ABSTRACT
OBJECTIVE: To measure the airway obstruction caused by adenoid hypertrophy in the sitting and recumbent positions in search of hypothesized differences. METHODS: Forty eight children between the ages of 2 and 12 years who sought the department of otorhinolaryngology spontaneously complaining of snoring and/or nasal obstruction. Children could be either male or female and belong to any social or racial group. Patients underwent nasal videoendoscopy sitting and lying performed by the same investigator. An image of the posterior nasopharynx was obtained from each nasal cavity of each patient for both positions. The free area of the nasopharynx was measured and compared in both positions. Image analysis was performed by two researchers other than that who carried out the examination. RESULTS: The nasopharynx free area obtained with seated patient is, on average, 53% bigger than the free area obtained with the patient lying down (confidence interval: 95%; p<0.001). Thus, adenoidal obstruction is larger when the examination is performed with the patient lying down. CONCLUSIONS: Nasal videoendoscopy to evaluate adenoid hypertrophy with the patient lying down makes testing more reliable, better reproducing the patient's position when sleeping. Such accuracy is essential since it influences the decision for surgical intervention in this important and widespread disease in the pediatric population.
Subject(s)
Adenoids/pathology , Airway Obstruction/etiology , Nasal Cavity/pathology , Nasopharynx/pathology , Airway Obstruction/diagnosis , Child , Child, Preschool , Endoscopy/methods , Female , Humans , Hypertrophy , Male , Patient Positioning , Snoring/etiologyABSTRACT
UNLABELLED: Ear diseases are illnesses which represent a relevant group of morbidity. Otitis media, for instance, still is a public health problem today. OBJECTIVE: To correlate hospital morbidity of ear diseases according to data from the Information Technology Department of the Public Health Care System -SUS (DATASUS), through the Hospital Information System (SIH) with the Human Development Index (IDH) from each unit of the federation. To assess the use of this official data in the creation of otologic public health care policies. MATERIALS AND METHODS: Brazilian states were classified according to their respective IDH values. The percentage population from each state was calculated in relation to the entire population of the country, as well as the percentage of hospital admission caused by ear diseases (SIH) for each state in relation to their total number. The hospital admissions from each state were correlated with their respective IDH values. RESULTS: The state of São Paulo, the third largest IDH was responsible for 38.82% of hospital admissions caused by ear diseases, although its population represents 21.64% of the national population. States with lower IDH had lower hospital admission rates for ear diseases. CONCLUSION: SIH, a DATASUS tool, even with limitations, can be an instrument used to create public policies concerning ear diseases.
Subject(s)
Databases, Factual , Ear Diseases/epidemiology , Hospitalization/statistics & numerical data , Information Systems/instrumentation , Brazil/epidemiology , Health Policy , Hospital Information Systems , Humans , Information Systems/statistics & numerical dataABSTRACT
Ear diseases are illnesses which represent a relevant group of morbidity. Otitis media, for instance, still is a public health problem today. OBJECTIVE: To correlate hospital morbidity of ear diseases according to data from the Information Technology Department of the Public Health Care System -SUS (DATASUS), through the Hospital Information System (SIH) with the Human Development Index (IDH) from each unit of the federation. To assess the use of this official data in the creation of otologic public health care policies. MATERIALS AND METHODS: Brazilian states were classified according to their respective IDH values. The percentage population from each state was calculated in relation to the entire population of the country, as well as the percentage of hospital admission caused by ear diseases (SIH) for each state in relation to their total number. The hospital admissions from each state were correlated with their respective IDH values. RESULTS: The state of São Paulo, the third largest IDH was responsible for 38.82 percent of hospital admissions caused by ear diseases, although its population represents 21.64 percent of the national population. States with lower IDH had lower hospital admission rates for ear diseases. CONCLUSION: SIH, a DATASUS tool, even with limitations, can be an instrument used to create public policies concerning ear diseases.
