Érika Ferreira Gomes

Endoscopic surgery of nasopharyngeal angiofibroma

UNLABELLED Nasopharyngeal angiofibroma is a vascular benign tumor that affects young men, and surgery is the treatment of choice. Endoscopic surgery has been used to excise tumors in their initial stages, when there is no evidence of residual or recurrent disease. AIM The aim of this study is to evaluate the endoscopic approach preceded by tumor embolization as treatment option for stages II to III angiofibroma. Treatment morbidity was evaluated through: surgery duration, hospital stay after surgery, the need for blood transfusion, complications, the time span between preoperative embolization and surgery, and tumor recurrence. METHODS A prospective study was carried out with nine patients treated at the Fortaleza General Hospital SESA/SUS from October 2001 through November 2004. CONCLUSION Based on the results, we may conclude that the endoscopic approach, when preceded by embolization, is effective to treat angiofibromas in their initial stages, with reduced postoperative morbidity.

Ressecção endoscópica de nasoangiofibroma

O nasoangiofibroma e um tumor benigno com componente vascular que acomete homens jovens, e tem como principal tratamento a cirurgia. Tem sido descrita a utilizacao de cirurgia endoscopica para a resseccao de tumores em estadios iniciais, sem evidencia de permanencia de restos tumorais ou recidiva da doenca. OBJETIVO: Este estudo tem o objetivo de avaliar a via endoscopica precedida pela embolizacao como meio de tratamento para nasoangiofibroma em estadios II, e um caso selecionado em estadio III, com avaliacao da morbidade pos-operatoria a partir das seguintes variaveis: tempo cirurgico, tempo de internamento pos-operatorio, necessidade de transfusao sanguinea, presenca de complicacoes, tempo entre embolizacao e cirurgia e presenca de recidiva tumoral. MATERIAIS E METODOS: Foi realizado em estudo prospectivo, a partir de nove pacientes internados no Hospital Geral de Fortaleza SESA/SUS no periodo de outubro de 2001 a novembro de 2004. CONCLUSAO: Pelos dados obtidos, concluiu-se que a via endoscopica, quando precedida pela embolizacao tumoral, e uma via eficaz no tratamento de nasoangiofibromas em estadios iniciais, com reduzida morbidade pos-operatoria.

Ética da pesquisa em modelos animais

UNLABELLED The use of animals in scientific experiments has been described since the fifth century BC. A number of scientific advances in health are attributed to animal models. The issue of the moral status of animals has always been debated. OBJECTIVES This article aims to review and to present a historical summary of the current laws, to guide researchers who wish to use animal models in otolaryngology research. MATERIAL AND METHODS Research on the medline database. RESULTS For many years there were no laws ruling the use of animals in scientific experimentation in Brazil. Standards set by national and international organizations were followed. Recently, Law No. 11.794/08 established procedures for the scientific use of animals. Studies in otolaryngology have used the larynxes of rabbits, pigs, dogs, guinea pigs (Cavia porcellus), and mice. There were also studies comparing rabbits, rats, and dogs, rhinoplasty on rabbits, and inner ear studies on rats and guinea pigs (albino). CONCLUSIONS The researchers involved in scientific work with animals should know the principles of Law 11.794/08 and investigate what animals are appropriate for each area of study in their models. Otolaryngologists, especially those dedicated to research, need to be mindful of the ethical rules regarding the use of animals in their studies.

Rare nasosinusal tumors: case series and literature review

Tumors of the nasal cavity and paranasal sinuses are unusual pathologies found in clinical practice. Approximately 0.8% of all human cancers are located in this area. Despite being rare, nasosinusal neoplasms usually manifest through nonspecific symptoms that are common to numerous inflammatory pathologies. The aim of this study is to describe a series of rare nasosinusal tumors, including esthesioneuroblastomas, central giant cell granulomas, extramedullary plasmocytomas, nasosinusal hemangiopericytomas, neurofibromas and cemento-ossifying fibromas, diagnosed at the Fortaleza General Hospital. We, hereby, briefly review each of the aforementioned pathologies, stressing the need for a precise histological diagnosis for proper treatment in each case.

Tumores nasossinusais raros: série de casos e revisão de literatura

Tumors of the nasal cavity and paranasal sinuses are unusual pathologies found in clinical practice. Approximately 0.8% of all human cancers are located in this area. Despite being rare, nasosinusal neoplasms usually manifest through nonspecific symptoms that are common to numerous inflammatory pathologies. The aim of this study is to describe a series of rare nasosinusal tumors, including esthesioneuroblastomas, central giant cell granulomas, extramedullary plasmocytomas, nasosinusal hemangiopericytomas, neurofibromas and cemento-ossifying fibromas, diagnosed at the Fortaleza General Hospital. We, hereby, briefly review each of the aforementioned pathologies, stressing the need for a precise histological diagnosis for proper treatment in each case.

