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Perfura??o do septo nasal: etiologia e diagnóstico
Fornazieri, Marco Aurélio;Moreira, Jemima Herrero;Pilan, Renata;Voegels, Richard Louis;
Arquivos Internacionais de Otorrinolaringologia , 2010, DOI: 10.1590/S1809-48722010000400015
Abstract: introduction: the nasal septum perforation is an occasional finding of rhinoscopy and most patients are asymptomatic. however, there are several possible etiologies of this condition, making necessary a thorough investigation. objective: to review the literature the main causes of septal perforation and describe the diagnostic tests currently used. method: a systematic literature review of journals indexed identifiable until december 2008. final comments: the main causes are the traumatic / iatrogenic nasal drug use, exposure to toxic gases, inflammatory and infectious diseases and neoplasms. the diagnosis is based on detailed medical history, focusing on occupation and origin of the patient, observation of the characteristics of mucosal injury on biopsy and collection of additional tests such as anca, guided by the main suspect.
Rabdomiossarcoma de cabe?a e pesco?o: 24 casos e revis?o da literatura
Moretti, Giovana;Guimar?es, Ricardo;Oliveira, Karisa Martins de;Sanjar, Fernanda;Voegels, Richard Louis;
Brazilian Journal of Otorhinolaryngology , 2010, DOI: 10.1590/S1808-86942010000400020
Abstract: rhabdomyosarcoma (rms) is a malignant tumor of soft tissues, more common in childhood, mainly located in the head and neck. it presents varied clinical and biological behavior and requires individualized management. aim: to describe information on patients with head and neck rms diagnosed and treated in a hospital, and to compare them to results in the literature. study design: descriptive and retrospective. materials and methods: a retrospective analysis of data from 24 patients with head and neck rhabdomyosarcoma diagnosed and treated in a hospital from 1994 to 2008. results: the mean age was 7.79 years. according to gender, 54.17 % were males and 45.83 % were female. all patients underwent chemotherapy (ct), 62.5% of them also underwent radiotherapy (rt) and 16.67% were submitted to surgery. of the 24 patients, 8 (33.3%) died, 6 (25%) were found free of neoplasia and 2 (8.3%) experienced tumor recurrence. conclusion: the rms of the head and neck often presents with nonspecific symptoms. individualized multimodal therapy should be performed for these patients, including surgery, chemotherapy and radiotherapy.
Estudo da anatomia do recesso frontal por meio de dissec??o endoscópica em cadáveres
Lessa, Marcus Miranda;Voegels, Richards Louis;Cunha Filho, Bernardo;Sakae, Flavio;Butugan, Ossamu;Wolf, Gerald;
Revista Brasileira de Otorrinolaringologia , 2007, DOI: 10.1590/S0034-72992007000200010
Abstract: introduction and aims: the frontal sinus ostium is frequently difficult to recognize because of anatomical structures that hide it. the objective of the present study was to identify and describe the frontal recess anatomy that impairs the endoscopic recognition of the frontal sinus ostium. study design and methods: a prospective study was conducted by consecutive endoscopic dissections of 32 cadavers (59 sides), 10 (31.25%) females and 22 (68.75%) males. after resection of the lower portion of the uncinate process, with preservation of its upper insertion, we evaluated which anatomical structures needed to be removed for complete visualization of the frontal sinus ostium. results and conclusions: visualization of the frontal sinus ostium after resection of the lower portion of the uncinate process was possible in only 11 (18.64%) nasal cavities. the uncinate process (terminal recess) was the main anatomical structure that impaired the recognition of the frontal sinus ostium, present in 45 (76.27%) nasal cavities, followed by the ethmoid bulla (16.95%) and agger nasi cells (6.78%).
Angioleiomioma de cavidade nasal: relato de um caso e revis?o de literatura
Campelo, Victor Eulalio Sousa;Neves, M.C.;Nakanishi, M.;Voegels, R.L.;
Revista Brasileira de Otorrinolaringologia , 2008, DOI: 10.1590/S0034-72992008000100024
Abstract: liomyomas of the nasal cavity and paranasal sinuses are rare. they make up less than 1% of all leiomyomas in the human body. this is due to the paucity of smooth muscle in the nose. they are classified in three groups: leiomyoma, angiomyoma and epithelioid leiomyoma. only 15 cases of vascular leiomyomas have been found in the literature. the treatment of choice is surgical excision. hereby we present a new case and review the literature.
Glioma nasal: relato de três casos e revis?o de literatura
Frizzarini, Ronaldo;Lessa, Marcus M.;Goto, Elder Y.;Voegels, Richard L.;Sennes, Luiz U.;Butugan, Ossamu;
Revista Brasileira de Otorrinolaringologia , 2003, DOI: 10.1590/S0034-72992003000400019
Abstract: nasal glioma is a rare and benign congenital defect. this condition is diagnosed usually at birth time and requires early treatment to prevent facial deformations. we report three patients with nasal glioma that were diagnosed and treated at otorhinolaryngology department of clinics hospital of s?o paulo university, and discuss clinical aspects, complementary exams, treatment and follow-up for each case. the first case was female, who presented a solid mass getting off left nasal fossae. the second case was male and presented cleft palate with a solid mass occupying the oral cavity. the third patient was male and had a solid mass over nasal pyramid. after surgical resection, all cases showed nasal glioma. nasal congenital midline mass may be difficult to diagnose before histopathology, but is necessary to make an effort to do the correct diagnosis, letting an accuracy prognosis and appropriate surgical treatment.
