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1.
Facial Plast Surg ; 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-38925163

RESUMO

This study was conducted to compare the outcomes of the tongue-in-groove (TIG) technique with and without septal extension graft (SEG) on smile and lip position in rhinoplasty. Fifty-eight rhinoplasty patients, treated at a tertiary referral center between 2020 and 2022, underwent preoperative and 12-month postoperative evaluations, using the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) and the visual analog scale (VAS). The preoperative and 12-month postoperative photographs were analyzed using Adobe Photoshop to assess changes in lip and smile positions. The study included 38 patients in the TIG with SEG group and 20 patients in the TIG without SEG group. The participants, with an average age of 32.12 ± 7.97 years, comprised 81% females. In terms of surgical outcomes, postoperative evaluations revealed significant improvements in the VAS aesthetic score, SCHNOS-O score, and SCHNOS-C score compared with preoperative scores (p < 0.001) for both groups. Notably, both groups demonstrated significant improvements in the upper lip length, nasolabial angle (NLA), columellar inclination (CI) angle, and smile NLA. Patients in the SEG group exhibited markedly superior SCHNOS-O results, as well as distinctions in smile NLA and smile CI, compared with the group without SEG. The impact of rhinoplasty techniques on lip and smile remains complex requiring further evaluation. Both of the TIG techniques, with and without SEG, resulted in positive outcomes in terms of improving lip and smile positions, with the use of SEG demonstrating greater stability during a smile.

2.
Braz. j. otorhinolaryngol. (Impr.) ; 87(2): 188-192, mar.-abr. 2021. tab, graf
Artigo em Inglês, Português | LILACS | ID: biblio-1249356

RESUMO

Resumo Introdução: O enxerto de extensão caudal é geralmente um enxerto de cartilagem que se sobrepõe à margem caudal do septo nasal. Uma combinação do enxerto de extensão caudal e a técnica de tongue-in-groove é usada para estabilizar a base nasal, definir a projeção da ponta e refinar a relação alar-columelar. Objetivo: Apresentar algumas novas modificações na colocação dos enxertos de extensão caudal na rinoplastia. Método: Revisão retrospectiva de um banco de dados prospectivamente coletado de 965 pacientes que se submeteram a rinosseptoplastia de junho de 2011 a julho de 2015. Desses, 457 pacientes necessitaram de enxerto de extensão caudal e foram incluídos no estudo. O seguimento mínimo foi de 13,2 meses, com tempo médio de seguimento de 17,4 meses. Resultados: Na maioria dos casos, a comparação das fotografias antes e após a cirurgia foi satisfatória e apresentou melhora do contorno. Pequenas deformidades foram detectadas em 41 pacientes e 11 pacientes necessitaram de cirurgia de revisão. Conclusão: Com essas modificações, o cirurgião pode usar o enxerto de extensão caudal mesmo em desvios angulares do septo caudal. Vários métodos têm sido propostos para correção do desvio septo-caudal.


Assuntos
Rinoplastia , Deformidades Adquiridas Nasais , Cartilagem/transplante , Estudos Retrospectivos , Resultado do Tratamento , Septo Nasal/cirurgia
3.
Braz J Otorhinolaryngol ; 87(2): 188-192, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-31585700

RESUMO

INTRODUCTION: The caudal extension graft is usually a cartilage graft that overlaps the caudal margin of the nasal septum. A combination of the caudal extension graft and the tongue-in-groove technique is used to stabilize the nasal base, set tip projection, and refine the alar-columellar relationship. OBJECTIVES: In this study we present some new modifications to the placement of caudal extension grafts in rhinoplasty. METHODS: This study is a retrospective review of a prospectively collected database of 965 patients who underwent septorhinoplasty from June 2011 to July 2015. Of these, 457 patients required a caudal extension graft and were included in the study. Minimum follow-up was 13.2 months with a mean follow-up time of 17.4 months. RESULTS: In most cases, comparison of photographs before and after surgery were satisfactory and showed improved contour. Minor deformity was detected in 41 patients and 11 patients needed revision surgery. CONCLUSION: With these modifications the surgeon can employ the caudal extension graft even in angulated caudal septal deviations. A variety of methods have been proposed for correction of caudal nasal deviation.


