Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 14 de 14
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Rev. otorrinolaringol. cir. cabeza cuello ; 82(3): 333-337, sept. 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1409942

RESUMO

Resumen Durante la cirugía endoscópica nasosinusal, la sección inadvertida y retracción hacia la órbita de la arteria etmoidal anterior (AEA) es el mecanismo habitual del hematoma orbitario (HO); éste se manifiesta con proptosis, dolor y déficit visual potencialmente irreversible. El déficit visual es secundario a isquemia del nervio óptico por aumento de la presión intraocular, siendo suficientes treinta minutos para que ocurra daño visual permanente. Por sus secuelas el tratamiento del HO debe ser rápido y agresivo. Presentamos el caso de un varón de 72 años con diagnóstico de rinosinusitis crónica con pólipos nasales refractaria a tratamiento médico que se sometió a cirugía endoscópica nasal y que desarrolló en el posoperatorio inmediato con un HO. Se manejó precozmente con cantotomía-cantolisis, descompresión orbitaria medial endoscópica y control vascular de la AEA. El paciente evoluciona favorablemente, sin déficit visual. En este artículo se discutirán el diagnóstico y manejo oportunos del hematoma orbitario iatrogénico.


Abstract During endoscopic sinonasal surgery, inadvertent section of the anterior ethmoidal artery (AEA) with retraction into the orbit is the usual mechanism of orbital hematoma (OH), leading to proptosis, pain, and potentially irreversible visual loss. Thirty minutes is sufficient for retinal ischemia and permanent visual loss. The explanation for blindness is due to increased intraorbital pressure. The treatment of iatrogenic HO must be quick and aggressive, because if it is not managed in time, it can cause a permanent visual deficit. We present the case of a 72-year-old man with a diagnosis of chronic rhinosinusitis with nasal polyps refractory to medical treatment who underwent nasal endoscopic surgery, evolving in the immediate postoperative period with an HO, requiring canthotomy - cantolysis and early surgical reintervention for endoscopic medial orbital decompression and vascular control of AEA. The patient evolves favorably, without visual deficit. This article will discuss the timely diagnosis and management of iatrogenic orbital hematoma.


Assuntos
Humanos , Masculino , Idoso , Doenças Orbitárias/etiologia , Pólipos Nasais/cirurgia , Endoscopia/efeitos adversos , Hematoma/etiologia , Endoscopia/métodos , Hemorragia/etiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-34294226

RESUMO

Chronic Rhinosinusitis with Nasal Polyps (CRScPN) is a disease with great impact on health. The surgical option using endoscopic nasosinus surgery is the therapeutic alternative when control of the disease is not achieved with medical treatment. Extensive endoscopic approaches are being postulated as a possible best surgical treatment option in certain phenotypes of CRScPN. Endonasal mucoplasty associated with these approaches has been shown to be a complementary technique that improves both healing and mucosal oedema in patients with CRScPN in the short term. The aim of our study was to analyse the results of endonasal mucoplasty associated with a complete ethmoid-sphenoidotomy plus grade III frontal sinusotomy in the treatment of CRScPN in the medium term. For this purpose, a prospective case-control study (10/10) was carried out on patients with CRScPN. In the case group, endonasal mucoplasty in the left nostril was associated with surgery, and the control group was not. The assessment of quality of life at one year after surgery, as measured by the mean difference in SNOT-22 (mean [SD]), in the case group was significantly better than in the control group, (45.9 [19.6]-26.6 [16.05], P = 0.027). The endoscopic improvement in healing and mucosal oedema, measured by the Modified Lund-Kennedy scale, showed relevant improvements, when comparing both pits, but without reaching significance (P = 0.29). Endonasal mucoplasty promotes short-term healing, improving the quality of life in the medium term (one year) of patients treated with extensive endoscopic breast resections.


