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Treatment of retroauricular keloids: Revision of cases treated at the ENT service of HC/UFPR
Carvalho, Bettina,Ballin, Annelyse Cristine,Becker, Renata Vecentin,Ribeiro, Talita Beithum
International Archives of Otorhinolaryngology , 2012,
Abstract: Introduction: Keloids are benign tumors arising from abnormal healing of the skin, and there are several procedures available for their treatment. Objective: The objective of this study was to evaluate the outcomes of patients undergoing treatment of keloids after ear, nose, and throat (ENT) surgeries at our service center. Method: We conducted thorough, retrospective and prospective analysis of records of patients undergoing treatment of retroauricular keloids at our center. Results: Nine patients were evaluated, and 6 underwent resection and adjuvant beta-therapy, 2 underwent resection with local application of corticosteroids, and only 1 underwent resection without adjuvant therapy. There was no recurrence of keloids in patients that were treated with beta-therapy in the early postoperative period. One patient had relapsed despite corticosteroid administration and late beta-therapy. Discussion: Several techniques have been used for the treatment of retroauricular keloids, and beta-therapy is thought to yield the best results, followed by the use of intralesional corticosteroids. Conclusion: Treatment of retroauricular keloids remains a challenge. While new techniques are being developed, resection followed by early beta-therapy is still the best treatment option.
Palatine Tonsils Asymmetry: 10 Years Experience of the Otorhinolaryngology Service of the Clinical Hospital of the Federal University of Paraná
Ballin, Annelyse Cristine,Koerner, Heloisa Nardi,Ballin, Carlos Henrique,Pereira, Rodrigo
International Archives of Otorhinolaryngology , 2011,
Abstract: Introduction: A few patients with asymmetric palatine tonsils have lymphoma; but most lymphomas in palatine tonsils evolve with tonsillar asymmetry. Objective: To report the profile of patients and histopathological changes in patients submitted to adenotonsillectomy/tonsillectomy with disproportional palatine tonsils. Method: Retrospective study based on data analysis from the Pathologic Anatomy Service Database and in the review of reports of patients submitted to adenotonsillectomy and tonsillectomy with palatine tonsils asymmetry during the period from October 1999 through October 2009 at the Clinical Hospital (HC) of the Federal University of Paraná (UFPR). Results: 50 patients took part, aged between 3 to 53 years old, mean age of 14.05 years. The anatomopathological exam confirmed 48 patients (96%) with lymphoid hyperplasia and 2 cases of lymphoma (4%). These included men aged from 40 to 53 yeas with complaint of unilateral increase of the tonsil, one of whom had other symptoms (asthenia and weight loss). Upon physical examination: tonsils disproportion without involvement of other organs or lymph nodes. Conclusion: Our study is according to the literature as regards the fact the lymphomas are more common in men, the patient is the first one to notice the increase in volume and the asymmetry is larger than 2 degrees between palatine tonsils in cases of lymphoma. Although it is rare, even in the presence of differences, there are chances for the asymmetry to evolve to a malignant profile. The need for anatomopathological evaluation of a part must be considered along with other clinical data that suggests a malignant profile.
Efficacy of endoscopic sinus surgery in the treatment of chronic rhinosinusitis
Basílio, Flávia Machado Alves,Arantes, Murilo Carlini,Ballin, Annelyse Cristine,Dallagnol, Moises Rafael
International Archives of Otorhinolaryngology , 2010,
Abstract: Introduction: The endoscopic sinus surgery (FESS) is currently regarded as the gold standard in the treatment of chronic rhinosinusitis (RNSC), with or without nasal polyposis refractory to medical therapy optimized. Objective: To evaluate the improvement of symptoms after FESS RNSC, through a questionnaire. Method: This is a prospective study, which included 34 patients undergoing FESS during the year 2009, the Service of Otorhinolaryngology, Hospital das Clínicas / UFPR. Of these, 22 were diagnosed as RNSC RNSC and 12 had associated nasal polyps. All patients underwent a questionnaire on preoperative symptoms, comorbidities and degree of symptom improvement after surgery, six months after the procedure. Results: The percentage improvement of symptoms more prevalent in the group with RNSC was as follows: nasal obstruction 87.4%, 80.5% headache, pain / facial pressure 91.6% 81.2% posterior nasal discharge. In the group with polyposis associated improvement was nasal obstruction 76.6%, 76.6% posterior nasal discharge, hyposmia, 68.7%, headache 83%. In our study we found an overall improvement in symptoms of 83.74% in patients with RNSC and 80.5% in patients with associated nasal polyposis. Conclusion: FESS is highly effective in controlling symptoms of RNSC with or without polyposis and is, in our study, its efficacy similar to that found in the literature. With respect to patients with nasal polyposis, studies are needed with longer follow up, since this disease has a high degree of recurrence.
