Ronaldo Frizzarini

Crescimento pôndero-estatural de crianças após adenoamigdalectomia

Tonsil and adenoid hyperplasia is one of the most common causes of upper airway obstruction in children; and generally comes along with sleep apnea. It is usually associated to poor school performance, non-specific behavioral disturbs, hyperactivity, daytime sleepiness, distraction and failure to thrive. This one is a very serious consequence for the child. The purpose of this study is to compare height and weight percentiles before and after surgery. STUDY DESIGN: Clinical prospective randomized. MATERIAL AND METHOD: We studied 55 children (male and female) from 2 to 12 years old; with upper airway obstruction due to tonsil and adenoid hyperplasia. All of them were measured (height and weight) before and 6 months after adenotonsillectomy. Height and weight percentiles were plotted in graphics and compared with statistical analysis. RESULTS: Before surgery, the majority of the children, 78.2% were under p75 for height and 70.9% were under p50 for weight. Three months after surgery there was a better distribution of the children throughout the percentil ranges. For height: 34.6% were under p75; 32.85 were between p75-95 and 32.6% were above p95. For weight 35.5% were under p50; 36.4% were under p50-95 and 29.1% were above p95. CONCLUSION: After surgery, children presented an improvement in their height and weight percentiles. They develop better after the treatment of upper airway obstruction, with T&A surgery.

Infecções dos espaços cervicais: estudo prospectivo de 57 casos

Aim: Since the development of penicillin, the head and neck space infections have become relatively uncommon, although the morbidity remains high. The delayed diagnosis and treatment can cause serious complications as airway obstruction, mediastinitis, sepsis and death. Controversy still exists about choice of antibiotic therapy, diagnosis, and clinical or surgical treatment. The aim of this prospective study is analyze the etiology (associated factors, site of origin and bacteriology), clinical presentation (symptoms, origin, primary and secondary involved spaces and the routes of propagation of the infection), treatment (antimicrobial therapy, corticosteroid, surgical drainage) and complications. Study design: Prospective clinical. Material and method: This prospective series included 58 patients that need hospitalization due to deep neck infection in a two-year period, from December 1997 to December 1999. In all cases there was confirmation of the diagnosis by cervical ultrasound and/or CT scanning. The management consisted of maintenance of an adequate airway and systemic antibiotics. Surgical drainage was performed promptly as required. Bacteriological cultures were done when purulent material was found in spontaneous drainage and during surgical procedures. Results: Thirty patients were males and 28 females. The mean age was 33,4 years. The most common site of infection was the submandibular (46,6%), followed by pterygomandibular (31%), sublingual (29,3%) and parapharyngeal space (20,7%). Thirty-two patients had infection in more than one site. The etiology was odontogenic (40%), suppurative adenitis (13,8%), salivary gland infection (10,3%). Surgical drainage was performed in 72,4% of patients. The association of penicillin and metronidazole was used in 55.2% of cases and clindamicin in 13.8%. The cultures were negative in 38.1%. S. viridans, S. aureus, S. pyogenes, H. influenzae and Peptostreptococcus were isolated. Recovery occurred in 57 patients. One patient died due to mediastinal spread of infection. Two patients had dehiscence of the suture and one had infection recurrence. Conclusion: Deep neck space infections are potential severe disease and a challenging problem in the care of children and adults. An accurate diagnosis based in image studies is related with less complications and sequels. Odontogenic infections are the most prevalent etiology. The association of penicillin and metronidazole still is a cheap and effective treatment to the most cases. The early and wide drainage is the key to infection control, and is related to quickly recuperation and hospital discharge.

Individually Customized Implants for Laryngoplasty—Are They Possible?

OBJECTIVE To standardize the design of individually fitted implants based on computed tomographic (CT) images for use in medialization laryngoplasty without intraoperative voice monitoring. STUDY DESIGN Prospective tomographic and anatomical experimental study of 10 human cadaveric larynges. METHODS CT scans of 10 excised human larynges were analyzed to define the shape and size of ideal implants for medialization laryngoplasty. Silicone implants were designed according to CT parameters and used in simulated laryngoplasties in the laryngeal specimens. The efficacy of each implant in providing adequate medialization of the vocal fold was evaluated. RESULTS Diverse shapes and sizes of implants were obtained, reflecting variations in laryngeal anatomy. The implants enabled regular medialization of the entire extent of the free border of the vocal fold, including its posterior aspect. Medialization was considered adequate in all cases. CONCLUSIONS This method proved to be a simple and efficient way to design individualized implants for medialization laryngoplasty, regardless of the size and shape of the larynx. LEVEL OF EVIDENCE Not available.

Small cell lung carcinoma metastasis to palatine tonsils

1 MD Fellowship Plastica Facial do departamento de Otorrinolaringologia Faculdade de Medicina da Universidade de Sao Paulo. 2 MD Preceptor da Disciplina de Otorrinolaringologia da Faculdade de Medicina da Universidade de Sao Paulo. 3 MD Medico assistente da disciplina Otorrinolaringologia-Oncologia do Instituto do Câncer do Estado de Sao Paulo. 4 MD Medico assistente da disciplina Otorrinolaringologia Faculdade de Medicina da Universidade de Sao Paulo. 5 Medico preceptor (2010) da divisao de Anatomia Patologica Faculdade de Medicina da Universidade de Sao Paulo (Medico Patologista). Faculdade de Medicina da Universidade de Sao Paulo (FMUSP). Endereco para correspondencia: Helena Hotz Arroyo. Rua Oscar Freire, no 2040, apto 65. Sao Paulo SP. Brasil. CEP: 05409-011. E-mail: helenaharroyo@hotmail.com Este artigo foi submetido no SGP (Sistema de Gestao de Publicacoes) do BJORL em 11 de junho de 2012. cod. 9259. Artigo aceito em 30 de agosto de 2012. CASE REPORT Braz J Otorhinolaryngol. 2013;79(5):645.