Comparison between endoscopic and open surgery in 37 patients with nasopharyngeal angiofibroma

UNLABELLED Juvenile nasopharyngeal angiofibroma is a rare benign vascular tumor of the nasopharynx. Although the treatment of choice is surgery, there is no consensus on what is the best approach. AIM To compare surgical time and intraoperative transfusion requirements in patients undergoing endoscopic surgery versus open / combined and relate the need for transfusion during surgery with the time between embolization and surgery. MATERIAL AND METHODS Study descriptive, analytical, retrospective study with a quantitative approach developed in the Otorhinolaryngology department of a teaching hospital. Analyzed 37 patients with angiofibroma undergoing surgical treatment. Data obtained from medical records. Analyzed with tests of the Fisher-Freeman-Halton and Games-Howell. Was considered significant if p <0.05. STUDY DESIGN Historical cohort study with cross-sectional. RESULTS The endoscopic approach had a shorter operative time (p <0.0001). There is less need for transfusion during surgery when the embolization was performed on the fourth day. CONCLUSION This suggests that the period ahead would be ideal to perform the process of embolization and endoscopic surgery by demanding less time would be associated with a lower morbidity. This study, however, failed to show which group of patients according to tumor stage would benefit from specific technical.

Midfacial degloving - acess to nasal cavity and paranasal sinuses lesions

Common surgical approaches for medial maxillectomy include lateral rhinotomy and midfacial degloving. Lateral rhinotomy provides excellent surgical exposure but leaves a bulging scar on the face. Despite its own limitations, midfacial degloving has been preferred to lateral rhinotomy because it does not leave any external scar on the face(1). The aim of this study is to evaluate the cosmetic results and surgical exposure access of midfacial degloving. Treatment morbidity was evaluated through: post operative hospital stay length, blood transfusion needs, complications, pre and post operative hemoglobin levels, disease recurrence, nasal packing, type of suture and antibiotics. Retrospective study was carried out with sixteen patients treated at the Hospital Geral de Fortaleza SESA/SUS from December 1999 through November 2003. Based on the results, we may conclude that midfacial degloving is effective to treat extensive nasal cavity lesions and paranasal sinuses with reduced post operative morbidity.

Degloving médio-facial como via de acesso a tumores nasossinusais

Abordagens cirurgicas comuns para maxilectomia medial incluem a rinotomia lateral e a via de acesso degloving medio-facial. A rinotomia lateral fornece um excelente campo cirurgico, mas deixa proeminentes cicatrizes na face. Ja o degloving medio-facial tem sido superior a rinotomia lateral, pois nao deixa nenhuma cicatriz externa, embora saibamos que este procedimento tem suas limitacoes¹. Este estudo tem o objetivo de descrever os resultados esteticos e de melhor acesso transoperatorio de cirurgias nasossinusais via degloving, com avaliacao da morbidade pos-operatoria atraves das seguintes variaveis: hemoglobina pre e pos-operatoria, necessidade de transfusao sanguinea, presenca de complicacoes, uso de tampao nasal, uso de antibiotico, fio cirurgico utilizado, tempo de internamento pos-operatorio e presenca de recidiva. Foi realizado um estudo retrospectivo a partir de 16 pacientes internados no Hospital Geral de Fortaleza SESA/SUS durante o periodo de dezembro de 1999 a novembro de 2003. Pelos dados obtidos, conclui-se que a via de acesso degloving e eficaz no tratamento de lesoes nasossinusais extensas, com bons resultados esteticos e com reduzida morbidade pos-operatoria.

Endoscopic surgery to treat inverted papilloma: which are the limits?

1 Especialista em Cirurgia geral e em Otorrinolaringologia (Pos-graduanda da FMUSP, medica assistente do Hospital Geral de Fortaleza SUS/SESA). Hospital Geral de Fortaleza SUS/SESA. Endereco para correspondencia: Erika Ferreira Gomes. Rua Carolina Sucupira, no 1151. Aldeota. Fortaleza CE. Brasil. CEP: 60140-120. Este artigo foi submetido no SGP (Sistema de Gestao de Publicacoes) do BJORL em 12 de marco de 2012. cod. 9090. Artigo aceito em 23 de agosto de 2012. LETTER TO THE EDITOR Braz J Otorhinolaryngol. 2013;79(3):275.

Tonsillar melanoma metastasis

Malignant melanoma is an aggressive cutaneous melanocytic neoplasia of fast spread1. Despite its diagnosis, the disease mortality still reaches high levels. Metastasis to the oral cavity of the cutaneous melanoma is rare2-5: until 2001 less than 30 cases of metastasis in the palatine tonsils had been published3. This type of dissemination is blood-born and the prognosis is deleterious. The reasons for presenting this case are the fact of being a rare finding and the importance of early diagnosis, since the oral cavity is not always examined as routine by clinicians and oncologists in the follow up of patients diagnosed with melanomas.