Papel da punção do seio maxilar no diagnóstico e no tratamento de pacientes com rinossinusite hospitalar / The role of maxillary sinus puncture on the diagnosis and treatment of patients with hospital-acquired rhinosinusitis
Braz. j. otorhinolaryngol. (Impr.)
;
78(4): 35-41, jul.-ago. 2012. ilus, tab
Article
in Portuguese
| LILACS
| ID: lil-646768
RESUMO
A rinossinusite é uma das principais causas de febre em pacientes críticos e deve ser sistematicamente pesquisada. OBJETIVO:
Avaliar o impacto da punção do seio maxilar à beira leito, no diagnóstico e no tratamento dos pacientes com rinossinusite infecciosa internados em Unidade de Terapia Intensiva de um hospital universitário de alta complexidade.MATERIAIS E MÉTODOS:
Estudo retrospectivo que avaliou os pacientes em ventilação mecânica com febre de origem indeterminada e sinais tomográficos de rinossinusite submetidos à punção do seio maxilar pelo meato inferior.RESULTADOS:
A amostra total do estudo consistiu de 27 pacientes (70,3% do sexo masculino com média de idade 45,3 anos). Os diagnósticos de admissão mais frequentes na Unidade de Terapia Intensiva foram Trauma Crânio Encefálico e Acidente Vascular Cerebral. No exame tomográfico, os seios paranasais mais acometidos foram o maxilar, em 85,2%, e esfenoidal, em 74,1%. A secreção purulenta foi visualizada no meato médio em 30,7% das fossas nasais. Os microrganismos mais frequentes nos aspirados dos seios foram Pseudomonas aeruginosa e Acinetobacter baumannii.CONCLUSÃO:
A punção do seio maxilar à beira leito demonstrou-se uma importante ferramenta diagnóstica e terapêutica nos pacientes de UTI com rinossinusite hospitalar, submetidos à ventilação mecânica invasiva.ABSTRACT
Rhinosinusitis is one of the most commom causes of fever of unknown origin in critically ill patients and should be systematically searched. OBJECTIVE:
This study aims to evaluate the diagnostic and therapeutic effect of maxillary sinus puncture performed at the bedside in patients with infective rhinosinusitis hospitalized in an Intensive Care Unit of a high complexity care hospital. MATERIALS ANDMETHODS:
This retrospective study looks into patients on mechanical ventilation with fever of unknown origin and signs of rhinosinusitis on CT images who were submitted to inferior meatus maxillary sinus puncture.RESULTS:
The total study sample consisted of 27 patients (70.3% male; mean age 45.3 years). The most common Intensive Care Unit admission diagnoses were head trauma and stroke. CT scans revealed the maxillary (85.2%) and sphenoid (74.1%) sinuses were the most involved paranasal sinuses. Middle meatus purulent drainage was seen in 30.7% of the nasal cavities. Fever was reduced in 70.4% of the patients after puncture (p < 0.001). The most commonly found organisms in sinus aspirates were Pseudomonas aeruginosa and Acinetobacter baumannii.CONCLUSION:
Maxillary sinus puncture performed at the bedside of the patients is an important diagnostic and theraupetic tool for critically ill patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Sinusitis
/
Rhinitis
/
Cross Infection
Type of study:
Diagnostic study
/
Observational study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
Portuguese
Journal:
Braz. j. otorhinolaryngol. (Impr.)
Journal subject:
Otolaryngology
Year:
2012
Type:
Article
Affiliation country:
Brazil
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