Geraldo Augusto Gomes

Evaluation of the utility of histopathologic exam as a routine in tonsillectomies

UNLABELLED Tonsillectomy is one of the most commonly performed procedures of the head and neck. It is performed for a wide variety of indications in both adults and children. It is common to send the material achieved in the surgery to routine histopathologic exam, as to analyze suspected material or for a medical-legal documentation. OBJECTIVE Analyze the utility and cost of routine histopathologic diagnosis for tonsillectomy. METHODOLOGY retrospective study of the histopathologic result of all tonsillectomies between 1978 and 2004 in a university hospital and analyzed the files of the patients with cancer. RESULTS 2103 results of histopathologic exams were analyzed. Of these, only four cases presented any case of malignancy, being all of these non-Hodgkin lymphoma and already suspected before the surgery. DISCUSSION The world literature has encountered similar results and each time more the histopathologic analysis of all cases is questioned. The cost of the exam is high and your results, in the case of malignancy were already knew before the surgery. CONCLUSION Histopathologic analysis of all tonsillectomies is not indicated. The risks factors established by Beaty should guide the solicitation of the exam, to try to low the costs with unnecessary exams.

Avaliação da utilidade do exame histopatológico como rotina em tonsilectomias

Tonsillectomy is one of the most commonly performed procedures of the head and neck. It is performed for a wide variety of indications in both adults and children. It is common to send the material achieved in the surgery to routine histopathologic exam, as to analyze suspected material or for a medical-legal documentation. OBJECTIVE: Analyze the utility and cost of routine histopathologic diagnosis for tonsillectomy. METHODOLOGY: retrospective study of the histopathologic result of all tonsillectomies between 1978 and 2004 in a university hospital and analyzed the files of the patients with cancer. RESULTS: 2103 results of histopathologic exams were analyzed. Of these, only four cases presented any case of malignancy, being all of these non-Hodgkin lymphoma and already suspected before the surgery. DISCUSSION: The world literature has encountered similar results and each time more the histopathologic analysis of all cases is questioned. The cost of the exam is high and your results, in the case of malignancy were already knew before the surgery. CONCLUSION: Histopathologic analysis of all tonsillectomies is not indicated. The risks factors established by Beaty should guide the solicitation of the exam, to try to low the costs with unnecessary exams.

Nasal histoplasmosis in the acquired immunodeficiency syndrome

Disseminated histoplasmosis is a disease with a high case-fatality rate, especially in patients with the acquired immunodeficiency syndrome (AIDS). The disease can occur in various sites, such as the lungs, eyes, oral cavity, larynx, nervous system, gastrointestinal tract and, more rarely, the nasal sinus region. It is a cosmopolitan mycosis with a high prevalence in Brazil. Nasal manifestation of the disease is rare, with only three cases reported in the literature, but it is part of the differential diagnosis for other granulomatous diseases, such as Wegeners granulomatosis, tegumentary leishmaniasis and nasal lymphoma. The authors of this study present a literature review and report a case of nasal histoplasmosis in a patient with AIDS. No record of such an aggressive presentation has been reported previously in the literature.

Painful tongue leiomyoma

Leiomyomas are benign tumors that originate on the smooth muscle, usually found in the uterus, gastrointestinal tract and skin. This type of tumor rarely occurs in the oral cavity, specially because of the lack of smooth muscle in this area1. Its most frequent location in this region, by decreasing order of appearance is: lips, palate, tongue and oral mucosa. It is usually asymptomatic; however it may be painful in some cases. Our goal with this paper is to report on a case of a patient with a painful tongue leiomyoma.

The role of new vaccines in the prevention of otitis media

Otitis media is one of the most common infectious diseases of infancy; a reduction in its incidence would have a significant economic and social impact. Vaccines may play a role in the prevention of otitis media. This report discusses vaccines against pneumococci and influenza viruses. We reviewed the literature for results of studies examining the role of these vaccines in the prevention of otitis media. The 23-valent polysaccharide anti-pneumococcal vaccine did not modify the incidence of otitis media in children aged 2 years less, the age group with the highest incidence of otitis. The heptavalent anti-pneumococcal vaccine did not significantly reduce the incidence of otitis media overall. This vaccine did, however, reduce the number of episodes of otitis media with effusion and the number of recurrences; it also altered the profile of causative microorganisms by increasing otitis caused by different microorganisms. We found the inactivated anti-influenza virus vaccine to be effective in reducing otitis media during peak incidence periods of influenza. As these new vaccines are currently available in Brazil, otolaryngologists must be aware of their potential role and impact in the reduction of otitis media, to counsel patients appropriately.