Assuntos
Pólipos Nasais , Sinusite , Estudos de Casos e Controles , Doença Crônica , Humanos , Pólipos Nasais/cirurgia , Estudos Prospectivos , Qualidade de Vida , Sinusite/cirurgia
3.
Acta otorrinolaringol. esp ; 72(4): 256-261, julio 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-207273

RESUMO

La rinosinusitis crónica con pólipos nasales (RSCcPN) es una enfermedad con gran impacto sobre la salud. La opción quirúrgica mediante cirugía endoscópica nasosinusal es la alternativa terapéutica cuando no se alcanza el control de la enfermedad con el tratamiento médico. Los abordajes endoscópicos extensos se están postulando como posible mejor opción de tratamiento quirúrgico en ciertos fenotipos de RSCcPN. La mucoplastia endonasal asociada a estos abordajes ha demostrado ser una técnica complementaria que mejora tanto la cicatrización como el edema mucoso a corto plazo en pacientes con RSCcPN. El objetivo de nuestro estudio ha consistido en analizar los resultados de las mucoplastia endonasal asociada a una etmoidoesfenoidotomía completa más sinusotomía frontal de grado III en el tratamiento de RSCcPN a medio plazo. Para ello se realizó un estudio prospectivo de casos y controles (10/10) en pacientes con RSCcPN. En el grupo de casos se asoció a la cirugía una mucoplastia endonasal en la fosa nasal izquierda y en el grupo control no. La evaluación de la calidad de vida al año de la intervención quirúrgica, medida mediante la diferencia de medias de SNOT-22 (media [DE]), en el grupo de casos fue significativamente mejor que en el grupo control (45,9 [19,6]-26,6 [16,05]; p=0,027). La mejoría endoscópica de la cicatrización y del edema mucoso, medida mediante la escala de Lund-Kennedy modificada, mostró mejorías relevantes al comparar ambas fosas, pero sin alcanzar la significación (p=0,29). La mucoplastia endonasal favorece la cicatrización a corto plazo, lo que mejora la calidad de vida a medio plazo (un año) de los pacientes tratados con resecciones extensas endoscópicas de los senos. (AU)


Chronic rhinosinusitis with nasal polyps (CRSwNP) is a disease with great impact on health. The surgical option using endoscopic sinus surgery is the therapeutic alternative when control of the disease is not achieved with medical treatment. Extensive endoscopic approaches are being postulated as a possible best surgical treatment option in certain phenotypes of CRSwNP. Endonasal mucoplasty associated with these approaches has been shown to be a complementary technique that improves both healing and mucosal edema in patients with CRSwNP in the short term. The aim of our study was to analyse the results of endonasal mucoplasty associated with a complete ethmoid-sphenoidotomy plus grade III frontal sinusotomy in the treatment of CRSwNP in the medium term. For this purpose, a prospective case-control study (10/10) was carried out on patients with CRSwNP. In the case group, endonasal mucoplasty in the left nostril was associated with surgery, and the control group was not. The assessment of quality of life at one year after surgery, as measured by the mean difference in SNOT-22 (mean [SD]), was significantly better in the case group than in the control group (45.9 [19.6]-26.6 [16.05] P=0.027). The endoscopic improvement in healing and mucosal edema, measured by the Modified Lund-Kennedy scale, showed relevant improvements, when comparing both nostrils, but without reaching significance (P=0.29). Endonasal mucoplasty promotes short-term healing, improving the quality of life in the medium term (one year) of patients treated with extensive endoscopic mucosal resections. (AU)


Assuntos
Humanos , Doença Crônica , Pólipos Nasais/cirurgia , Qualidade de Vida , Sinusite/cirurgia , Estudos de Casos e Controles , Estudos Prospectivos
4.
Acta otorrinolaringol. cir. cuello (En línea) ; 48(1): 53-61, 20200000. ilus, graf, tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1097449

