Joana Filipe

Adenoid bacterial colonization in a paediatric population

Adenoids play a key role in both respiratory and ear infection in children. It has also been shown that adenoidectomy improves these symptoms in this population. The main goal of the present study was to evaluate adenoid bacterial colonization and document a possible relation with infectious respiratory disease. A prospective observational study was designed to evaluate the proposed hypothesis in a paediatric population submitted to adenoidectomy by either infectious or non-infectious indications and compare these two cohorts. A total of 62 patients with ages ranging from 1 to 12 years old were enrolled in the study. Adenoid surface, adenoid core and middle meatus microbiota were compared. A close association between adenoid colonization and nasal infection was found, supporting that adenoids may function as bacterial reservoir for upper airway infection. The obtained results also contribute to explain the success of adenoidectomy in patients with infectious indications.

Adenocarcinoma in facial nerve.

Facial nerve malignancies are rare, destructive, and an uncommon cause of facial paralysis, accounting for less than 5% of all cases (1). The neoplastic involvement can be intrinsic or extrinsic and occur along the entire course of the nerve: extracranial, intratemporal, or intracranial. Extratemporal malignancies, such as parotid tumors, can present as perineural invasion, providing a route of spread and being a major risk factor for recurrence and regional dissemination (1). Parotid adenocarcinoma is considered a high-grade malignancy according to the World Health Organization’s classification of salivary gland tumors and has a higher risk of local recurrence or metastases compared to nonYhigh-grade malignancies (2). Adenocarcinomas of the parotid have a propensity to invade and infiltrate facial nerve fibers, and the disease course can be characterized by an acute facial paralysis that can appear many years after the primary surgery. Although rare, facial nerve carcinoma must be considered in the differential diagnosis of a facial nerve paralysis in the presence of a previous history of a parotid adenocarcinoma, and Bell’s palsy must be used cautiously as a diagnosis of exclusion.

Endonasal Endoscopic Repair of Orbital Floor Defects

Objective: We have previously published an endonasal endoscopic technique of inferior orbital floor reconstruction, for the surgical management of the “silent sinus syndrome” and “blow-out” orbital fractures. Based on the same principles, we present an alternative version of the technique with the advantage of an “overlay” approach to the bone defect. Method: After creating a large middle meatal antrostomy, an autologous septal bone graft is placed over the orbit floor defect, in the subperiostal plane between orbital contents and bony floor, through an incision on the lamina papyracea. Results: At long-term follow-up we achieve, in most, if not all, cases, resolution of enophthalmos and ipsilateral chronic maxillary sinus atelectasis, with minimal morbidity. Conclusion: This technique provides excellent functional and aesthetic results in the surgical reconstruction of the orbit floor.