Difficulty Systematized Evaluation of Vocal Folds Exposure in Microsurgery of the Larynx
Ballin, Annelyse Cristine,Macedo Filho, Evaldo Dacheux de,Sela, Gustavo B,Catani, Guilherme S
International Archives of Otorhinolaryngology , 2010,
Abstract: Introduction: Several studies addressing preoperative factors that predict difficulty of endotracheal intubation graduated by anesthesiologists, for the scale of the Cormack-Lehane. These parameters were evaluated for the difficulty of location of the laryngoscope in microsurgery of the larynx. There is not a standard scale of difficulty targeted to surgeons of the larynx. Objective: Create a standard scale of difficulty leasing the laryngoscope during microsurgery of the larynx, with a focus on exposure of the vocal folds (vocal cords) to evaluate which clinical parameters predict difficulty of exposure of their vocal folds and verify the improvement of laryngeal exposure with the hanger of the laryngoscope. Method: A prospective randomized study, 57 patients undergoing laryngeal microsurgery. The preoperative parameters were evaluated: three epidemiological data, two of history and 13 physical examination. Intraoperatively: the anesthesiologist evaluated the Cormack-Lehane score and the surgeon evaluated according to the proposed scale, before and after placement of the hanger. Results and Conclusion: Several parameters showed sensitivity, specificity, positive predictive value for high inadequate exposure of the larynx. But only distance hiomentual <6.05 cm (p = 0.003) and 2 classes of Cormack-Lehane (p = 0.04) with statistical significance and high sensitivity of 100% and 81% respectively. The use of the hanger of laryngoscope laryngeal exposure improved significantly (p = 0.04). The proposed scale standardizes the visualization and grades the difficulty of exposure of their vocal folds, facilitating comparisons between studies and communication between otolaryngologists.
Avalia o Sistematizada da Dificuldade de Exposi o das Pregas Vocais na Microcirurgia da Laringe
Ballin, Annelyse Cristine,Macedo Filho, Evaldo Dacheux de,Sela, Gustavo B,Catani, Guilherme S
Arquivos Internacionais de Otorrinolaringologia , 2010,
Abstract: Introdu o: Diversos estudos abordam fatores pré-operatórios que predizem dificuldade de intuba o endotraqueal, graduada pelos anestesistas pela escala de Cormack-Lehane. Estes parametros foram pouco avaliados para a dificuldade de loca o do laringoscópio nas microcirurgias da laringe. N o há uma escala padr o de dificuldade direcionada aos cirurgi es de laringe. Objetivo: Criar uma escala padr o de dificuldade de loca o do laringoscópio durante microcirurgia da laringe, com foco na exposi o das pregas vocais (PPVV); avaliar quais parametros clínicos predizem dificuldade de exposi o das PPVV; verificar a melhora da exposi o laríngea com o suspensor do laringoscópio. Método: Estudo prospectivo, randomizado, de 57 pacientes submetidos à microcirurgia de laringe. No pré-operatório foram avaliados: 3 dados epidemiológicos, 2 de anamnese e 13 de exame físico. No intra-operatório: o anestesista avaliava o escore de Cormack-Lehane e o cirurgi o avaliava conforme a escala proposta, antes e após a coloca o do suspensor. Resultados e Conclus o: Vários parametros apresentaram sensibilidade, especificidade, valor preditivo positivo altos para exposi o inadequada da laringe. Porém, apenas distancia hiomentual <6,05cm (p=0,003) e classe 2 de Cormack-Lehane (p=0,04) com significancia estatística e alta sensibilidade, 100% e 81% respectivamente. O uso do suspensor do laringoscópio melhorou a exposi o laríngea de forma significativa (p=0,04). A escala proposta padroniza a vizualiza o e gradua a dificuldade de exposi o das PPVV, facilitando compara es entre estudos e comunica o entre otorrinolaringologistas.
