RESUMEN
Introduction: Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%. Objectives: To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus. Resumed: Report a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination. Conclusion: Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation...
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Cavidad Nasal , Papiloma Invertido , Seno EsfenoidalRESUMEN
Fundamentos: Estudos em diferentes populações revelam prevalências diversas de complicações pós-operatórias em cirurgias cardíacas, dependendo do critério utilizado e das características da população estudada. No Brasil os dados são escassos, necessitando de estudos que caracterizem melhor tais complicações. Objetivo: Identificar quais são e como se apresentam as complicações mais frequentes no pós-operatório imediato de pacientes submetidos a cirurgias cardíacas, no município de Juiz de Fora (MG). Métodos: Estudo transversal com 204 pacientes submetidos à cirurgia cardíaca na Santa Casa de Misericórdia do município de Juiz de Fora (MG), noperíodo de 01 junho a 31 dezembro 2009. Foram computadas as prevalências das principais complicaçõesno pós-operatório imediato com base na análise dos prontuários médicos.Resultados: A prevalência de complicações foi de 58%, sendo a maioria pulmonar (31,02%), seguida pelas complicações cardíacas (15,78%) e neurológicas (13,9%). Dentre as complicações infecciosas (9,89%), o sítio pulmonar foi o mais comum. O distúrbio hidroeletrolítico mais prevalente foi hipernatremia; hiperglicemia foi mais frequente que hipoglicemia. Sangramentos foram maisprevalentes que eventos trombóticos.Conclusões: Observou-se uma considerável prevalência de complicações, principalmente pulmonares, na população estudada. Os resultados encontrados poderãodirecionar os cuidados prioritários que serão implementados a esses pacientes e assim contribuir para melhor intervenção.
Background: Studies in different populations reveal differing levels of complications after cardiac surgery,depending on the criteria and characteristics of population studied. As data is sparse in Brazil, studies are needed to characterize these complications more effectively. Objective: To identify the most frequent complications and how they are presented in the immediate postoperative period among patients undergoing cardiac surgery in the town of Juiz de Fora, Minas Gerais State,Brazil Methods: Cross-section study with 204 patients undergoing cardiac surgery at the Santa Casa de Misericordia hospital in Juiz de Fora from June 1 toDecember 31, 2009, calculating the prevalence of major complications during the immediate postoperative period through an analysis of medical records.Results: The prevalence of complications was 58%, mainly (31%) pulmonary, followed by cardiac (15.78%) and neurological (13.9%). Among the infectious complications (9.89%), the lung was the most common site. The most prevalent hydroelectrolytical disorder was hypernatremia, with hyperglycemia more common thanhypoglycemia. Bleeding was more prevalent than thrombotic events.Conclusions: There was a significant prevalence of complications, mainly pulmonary, in the population. These findings can guide the high-priority care that will be implemented for these patients and thus contribute to better interventions.