Carlos Roberto Ballin

Comparative study of the effects of submucosal cauterization of the inferior turbinate with or without outfracture

AIM The objective of this study was to compare the effects of submucosal cauterization of the inferior turbinate with or without outfracture. STUDY DESIGN Clinical prospective. METHOD Twenty patients with inferior turbinate hypertrophy were randomized and divided into two groups. The first one was submitted to submucosal cauterization associated with outfracture, and the second one without fracture. Five items were assessed to compare both methods: pain, nasal bleeding, scarring--analyzed through anterior rhinoscopy, observing edema, hyperemia and seropurulent secretion; crust formation (seen through anterior rhinoscopy); and nasal airway patency. Follow-up was performed on days 7, 14, 30. RESULTS In both groups crusting formation was similar. Scarring showed better results in the outfracture group in the first two weeks postoperative. The analysis of nasal airway patency showed good results in 80% of the patients submitted to submucosal cauterization with outfratcture on day 30 postoperatively. CONCLUSIONS We concluded that submucosal cauterization of inferior turbinate with outfracture is better than the procedure without outfracture.

Estudo comparativo de pacientes submetidos à cauterização submucosa com ou sem fratura lateral do corneto inferior

OBJETIVO: Comparar os efeitos da cauterizacao submucosa do corneto inferior com e sem a fratura lateral. FORMA DE ESTUDO: Clinico prospectivo. MATERIAIS E METODOS: Foram selecionados 20 pacientes aleatoriamente com diagnostico de hipertrofia cronica dos cornetos nasais, e divididos em dois grupos. O primeiro foi submetido a cauterizacao submucosa com fratura lateral do corneto, e o segundo sem a fratura. Foram avaliados cinco quesitos, comparando-se os dois metodos: dor, sangramento nasal, cicatrizacao, formacao de crostas e perviedade nasal. O seguimento pos-operatorio foi realizado no 1o, 7o, 14o e 30o dias. RESULTADOS: Quanto a dor, sangramento nasal e formacao de crostas o resultado foi semelhante para ambos os grupos. Em relacao a cicatrizacao, houve melhores resultados no grupo submetido a fratura lateral nas primeiras duas semanas do seguimento. Quanto a perviedade nasal, 80% dos pacientes submetidos a cauterizacao submucosa com a fratura lateral referiram boa perviedade. Por outro lado, 30% dos pacientes nao submetidos a fratura lateral relataram boa perviedade. CONCLUSAO: A realizacao da cauterizacao submucosa do corneto inferior associada a fratura lateral e mais eficaz que a realizacao da cauterizacao isoladamente.

Endoscopic transnasal approach for treatment of the medial orbital blowout fracture using nasal septum graft.

We present the experience of the Ear, Nose, and Throat Department of Santa Casa de Misericórdia de Curitiba and Hospital Universitário Cajuru PUC-PR in the transnasal endoscopic approach to medial orbital blowout fractures using nasal septum grafts. Seventeen patients have undergone endoscopic repair since June 2005, and septum grafts were used to maintain the orbital contents in position. All 17 patients were treated with this method. Two patients had diplopia on immediate postoperative evaluation. This symptom was corrected with orthoptic exercises in one patient, and the other had a little residual diplopia. Postoperative computed tomography scans showed anatomic reduction in 14 of 17 cases. There were no complications in these surgeries. The transnasal endoscopic approach is a reasonable method for the treatment of medial orbital blowout fractures. Use of septum graft is another surgical alternative for this technique.

Treatment of retroauricular keloids: revision of cases treated at the ENT service of HC/UFPR

Summary 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.

Experimental study on the effects of bismuth subgallate on the inflammatory process and angiogenesis of the oral mucosa

INTRODUCTION Bismuth subgallate is a salt derived from heavy metal. The aim of this study was to evaluate the effect of this salt on some phases of healing. OBJECTIVES To assess the effect of subgallate on mucosa and to evaluate the association between the use of bismuth subgallate and neogenesis of vessels in oral mucosal wounds. METHODS This was a prospective and experimental study. This study used sixty rats, which were divided into control and experimental groups. The animals were submitted to a surgical procedure, which caused oral mucosal injury. A saline solution was applied on the wound of the control group, and in the experimental group, a solution of bismuth subgallate was administrated. RESULTS The experimental group showed greater inflammatory reaction with increasing monomorphic proliferation. There was increased vessel proliferation in the control group. CONCLUSION Bismuth subgallate had a negative influence on the healing process, delaying the rate of new vessel formation and optimal wound healing.

Epidemiological profile of 277 patients with facial fractures treated at the emergency room at the ENT Department of Hospital do Trabalhador in Curitiba/PR, in 2010

Summary Introduction: Epidemiological studies that focus on facial injuries are of great interest for the knowledge of occurrence and severity of presentation. Aim: To study the epidemiological profile of 277 patients who suffered facial fractures at the Hospital do Trabalhador (HT), with an emphasis on variables such as sex, age, cause, and anatomical sites of fractures, comparing the clinical findings with other studies. Method: Retrospective nonrandomized chart review of 277 patients who were treated at HT by the ENT service during the full year 2010, victims of facial fractures. Results: Of 277 patients, 74.72% were male and 25.27% female (ratio 3:1). According to age, the fractures were distributed as follows: 0–9 years: 4.69%, 10–19 years: 17.32%, 20–29 years: 23.82%, 30–39 years: 20.21%, 40–49 years: 16.24%, 50–59 years: 10.83%, 60–69 years: 3.97%, and 60–79 years: 2.88%. The cause of trauma was most frequently interpersonal violence, 36.45%, followed by falls, 23.09%, and motor vehicle crashes with 17.32%. Regarding location, nasal fracture was the most common, with 44.75%, followed by the mandible, 14.32%, orbit, 12.78%, maxillary, 12.02%, zygomatic, 9.97%, 3.32% and front Le Fort 2.88%. Conclusion: The patients were mostly males, aged 21–30 years, victims of aggression with the most commonly fractured bone being the nose. The adoption of personal and public strategies and measures may prevent facial fractures.

Endoscopic Management of Orbital Fractures

Abstract The main indications for surgical correction of orbital fracture are diplopia, enophthalmos, signs of herniation of orbital contents into the ethmoid and maxillary sinuses, orbital muscle incarceration leading to reduced ocular motility, decreased visual acuity, persistent infraorbital hypoesthesia, and hypo-ophthalmia. The location of the fracture is important in determining the treatment approach. Endoscopic repair of orbital fractures has received increased attention since the development of better endoscopic materials and high-tech fiberoptics. This article reviews the endoscopic treatment of orbital fractures.