Assuntos
Deformidades Adquiridas Nasais , Rinoplastia , Cartilagem/transplante , Humanos , Septo Nasal/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
5.
Indian J Otolaryngol Head Neck Surg ; 71(Suppl 3): 2031-2035, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31763288

RESUMO

Eosinophilic angiocentric Fibrosis (EAF) is a rare condition involving the sinonasal tract and nasal septum which is mostly considered as a benign condition. EAF could present with progressive nasal obstruction as its most common symptom. In this case report, we try to report a case of middle aged man with nasal septum tumor-link lesion which was diagnosed with EAF. A 45 years old man presented with complete nasal obstruction who described a growing nasal cavity mass for over 6 months. Anterior rhinoscopy revealed bilateral mass with a smooth surface on the nasal septum and mass protruded into both nasal cavities. CT scan showed a 28 × 18 mm soft tissue mass in nasal cavity mostly in right side with erosion of right maxillary alveolar ridge. Microscopic examination of a biopsy taken from the mass showed dense infiltration of inflammatory cells rich in eosinophils as well as perivascular condensation of fibrotic bundles creating onion-skin appearance was noted. The patient went under surgical ablation of the tumor and has been followed up every 2-3 month for about 1 year and there was no evidence of recurrent disease. The complete surgical excision may eradicate the allergic manifestations in the EAF patients and cartilage graft such as rib graft seems to be safe if the reconstruction is needed. It is important to prevent tumor from recurrence by totally resecting the involved tissues.

8.
Ann Plast Surg ; 73(2): 124-7, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23486145

RESUMO

The difficulty in correcting deviated nose has been discussed for more than 50 years. Numerous techniques have been proposed for the rectification of this deformity. In this study, we describe a modification to the extracorporeal septoplasty technique that comprises a more conservative approach and results in a stable cartilaginous framework. Combination of curved spreader graft with a septal caudal graft is introduced in the method as a modified extracorporeal septoplasty. Twenty-three patients were enrolled in the study. There were no revision cases. In all cases, comparison of preoperative and postoperative photographs showed improved contour.


Assuntos
Cartilagens Nasais/transplante , Septo Nasal/cirurgia , Nariz/anormalidades , Rinoplastia/métodos , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/cirurgia , Avaliação de Resultados da Assistência ao Paciente , Fotografação , Adulto Jovem
10.
Acta Otolaryngol ; 130(10): 1130-4, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20377506

RESUMO

CONCLUSION: Our results suggest that isolated auditory or vestibular involvement is unlikely and in fact audiovestibular neuropathy can better explain auditory neuropathy. OBJECTIVE: The purpose of this study was to investigate saccule and related neural pathways in auditory neuropathy patients. METHODS: Three males and five females diagnosed with auditory neuropathy were included in this prospective study. Patients' ages ranged from 21 to 45 years with a mean age of 28.6 ± 8.1 years and the history of disease was between 4 and 19 years. A group of 30 normal subjects served as the control group. The main outcome measures were the mean peak latency (in ms) of the two early waves (p13 and n23) of the vestibular evoked myogenic potential (VEMP) test in patients and controls. RESULTS: Of the 8 patients (16 ears), normal response was detected in 3 ears (1 in right and 2 in left ears). There were unrepeatable waves in four ears and absent VEMPs in nine ears.


Assuntos
Potenciais Evocados Miogênicos Vestibulares/fisiologia , Neuronite Vestibular/fisiopatologia , Adolescente , Adulto , Progressão da Doença , Feminino , Seguimentos , Perda Auditiva Central/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
12.
Eur Arch Otorhinolaryngol ; 266(8): 1225-8, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19205715

RESUMO

This study investigate the effect of stapes surgery on bone conduction (BC) improvement in otosclerotic patients with mixed hearing loss and also compare the effect of three different types of surgery (complete stapedectomy, partial stapedectomy and microfenestration stapedotomy) on this improvement. We retrospectively reviewed surgical database of 84 otosclerotic patients with mixed hearing loss. Sixty-two patients (75%) had significant improvement in BC after surgery (P = 0.03). In 85% of patients with follow-up time longer than 1 year, this improvement had remained. Improvement in BC after surgery was better in partial stapedectomy group (82.6%) and complete stapedectomy group (80.8%) in comparison with microfenestration stapedotomy group (63%) (P = 0.052).