RESUMO

Objetivos: La cirugía endoscópica del seno frontal es quizá uno de los procedimientos más complejos en el manejo endoscópico de los senos paranasales debido a su localización y a las múltiples variantes anatómicas que pueden encontrarse durante su disección. Es indispensable conocer al detalle la anatomía quirúrgica de esta región en nuestra población, para optimizar la planeación quirúrgica de los pacientes. Actualmente en nuestro país se desconoce la frecuencia de estas variaciones. El objetivo del proyecto es evaluar la frecuencia de las variables anatómicas del seno frontal y realizar un estudio radio-anatómico en una muestra de pacientes en Colombia. Diseño del estudio: Observacional, descriptivo de tipo transversal. Métodos: Muestra aleatorizada de 406 tomografías computarizadas de senos paranasales que incluyeron 812 senos frontales recolectados durante el año 2018 Resultados: La celdilla suprabular fue la más comúnmente reportada con una frecuencia de 59.61%. La segunda celdilla fue la supra agger nasi con una frecuencia de 57.88%, seguido de la celdilla supra agger frontal (25.12%), celdilla suprabular frontal (22.17%), celdillas supraorbitarias (34.98%) y las celdilla frontal intersinusal (24,14%). La arteria etmoidal anterior se reportó colgante en un 31.28% y el diámetro AP más frecuente fue entre 5 -10 milímetros. Conclusiones: Para realizar una sinusotomía frontal endoscópica de forma adecuada es necesario conocer al detalle la anatomía del receso del seno frontal. Las diferentes variantes radio-anatómicas son muy frecuentes en el grupo poblacional estudiado. Creemos que este trabajo permitirá a los cirujanos un mejor entendimiento de esta región de difícil acceso quirúrgico en nuestra población. Palabras clave: Seno frontal, senos paranasales, seno clasificación frontal, cirugia endoscopica nasosinusal


Objectives: Endoscopic frontal sinus surgery is perhaps, one of the most complex procedures in the endoscopic sinus surgery, due to its anatomical location and the multiple anatomical variants that can be found. It is essential to know in detail the anatomy of this region in order to obtain a better understanding for the surgical planning. Currently, the frequency of these anatomical variations remains unknown in our country. Therefore, the objective of the study is to evaluate the frequency of the anatomical variants of the frontal sinus and to carry out a radio-anatomic study in a sample of patients from Colombia. Study design: Observational, cross-sectional descriptive. Methods: Randomized sample of 406 CT scan of the paranasal sinuses that included 812 frontal sinuses collected during the year 2018. Results: The supra bulla cell was the most frequently reported with a frequency of 59.61%. The second cell was the supra agger (57.88%) followed by supra agger frontal cell (25.12%), supra bulla frontal cell (22.17%), supraorbital ethmoid cells (34,98%) and frontal septal cell (24,14%) . The anterior ethmoidal artery was found hanging in 31.28% and the most frequent AP diameter was between 5 -10 mm. Conclusions: To perform an appropriate endoscopic frontal sinusotomy, it is necessary to know in detail the anatomy of the frontal sinus recess. The different radio-anatomical variants of the frontal sinus are very frequent in the population group studied. We believe that this study will allow surgeons to obtain a better understanding of this anatomical region of difficult surgical access.


Assuntos
Humanos , Seio Frontal , Seios Paranasais
5.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29784243

RESUMO

OBJECTIVE: The objective was to determine the results of the treatment of severe and/or refractory epistaxis requiring hospital admission. In addition, the results of arterial ligation versus embolization were compared. MATERIAL AND METHOD: Sixty-three patients with severe and/or refractory epistaxis requiring hospital admission between August 2014 and December 2016 were included prospectively. RESULTS: Eleven patients (17%) underwent embolization, 5 (8%) endoscopy ligation and the remaining 47 (75%) underwent conservative treatment with tamponade. The mean age of the patients in which conservative measures were sufficient was 72 years, while the age of those treated with embolization was 71 years and of those who underwent surgery was 53 years. For the patients who underwent conservative treatment or surgery, the average stay was 6 days, compared to 9 days for those who underwent embolization. One patient suffered a hemispheric stroke after embolization. No post-surgical complications were observed. CONCLUSIONS: Most cases of severe and/or refractory epistaxis are resolved by conventional tamponade. Endoscopy ligation is associated with a decrease in hospital stay, without serious complications. It is advisable to have all the possible therapeutic options available, for which the presence of interventional radiologists and experienced surgeons is essential to avoid complications and decide the treatment to be performed individually for each patient.


