Gabriel Cesar Dib

Rhinolithiasis as cause of oronasal fistula

Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity, leading to unilateral nasal obstruction, fetid rhinorrhea, epistaxis, and it may cause complications. The authors present a case of rhinolithiasis with oronasal fistula and literature review.

Rinolitíase como causa de fístula oronasal

Rhinolithiasis is a disease caused by deposition of organic and inorganic compounds in the nasal cavity, leading to unilateral nasal obstruction, fetid rhinorrhea, epistaxis, and it may cause complications. The authors present a case of rhinolithiasis with oronasal fistula and literature review.

Tinnitus treatment with Trazodone.

UNLABELLED Tinnitus is a common symptom, defined as a sound perception in absence of a sound stimulus. AIM Evaluate if Trazodone, an antidepressant drug, which modulates serotonin at central neuronal pathways, is effective in controlling tinnitus. STUDY DESIGN Prospective, double blind, randomized, placebo-controlled. MATERIALS AND METHODS Study performed with patients presenting tinnitus. 85 patients were analyzed between February and June of 2005. 43 received trazodone and 42 placebo, for 60 days. The clinical criteria of analysis were tinnitus intensity, discomfort and life quality impact by tinnitus, using an analogue scale varying between 0 and 10, scored by patients before and after drug or placebo use. RESULTS There was a significant improvement in intensity, discomfort and life quality in both groups after treatment; however, there was no significant difference between the drug and placebo groups. Patients with age equal or over 60 years presented better results after treatment. CONCLUSION Trazodone was not efficient in controlling tinnitus in the patients evaluated under the doses utilized.

Tratamento do zumbido com a trazodona

O zumbido e um sintoma frequente, definido como percepcao sonora auditiva na ausencia de estimulo sonoro. OBJETIVO: Avaliar se a Trazodona, antidepressivo modulador da serotonina nas vias neuronais centrais, atua positivamente no controle do zumbido. Forma de Estudo: Prospectivo, duplo-cego, randomizado, controlado com placebo. MATERIAL E METODO: estudo realizado com pacientes com zumbido. Oitenta e cinco pacientes foram avaliados entre fevereiro e junho de 2005, sendo que 43 pacientes receberam droga e 42, placebo, pelo periodo de 60 dias. Os criterios de analise foram intensidade, efeito sobre a qualidade de vida e grau de incomodo devido ao zumbido, atraves de escala analogica com notas de 0 a 10 dadas pelos pacientes antes e apos o uso da trazodona ou placebo. RESULTADOS: Em ambos os grupos houve melhora da intensidade, qualidade de vida e incomodo apos o tratamento, porem nao houve diferenca significativa entre os grupos droga e placebo. Quando se avaliou os criterios clinicos na faixa etaria maior ou igual a 60 anos, obteve-se melhora nos niveis de intensidade, incomodo e efeito sobre a qualidade de vida apos o tratamento. CONCLUSAO: A trazodona nao foi eficiente no controle do zumbido dos pacientes avaliados na dose utilizada.

Hemorragia pós-operatória em 397 adenotonsilectomias realizadas nos Hospitais Geral de Pirajussara (HGP) e Hospital Estadual de Diadema (HED) / UNIFESP-EPM

Adenotonsillectomy is a common procedure in otorhinolaryngology, and it is recommended for tonsil and adenoid hypertrophy. Hemorrhage is the most common complication of this procedure. In this study, we present the incidence of postoperative hemorrhage following adenotonsillectomy carried out at Hospital Geral de Pirajussara (HGP) and Hospital Estadual de Diadema (HED), whose purpose was to identify cases of bleeding. STUDY DESIGN: Historic transversal cohort. MATERIAL AND METHOD: We analyzed 397 patients who underwent adenoidectomy, tonsillectomy and adenotonsillectomy. Adenotonsillectomy represented 91.7% of all surgeries. Patients were aged 2 to 39 years. Preoperative tests were conducted in all patients, with weekly follow-up up to the first month after surgery. RESULTS: 397 surgeries were performed in the hospitals (HGP and HED), 364 adenotonsillectomies (91.7%), 16 tonsillectomies (4.03%) and 17 adenoidectomies (4.28%). There were 5 cases of postoperative bleeding, 3 of which occurred in the early postoperative period and 2 in the middle postoperative period. There were no reports of bleeding in late postoperative period. The incidence of hemorrhage was 1.37% (5 out of 364 cases). CONCLUSION: Postoperative hemorrhage possibly results from poor surgical technique and blood clotting disorder in some patients.

Schwanoma vestibular como causa de surdez súbita

The sudden Hearing Loss (SHL) is a symptom caused by more than 60 different diseases, including Vestibular Schwannoma (VS). Shaia & Sheehy (1976) presented a study with 1,220 cases of SHL reporting 1% incidence of VS. There is no specific characteristic for the diagnosis of VS and Magnetic Resonance Imaging (MRI) is the gold standard exam to diagnose such disease. AIM: To determine the real incidence of VS presenting as SHL performing MRI in all patients with SHL. STUDY DESIGN: Transversal cohort. MATERIL AND METHOD: Prospective study in which MRI with gadolinium was performed in all patients with SHL in the Emergency Service of Sao Paulo Hospital from April 2001 through May 2003. RESULTS: MRI was performed in 49 patients with symptoms of SHL, with three cases (6.1%) of VS found. CONCLUSION: The real incidence of VS presenting as SHL may be greater than that mentioned in conventional reports probably because MRI had not been performed in all patients with SHL.