Eficácia da cirurgia endoscópica nasal no tratamento da rinossinusite cr nica
Basílio, Flávia Machado Alves,Arantes, Murilo Carlini,Ballin, Annelyse Cristine,Dallagnol, Moises Rafael
Arquivos Internacionais de Otorrinolaringologia , 2010,
Abstract: Introdu o: A cirurgia endoscópica nasal (FESS) é encarada atualmente como o padr o ouro no tratamento da rinossinusite cr nica (RNSC), associada ou n o à polipose nasal, refratária ao tratamento clínico otimizado. Objetivo: Avaliar a melhora dos sintomas da RNSC após FESS, através de um questionário dirigido. Método: Trata-se de um estudo prospectivo, em que foram incluídos 34 pacientes submetidos à FESS durante o ano de 2009, no servi o de Otorrinolaringologia do Hospital de Clínicas/UFPR. Desses, 22 tinham o diagnóstico de RNSC e 12 apresentavam RNSC associada à polipose nasal. Todos os pacientes foram submetidos a um questionário sobre a sintomatologia pré-operatória, comorbidades e grau de melhora dos sintomas no pós-operatório, 6 meses após o procedimento. Resultados: A melhora percentual dos sintomas mais prevalentes no grupo com RNSC foi a seguinte: obstru o nasal 87,4%; cefaleia 80,5%; dor/press o facial 91,6%; secre o nasal posterior 81,2%. No grupo com polipose associada, a melhora foi: obstru o nasal 76,6%; secre o nasal posterior 76,6%; hiposmia 68,7%; cefaleia 83%. Em nosso estudo encontramos uma melhora global dos sintomas de 83,74% nos pacientes com RNSC e de 80,5% nos pacientes com polipose nasal associada. Conclus o: A FESS é altamente eficiente no controle dos sintomas da RNSC, associada ou n o à polipose, sendo, em nosso estudo, sua eficácia semelhante à encontrada na literatura internacional. Com rela o aos portadores de polipose nasal, s o necessários estudos com seguimento maior, visto que essa patologia apresenta alto grau de recorrência.
Assimetria de Tonsilas Palatinas: Experiência de 10 Anos do Servi o de Otorrinolaringologia do Hospital de Clínicas da Universidade Federal do Paraná
Ballin, Annelyse Cristine,Koerner, Heloisa Nardi,Ballin, Carlos Henrique,Pereira, Rodrigo
Arquivos Internacionais de Otorrinolaringologia , 2011,
Abstract: Introdu o: Poucos pacientes com amígdalas palatinas assimétricas apresentam linfoma, entretanto a maioria dos linfomas em amígdalas palatinas cursam com assimetria amigdaliana. Objetivo: Relatar o perfil dos pacientes e das altera es histopatológicas em pacientes submetidos a adenoamigdalectomia/amigdalectomia com amígdalas palatinas desproporcionais. Método: Estudo retrospectivo, baseado na análise de dados do Banco de Dados do Servi o de Anatomia Patológica e na revis o dos prontuários de pacientes submetidos a adenoamigdalectomias e amigdalectomias com assimetria de amígdalas palatinas durante o período de outubro de 1999 a outubro de 2009 no Hospital de Clínicas (HC) da Universidade Federal do Paraná (UFPR). Resultados: Foram incluídos 50 pacientes, com idade entre 3 a 53 anos, idade média de 14,05 anos. O exame anatomopatológico evidenciou 48 pacientes (96%) com hiperplasia linfoide e 2 casos de linfoma (4%). Estes eram homens de 40 e 53 anos com queixa de aumento unilateral da amígdala, um deles apresentava outros sintomas (astenia e emagrecimento). Ao exame físico: despropor o amigdaliana, sem envolvimento de outros órg os ou linfonodos. Conclus es: Nosso estudo concorda com a literatura quanto aos linfomas serem mais comuns em homens, o paciente ser o primeiro a notificar o aumento de volume e a assimetria ser maior que 2 graus entre as amígdalas palatinas em casos de linfoma. Embora raro, mesmo na presen a de disparidades, há chances da assimetria cursar com um quadro maligno. A necessidade de avalia o anatomopatológica de uma pe a deve ser considerada juntamente a outros dados clínicos que sugiram um quadro maligno em vigência.
Tratamento de queloide retroauricular: revis?o dos casos tratados no servi?o de otorrinolaringologia do HC/UFPR
Carvalho, Bettina;Ballin, Annelyse Cristine;Becker, Renata Vecentin;Ribeiro, Talita Beithum;Cavichiolo, Juliana Benthien;Ballin, Carlos Roberto;Mocellin, Marcos;
International Archives of Otorhinolaryngology , 2012, DOI: 10.7162/S1809-97772012000200007
Abstract: introduction: keloids are benign tumors arising from abnormal healing of the skin, and there are several procedures available for their treatment. objective: the objective of this study was to evaluate the outcomes of patients undergoing treatment of keloids after ear, nose, and throat (ent) surgeries at our service center. method: we conducted thorough, retrospective and prospective analysis of records of patients undergoing treatment of retroauricular keloids at our center. results: nine patients were evaluated, and 6 underwent resection and adjuvant beta-therapy, 2 underwent resection with local application of corticosteroids, and only 1 underwent resection without adjuvant therapy. there was no recurrence of keloids in patients that were treated with beta-therapy in the early postoperative period. one patient had relapsed despite corticosteroid administration and late beta-therapy. discussion: several techniques have been used for the treatment of retroauricular keloids, and beta-therapy is thought to yield the best results, followed by the use of intralesional corticosteroids. conclusion: treatment of retroauricular keloids remains a challenge. while new techniques are being developed, resection followed by early beta-therapy is still the best treatment option.