Assuntos
Epistaxe/terapia , Técnicas Hemostáticas , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Tratamento Conservador , Embolização Terapêutica/efeitos adversos , Endoscopia/métodos , Endoscopia/estatística & dados numéricos , Epistaxe/cirurgia , Feminino , Técnicas Hemostáticas/estatística & dados numéricos , Hospitalização , Humanos , Tempo de Internação/estatística & dados numéricos , Ligadura/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Utilização de Procedimentos e Técnicas , Estudos Prospectivos , Recidiva , Acidente Vascular Cerebral/etiologia , Tampões Cirúrgicos , Resultado do Tratamento , Adulto Jovem
6.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29764608

RESUMO

BACKGROUND AND OBJECTIVES: Juvenile angiofibroma (JA) is a benign tumour, for which the treatment of choice is surgery. It may be associated with significant morbidity because of its anatomical location and its locally destructive growth pattern. Severe haemorrhage constitutes a high risk in JA and its surgical management can be complex. The management of JA remains a challenge. The objective of this study was to review a series of patients with JA treated via the endonasal/endoscopic approach. MATERIAL AND METHODS: Medical records of patients operated for JA were reviewed. MAIN OUTCOME MEASURES: tumour stage, intraoperative blood loss, complications and persistence/recurrence rates. RESULTS: A total of 30 male patients and one female were included. The mean age was 17 years. Using the Radkowski classification, one JA was classified as stage I, 5 stage IIA, 9 stage IIB, 4 stage IIC, 10 stage IIIA and 2 stage IIIB. Thirty-nine percent of the JA was classified as advanced stage JA (IIIA and IIIB). The mean blood loss was 1.156mL Except in one case, no significant complications were observed. Tumour persistence/recurrence was observed in 2 JA (6%), at the end of the follow-up. Mean postoperative follow-up time was 86 months. CONCLUSIONS: This retrospective study supports the notion that endonasal endoscopic approaches for a JA are a feasible option associated with good long-term results.


Assuntos
Angiofibroma/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias Nasais/cirurgia , Adolescente , Adulto , Angiofibroma/complicações , Angiofibroma/patologia , Perda Sanguínea Cirúrgica , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Cirurgia Endoscópica por Orifício Natural/efeitos adversos , Estadiamento de Neoplasias , Neoplasias Nasais/complicações , Neoplasias Nasais/patologia , Complicações Pós-Operatórias , Estudos Retrospectivos , Adulto Jovem
7.
Rev. otorrinolaringol. cir. cabeza cuello ; 77(3): 281-288, set. 2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-902777

RESUMO

El osteoma es el tumor más frecuente de los senos paranasales, habitualmente asintomático debido a su lento crecimiento, sin embargo, pueden desarrollarse síntomas dependiendo del tamaño, localización y extensión, con potencial compromiso de órbita y cerebro. La cirugía está indicada en casos sintomáticos pudiendo realizarse abordaje externo, endoscópico o combinado. Presentamos un caso de osteoma etmoidal con compromiso orbitario resuelto, manejado por medio de la cirugía endoscópica nasal, con apoyo de navegación.


The osteoma is the most common tumor of the paranasal sinuses, is usually asymptomatic because of their slow growth, however, may develop symptoms depending on the size, location and extent, with potential compromise of orbit and brain. Surgery is indicated in symptomatic cases, with external, endoscopic or combined approach. We present a case of ethmoidal osteoma with orbital involvement managed by endoscopic image guided surgery.


