[Paranasal sinuses mucoceles. Our experience in 72 patients]. / Mucoceles de senos paranasales. Nuestra experiencia en 72 pacientes.

INTRODUCTION: Traditional treatment for paranasal sinuses mucoceles recommended total removal through external approaches. Since the 90s, endoscopic marsupialization has been proposed as optimal surgical treatment. We present our experience in the treatment of this pathology. MATERIAL AND METHOD: A retrospective review of 72 patients treated for paranasal sinuses mucoceles between 1980 and 2006 in our ENT department was performed. We describe clinical features, surgical approaches employed and recurrence of disease. RESULTS: The sample was composed of 72 patients with average follow-up period of 44 months (range 13-214 months). A total of 81 mucoceles were presented, with 44% affecting the frontal sinus or frontoethmoidal cells, followed in frequency by maxillary sinus mucoceles (35%). Twenty-nine percent of the patients did not present predisposing factors; 31% of patients had a history of nasal polyposis, 35% had undergone previous sinus surgery and 14% suffered previous facial fractures; 48 mucoceles patients were treated endoscopically and 33 were treated with external or combined approaches. Recurrence was found in 7 patients, 2 in the endoscopic surgery group and 5 in the external/combined surgery group. CONCLUSIONS: Endoscopic marsupialization is a safe approach with a low rate of recurrence. The endoscopic approach may be unsuitable for frontal lateral sinus mucoceles or those with significant bone blockage.

Is galectin-3 a good method for the detection of malignancy in patients with thyroid nodules and a cytologic diagnosis of "follicular neoplasm"? A critical appraisal of the evidence.

BACKGROUND: Thyroid nodules are the most common surgical disease of the thyroid. Fine-needle aspiration biopsy (FNAB) is the most commonly employed tool for establishing a diagnosis. However, 15% to 25% of FNAB reports yield inconclusive results. Immunostaining of cytological smears from FNAB with galectin-3 has been proposed as a tool for differentiating between benign and malignant nodules. We performed a systematic review to evaluate the utility of galectin-3. METHODS: Prospective studies of nodules with FNAB reports of "follicular neoplasm" and with a definitive diagnosis confirmed by histopathology were selected. Calculations of individual sensitivity, specificity, and positive and negative likelihood ratios were made. RESULTS: The articles selected were those with the best methodological quality. CONCLUSION: Galectin-3 could be a good tool to guide therapeutic decision in patients with thyroid nodules and FNAB results of follicular neoplasm, but available information has methodological flaws that precludes a definitive answer about galectin-3 utility in the clinical setting.