As doenças do ouvido são enfermidades que representam um grupo relevante de morbidade. A otite média, por exemplo, ainda hoje, é um problema de saúde pública. OBJETIVO: Correlacionar a morbidade hospitalar das doenças otológicas segundo dados disponibilizados pelo Departamento de Informática do Sistema Único de Saúde (DATASUS), pelo do Sistema de Informação Hospitalar(SIH) com o Índice de Desenvolvimento Humano (IDH) de cada unidade federativa. Avaliar a utilização destes dados oficiais na elaboração de políticas públicas otológicas. MATERIAL E MÉTODOS: Os Estados brasileiros foram classificados de acordo com os respectivos valores de IDH. Foi calculado o percentual da população de cada Estado em relação à população total do país, bem como o percentual de internações hospitalares por doenças otológicas(SIH) para cada Estado em relação ao número total das mesmas. Correlacionaram-se internações hospitalares de cada unidade federativa com seus respectivos valores de IDH. RESULTADOS: O Estado de São Paulo, terceiro maior IDH, foi responsável por 38,82 por cento das internações hospitalares de causa otológica, apesar de sua população representar 21,64 por cento da população nacional. Estados com menor IDH apresentaram menores taxas de internação hospitalar por doenças otológicas. CONCLUSÃO: O SIH, instrumento do DATASUS, mesmo com limitações, pode ser instrumento na elaboração de políticas públicas otológicas.
Subject(s)
Humans , Databases, Factual , Ear Diseases/epidemiology , Hospitalization/statistics & numerical data , Information Systems/instrumentation , Brazil/epidemiology , Health Policy , Hospital Information Systems , Information Systems/statistics & numerical dataABSTRACT
Introdução: O rinoscleroma é uma doença nasal granulomatosa rara, causada pela bactéria klebsiella rhinoscleromatis. O nariz representa a região primária de ocorrência. O linfoma não-Hodgkin nasal é uma rara neoplasia maligna, podendo ser do tipo T ou B. O rinoscleroma e o linfoma nasal não-Hodgkin apresentam como principal sintoma a obstrução nasal, e fazem parte do diagnóstico diferencial das granulomatoses nasais. Objetivo: Relatar a associação de rinoscleroma e linfoma não-Hodgkin nasal em um mesmo paciente, destacando a importância do diagnóstico diferencial das granulomatoses nasais. Relato do Caso: Paciente do sexo feminino, 49 anos, atendida com obstrução nasal progressiva há um mês. A rinoscopia evidenciava lesão aspecto papilomatoso em meato médio esquerdo. A imunohistoquímica confirmou rinoscleroma. A paciente foi corretamente tratada com remissão total da lesão. Dez meses após retornou com mesmos sintomas, mas histologia confirmou linfoma não-Hodgkin. Comentários Finais: Ambas as patologias podem causar sintomas nasais graves e complicações. O diagnóstico precoce possibilita a instituição do tratamento adequado e favorece o prognóstico. O estudo imunohistoquímico foi fundamental para a diferenciação diagnóstica.
Introduction: Rhinoscleroma, a rare nasal granulomatous disease, is caused by Klebsiella rhinoscleromatis. The nose is the primary occurrence region. Nasal non-Hodgkin lymphoma is a rare cancer, and could be of T or B type. The rhinoscleroma and the nasal non-Hodgkin lymphoma present with nasal obstruction as the main symptom, and are part of the nasal granulomatosis differential diagnosis. Objective: To report the association of rhinoscleroma and non-Hodgkin lymphoma in the same patient, by remarking the importance of the nasal granulomatosis' differential diagnosis. Case Report: A forty-nine year old female patient that appeared with a one-month progressive nasal obstruction. Rhinoscopy showed papillomatous feature lesion in left middle meatus. The immunohistochemical analysis confirmed rhinoscleroma. The patient was duly treated with total remission of the lesion. Ten months after, she returned with the same symptoms, but the histologic study confirmed non-Hodgkin lymphoma. Final Comments: Both pathologies may cause more severe nasal symptoms and complications. The early diagnostic enables the choice for the right treatment and contributes for the prognosis. The immunohistochemical study was essential for the diagnostic differentiation.