Assuntos
Humanos , Masculino , Adolescente , Osteoma/cirurgia , Neoplasias Ósseas/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Endoscopia/métodos , Osteoma/diagnóstico por imagem , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Cirurgia Assistida por Computador , Seio Etmoidal/cirurgia , Seio Etmoidal/diagnóstico por imagem , Seio Frontal/cirurgia , Seio Frontal/diagnóstico por imagem
8.
Acta Otorrinolaringol Esp ; 68(2): 80-85, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27515764

RESUMO

INTRODUCTION AND OBJECTIVES: Endoscopic sinus surgery is currently the surgical procedure chosen in cases of sinonasal polyposis refractory to medical treatment. The aim of this study was to show our experience in managing such patients operated using endoscopic sinus surgery. METHOD: A retrospective study of 246 patients with chronic rhinosinusitis and nasal polyps who were operated by endoscopic surgery. We studied the characteristics of the population, symptoms, grade of affectation, complications and recurrences. RESULTS: The most frequent comorbidity was asthma (34.6%) and its relationship with Samter's triad (16.3%). Grades 2 and 3 polyposis prevailed according to Lildholdt staging by nasofibroscopy, coinciding with the radiological preoperative staging. The microdebrider did not shorten surgical time but it lowered complications. Reducing the average stay with the use of absorbable haemostatic agents and their effectiveness in controlling hemostasis were statistically significant. We found 23.2% complications, with only one (.4%) being a major complication; the rest were minor complications, with synechiae as the most frequent (16.3%). CONCLUSION: Endoscopic sinus surgery is a minimally invasive and safe technique. Absorbable haemostatic agents are an effective alternative to get complete and stable hemostasis, reducing mean hospital stay. Synechiae continue being the most frequent complication. The fact that many patients recurred but without complications speaks in favour of a natural evolution of the disease and not of the influence of technique.


Assuntos
Endoscopia/métodos , Pólipos Nasais/cirurgia , Rinite/complicações , Sinusite/complicações , Adulto , Asma/epidemiologia , Doença Crônica , Terapia Combinada , Comorbidade , Estudos Transversais , Osso Etmoide/cirurgia , Feminino , Hemostasia Cirúrgica/métodos , Humanos , Hipersensibilidade/epidemiologia , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/epidemiologia , Pólipos Nasais/etiologia , Complicações Pós-Operatórias/epidemiologia , Recidiva , Estudos Retrospectivos , Rinite/tratamento farmacológico , Rinite/epidemiologia , Fatores Sexuais , Sinusite/tratamento farmacológico , Sinusite/epidemiologia , Resultado do Tratamento , Conchas Nasais/cirurgia , Adulto Jovem
9.
Acta Otorrinolaringol Esp ; 68(1): 1-8, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27206393

RESUMO

INTRODUCTION AND OBJECTIVES: Endoscopic sinonasal surgery is the procedure of choice in the treatment of chronic rhinosinusitis and sinonasal polyposis refractory to medical treatment, with high rates of success (76% to 97.5%). However, 2.5%-24% of those patients will require revision surgery (RESS). In this study, we present the clinical, anatomical, radiological and histological features of patients receiving RESS in our centre during a 3-year period. METHODS: A retrospective review of clinical, anatomical, radiological and histopathological data of patients receiving revision endoscopic sinonasal surgery between 2012 and 2014 was carried out. RESULTS: From 299 surgery procedures performed, 27 (9%) were revision surgeries. The mean patient age was 46 years, with a male/female ratio of 1.4/1. The most frequent preoperative and postoperative diagnosis was chronic polypoid rhinosinusitis. The mean time since the previous surgery was 6.1 years, with 11.9 months of mean follow-up since that surgery. Stenotic antrostomy was found during revision in 81.5% of the patients and incomplete anterior ethmoidectomy and persistent uncinate process, in 59.3%. In radiology, 70.4% of patients had persistent anterior ethmoidal cells. Antrostomy or widening of antrostomy was performed in 96.3% of cases and anterior ethmoidectomy or completion of it was performed in 66.7%. CONCLUSIONS: Polyps, stenotic antrostomy and incomplete ethmoidectomy were the most frequent causes of revision surgery, in concordance with the procedures performed. The patients had long periods of time without follow-up between surgeries. Further investigation is necessary to generate measures to reduce the number of revision surgeries.