Linfoma não-Hodgkin envolvendo tonsila palatina: relato de 3 casos

O objetivo deste trabalho consiste em relatar tres casos de linfoma nao-Hodgkin (LNH) com acometimento de tonsilas palatinas acompanhados no Hospital Universitario Clementino Fraga Filho (HUCFF) da Universidade Federal do Rio de Janeiro (UFRJ), com pequena revisao de literatura. Os LNH acometem sitios extra-nodais em 25-30% dos casos. Dos casos extra-nodais, 10-30% acometem cabeca e pescoco. Destes casos de LNH em cabeca e pescoco, 60-70% estao presentes no anel de Waldeyer, e deste grupo, algumas series relatam que 80% encontram-se na tonsila palatina. Concluimos, portanto, que o acometimento das tonsilas pelo LNH constitui uma apresentacao incomum desta malignidade hematologica, que merece atencao e destaque para que seja feito diagnostico precoce, seguido de tratamento e acompanhamento corretos.

Aesthetic comparison of the ideal nasal radix height in brazilians

UNLABELLED The harmony of the facial profile is widely influenced by the height and form of the nasal dorsum. A few millimeters can make the lateral view aesthetically more or less pleasing and adequate in a subjects face. Professionals working with facial aesthetics should focus not only on the surgical techniques for proposed outcomes, but also with the subtleties and subjectivity that characterize aesthetic concepts and judgment. MATERIAL AND METHODS A prospective survey to evaluate the preferences of a group of healthcare professionals working with facial aesthetics, a group of fine artists, and lay people about the best nasal radix height; the survey involved comparing 3 different nasal radix heights using computer-altered photographs of women with measurements close to the Caucasian standard. RESULTS AND CONCLUSION The lowest position of the nasal radix--close to the height of the pupil--was preferred (53%), followed by the middle position (superior crease of the eye). The highest position, resembling classic Greek statues, was considered the worst. The authors evaluated the effect of age, gender, and educational level on the choice of the best and worst female profiles.

Original ArticleAesthetic comparison of the ideal nasal radix height in brazilians

UNLABELLED The harmony of the facial profile is widely influenced by the height and form of the nasal dorsum. A few millimeters can make the lateral view aesthetically more or less pleasing and adequate in a subjects face. Professionals working with facial aesthetics should focus not only on the surgical techniques for proposed outcomes, but also with the subtleties and subjectivity that characterize aesthetic concepts and judgment. MATERIAL AND METHODS A prospective survey to evaluate the preferences of a group of healthcare professionals working with facial aesthetics, a group of fine artists, and lay people about the best nasal radix height; the survey involved comparing 3 different nasal radix heights using computer-altered photographs of women with measurements close to the Caucasian standard. RESULTS AND CONCLUSION The lowest position of the nasal radix--close to the height of the pupil--was preferred (53%), followed by the middle position (superior crease of the eye). The highest position, resembling classic Greek statues, was considered the worst. The authors evaluated the effect of age, gender, and educational level on the choice of the best and worst female profiles.

O papel de novas vacinas na prevenção da otite média

Otitis media is one of the most common infectious diseases of infancy; a reduction in its incidence would have a significant economic and social impact. Vaccines may play a role in the prevention of otitis media. This report discusses vaccines against pneumococci and influenza viruses. We reviewed the literature for results of studies examining the role of these vaccines in the prevention of otitis media. The 23-valent polysaccharide anti-pneumococcal vaccine did not modify the incidence of otitis media in children aged 2 years less, the age group with the highest incidence of otitis. The heptavalent anti-pneumococcal vaccine did not significantly reduce the incidence of otitis media overall. This vaccine did, however, reduce the number of episodes of otitis media with effusion and the number of recurrences; it also altered the profile of causative microorganisms by increasing otitis caused by different microorganisms. We found the inactivated anti-influenza virus vaccine to be effective in reducing otitis media during peak incidence periods of influenza. As these new vaccines are currently available in Brazil, otolaryngologists must be aware of their potential role and impact in the reduction of otitis media, to counsel patients appropriately.

P185: Positive Cottle Test in Randomly Selected Volunteers:

to patients on the internet for endoscopic sinus surgery. METHODS: Study design: Review of 250 web sites on endoscopic sinus surgery (top 50 web pages on each of the five most commonly used search engines: Google, Yahoo, MSN, AOL, Ask Jeeves). Assessment of quality and readability using clinical criteria and Flesch-Kincaid reading grade. Setting: Department of Otolaryngology, Bradford Teaching Hospitals, UK. Main outcome measure: Identification of web sites with inadequate or misleading information or containing a commercial interest. RESULTS: Out of 250 web sites reviewed, 142 contained information on ESS. Only 13 (5.2%) were found to have adequate good-quality information after excluding duplicates for all search engines. Twenty-eight (11.2%) were found to have a commercial interest. The information required a higher grade of education to understand (Flesch – Kincaid Reading Grade average 11.26). Of all search engines, Google was found to be the most commonly used by web users and identified most of the good quality web sites. The position of good sites on Google was 1, 3, 6, 12, 18, 37, 48. CONCLUSIONS: Patient information on the internet is dominated by U.S. sites. Information from the ENT-UK web site is not on the listing by all search engines. There are few good quality web sites that explain the nature and risks of ESS, which may help patients in making decisions regarding treatment. Most of the information on the sites relates to postoperative care. A higher ranked web site is no indication of reliability.