RESUMO
Abstract Introduction The endoscopic access has reduced the morbidity associated with external approaches in diseases of themaxillary sinus. A reversible endoscopic medialmaxillectomy (REMM) is presented as an alternative for treatment of benign maxillary diseases. Objective To describe the REMM technique and report four cases of patients with benign maxillary sinus conditions treated through this approach. Methods The present study was divided into two parts: anatomical and case series. Two cadaveric dissections confirmed the feasibility of the REMMapproach. The same technique was performed on four consecutive patients with benign maxillary sinus disease. Results The cadaveric dissections confirmed wide exposure to the maxillary cavity, preserving the anatomy of the maxillary sinus. In the patient series, one patient presented with an antrochoanal polyp, one had a silent sinus syndrome, one had a chronic maxillary sinusitis secondary to a gunshot, and the last one had an inverted papilloma in the maxillary sinus. In all of the cases, the REMM approach provided excellent access and adequate resection, as well as preservation of the inferior turbinate, nasolacrimal duct, and lateral wall of the nose (including its osteomucosal component). Finally, all of the patients had an uneventful postoperative course. Conclusion The REMM technique is an excellent surgical approach to benign conditions of the maxillary sinus. It has few limitations and appears to be associated with less morbidity than conventional techniques.
RESUMO
OBJETIVO: Estudar o efeito da aplicação tópica de Mitomicina-C em diferentes concentrações sobre os depósitos de colágeno total na submucosa de pregas vocais íntegras de suínos. MÉTODOS: Os animais foram divididos em três grupos de acordo com o conteúdo da solução tópica aplicada sobre as pregas vocais: solução fisiológica 0,9 por cento (grupo controle); Mitomicina-C tópica 4 mg/mL (grupo 1); e Mitomicina-C 8 mg/mL (Grupo 2). Após 30 dias da aplicação, os animais foram submetidos à eutanásia, coletado amostras das pregas vocais e coradas pela técnica do picrosirius red com polarização para a quantificação computadorizada da deposição do colágeno, através do programa Image Pro plus 4.5Ò. Compararam-se as médias de área do colágeno depositado na submucosa das pregas vocais dos três grupos através do teste não paramétrico de Mann-Whitney. RESULTADOS: As médias das áreas de depósito colágeno na submucosa das pregas vocais foram de 3.110,44 micrômetros quadrados (mm²); 3.115,98 mm² e 3.105,78 mm² nos grupos controle, 1 e 2 respectivamente. Não houve diferença significativa nas áreas de depósitos de colágeno total da submucosa das pregas vocais entre os três grupos estudados (p>0,05). CONCLUSÃO: A mitomicina-C aplicada topicamente em pregas vocais suínas íntegras não alterou significativamente a deposição de colágeno na submucosa.
OBJECTIVE: To compare the effects of topical mitomycin-C at different concentrations on submucosal collagen deposition on the vocal folds of swine. METHODS: The animals were divided into three groups according to the composition of the topical solution to be applied to the vocal folds: 0.9 percent saline solution (control group); 4 mg/ml mitomycin-C (group 1) and 8 mg/ml mitomycin-C (group 2). Thirty days after the application, all animals were sacrificed, their vocal folds were collected and stained by the picrosirius red technique, and submucosal collagen deposition areas were estimated by the Image Pro Plus 4.5® software. Mann-Whitney test was used to compare differences between parameters of each group. RESULTS: The means of the areas of submucosal collagen deposits on vocal folds were 3110.44 square micrometers (mm²), 3115.98 mm² and 3105.78 mm² for groups control, 1 and 2, respectively. There were no statistical differences across the three groups (p>0.05). CONCLUSION: Mitomycin-C topically applied to intact vocal folds of swine did not alter submucosal collagen deposition.