay , Interleukin 1 Receptor Antagonist Protein , Interleukin-18 , Interleukins , Leukocyte Elastase , Logistic Models , Nasal Polyps , Necrosis , Neutrophils , Oncostatin M , Peroxidase , Principal Component Analysis , Rhinitis , Risk Factors , Sinusitis
19.
Article in English | WPRIM | ID: wpr-876443

ABSTRACT

@#Objective: To present a unique case of blindness resulting from fungal rhinosinusitis involving multiple sinuses mimicking a malignant process in a pregnant patient. Methods: Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Result: A 36-year-old pregnant woman developed unilateral blindness during her 20th week of gestation with a history of binocular diplopia, unilateral nasal obstruction and anosmia for 13 months during the pre-pregnancy period. Sphenoid sinus malignancy was suspected on imaging. The planned biopsy was intraoperatively shifted to endoscopic sinus surgery when clay-like materials were seen involving the left maxillary sinus and bilateral sphenoid and ethmoid sinuses. Histopathologic examination confirmed fungal growth. Postoperatively, nasal symptoms resolved but blindness of the left eye and blurring of vision of the right eye persisted. Conclusion: Fungal rhinosinusitis rarely occurs in multiple sinuses and is commonly misdiagnosed. It can afflict pregnant patients and mimic a malignant process. A high index of suspicion early on, especially in the presence of nasal congestion and diplopia may prevent potentially irreversible complications.


Subject(s)
Sinusitis , Sphenoid Sinus , Maxillary Sinus , Pregnancy
20.
Article in English | WPRIM | ID: wpr-876439

ABSTRACT

@#Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: Design: Quasi - Experimental Prospective Cohort Study Setting: Tertiary Government Training Hospital Participants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.


Subject(s)
Stents , Nasal Obstruction , Nasal Polyps , Sinusitis
SELECTION OF CITATIONS
SEARCH DETAIL