ABSTRACT
ABSTRACT INTRODUCTION: There is a controversy concerning the terminology and definition of rhinitis in pregnancy. Gestational rhinitis is a relatively common condition, which has drawn increasing interest in recent years due to a possible association with maternal obstructive sleep apnea syndrome (OSAS) and unfavorable fetal outcomes. OBJECTIVE: To review the current knowledge on gestacional rhinitis, and to assess its evidence. METHODS: Structured literature search. RESULTS: Gestational rhinitis and rhinitis "during pregnancy" are somewhat similar conditions regarding their physiopathology and treatment, but differ regarding definition and prognosis. Hormonal changes have a presumed etiological role, but knowledge about the physiopathology of gestational rhinitis is still lacking. Management of rhinitis during pregnancy focuses on the minimal intervention required for symptom relief. CONCLUSION: As it has a great impact on maternal quality of life, both the otorhinolaryngologist and the obstetrician must be careful concerning the early diagnosis and treatment of gestational rhinitis, considering the safety of treatment measures and drugs and their current level of evidence.
RESUMO INTRODUÇÃO: Há grande confusão quanto à terminologia e definição da rinite na gestação. A rinite gestacional é uma condição relativamente comum que vem ganhando importância nos últimos anos pela descoberta de sua associação com a SAOS materna e possíveis desfechos desfavoráveis ao feto. Há pouca evidência na literatura nacional sobre o tema. OBJETIVO: Revisar o conhecimento científico atual sobre a rinite na gestação e suas evidências disponíveis. MÉTODO: Revisão de literatura estruturada. RESULTADOS: A rinite gestacional e a rinite "durante a gestação" são condições com alguns pontos de fisiopatologia e tratamento semelhantes, mas com definições e prognósticos diferentes. O papel dos hormônios nessas condições vem sendo sugerido por muitos trabalhos, mas o conhecimento sobre a fisiopatogenia da rinite gestacional ainda é escasso. O manejo da rinite na gestação requer o mínimo de intervenção com o maior alívio sintomático possível. CONCLUSÃO: Dado o grande impacto na qualidade de vida da gestante, tanto o otorrinolaringologista quanto o obstetra devem estar atentos para o diagnóstico precoce e manejo desta entidade, considerando o perfil de segurança e o nível de evidência das medidas e medicamentos disponíveis atualmente.
Subject(s)
Female , Humans , Pregnancy , Pregnancy Complications/diagnosis , Rhinitis/diagnosis , Diagnosis, Differential , Pregnancy Complications/etiology , Pregnancy Complications/therapy , Risk Factors , Rhinitis/etiology , Rhinitis/therapy , Terminology as TopicABSTRACT
INTRODUCTION: There is a controversy concerning the terminology and definition of rhinitis in pregnancy. Gestational rhinitis is a relatively common condition, which has drawn increasing interest in recent years due to a possible association with maternal obstructive sleep apnea syndrome (OSAS) and unfavorable fetal outcomes. OBJECTIVE: To review the current knowledge on gestational rhinitis, and to assess its evidence. METHODS: Structured literature search. RESULTS: Gestational rhinitis and rhinitis "during pregnancy" are somewhat similar conditions regarding their physiopathology and treatment, but differ regarding definition and prognosis. Hormonal changes have a presumed etiological role, but knowledge about the physiopathology of gestational rhinitis is still lacking. Management of rhinitis during pregnancy focuses on the minimal intervention required for symptom relief. CONCLUSION: As it has a great impact on maternal quality of life, both the otorhinolaryngologist and the obstetrician must be careful concerning the early diagnosis and treatment of gestational rhinitis, considering the safety of treatment measures and drugs and their current level of evidence.
Subject(s)
Pregnancy Complications/diagnosis , Rhinitis/diagnosis , Diagnosis, Differential , Female , Humans , Pregnancy , Pregnancy Complications/etiology , Pregnancy Complications/therapy , Rhinitis/etiology , Rhinitis/therapy , Risk Factors , Terminology as TopicABSTRACT
PURPOSE: The aim of this study was to validate the Rhinoplasty Outcomes Evaluation (ROE) questionnaire adapted to the Brazilian Portuguese. METHOD: A prospective study was conducted with ROE administration to 56 patients submitted to rhinoplasty (preoperatively, and then 15-day and 90-day postoperatively) and 100 volunteers without the need or desire of cosmetic or functional nasal surgery. Reliability (internal consistency and test-retest reproducibility), validity, responsiveness and clinical interpretability were assessed. RESULTS: Rhinoplasty patients' mean preoperative score was 7.14, 15 days post-op 17.73 and 90 days post-op 20.50, while controls presented 17.94 points (p < 0.0001), showing the questionnaire's validity and responsiveness. Internal consistency was 0.86. Inter- and intra-examiner test-retest reproducibility was 0.90 and 0.94, respectively. The effect size caused by the surgery was considered large (15 days post-op compared to the preoperative score: effect size = 3.22; 90 days post-op compared to preoperative score: effect size = 4.06). The minimally important difference was 8.67 points, so changes smaller than 9 points in ROE might not be perceived by the patient as an improvement or worsening. CONCLUSION: The Brazilian Portuguese version of ROE is a valid instrument to assess results in rhinoplasty patients.
