RESUMO
Objetivo: Describir la anatomía del proceso uncinado y sus variaciones observadas a través de cortes coronales por tomografía computada multidetector (TCMD) en una población con rinosinusitis crónica. Introducción: Según la literatura científica revisada, no se encontraron estudios sobre las variaciones anatómicas del complejo osteomeatal (COM) en la población adulta colombiana. Los reportes coinciden en que las variaciones anatómicas de este complejo son parte de las causas de la sinusitis crónica refractaria a tratamiento médico, por lo que el presente trabajo se propone estudiar la anatomía de este complejo e identificar sus posibles variaciones anatómicas en pacientes adultos colombianos diagnosticados con sinusitis crónica. Materiales y métodos: Se realizó un estudio descriptivo de corte transversal, observacional y retrospectivo. Para las variables continuas se estimaron medidas de tendencia central y de dispersión, con un intervalo de confianza del 95%, mientras que para las variables categóricas se determinaron las frecuencias y los porcentajes con que se presentaron en la muestra. Resultados: Se contó con 143 casos. De este total, el 53,8% fueron hombres y el 46,2% mujeres. Tanto en el lado derecho como en el izquierdo, el proceso uncinado del hueso etmoides se insertó en la lámina papirácea (el 49,7% y el 53,1% de los hombres y mujeres, respectivamente). La inserción del proceso uncinado en la lámina cribosa del hueso etmoides en el lado derecho fue el segundo en frecuencia (25,2%) y en el lado izquierdo este lugar lo ocupó la inserción en la concha nasal media (23,8%). También se encontró que, en la mayoría de los casos, el proceso uncinado tuvo una orientación lateral (el 51% en el lado derecho y el 56,6% en el lado izquierdo). Conclusión: El proceso uncinado es una estructura anatómica muy variable que se encuentra a cada lado de la cavidad nasal. Presenta diferentes puntos de inserción y tiene cambios en su angulación y distintas longitudes. Es importante tener en cuenta estas variaciones para el manejo quirúrgico de la rinosinusitis crónica.
Objective: To describe the uncinate process anatomy and its variations observed through coronal, multislice computed tomography (MSCT) in patients with chronic rhinosinusitis. Introduction: As reviewed in the literature, no studies of anatomical variations ostiomeatal complex in Colombian adults were found. The reports agree that the anatomical variations of this complex are part of the causes of chronic sinusitis refractory to medical treatment, which motivated the present work to study the anatomy of this complex and identify possible anatomic variations in adult patients from Colombia, diagnosed with chronic sinusitis. Materials and methods: A descriptive, cross-sectional, observational and retrospective study. Continuous variables were estimated with measures of central tendency and dispersion, with a confidence interval of 95%. Categorical variables were determined with frequencies and percentages. Results: The total sample was 143 cases. In the sample, 53.8% were men and 46.2% were women. Both of the right and left, the uncinate process of the ethmoid was inserted into the lamina papyracea in 49.7% and 53.1% of cases, respectively. The insertion of the uncinate process in the cribriform plate of the ethmoid (T6) had a frequency to the right side of 25.2%, but for the left side was the insertion into the middle nasal concha (T1) (23.8%). In most cases, the uncinate process had a lateral orientation and 51% on the right side and 56.6% on the left side. Conclusion: The uncinate process is a highly variable anatomical structure at each side of the nasal cavity, arranged indifferent insertion sites, changes in angle and different lengths which is important from the point of view of surgical management of chronic rinosinusitis.
RESUMO
A combinação de fatores como viscosidade das secreções dos seios paranasais, diminuição da drenagem sinusal e comprometimento do transporte mucociliar podem ser responsáveis pela criação de um ambiente propício e adequado para a colonização de bactérias nos seios paranasais de pacientes com fibrose cística. OBJETIVO: Analisar a bacteriologia do aspirado do meato médio de pacientes portadores de fibrose cística. MATERIAL E MÉTODO: Através de um estudo prospectivo de delineamento transversal, avaliou-se uma amostra composta de 23 pacientes, avaliados durante 2 anos. Realizaram-se relações entre a cultura do meato médio e a avaliação radiológica do seio maxilar e a avaliação clínica. Secundariamente, estudou-se a relação da bacteriologia do aspirado do meato médio e a do escarro. RESULTADOS: No total foram realizadas 42 aspirações do meato médio. Em 17 (73,91 por cento) dos 23 pacientes, as culturas foram negativas e, em 6 (26,08 por cento), positivas. Das 42 aspirações, 31 (73,8 por cento) foram negativas e 11 (26,2 por cento), positivas. A presença de Pseudomonas aeruginosa foi observada em 18,18 por cento das culturas positivas e o Staphylococcus aerus em 27,28 por cento. CONCLUSÃO: A maioria das culturas do aspirado do meato médio de pacientes com fibrose cística foi negativa.
The combination of factors, such as abnormal viscosity of the paranasal sinus secretions, decreased sinus drainage, and impaired mucociliary clearance may account for the establishment of a suitable and opportune environment for the colonization of bacteria in the paranasal sinuses of patients with cystic fibrosis. AIM: The goal of the present study was to assess the bacteriology of the middle meatus aspirate in patients diagnosed whit cystic fibrosis. MATERIAL AND METHODS: Through a cross-sectional prospective study, a sample consisting of 23 patients evaluated for 2 years, was assessed. Firstly, we established the relationship between the middle meatus culture and the maxillary sinus x-ray. In second, we studied the relationship between the middle meatus aspirate bacteriology and the sputum bacteriology. RESULTS: In total, 42 aspirates of the middle meatus were carried out. In 17 (73.91 percent) of the 23 patients, the aspirates were negative; and in 6 (26.08 percent) they were positive. Out of the 42 aspirates,31 (78.8 percent) were negative, and 11 (26.2 percent) were positive. The presence of Pseudomonas aeruginosa was observed in 18.18 percent of the positive cultures, and Staphylococcus aureus was observed in 27.28 percent. CONCLUSION: The great majority of the middle meatus aspirates of the patients with cystic fibrosis were negative.