Assuntos
Condução Óssea/fisiologia , Perda Auditiva Condutiva-Neurossensorial Mista/cirurgia , Otosclerose/cirurgia , Cirurgia do Estribo/métodos , Adolescente , Adulto , Feminino , Seguimentos , Perda Auditiva Condutiva-Neurossensorial Mista/etiologia , Perda Auditiva Condutiva-Neurossensorial Mista/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Otosclerose/complicações , Otosclerose/fisiopatologia , Período Pós-Operatório , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
13.
Am J Otolaryngol ; 29(6): 385-92, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19144299

RESUMO

PURPOSE: In this study, we aimed to study the frequency of possible underlying immunodeficiency responsible for susceptibility to ear, nose, and throat (ENT) infection. MATERIALS AND METHODS: One hundred three (72 males and 31 females) consecutive children and adult patients with history of recurrent or chronic ENT infections, referred by otolaryngologists to the Department of Allergy and Clinical Immunology, Children's Medical Center, Tehran University of Medical Sciences (Tehran, Iran), were enrolled to the study from March 2003 to March 2006. For each patient, demographic information and medical histories of any ENT infections were collected by reviewing the patient's records. We measured immunoglobulin isotype concentrations and immunoglobulin (Ig) G subclasses by nephelometry and enzyme-linked immunosorbent assay methods, respectively. Of 103 patients, 75 received unconjugated pneumococcus polyvalent vaccine, and blood samples were taken before and 21 days after vaccination. Specific antibodies against whole pneumococcal antigens were measured using enzyme-linked immunosorbent assay method. Existence of bronchiectasis was confirmed in each patient using high resolution computed tomography scan. RESULTS: Among 103 patients, 17 (16.5%) patients were diagnosed to have defects in antibody-mediated immunity including 6 patients with immunoglobulin class deficiency (2 common variable deficiency and 4 IgA deficiency), 3 with IgG subclass deficiency (2 IgG2 and 1 IgG3), and 8 with specific antibody deficiency against polysaccharide antigens. In our series, bronchiectasis was detected in 5 cases associated with primary immunodeficiency. CONCLUSIONS: Long-standing history of ENT infections could be an alarm for ENT infections associated with primary antibody deficiency.


Assuntos
Síndromes de Imunodeficiência/diagnóstico , Otite Média/imunologia , Faringite/imunologia , Rinite/imunologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Deficiência de IgA/diagnóstico , Deficiência de IgA/epidemiologia , Deficiência de IgG/diagnóstico , Deficiência de IgG/epidemiologia , Síndromes de Imunodeficiência/epidemiologia , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Monitorização Imunológica , Otite Média/epidemiologia , Faringite/epidemiologia , Recidiva , Rinite/epidemiologia , Medição de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
14.
Acta Otolaryngol ; 128(2): 177-80, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17851921

RESUMO

CONCLUSION: The vestibular area is closer than the auditory region to nucleus ambiguus. If a 'shared' lesion involves regions of adjacent nuclei of the brainstem in patients with spasmodic dysphonia then vestibular area involvement is more possible than that of the auditory region. OBJECTIVES: The authors hypothesize that lower brainstem lesions and involvement of descending pathways of the spinal tract may be the site of lesion in patients with spasmodic dysphonia. PATIENTS AND METHODS: Ten patients with spasmodic dysphonia were tested using the auditory brainstem response (ABR) and vestibular evoked myogenic potentials (VEMPs). RESULTS: No ABR abnormalities were found in right ears. Results of ABR on the left ear showed that one patient had abnormal ABR. This patient had severe sensorineural hearing loss on the left side. VEMPs displayed normal response in two patients bilaterally. First positive (p13) and second negative (n23) waves of VEMP could not be recorded in three cases unilaterally and in five patients bilaterally.