Detection of hearing loss in elementary schools: a national campaign

Abstract Objective: The aim of this study is to report the results of a National Campaign for hearing screening in 264,189 Brazilian scholars and discuss some important aspects of the Public Health in Brazil. Method: 264,189 scholars were applied a video test hearing screening. Those who failed the screening were referred to medical and audiological assessment. The prevalence of specific pathological conditions and hearing loss were recorded. Results: 86,948 failed the video test, 20% of which showed some condition that could lead to hearing disabilities. Conclusion: A National Campaign for hearing screening is of great importance, especially in Brazil, a very large country with Public Health difficulties.

Case ReportSmall cell lung carcinoma metastasis to palatine tonsils

1 MD Fellowship Plastica Facial do departamento de Otorrinolaringologia Faculdade de Medicina da Universidade de Sao Paulo. 2 MD Preceptor da Disciplina de Otorrinolaringologia da Faculdade de Medicina da Universidade de Sao Paulo. 3 MD Medico assistente da disciplina Otorrinolaringologia-Oncologia do Instituto do Câncer do Estado de Sao Paulo. 4 MD Medico assistente da disciplina Otorrinolaringologia Faculdade de Medicina da Universidade de Sao Paulo. 5 Medico preceptor (2010) da divisao de Anatomia Patologica Faculdade de Medicina da Universidade de Sao Paulo (Medico Patologista). Faculdade de Medicina da Universidade de Sao Paulo (FMUSP). Endereco para correspondencia: Helena Hotz Arroyo. Rua Oscar Freire, no 2040, apto 65. Sao Paulo SP. Brasil. CEP: 05409-011. E-mail: helenaharroyo@hotmail.com Este artigo foi submetido no SGP (Sistema de Gestao de Publicacoes) do BJORL em 11 de junho de 2012. cod. 9259. Artigo aceito em 30 de agosto de 2012. CASE REPORT Braz J Otorhinolaryngol. 2013;79(5):645.

Video test for hearing screening in children

Abstract Objective: The purpose of this study is to evaluate the sensibility and specificity of a video test hearing screening for scholars. Method: The video test and pure tone audiometry were applied to 122 students (7–9 years old). Sensibility and specificity of the video test were measured by comparing it to the audiometry. Results: The video test showed a sensibility of 100% and specificity of 79.3%. Discussion. The video test is a cheap hearing screening method and can be performed by the teacher at school.

Congenital laryngeal saccular cyst

1 Professor of Otorhinolaryngology in the Medical School of the University of São Paulo. 2 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 3 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 4 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 5 MD, Specialization Student on ENT in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. Divisão de Clínica Otorrinolaringológica e no Departamento de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Send correspondence to: Av. Dr. Enéas de Carvalho Aguiar, 255. Cerqueira César. Prédio Instituto Central, 6o andar, Divisão de Clínica Otorrinolaringológica. São Paulo SP, Brasil. CEP: 05403-000. Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on April 12, 2011; and accepted on August 29, 2011. cod. 7704 CASE REPORT Braz J Otorhinolaryngol. 2012;78(3):137. BJORL

Case ReportCongenital laryngeal saccular cyst

1 Professor of Otorhinolaryngology in the Medical School of the University of São Paulo. 2 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 3 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 4 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 5 MD, Specialization Student on ENT in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. Divisão de Clínica Otorrinolaringológica e no Departamento de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Send correspondence to: Av. Dr. Enéas de Carvalho Aguiar, 255. Cerqueira César. Prédio Instituto Central, 6o andar, Divisão de Clínica Otorrinolaringológica. São Paulo SP, Brasil. CEP: 05403-000. Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on April 12, 2011; and accepted on August 29, 2011. cod. 7704 CASE REPORT Braz J Otorhinolaryngol. 2012;78(3):137. BJORL

Cisto sacular congênito da laringe

1 Professor of Otorhinolaryngology in the Medical School of the University of São Paulo. 2 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 3 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 4 Assisting Physician-PhD in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. 5 MD, Specialization Student on ENT in the Division of Clinical ENT at the Hospital das Clínicas of the Medical School of the University of São Paulo. Divisão de Clínica Otorrinolaringológica e no Departamento de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Send correspondence to: Av. Dr. Enéas de Carvalho Aguiar, 255. Cerqueira César. Prédio Instituto Central, 6o andar, Divisão de Clínica Otorrinolaringológica. São Paulo SP, Brasil. CEP: 05403-000. Paper submitted to the BJORL-SGP (Publishing Management System – Brazilian Journal of Otorhinolaryngology) on April 12, 2011; and accepted on August 29, 2011. cod. 7704 CASE REPORT Braz J Otorhinolaryngol. 2012;78(3):137. BJORL