Transcanal labyrinthectomy in childhood: report of a case.

Vertigo in children is caused by several factors. One such factor is viruses (e.g., mumps, measles, and rubeola) afflicting the inner ear by various mechanisms. In the majority of cases, affected patients improve with clinical therapy and vestibular rehabilitation. We present the case of a child with vertigo as a sequela of mumps virus infection that did not improve with clinical treatment and vestibular rehabilitation. Consequently, the child was submitted to a transcanal labyrinthectomy followed by vestibular rehabilitation, with significant postprocedure improvement of symptoms. We discuss surgical indications, the technique used in this case, and the importance of vestibular rehabilitation in the postoperative period.

Acoustic neurinomas. Diagnosis and treatment.

We present our experience with 83 patients with acoustic neurinomas (January 1988 to November 1996); 81 patients underwent surgery and 2 patients with intracanalicular neurinomas received conservative therapy due to their advanced age (1 case) and patient's option (1 case). The surgical approach was retrosigmoid/transmeatal and the goal was total removal in one procedure with preservation of facial and cochlear nerves. Radical removal of lesion was attempted in 79 cases and it was possible in 77 patients. Subtotal tumor resection was planned in 2 cases. Facial nerve function (grades I to III, House and Brackman) was preserved in 90% and hearing in 58% of those with preoperative hearing. Three patients died due to postoperative complications. Early diagnosis of acoustic neurinomas is the most important factor in the prognosis and is one of the most important conquest of neurophysiology and modern neuroimaging. The management of these patients still present many controversial points. This article presents the diagnostic procedures used for acoustic neurinomas, the advantages and disadvantages of the different surgical approaches and the alternative management of these lesions.

[Surgical anatomy of the nasal transphenoidal approach for pituitary tumors]. / Anatomia cirúrgica do acesso nasal transesfenoidal para tumores da hipófise.

Different distances related to the nasal transphenoidal approach were measured on the hemiheads of eighteen cadavers in order to study its limits and advantages. The main mean measures obtained (mm) were: major diameter of the nostril 15.18: height of the nasal cavity 44.11, nostril-sella turcica distance 71.71. These results show that the nasal approach is wide and direct to the sella turcica. The present study demonstrate the possibility of preservation of the cartilaginous septum and other structures which are usually damaged when the sublabial approach is employed.

Estenose congênita de abertura nasal piriforme: relato de caso / Congenital stenosis of the aperture nasal pyriform: a case report

A estenose congênita de abertura piriforme é causa rara de obstruçäo nasal no recém-nato descrita pela primeira vez em 1989 por BROWN et al relatou 6 casos, seguido por ARLIS et al que relatou outros 6 casos em 1992, totalizando 12 casos descrito na literatura até o momento. Esta anomalia produz sintomas e sinais clínicos de obstruçäo nasal, em recém-nascidos e crianças, similares aos encontrados na atresia coanal bilateral. A tomografia computadorizada confirma o diagnóstico e delimita a anomalia. Descrevemos um caso diagnosticado no Hospital de Clínicas da Universidade Federal do Paraná no ano de 1993, no serviço de otorrinolaringologia, tratado cirurgicamente por acesso sublabial

Conceitos em cirurgia da base do crânio: definiçäo de "área de transiçäo" / Conceptos in skull base surgery: definition of \"trasition area\"

Os autores sugeriram um conceito anatômico para a base do crânio. Dividiram a base do crânio em três níveis: anterior, médio e posterio. Cada nível é composto por componentes intra e extracrânianos separados por uma "área de transiçäo". Usaram três casos para ilustrar patologia nos diferentes níveis, onde a atuaçäo multidisciplinar e simultânea claramente mostrou uma superioridade em relaçäo ao tratamento clássico

Esthesioneuroblastoma with intracranial extension.

The authors present five cases of olfactory neuroblastoma with intracranial extension operated on in the Department of Neurosurgery in collaboration with otorhinolaryngologists. This tumor is most frequently reported as growing inside the nasal cavities, and it can extend to the paranasal sinuses. Cases presenting initially as intracranial tumors have been infrequently reported. At present, histological diagnosis of this tumor is aided by the use of electron microscopy and immunocytochemistry. Total resection combined with radiation therapy remains the most satisfactory treatment.

[Glomus tumors of the temporal bone: a report of 6 cases]. / Tumores glômicos do osso temporal. Relato de 6 casos.

The authors review the clinical, radiological and pathological features of 6 cases of glomus tumors of the temporal bone. Out of the 6 patients, 5 were female; age was distributed between 22 and 76 years (mean 48 years). The main clinical features were hypoacusia, tinnitus and otoscopic findings suggestive of the diagnosis. In one case was noted the concomitant presence of a neurinoma of the VIII cranial nerve with a ipsilateral glomus tumor, and in another case there was a concomitancy of carotid body tumor with temporal glomus jugularis tumor. Metastases were not observed in any case. Tumoral lesions were successfully ressected employing microsurgical techniques and a multidisciplinary staff involving neurosurgeons, head and neck surgeons and otolaryngologists. Radioteraphy was not employed, neither pre-operative embolization. Some aspects related to the nosology, embriology, pathophysiology, diagnosis and treatment of this interesting type of neoplasms are discussed.

Nasoangiofibroma juvenil em mulher. / Juvenile angiofibroma of the nose in women

Os autores relatam um caso de nasoangiofibroma juvenil em uma mulher de 16 anos. A literatura revista mostra a raridade do caso e salientam a importancia do exame da cromatina sexual

Angina de Ludwig. / Ludwig's angina

Os autores apresentam dois casos de angina de Ludwig, mostrando realmente que esta patologia nao esta erradicada, exigindo medidas terapeuticas agressivas e imediatas. Paralelamente, mostram uma revisao bibliografica do assunto chamando atencao para a importancia do diagnostico precoce e preciso dessa entidade

Otoplasty--an eclectic technique.

The authors report their experience in the surgical treatment of 78 patients with lop, prominent, or protruding ears. Four patients had a unilateral deformity. The procedure used in 110 ears consisted of a cartilage excision-incision and horizontal mattress suture technique. In 42 ears, horizontal mattress sutures only, with or without scoring of cartilage, were used. The complications and unsatisfactory cosmetic results are reported. No major complications such as perichondritis, severe infection or unsightly postoperative deformities occurred. In conclusion, 94,7% of all cases had a good cosmetic result. The techniques are easy to learn and very useful in training residents.