Joao J. Maniglia

Esthesioneuroblastoma with Intracranial Extension

The authors present five cases of olfactory neuroblastoma with intracranial extension operated on in the Department of Neurosurgery in collaboration with otorhinolaryngologists. This tumor is most frequently reported as growing inside the nasal cavities, and it can extend to the paranasal sinuses. Cases presenting initially as intracranial tumors have been infrequently reported. At present, histological diagnosis of this tumor is aided by the use of electron microscopy and immunocytochemistry. Total resection combined with radiation therapy remains the most satisfactory treatment.

Botulinum toxin for treatment of Frey's syndrome: report of two cases

Freys syndrome is a phenomenon of hemifacial flushing and sweating after gustatory stimulus, usually secondary to surgical trauma over the parotid gland, although other injury mechanisms may be seen. It is accepted as a result of aberrant regeneration of facial autonomic nerve fibers. Treatment evolved from ineffective medical and surgical approaches to botulinum toxin. We evaluate the effectiveness and safety of botulinum toxin in the treatment of this complication in two patients.

Anatomia cirúrgica do acesso nasal transesfenoidal para tumores da hipófise

Foram analisadas diferentes medidas relacionadas ao acesso nasal transesfenoidal em 18 hemicabecas de cadaveres com o objetivo de estudar os limites e vantagens dessa via. Foram obtidos os seguintes valores medios (mm) para as principais medidas: diâmetro maior da narina 15,18; altura da cavidade nasal 44,11; distância narina - sela turca 71,71. Esses valores demonstram ser o acesso nasal uma via ampla e direta a sela turca. O presente estudo demonstrou tambem ser possivel nesse acesso preservar o septo cartilagino e outras estruturas que sao usualmente lesadas no acesso sublabial.

A Comparative Study between Universal Eclectic Septoplasty Technique and Cottle

Introduction  Since the last century surgical correction of nasal septum deviation has been improved. The Universal Eclectic Technique was recently reported and there are still few studies dedicated to address this surgical approach. Objective  The objective of this study is to compare the results of septal deviation correction achieved using the Universal Eclectic Technique (UET) with those obtained through Cottles Technique. Methods  This is a prospective study with two consecutive case series totaling 90 patients (40 women and 50 men), aged between 18 and 55 years. We divided patients into two groups according to the surgical approach. Fifty-three patients underwent septoplasty through Universal Eclectic Technique (UET) and thirty-seven patients were submitted to classical Cottles septoplasty technique. All patients have answered the Nasal Obstruction Symptom Evaluation Scale (NOSE) questionnaire to assess pre and postoperative nasal obstruction. Results  Statistical analysis showed a significantly shorter operating time for the UET group. Nasal edema assessment performed seven days after the surgery showed a prevalence of mild edema in UET group and moderate edema in Cottles technique group. In regard to complication rates, UET presented a single case of septal hematoma while in Cottles technique group we observed: 02 cases of severe edemas, 01 case of incapacitating headache, and 01 complaint of nasal pain. Conclusion  The Universal Eclectic Technique (UET) has proven to be a safe and effective surgical technique with faster symptomatic improvement, low complication rates, and reduced surgical time when compared with classical Cottles technique.

Juvenile Angiofibroma with Intracranial Extension

(ESS) on the lower and upper airways one year post-surgery in a group of asthmatics with nasal polyposis (NP). METHOD: We have previously showed in a prospective study that ESS improved asthma and nasal parameters, five and 12 weeks post-surgery in a group of 68 asthmatics with NP. The same parameters were evaluated in 51 of these patients one year post-surgery. RESULTS: One year post-surgery, the symptoms of dyspnoea (p 0.001) and cough (p 0.022), daily peak expiratory flow (p 0.001), olfactory threshold test (p 0.001), sense of smell (p 0.001), peak nasal inspiratory flow (p 0.001), and nasal congestion (p 0.001) were still improved as compared to pre-surgery. CONCLUSION: ESS has long-term beneficial effects on lower and upper airways, and could be considered early in the treatment of NP with concomitant asthma.

Tumores glômicos do osso temporal: relato de 6 casos

The authors review the clinical, radiological and pathological features of 6 cases of glomus tumors of the temporal bone. Out of the 6 patients, 5 were female; age was distributed between 22 and 76 years (mean 48 years). The main clinical features were hypoacusia, tinnitus and otoscopic findings suggestive of the diagnosis. In one case was noted the concomitant presence of a neurinoma of the VIII cranial nerve with a ipsilateral glomus tumor, and in another case there was a concomitancy of carotid body tumor with temporal glomus jugularis tumor. Metastases were not observed in any case. Tumoral lesions were successfully ressected employing microsurgical techniques and a multidisciplinary staff involving neurosurgeons, head and neck surgeons and otolaryngologists. Radioteraphy was not employed, neither pre-operative embolization. Some aspects related to the nosology, embriology, pathophysiology, diagnosis and treatment of this interesting type of neoplasms are discussed.The authors review the clinical, radiological and pathological features of 6 cases of glomus tumors of the temporal bone. Out of the 6 patients, 5 were female; age was distributed between 22 and 76 years (mean 48 years). The main clinical features were hypoacusia, tinnitus and otoscopic findings suggestive of the diagnosis. In one case was noted the concomitant presence of a neurinoma of the VIII cranial nerve with a ipsilateral glomus tumor, and in another case there was a concomitancy of carotid body tumor with temporal glomus jugularis tumor. Metastases were not observed in any case. Tumoral lesions were successfully ressected employing microsurgical techniques and a multidisciplinary staff involving neurosurgeons, head and neck surgeons and otolaryngologists. Radioteraphy was not employed, neither pre-operative embolization. Some aspects related to the nosology, embriology, pathophysiology, diagnosis and treatment of this interesting type of neoplasms are discussed.