Assuntos
Endoscopia , Reoperação/métodos , Feminino , Seguimentos , Humanos , Masculino , Obstrução Nasal/etiologia , Obstrução Nasal/cirurgia , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/cirurgia , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/cirurgia , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/cirurgia , Pólipos/diagnóstico por imagem , Pólipos/cirurgia , Estudos Retrospectivos , Rinite/diagnóstico por imagem , Rinite/cirurgia , Sinusite/diagnóstico por imagem , Sinusite/cirurgia , Tomografia Computadorizada por Raios X
10.
Acta Otorrinolaringol Esp ; 66(1): 1-7, 2015.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-25052487

RESUMO

INTRODUCTION AND OBJECTIVES: Cerebrospinal fluid leaks associated to meningoencephaloceles of the sphenoid lateral recess are rare entities. A congenital bony defect at this level results in the persistence of Sternberg's canal, or a lateral craniopharyngeal canal, which is supposed to be the origin of these lesions. Our objective was to show that the endoscopic transpterygoid approach is an effective technique for their treatment. METHODS: We present a series of 5 cases of meningoencephaloceles of the sphenoid lateral recess treated with endoscopic sinus surgery (4 women and one man; mean age=59, range 37-72 years). Cerebrospinal fluid rhinorrhoea was present in all of them and they all underwent a transpterygoid approach with reconstruction of the skull base. We describe the surgical technique and review the literature. RESULTS: No complications were observed during surgery or the postoperative period. After a mean follow-up of 81 months, only one recurrence was seen. CONCLUSIONS: The transpterygoid approach has proven to be effective for the treatment of meningoencephaloceles of the sphenoid lateral recess. Providing wide access to identify the defect, followed by meningoencephalocele ablation, is the key for successful surgery.


Assuntos
Encefalocele/cirurgia , Endoscopia/métodos , Procedimentos de Cirurgia Plástica/métodos , Base do Crânio/cirurgia , Osso Esfenoide/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Rinorreia de Líquido Cefalorraquidiano/etiologia , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Traumatismos Craniocerebrais/complicações , Encefalocele/diagnóstico por imagem , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Meningites Bacterianas/etiologia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Recidiva , Base do Crânio/diagnóstico por imagem , Osso Esfenoide/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Conchas Nasais/cirurgia
11.
Acta Otorrinolaringol Esp ; 65(3): 162-9, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-24698399

RESUMO

OBJECTIVE: We present our experience in the reconstruction of cerebrospinal fluid (CSF) leaks according to their size and location. MATERIAL AND METHODS: Fifty-four patients who underwent advanced skull base surgery (large defects) and 62 patients with CSF leaks of different origin (small and medium-sized defects) were included. Large defects were reconstructed with a nasoseptal pedicled flap positioned on fat and fascia lata and lumbar drainage was used. In small and medium-sized leaks of other origin, intrathecal fluorescein 5% was applied previously to identify the defect. Fascia lata in an underlay position was used for reconstruction, which was then covered with mucoperiosteum from the turbinate. Perioperative antibiotics were administered for 5-7 days. Nasal packing was removed after 24-48 hours. RESULTS: The most frequent aetiology for small and medium-sized defects was spontaneous (48.4%), followed by trauma (24.2%), iatrogenic (5%) and others. The success rate was of 91% after the first surgery and 98% in large skull base defects and small/medium-sized respectively. After rescue surgery, the rate of closure achieved was 100%. The follow-up was 15.6 ± 12.4 months for large defects and 75.3 ± 51.3 months for small/medium-sized defects without recurrence. CONCLUSIONS: Endoscopic surgery for closure of any type of skull base defect is the gold standard approach. Defect size does not play a significant role in the success rate. Fascia lata and mucoperiosteum allow a reconstruction of small/medium-sized defects. For larger skull base defects, a combination of fat, fascia lata and nasoseptal pedicled flaps provide a successful reconstruction.