Assuntos
Tronco Encefálico/fisiopatologia , Eletromiografia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Potencial Evocado Motor/fisiologia , Músculos do Pescoço/inervação , Processamento de Sinais Assistido por Computador , Testes de Função Vestibular , Distúrbios da Voz/fisiopatologia , Estimulação Acústica , Adulto , Idoso , Feminino , Lateralidade Funcional/fisiologia , Movimentos da Cabeça/fisiologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Técnicas In Vitro , Masculino , Pessoa de Meia-Idade , Vias Neurais/fisiopatologia , Tempo de Reação/fisiologia , Medula Espinal/fisiopatologia
15.
Arch Iran Med ; 10(1): 43-7, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17198453

RESUMO

BACKGROUND: Microtia is a congenital abnormality with low incidence but considerable morbidities. Reconstruction of the microtia deformity is a complex and difficult process that requires a proper planning. The primary technique of reconstruction employs patient's own rib cartilage. Irradiated homograft cartilages previously have been used in facial reconstruction but its application in microtia surgery has not been reported yet. This study is designed to compare the results of autograft versus homograft auriculoplasty. METHODS: Between 1992 - 2002, 23 patients underwent auricular reconstructive surgery by the senior author in our department. Autograft implantation was performed in one stage but homograft auriculoplasty was done in two stages. RESULTS: Auricular deformity was right-sided in 13, left-sided in 8, and bilateral in 2 cases. Implanted graft was autograft in 9 patients and homograft in 14 patients. During mean follow-up of 4 years, cartilage graft resorption was detected in two cases, one in autograft and one in homograft group (P > 0.05). No postoperative infection was observed. Status of postauricular sulcus was optimal in 85.7% of homograft and 77.8% of autograft groups (P > 0.05). The satisfaction score of the patients and/or parents was excellent in 66.7% of autograft and 92.9% of homograft groups (P < 0.01). CONCLUSION: Based on better satisfaction score, equivalent aesthetic appearance, and absence of complications such as scaring and pain on the chest wall, homograft auriculoplasty is an appropriate option for reconstructive surgery in patients with microtia.


Assuntos
Cartilagem da Orelha/transplante , Otopatias/cirurgia , Orelha Externa/anormalidades , Procedimentos Cirúrgicos Otológicos/métodos , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Adulto , Criança , Otopatias/congênito , Feminino , Seguimentos , Humanos , Masculino , Satisfação do Paciente , Estudos Retrospectivos , Inquéritos e Questionários , Transplante Autólogo , Transplante Homólogo , Resultado do Tratamento
16.
Arch Iran Med ; 9(4): 344-7, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17061607

RESUMO

BACKGROUND: Most deaf and severe to profound sensorineural hearing loss patients are incapable to communicate well because of a lack of receiving sound signals. Cochlear implant is one of the effective measures, which has been of great help to the deaf. Up to now, more than 1000 cochlear implants have been accomplished successfully in Iran. Since cochlear implantation is faced with numerous problems and difficulties, we should establish other methods for sound communication. Tactile aids can be a very effective help regarding this issue. METHODS: We designed and accomplished a study on the use of tactile aid, along with rehabilitation and training of these patients in our department. We designed four educational stages to check the improvement of subjects who used one-, two-, and seven-channel tactile aids. RESULTS: Hundred percent of the cases passed the first stage (detection) successfully. In the second stage (beginning pattern perception) all the cases with two and seven channel tactile aids were able to distinguish all kinds of sounds. They could differentiate between speech and non-speech sounds. In the third stage (recognition of speech), all the cases were able to recognize environmental and "sound maker" sounds, but only 43% of the individuals were able to recognize speech sounds and repeat correctly with two-channel tactile aids. In the fourth stage (comprehension of words), identification and repetition of the words were only possible with seven-channel tactile aids. CONCLUSION: The results of our study show that tactile aids are well accepted by the patients with severe to profound sensorineural hearing loss who do not benefit from usual hearing aids.


Assuntos
Surdez/terapia , Auxiliares de Audição , Perda Auditiva Neurossensorial/terapia , Audição , Adolescente , Percepção Auditiva , Limiar Auditivo , Criança , Pré-Escolar , Auxiliares de Comunicação para Pessoas com Deficiência/estatística & dados numéricos , Feminino , Auxiliares de Audição/estatística & dados numéricos , Humanos , Irã (Geográfico) , Masculino , Estudos Prospectivos , Percepção da Fala
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