Nelson Caldas

Assessment of pre and postoperative symptomatology in patients undergoing inferior turbinectomy

UNLABELLED Partial inferior turbinectomy is a procedure directed to treat nasal obstruction secondary to hypertrophy rhinitis. This study evaluates the impact of this procedure in the quality of life of the patients, analyzing the improvement of other symptoms such as rhinorrhea, nasal itching and sneezing after six months of the surgical procedure. STUDY DESIGN Clinical prospective. MATERIAL AND METHOD Forty-nine patients submitted to turbinectomy associated or not with septoplasty, received questionnaires to grade the intensity of symptoms. Through the comparison of severity of symptoms before and after six months of the surgery, it was possible to evaluate the degree of improvement of each symptom. The results were classified as null, good, moderate and great, and we subtracted postoperative score from the preoperative score. RESULTS The nasal obstruction presented good or great results in 98% of the patients. For rhinorrhea, the surgery has resulted in good or great improvement in 49% of the cases. Sneezing presented good or great results in 81.6% of the patients and, nasal itching, 45%. CONCLUSION The study showed that the clinical benefits obtained with the partial inferior turbinectomy are not limited to nasal obstruction, extending also to others symptoms of rhinitis, mainly in relation to sneezing crisis.

Avaliação da sintomatologia pré e pós-operatória de pacientes submetidos à turbinectomia inferior

Partial inferior turbinectomy is a procedure directed to treat nasal obstruction secondary to hypertrophy rhinitis. This study evaluates the impact of this procedure in the quality of life of the patients, analyzing the improvement of other symptoms such as rhinorrhea, nasal itching and sneezing after six months of the surgical procedure. STUDY DESIGN: clinical prospective. MATERIAL AND METHOD: Forty-nine patients submitted to turbinectomy associated or not with septoplasty, received questionnaires to grade the intensity of symptoms. Through the comparison of severity of symptoms before and after six months of the surgery, it was possible to evaluate the degree of improvement of each symptom. The results were classified as null, good, moderate and great, and we subtracted postoperative score from the preoperative score. RESULTS: The nasal obstruction presented good or great results in 98% of the patients. For rhinorrhea, the surgery has resulted in good or great improvement in 49% of the cases. Sneezing presented good or great results in 81.6% of the patients and, nasal itching, 45%. CONCLUSION: The study showed that the clinical benefits obtained with the partial inferior turbinectomy are not limited to nasal obstruction, extending also to others symptoms of rhinitis, mainly in relation to sneezing crisis.

Myringosclerosis in patients with chronic renal failure: comparative analysis with a control group

UNLABELLED Myringosclerosis is a scar of the tympanic membrane lamina propria, resulting from trauma or inflammation, characterized by proliferation of collagen, hyalinization, calcium and phosphate deposits and cartilaginous or osseous metaplasia of the middle ear mucosa, a sequence that is similar to that taking place in other types of pathologic calcification, common in chronic renal failure (CRF). AIM To verify the influence of chronic renal failure on the prevalence of myringosclerosis. METHOD The otoscopic examination was done in 341 chronic renal failure patients and in 356 normal control individuals. The frequency of positive otoscopies was compared between the two groups, based on individual variables and those pertaining to CRF. RESULTS 11.7% of the patients had a positive otoscopy in the CRF group, compared to 5.1% in the control group. There was no statistical difference in the frequency of myringosclerosis according to gender, ethnic group, time of dialysis or serum minerals. The groups had a wide age range. CONCLUSION Although the findings of this study suggest a higher occurrence of myringosclerosis in patients with renal disease, they do not provide a basis for stating that there is any relation between renal failure and tympanic alterations.

Miringosclerose em pacientes com insuficiência renal crônica: análise comparativa com um grupo controle

A miringoesclerose e uma alteracao cicatricial da lâmina propria da membrana timpânica caracterizada por proliferacao de fibras colagenas, seguida de hialinizacao, deposicao de calcio e fosforo, seguindo uma sequencia semelhante ao que ocorre em outros tipos de calcificacao patologica comuns em pacientes com doenca renal cronica. OBJETIVO: Verificar a influencia da insuficiencia renal cronica (IRC) na prevalencia da miringoesclerose. METODO: Foi realizada otoscopia em 341 pacientes com IRC em hemodialise e em 356 individuos de um grupo controle. Foi comparada a frequencia de otoscopia positiva entre os dois grupos, procurando-se relacionar com variaveis pessoais e relacionadas a IRC. RESULTADOS: O grupo de pacientes apresentou 11,7% de otoscopia positiva contra 5,1% do grupo controle. Nao houve influencia do sexo ou cor na frequencia da miringoesclerose. Porem, os grupos foram heterogeneos em relacao a faixa etaria. Tambem nao houve diferenca importante no tempo de dialise nem nos niveis sericos de minerais e do PTH entre os pacientes do grupo de estudo que apresentavam otoscopia positiva ou negativa. CONCLUSAO: Os achados, embora apontem para uma maior ocorrencia da miringoesclerose nos pacientes renais cronicos, nao nos permitem concluir com certeza que exista alguma relacao entre a IRC e as alteracoes timpânicas.

Transtornos factícios por procuração: discussão de um caso

Chondrosarcoma is the most frequent sarcoma of the larynx. It is more prevalent in the cricoid and less prevalent in the other laryngeal cartilages. Chondrosarcoma is rarely located in the epiglottis. We reported a case of epiglottis chondrosarcoma that was treated with a supracricoid laryngectomy with cricohyoidopexy.

Cutaneous presentation of Chagas' disease reactivation in a heart-transplant patient.

plete set of Japanese-population-specific filaggrin gene mutations. Allergy 2014; 69: 537–540. 6 Gruber R, Janecke AR, Grabher D, Sandilands A, Fauth C, Schmuth M. Evidence for genetic modifiers other than filaggrin mutations in X-linked ichthyosis. J Dermatol Sci 2010; 58: 72–82. 7 Uehara M, Hayashi S. Hyperlinear palms: association with ichthyosis and atopic dermatitis. Arch Dermatol 1981; 117: 490–491. 8 Cuevas-Covarrubias SA, Vald es-Flores M, Orozco Orozco E, D ıaz-Zagoya JC, Kofman-Alfaro SH. Are atopy and palm-sole hyperlinearity clinical tools in the differential diagnosis between ichthyosis vulgaris and X-linked ichthyosis?. J Dermatol 1998; 25: 556–557.

Artéria carótida interna aberrante na orelha média

Vascular anomalies of the middle ear are uncommon and, because aberrant internal carotid artery, among others, implies great risk at middle ear surgery, it must be remembered at the differential diagnosis. The patient may be asymptomatic, or complains of pulsatile tinnitus and conductive hearing loss. Computer tomography of the temporal bones and magnetic resonance imaging supplemented with magnetic resonance angiography can make the diagnosis. The authors present an aberrant internal carotid artery on a 13-year-old patient, whose diagnosis was performed by otoscopic examination, and imaging methods based on a previous clinical suspicion.