Assuntos
Rinorreia de Líquido Cefalorraquidiano/diagnóstico , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Algoritmos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
12.
Rev. otorrinolaringol. cir. cabeza cuello ; 74(2): 109-114, 2014. graf, tab
Artigo em Espanhol | LILACS | ID: lil-726160

RESUMO

Introducción: Los mucoceles son pseudotumores expansivos de las cavidades paranasales, cuyos síntomas están dados por su crecimiento expansivo. El tratamiento tradicional ha sido la extracción quirúrgica por vía externa, siendo desplazado en las últimas décadas por la resección endoscópica. Objetivo: Evaluar la experiencia en nuestro servicio sobre el diagnóstico y tratamiento de los mucoceles. Material y método: Revisión retrospectiva de pacientes tratados por mucocele en el Servicio de Otorrinolaringología, entre 2002y 2013. Se describen características clínico-demográficas, métodos diagnósticos, tratamiento y aparición de recidivas. Resultados: Se analizaron 45pacientes con seguimiento promedio de 24,93 meses. El 51,11% correspondió al sexo masculino. La edad promedio fue 49,68 años. El 46,6% fueron mucoceles fronto-etmoidales (6 frontales, 6 etmoidales y 9 fronto-etmoidales), el resto en seno maxilar, con un periodo de latencia de 7,33 meses. Los síntomas más frecuentes fueron oftalmológicos (55,5%) como proptosis y diplopía, mientras que el 51,1% de los pacientes tenía antecedentes de rinosinusitis crónica. El tratamiento fue mediante resección endoscópica en el 66,22%, por vía abierta 31,1% y manejo combinado en 6,66%. Hubo 8 casos recidivados, que representan el 17,7% de la serie. Discusión: Nuestra casuística resultó semejante a otras series publicadas. En los últimos años se ha preferido el abordaje endoscópico, sin embargo, el abordaje externo o combinado siguen siendo claves en el manejo de mucoceles extensos o para tratar recidivas. La aparición potencialmente tardía de recidivas requiere un tiempo de seguimiento largo para estos pacientes. Conclusiones: Los mucoceles representan un desafío diagnóstico y terapéutico y el manejo endoscópico parece una alternativa segura en el manejo de mucoceles que no comprometan órbita o tengan extensión craneal.


Introduction: Mucoceles are expansive pseudotumors of the paranasal sinuses and clinical presentations of symptoms are given by expansive growth. Traditional treatment has been open surgical extraction, being shifted in recent decades by endoscopic resection. Aim: To evaluate our experience in diagnosis and treatment of mucoceles. Material and methods: Retrospective chart review of patients treated for mucocele in the Department of Otolaryngology, between 2002 and 2013. Clinical and demographic characteristics, diagnostic methods, treatment and recurrence are described. Results: 45 patients with average follow-up of 24.93 months were analyzed. 51.11% were male. The mean age was 49.68years. 46.6% were fronto-ethmoidal mucoceles (6 in frontal sinus, 6 in ethmoidal sinus and 9 fronto-ethmoidal), the rest in the maxillary sinus, with a latency period of 7.33 months. Most frequent symptoms were ophtalmologic (55.5%) as proptosis and diplopia, while 51.1% of patients had a history of chronic rhinosinusitis. Treatment was by endoscopic resection in 66.22%, 31.1% by open surgery and 6.66% in combined approach. There were 8 recurrent cases, accounting for 17.7% of the series. Discussion: Our series was similar to other published earlier. In recent years, endoscopic approach is preferred, however, combined external approach or keys remain in handling large mucoceles or to treat recurrences. The late onset of recurrences potentially requires a long follow-up time for these patients. Conclusions: Mucoceles represent a diagnostic and therapeutic challenge and endoscopic management seems a safe alternative in the management of orbital involvement or cranial extension mucoceles.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Seios Paranasais/cirurgia , Endoscopia/métodos , Mucocele/cirurgia , Recidiva , Estudos Retrospectivos , Seguimentos , Mucocele/epidemiologia
13.
Rev. cuba. cir ; 50(1)ene.-mar. 2011. tab, graf
Artigo em Espanhol | CUMED | ID: cum-48582