Subject(s)
Humans , Female , Adult , Nose Diseases/pathology , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/physiopathology , Nasal Obstruction/etiology , Rhinoscleroma , ImmunohistochemistryABSTRACT
Introdução: Otite média com efusão (OME) é uma das doenças mais comuns na infância. Manifestações clínicas variam do prejuízo na fala ao déficit no aprendizado. O diagnóstico deve ser feito, principalmente, pelo exame físico e timpanometria. O tratamento da OME pode ser clínico ou cirúrgico, inserindo-se um tubo de ventilação. Objetivo: Avaliar o seguimento de pacientes com OME submetidos à colocação de tubo de ventilação comparando-se os achados audiométricos pré e pós-operatórios. Método: Crianças com OME e falha no tratamento clínico foram submetidas à timpanostomia e colocação de tudo de ventilação. A audiometria obtida no pré-operatório foi comparada à solicitada durante o acompanhamento, entre seis e doze meses após a cirurgia, posteriormente à extrusão do tubo. Resultados: O Limiar de Reconhecimento de Fala passou de um valor médio de 28,75 dB para 13 dB. Conclusões: As crianças submetidas à colocação de tubo de ventilação apresentaram significativa melhora audiométrica após a cirurgia. Visto que os dados deste estudo foram obtidos de exames objetivos, acreditamos que esta seja uma excelente forma de avaliar os resultados cirúrgicos de pacientes submetidos à colocação de tubo de ventilação.
Introduction: Otitis media with effusion (OME) is one of the most common diseases in the childhood. Clinical manifestations vary from speech damage to learning deficit. The diagnosis must be made, mainly, through the physical exam and tympanometry. The treatment of OME may be clinical or surgical, with a vent tube. Objective: To evaluate the follow-up of patients with OME submitted to the placing of vent tube and compare the pre- and postoperative audiometric findings. Method: Children with OME and failure in the clinical treatment were submitted to tympanometry and placing of vent tube. The audiometry obtained in the postoperative period was compared with that requested during follow-up, between six and twelve months after surgery, subsequent to the tube extrusion. Results: The Speech Recognition Threshold exceeded an average value of 28.75 dB to 13 dB. Conclusions: The children submitted to the placement of the vent tube presented a significant audiometric improvement after the surgery. Since the data in this study were obtained from objective exams, we believe this is an excellent way to evaluate the surgical results of patients submitted to the placement of the vent tube.
Subject(s)
Humans , Child , Audiometry , Child , Middle Ear Ventilation , Otitis Media/surgery , Follow-Up StudiesABSTRACT
Introdução: A presença de dente supranumerário ou ectópico não é fato incomum, sendo estimado ocorrer em 1% da população geral. Contudo, um dente em cavidade nasal constitui-se em evento raro, independente da etiologia. Objetivo: Relatar um caso de dente em fossa nasal cuja etiologia não foi traumática nem iatrogênica. Relato de Caso: Paciente jovem apresentou imagem radiopaca em fossa nasal quando em propedêutica odontológica. Durante investigação otorrinolaringológica, verificou-se tratar-se se dente, a despeito da inexistência de qualquer trauma. Foi realizado tratamento cirúrgico sem intercorrências. Comentários Finais: A presença de dente em fossa nasal, apesar de infrequente, deve receber atenção especial. O triângulo perigoso da face é local potencial de complicações, portanto, a abordagem deve ser cirúrgica, mesmo que o paciente esteja assintomático.
Introduction: The presence of ectopic supernumerary tooth is not an uncommon fact, and the estimate is that 1% of the population is affected. However, a tooth in nasal cavity is a rare event, independently of the etiology. Objective: To report a case of a tooth in nasal cavity whose etiology is neither traumatic and nor iatrogenic. Case report: The young patient presented with a radiopaque image in nasal cavity during dental propedeutics. Upon otorhinolaryngological exams, a tooth was identified, in spite of no existence of any trauma. Surgical treatment was carried out without complications. Final Comments: The presence of tooth in nasal cavity, in spite of being uncommon, must be given special attention. The dangerous triangle of the face is a potential place of complications, therefore, the approach must be surgical even in asymptomatic patients.
Subject(s)
Humans , Male , Child , Nasal Cavity/surgery , Dentition, Permanent , Tooth Migration/surgery , Tooth Migration/complications , Tooth Migration/etiology , Physiological PhenomenaABSTRACT
Relato do Caso: Apresentamos um caso de pneumatização bilateral dos cornetos inferiores, condição muito rara, clinicamente manifesta por obstrução. A abordagem cirúrgica foi cuidadosamente planejada e conduzida, devido a uma grande comunicação entre os seios maxilares e as conhas inferiores bolhosas.
Case Report: We present one case of bilateral pneumatization of the inferior turbinates, a very rare condition, clinically manifested by obstruction. The surgical approach was carefully planned and carried out, due to a wide communication between the maxillary sinuses and the bobble-like inferior turbinates.