Subject(s)
Patient Outcome Assessment , Quality of Life , Rhinoplasty/psychology , Surveys and Questionnaires/standards , Adolescent , Adult , Aged , Brazil , Case-Control Studies , Cross-Cultural Comparison , Female , Humans , Male , Middle Aged , Portugal/ethnology , Postoperative Period , Preoperative Period , Prospective Studies , Reproducibility of Results , Rhinoplasty/methods , Translations , Young AdultABSTRACT
UNLABELLED: Rhinoplasty Outcome Evaluation (ROE) is an easy-to-use questionnaire that allows comprehensive assessment of rhinoplasty-related patient satisfaction. However, normal values for this questionnaire are not known. OBJECTIVE: To translate and cross-culture adapt the Rhinoplasty Outcome Evaluation questionnaire to Brazilian Portuguese and to establish normality parameters. MATERIALS AND METHODS: Cross-sectional study with ROE administration to 62 patients waiting for rhinoplasty or septorhinoplasty (Cases) and 100 volunteer subjects without desire or need for nasal surgery (Controls). Assessment of possible sensitivity and specificity cutoffs. RESULTS: The cases' mean score was 6.6 or 27.5% (SD 3.18; min 0; max 15) and controls' mean score was 17.94 or 74.75% (SD 3.91; min 7; max 24). The best cutoff was 12 or 50%, with 95.16% sensitivity and 95% specificity. CONCLUSION: At the zero-to-24 score of the Brazilian Portuguese ROE, we found 12 as the best cutoff, with 95.16% of sensitivity and 95% of specificity.
Subject(s)
Rhinoplasty/psychology , Surveys and Questionnaires , Adult , Brazil , Cross-Sectional Studies , Cultural Characteristics , Female , Humans , Language , Male , Reference Values , Reproducibility of Results , Translating , Treatment OutcomeABSTRACT
O Rhinoplasty Outcome Evaluation (ROE) é um questionário de fácil aplicação, que abrange os principais a spectos que influenciam na satisfação do paciente em relação à rinoplastia. Porém, não há, ainda, critérios de normalidade para este questionário. OBJETIVO: Realizar a tradução e adaptação cultural do questionário Rhinoplasty Outcome Evaluation para o Português Brasileiro e estabelecer um parâmetro de normalidade. CASUÍSTICA E MÉTODO: Tradução e adaptação cultural do questionário para Português Brasileiro. Estudo transversal com a aplicação do ROE em 62 pacientes em pré-operatório de rinoplastia ou rinosseptoplastia (Casos) e 100 voluntários sem desejo de cirurgia nasal (Controles). Análise da sensibilidade e especificidade das possíveis notas de corte. Resultados: A média dos escores dos Casos foi de 6,6 ou 27,5% (DP 3,18; mín 0; máx 15) e dos controles, 17,94 ou 74,75% (DP 3,91; mín 7; máx 24). O melhor valor mínimo para normalidade foi de 12 ou 50%, com sensibilidade de 95,16% e especificidade de 95%. CONCLUSÃO: No escore de zero a 24 do ROE em Português Brasileiro, encontramos o valor 12 como limite mínimo de normalidade, com índices de sensibilidade e especificidade de 95,16% e 95%, respectivamente.
Rhinoplasty Outcome Evaluation (ROE) is an easy-to-use questionnaire that allows comprehensive assessment of rhinoplasty-related patient satisfaction. However, normal values for this questionnaire are not known. OBJECTIVE: To translate and cross-culture adapt the Rhinoplasty Outcome Evaluation questionnaire to Brazilian Portuguese and to establish normality parameters. MATERIALS AND METHODS: Cross-sectional study with ROE administration to 62 patients waiting for rhinoplasty or septorhinoplasty (Cases) and 100 volunteer subjects without desire or need for nasal surgery (Controls). Assessment of possible sensitivity and specificity cutoffs. RESULTS: The cases' mean score was 6.6 or 27.5% (SD 3.18; min 0; max 15) and controls' mean score was 17.94 or 74.75% (SD 3.91; min 7; max 24). The best cutoff was 12 or 50%, with 95.16% sensitivity and 95% specificity. CONCLUSION: At the zero-to-24 score of the Brazilian Portuguese ROE, we found 12 as the best cutoff, with 95.16% of sensitivity and 95% of specificity.