RESUMO

La poliposis nasal es una enfermedad multifactorial con prevalencia en la población general del 2 al 5 por ciento. Fue objetivo de este estudio comparar los resultados quirúrgicos en 60 pacientes con poliposis nasosinusal, operados con microdesbridador y sin él. Se analizaron 60 pacientes operados entre el 2002 y el 2006. Se estudiaron factores relacionados, como asma, intolerancia al ácido acetilsalicílico y alergia. Fueron consideradas las cirugías previas, endoscópicas o convencionales, así como las complicaciones menores y mayores derivadas de éstas. Se revisaron los casos que no se lograron controlar con tratamiento médico...(AU)


Nasal polyposis is a multifactor disease with prevalence in general population from 2 to 5 percent. The objective of present paper was to compare the surgical results in 60 patients with nasosinusal polyposis operated on with and without micro-defibrillator. Sixty patients operated on between 2002 and 2006. The related factors were studied including asthma, acetylsalicylic acid and allergy. Previous, endoscopic or conventional surgeries were considered as well as the minor and major complications derived from it. The non-controlled cases with medical treatment were reviewed(AU


Assuntos
Humanos , Pólipos Nasais/cirurgia , Endoscopia/métodos
14.
Rev. cuba. cir ; 50(1)ene.-mar. 2011. tab, graf
Artigo em Espanhol | LILACS | ID: lil-616294

RESUMO

INTRODUCCIÓN. La poliposis nasal es una enfermedad multifactorial con prevalencia en la población general del 2 al 5 por ciento. Fue objetivo de este estudio comparar los resultados quirúrgicos en 60 pacientes con poliposis nasosinusal, operados con microdesbridador y sin él. MÉTODOS. Se analizaron 60 pacientes operados entre el 2002 y el 2006. Se estudiaron factores relacionados, como asma, intolerancia al ácido acetilsalicílico y alergia. Fueron consideradas las cirugías previas, endoscópicas o convencionales, así como las complicaciones menores y mayores derivadas de éstas. Se revisaron los casos que no se lograron controlar con tratamiento médico. RESULTADOS. Los resultados globales fueron satisfactorios: a los 2 años 29 pacientes (48,3 por ciento) estaban asintomáticos, 45 (75 por ciento) con las fosas libres de pólipos, 11 (18,3 por ciento) con recidiva controlada con tratamiento médico y hubo que reintervenir solo a 2 pacientes (3,3 por ciento). El número de complicaciones permaneció muy por debajo del nivel razonable; hubo solo 2 (3,3 por ciento) complicaciones mayores: un hematoma periorbitario y una lesión de lámina papirácea. CONCLUSIONES. Las afecciones inflamatorias nasosinusales, y en especial la poliposis nasal, se benefician con un tratamiento quirúrgico endoscópico. La experiencia y el uso de instrumental motorizado (microdesbridador) han mejorado aún más los resultados de esta técnica(AU)


INTRODUCTION. Nasal polyposis is a multifactor disease with prevalence in general population from 2 to 5 percent. The objective of present paper was to compare the surgical results in 60 patients with nasosinusal polyposis operated on with and without micro-defibrillator. METHODS. Sixty patients operated on between 2002 and 2006. The related factors were studied including asthma, acetylsalicylic acid and allergy. Previous, endoscopic or conventional surgeries were considered as well as the minor and major complications derived from it. The non-controlled cases with medical treatment were reviewed. RESULTS. The overall results were satisfactory: at two years 29 patients (48,3 percent) were asymptomatic, 45 (75 percent) with fossae free of polypi, 11 (18,3 percent) with relapse controlled by medical treatment and only a reintervention in two patients (3,3 percent). The figure of complications remained very low of the reasonable level; there was only 2 (3,3 percent) (major complications): a periorbital hematoma and a lesion of papyraceous plate. CONCLUSIONS. The nasosinusal affections and specially the nasal polyposis to do well out the endoscopic surgical treatment. The experience and the use of motorized instrumental (micro- defibrillator) have improved even more the results of this technique(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Endoscopia/métodos , Pólipos Nasais/cirurgia , Pólipos Nasais/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...