Ligadura da artéria esfenopalatina via endoscópica no tratamento da epistaxe posterior severa
Voegels, Richard L.;Thomé, Daniela C.;Iturralde, Patsy Priscilla V.;Butugan, Ossamu;
Revista Brasileira de Otorrinolaringologia , 2003, DOI: 10.1590/S0034-72992003000100009
Abstract: aim: to present our experience with endoscopic ligature of the sphenopalatine artery in the treatment of severe posterior epistaxis. study design: clinical prospective method: during a 56 month-period, 31 patients with severe posterior epistaxis who were treated using an endoscopic ligature of the sphenopalatine artery were reviewed. results: nineteen (61.3%) patients were male and 12 (38.7%) female, with ages ranging from 15 to 80 years, with an average age of 44.7 years. the endoscopic ligature of the sphenopalatine artery was performed unilaterally in 29 patients and bilaterally in 2 cases, with a total of 33 ligatures. it was possible to identify the sphenopalatine artery in all cases and we succeeded in using the surgical technique alone. conclusion: endonasal endoscopic ligature of the sphenopalatine artery is an effective and safe surgical technique to treat severe posterior epistaxis.
Carcinoma de pequenas células primário de seios paranasais: relato de caso
Neves, Maura C.;Tavares, Raquel A.;Angélico Jr, Fernando Veiga;Voegels, Richard L.;Butugan, Ossamu;
Revista Brasileira de Otorrinolaringologia , 2004, DOI: 10.1590/S0034-72992004000400020
Abstract: primary small cell neuroendocrine carcinomas (scc) of the sinusal tract are extremely uncommon and aggressive tumors. although the lungs are the most prevalent site of these tumors, this report focuses on the involvement of an extrapulmonary site, the paranasal sinuses. we report the case of a female patient with a primary small cell carcinoma of maxillary sinus. a literature discussion with all reported cases of scc and its metastasis, treatment and survival expectations are included.
Pseudotumor inflamatório de seios paranasais
Constantino, Guilherme de Toledo Leme;Sasaki, Fernando;Tavares, Raquel Aguiar;Voegels, Richard L.;Butugan, Ossamu;
Revista Brasileira de Otorrinolaringologia , 2008, DOI: 10.1590/S0034-72992008000200023
Abstract: inflammatory pseudotumors may be defined as lesions that clinically and radiologically simulate neoplasms. these tumor are not a single clinical-pathological entity, but rather a generic term applied to any nonspecific, chronic, inflammatory expanding lesion. there are few reports of inflammatory pseudotumors in the nasal cavity and paranasal sinuses. case report: we report three cases of inflammatory pseudotumors of the nose and paranasal sinuses seen at the division of otolaryngology of the medical school university hospital, sao paulo university. discussion: inflammatory pseudotumors of the paranasal sinuses present a variety of symptoms according to the site.
Microbiologia dos seios maxilar e etmoidal em pacientes com rinossinusite cr?nica submetidos à cirurgia funcional endoscópica dos seios paranasais
Nigro, Josiane Faria de Aguiar;Nigro, Carlos Eduardo Nazareth;Marone, Silvio Antonio Monteiro;Voegels, Richard Louis;
Revista Brasileira de Otorrinolaringologia , 2006, DOI: 10.1590/S0034-72992006000200011
Abstract: chronic rhinosinusitis microbiology studies show the presence of aerobe and anaerobe microorganisms, fungus and virus and their incidence vary according to each study. these studies guide us on choosing the most adequate antimicrobial agent to eliminate the infectious process, thus, helping in restoring rhinosinusal mucosa. study design: clinical prospective. aim: this work aimed at studying the microbiology of the maxillary and/or ethmoid sinuses of patients with chronic rhinosinusitis and with indication of functional endoscopic sinus surgery. materials and methods: during surgery, we collected secretion and/or fragments of maxillary and/or ethmoid sinus mucosa from 41 patients to perform gram stain, fungus direct research, aerobe and anaerobe microorganism culture and fungus culture. results: we identified the presence of aerobe microorganisms in 21 patients (51.2%), anaerobe microorganisms in 16 (39%) and fungus in 1 (2.4%). in the studied population, only 12 patients (29.2%) presented microorganisms considered pathogenic when analyzed together with the semi-quantitative leukocyte count. staphylococcus coagulase-negative and staphylococcus aureus were the most frequent microorganisms found, in 5 (12.18%) and in 4 (9.75%) patients respectively. conclusion: this study reveals that staphylococcus coagulase-negative and staphylococcus aureus were the most frequent microorganisms isolated from patients with chronic rhinosinusitis.
Corre??o endoscópica de fístula liquórica rinogênica: experiência de 44 casos
Araujo Filho, Bernardo Cunha;Butugan, Ossamu;Pádua, Francini Grecco de Melo;Voegels, Richard Louis;
Revista Brasileira de Otorrinolaringologia , 2005, DOI: 10.1590/S0034-72992005000400013
Abstract: cerebrospinal fluid (csf) rhinorrhea is a leakage of fluid from the subarachnoid space to the frontal, sphenoidal or ethmoidal sinuses. csf rhinorrhea is a known potential complication with significant morbidity and mortality. it may present a significant challenge in diagnosis, localization and management. study design: series study. material and method: between 1993 and 2004, 44 patients with cerebrospinal rhinorrhea were operated on using intranasal endoscopic approach in the university hospital of the university of sao paulo, medical school. the charts of all patients treated in our hospital were reviewed. results: forty-four patients, 16 women (36%) and twenty-eight men (64%), were included in the study. patients' ages ranged from 2 to 68 years (mean: 40.3 years). etiology, site of leakage, diagnosis, technique, cause of failure and follow-up are discussed. conclusion: the authors concluded that transnasal endoscopic surgery for csf rhinorrhea had high success rate, low morbidity and stable long-term results.
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