Avalia??o sistematizada da dificuldade de exposi??o das pregas vocais na microcirurgia da laringe
Ballin, Annelyse Cristine;Macedo Filho, Evaldo Dacheux de;Sela, Gustavo B;Catani, Guilherme S;Ido Filho, Jorge Massaaki;Ballin, Carlos Henrique;Mocellin, Marcos;
Arquivos Internacionais de Otorrinolaringologia , 2010, DOI: 10.1590/S1809-48722010000300005
Abstract: introduction: several studies addressing preoperative factors that predict difficulty of endotracheal intubation graduated by anesthesiologists, for the scale of the cormack-lehane. these parameters were evaluated for the difficulty of location of the laryngoscope in microsurgery of the larynx. there is not a standard scale of difficulty targeted to surgeons of the larynx. objective: create a standard scale of difficulty leasing the laryngoscope during microsurgery of the larynx, with a focus on exposure of the vocal folds (vocal cords) to evaluate which clinical parameters predict difficulty of exposure of their vocal folds and verify the improvement of laryngeal exposure with the hanger of the laryngoscope. method: a prospective randomized study, 57 patients undergoing laryngeal microsurgery. the preoperative parameters were evaluated: three epidemiological data, two of history and 13 physical examination. intraoperatively: the anesthesiologist evaluated the cormack-lehane score and the surgeon evaluated according to the proposed scale, before and after placement of the hanger. results and conclusion: several parameters showed sensitivity, specificity, positive predictive value for high inadequate exposure of the larynx. but only distance hiomentual <6.05 cm (p = 0.003) and 2 classes of cormack-lehane (p = 0.04) with statistical significance and high sensitivity of 100% and 81% respectively. the use of the hanger of laryngoscope laryngeal exposure improved significantly (p = 0.04). the proposed scale standardizes the visualization and grades the difficulty of exposure of their vocal folds, facilitating comparisons between studies and communication between otolaryngologists.
Assimetria de tonsilas palatinas: experiência de 10 anos do servi?o de otorrinolaringologia do hospital de clínicas da Universidade Federal do Paraná
Ballin, Annelyse Cristine;Koerner, Heloisa Nardi;Ballin, Carlos Henrique;Pereira, Rodrigo;Alcantara, Lauro Jo?o Lobo;Taques, Guilherme Ribas;Mocellin, Marcos;
Arquivos Internacionais de Otorrinolaringologia , 2011, DOI: 10.1590/S1809-48722011000100010
Abstract: introduction: a few patients with asymmetric palatine tonsils have lymphoma; but most lymphomas in palatine tonsils evolve with tonsillar asymmetry. objective: to report the profile of patients and histopathological changes in patients submitted to adenotonsillectomy/tonsillectomy with disproportional palatine tonsils. method: retrospective study based on data analysis from the pathologic anatomy service database and in the review of reports of patients submitted to adenotonsillectomy and tonsillectomy with palatine tonsils asymmetry during the period from october 1999 through october 2009 at the clinical hospital (hc) of the federal university of paraná (ufpr). results: 50 patients took part, aged between 3 to 53 years old, mean age of 14.05 years. the anatomopathological exam confirmed 48 patients (96%) with lymphoid hyperplasia and 2 cases of lymphoma (4%). these included men aged from 40 to 53 yeas with complaint of unilateral increase of the tonsil, one of whom had other symptoms (asthenia and weight loss). upon physical examination: tonsils disproportion without involvement of other organs or lymph nodes. conclusion: our study is according to the literature as regards the fact the lymphomas are more common in men, the patient is the first one to notice the increase in volume and the asymmetry is larger than 2 degrees between palatine tonsils in cases of lymphoma. although it is rare, even in the presence of differences, there are chances for the asymmetry to evolve to a malignant profile. the need for anatomopathological evaluation of a part must be considered along with other clinical data that suggests a malignant profile.
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