Assuntos
Proteínas Reguladoras de Apoptose/genética , Proteínas de Ligação a DNA/genética , Disfonia/genética , Mutação/genética , Proteínas Nucleares/genética , Distúrbios da Voz/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antidiscinéticos/uso terapêutico , Toxinas Botulínicas/uso terapêutico , Criança , Disfonia/complicações , Disfonia/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Distúrbios da Voz/complicações , Adulto JovemAssuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/metabolismo , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/metabolismo , Octreotida/farmacocinética , Receptores de Somatostatina/metabolismo , Neoplasias da Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/metabolismo , Feminino , Humanos , Pessoa de Meia-Idade , Cintilografia , Compostos Radiofarmacêuticos/farmacocinéticaRESUMO
OBJECTIVES: Despite effective medical therapy and repetitive endoscopic sinus surgery in the treatment of chronic rhinosinusitis, there still remains a small group of patients without improvement of symptoms. This study evaluates the effect of radical surgery on quality of life and pain in these patients with recalcitrant disease. STUDY DESIGN: A prospective, questionnaire-based study was conducted in 23 patients who underwent Denker's procedure for refractory chronic rhinosinusitis. Quality of life and pain were evaluated before surgery and 12 months and 2 years after surgery with the SF-36 and McGill Pain Questionnaire. RESULTS: Seven of the eight mean scores of the SF-36 postoperatively improved after surgery, with statistical significance for Role Physical (RP) P=0.048. Bodily pain showed a strong tendency to significance. Results of the McGill Pain Questionnaire show a significant improvement in most of the subscores after surgery implying less pain. CONCLUSION: Radical surgery improves the physical burden of chronic rhinosinusitis and pain experience in patients with therapy resistant chronic rhinosinusitis.
Assuntos
Procedimentos Cirúrgicos Otorrinolaringológicos , Qualidade de Vida , Rinite/cirurgia , Sinusite/cirurgia , Doença Crônica , Indicadores Básicos de Saúde , Humanos , Dor Pós-Operatória/prevenção & controle , Estudos Prospectivos , Falha de TratamentoRESUMO
OBJECTIVES: Endoscopic sinus surgery (ESS) is considered to be the golden standard for surgery in patients with chronic rhinosinusitis and nasal polyposis. However, there is still a small group of patients unresponsive despite repetitive surgery. Radical surgery aimed at reduction of the inflammatory burden and optimization of drainage of the sinuses has been suggested as a last resort for these patients. STUDY DESIGN: A prospective, questionnaire-based study was conducted in a group of 23 patients who underwent Denker's procedure for refractory chronic rhinosinusitis. Symptoms were evaluated before Denker's procedure and 12 months and 2 years after surgery. RESULTS: Patients reported improvement of feelings of congestion in 74%, rhinorrhea in 70%, and nasal obstruction in 60% of the cases. The following postoperative improvements were statistically significant: rhinorrhea (P = 0.001), feelings of congestion (P = 0.02), and nasal obstruction (P = 0.03). Reduced olfactory perception and asthma did not improve. CONCLUSION: Radical surgery may be a viable treatment option in case of recurrent ESS failure. EBM RATING: C-4.
