ABSTRACT
Resumo Introdução: A epistaxe recorrente é uma doença comumente vista por especialistas em otorrinolaringologia, médicos de emergência e pediatras. O fato de que muitas modalidades de tratamento estejam sendo pesquisadas e nenhum método único de tratamento seja universalmente aceito apoiam ainda mais essa informação. Objetivo: Comparar a eficácia clínica do uso de pomada antisséptica tópica, pomada descongestionante tópica e tratamentos de cauterização química, que são frequentemente usados em epistaxe anterior recorrente, tanto isoladamente como em combinação. Método: Entre agosto de 2017 e fevereiro de 2018, 137 pacientes diagnosticados com epistaxe anterior recorrente foram divididos aleatoriamente em 5 grupos. O grupo I foi tratado com pomada antisséptica tópica, o grupo II com pomada descongestionante tópica, o grupo III foi submetido a cauterização química, o grupo IV foi tratado com pomada antisséptica tópica + cauterização química e o grupo V com pomada descongestionante tópica + tratamento de cauterização química. Todos os pacientes foram contatados por telefone 2 semanas e um mês após o tratamento e perguntados sobre a presença (falha) ou ausência (sucesso) de pelo menos um episódio de epistaxe. Pacientes com comorbidades foram excluídos. O sucesso do tratamento foi analisado estatisticamente. Resultados: Não houve diferença significante (p > 0,05) entre os grupos em relação à taxa de sucesso no 15° dia após o tratamento. Os grupos IV e V tiveram maiores taxas de sucesso no 30° dia após o tratamento em comparação com os grupo I e II (p < 0,05). No grupo III, o sucesso do tratamento no 30° dia não foi diferente dos outros 4 grupos (p > 0,05). Conclusão: Embora o número de pacientes que melhoraram com a cauterização química (grupo III) tenha sido maior em nosso estudo, nenhuma diferença significante foi observada nas modalidades de tratamento único (grupos I - III) no 14° dia e no 30° dia após o tratamento. Embora não tenha sido observada diferença estatisticamente significante entre os tratamentos combinados (grupos IV - V) e os tratamentos simples (grupos I - III) na 2ª semana após o tratamento, os tratamentos combinados foram significantemente mais eficazes no 1° mês.
Subject(s)
Humans , Epistaxis/drug therapy , Anti-Infective Agents, Local , Cautery , Administration, Topical , Treatment OutcomeABSTRACT
INTRODUCTION: Recurrent epistaxis is a common medical problem faced by ENT specialists, emergency physicians, and pediatricians. The facts that many treatment modalities are being searched and no single treatment method is universally accepted yet support this information. OBJECTIVE: We aimed to compare the clinical efficacy of topical antiseptic ointment, topical decongestant ointment and chemical cauterization treatments, which are frequently used in recurrent anterior epistaxis, both singly and in combination. MATERIAL-METHODS: Between August 2017 and February 2018, 137 patients who were diagnosed with recurrent anterior epistaxis were randomly divided into 5 groups. group I received topical antiseptic ointment, group II received topical decongestant ointment, group III received chemical cauterization, group IV received topical antiseptic ointmentâ¯+â¯chemical cauterization and group V received topical decongestant ointmentâ¯+â¯chemical cauterization treatment. All patients were phoned 2 weeks and 1 month after the treatment and questioned about the presence (failure) or absence (success) of at least 1 episode of epistaxis. Patients with comorbid diseases were excluded. Treatment success was statistically analysed. RESULTS: There was no significant difference (pâ¯>â¯0.05) between the groups in the success rate at 15th day after treatment. Group IV and group V had higher success rates at 30th day after treatment compared with group I and group II (pâ¯<â¯0.05). In group III 30th day treatment success was not different from the other 4 groups (pâ¯>â¯0.05). CONCLUSION: Although the number of patients who improved with chemical cauterization (group III) was higher in our study, no significant difference was observed in single treatment modalities (group IâIII) at 14th day and 30th day after treatment. Although no statistically significant difference was observed between combined treatments (group IVV) and single treatments (group IâIII) in the 2nd week after treatment, combined treatments were significantly more effective in the 1st month.
Subject(s)
Anti-Infective Agents, Local , Epistaxis , Administration, Topical , Cautery , Epistaxis/drug therapy , Humans , Treatment OutcomeABSTRACT
INTRODUCTION: Concha bullosa is the most common variation of the middle turbinate of the paranasal sinuses. When it causes nasal obstruction, osteomeatal unit dysfunction, or rarely chronic infection, surgery is required. CASE REPORT: We present a fungal infection of concha bullosa, which is a rare indication for surgery of the concha bullosa. A 59-year-old female patient presented with hemifacial pain on the right side, which had lasted for 2 months. There were no pathological findings in her endoscopic nasal examination. Advanced examination by paranasal computed tomography (CT) revealed bilateral concha bullosa variation and soft tissue density in the right concha bullosa. As the biopsy taken from concha bullosa demonstrated fungal hyphae, endoscopic surgical treatment was performed. CONCLUSION: We stress the importance of the CT in hemifacial pain by this rare case report, in which endoscopic nasal examination was normal. Fungal infection in the concha bullosa is rare, and infected concha bullosa is a pathology to be considered in the differential diagnosis in patients with complaints of hemicranial headache.