Subject(s)
Adult , Female , Humans , Male , Rhinoplasty/psychology , Surveys and Questionnaires , Brazil , Cross-Sectional Studies , Cultural Characteristics , Language , Reference Values , Reproducibility of Results , Translating , Treatment OutcomeABSTRACT
UNLABELLED: It is well known that mouth breathing is associated with adenotonsillar hypertrophy - which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing. AIM: to determine the prevalence of obstructive sleep disorders in mouth breathing children and study its correlation with otorhinolaryngological findings. STUDY DESIGN: Retrospective cohort study. METHOD: Data analysis from 248 medical charts of mouth breathing children seen at the Pediatric Otolaryngologic Division of a large medical institution between the years of 2000 and 2006. All patients had nasofibroscopy and or Cavum radiographs and polysomnographic exams. According to the Apnea index, patients were classified as primary snorers (AI<1); and as OSAS (>1). RESULTS: From 248 patients included in the study, 144 (58%) were primary snorers and 104 (42%) had OSAS. The most prevalent otorhinolaryngological findings were adenotonsillar hypertrophy (n=152; 61.2%), tonsilar hypertrophy (n=17; 6.8%), adenoid hypertrophy (n=37; 14.9%), rhinitis (n=155; 62.5%) and secretory otitis (n=36; 14.5%). CONCLUSIONS: primary snoring and OSAS are frequent findings in mouth breathing children. The most frequent otorhinolaryngological disorder in children with OSAS is adenotonsillar hypertrophy with or without rhinitis.
Subject(s)
Mouth Breathing/epidemiology , Sleep Apnea, Obstructive/epidemiology , Snoring/epidemiology , Adolescent , Age Factors , Brazil/epidemiology , Chi-Square Distribution , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Otorhinolaryngologic Diseases/epidemiology , Polysomnography , Prevalence , Retrospective Studies , Sex Factors , Sleep Apnea, Obstructive/complicationsABSTRACT
É bem estabelecido que a respiração oral em crianças está relacionada à hipertrofia adenoamigdaliana, que é a principal causa de apneia do sono nesta população. Apesar da importância deste tema, há poucos estudos que comprovam a relação entre SAOS e respiração oral. OBJETIVO: Determinar a prevalência de distúrbios respiratórios do sono em crianças respiradoras orais e sua correlação com achados otorrinolaringológicos. MATERIAL E MÉTODO: Foram avaliados retrospectivamente 248 prontuários de crianças respiradoras orais do serviço de Otorrinolaringologia Pediátrica de uma grande instituição entre 2000 e 2006, analisando os achados otorrinolaringológicos, polissonografia, nasofibroscopia e/ou radiografia em perfil do Cavum. O principal dado polissonográfico utilizado foi o índice de apneia (IA). Classificou-se como ronco primário aqueles com IA< 1 e como SAOS, os com IA >1. Desenho Científico: Coorte retrospectivo. RESULTADOS: Dos 248 pacientes incluídos, 144 (58 por cento) apresentavam ronco primário e 104 (42 por cento) apresentavam SAOS. Os achados otorrinolaringológicos mais frequentes foram Hipertrofia adenoamigdaliana (n=152; 61,2 por cento), Hipertrofia de tonsila palatina (n=17; 6,8 por cento) Hipertrofia da tonsila faríngea (n=37; 14,9 por cento), Rinite Alérgica (n=155; 62,5 por cento) e Otite Secretora (36; 14,5 por cento). CONCLUSÕES: Ronco Primário e SAOS são frequentes em crianças respiradoras orais. A afecção otorrinolaringológica mais encontrada em crianças com SAOS é a hipertrofia adenoamigdaliana acompanhada ou não de rinite alérgica.
It is well known that mouth breathing is associated with adenotonsillar hypertrophy - which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing. AIM: to determine the prevalence of obstructive sleep disorders in mouth breathing children and study its correlation with otorhinolaryngological findings. STUDY DESIGN: Retrospective cohort study. METHOD: Data analysis from 248 medical charts of mouth breathing children seen at the Pediatric Otolaryngologic Division of a large medical institution between the years of 2000 and 2006. All patients had nasofibroscopy and or Cavum radiographs and polysomnographic exams. According to the Apnea index, patients were classified as primary snorers (AI<1); and as OSAS (>1). RESULTS: From 248 patients included in the study, 144 (58 percent) were primary snorers and 104 (42 percent) had OSAS. The most prevalent otorhinolaryngological findings were adenotonsillar hypertrophy (n=152; 61.2 percent), tonsilar hypertrophy (n=17; 6.8 percent), adenoid hypertrophy (n=37; 14.9 percent), rhinitis (n=155; 62.5 percent) and secretory otitis (n=36; 14.5 percent). CONCLUSIONS: primary snoring and OSAS are frequent findings in mouth breathing children. The most frequent otorhinolaryngological disorder in children with OSAS is adenotonsillar hypertrophy with or without rhinitis.
