Vinicius Ribas Fonseca

Benign masseter muscle hypertrophy

Idiopathic hypertrophy of the masseter muscle is a rare disorder of unknown cause. Some authors associate it with the habit of chewing gum, temporo-mandibular joint disorder, congenital and functional hypertrophies, and emotional disorders (stress and nervousness). Most patients complain of the cosmetic change caused by facial asymmetry, also called square face, however, symptoms such as trismus, protrusion and bruxism may also occur. The goals of the present investigation were: to report a case of idiopathic masseter hypertrophy, describe its symptoms and treatment. The patient reported bilateral bulging in the region of the mandible angle, of slow and progressive evolution. He did not complain of pain or discomfort, however there was bilateral otalgia, nighttime trismus and stress. In his physical exam we noticed bilateral masseter hypertrophy without local inflammatory alterations. We indicated surgical treatment with an extraoral approach. Complementary tests are indicated when there is diagnostic doubts. Treatment varies from conservative to surgical, and the later depends on surgeon skill and experience.

Estudo da prevalência de hipoacusia em indivíduos com diabetes mellitus tipo 1

UNLABELLEDnDiabetes mellitus (DM) is a chronic degenerative disease that impairs normal insulin production and use. DM chronic auditory complications may include spiral ganglion atrophy, degeneration of the vestibulocochlear nerve myelin sheath, reduction of the number of spiral lamina nerve fibers, and thickening of the capillary walls of the stria vascularis and small arteries.nnnOBJECTIVEnThis paper aims to verify the hearing thresholds of individuals with type 1 DM.nnnMATERIALS AND METHODSnSixty patients were enrolled in this trial and divided into case and control groups featuring diabetic and non-diabetic subjects respectively. All individuals were interviewed and underwent physical examination, ENT examination, and audiometric tests.nnnRESULTSnStatistically significant difference was observed in hearing thresholds of case group subjects at 250, 500, 10,000, 11,200, 12,500, 14,000 and 16,000 Hz for both ears and ear average. Case group subjects had higher likelihood of having hypacusis at any frequency regardless of ear than controls.nnnCONCLUSIONnStatistically significant differences were seen in the audiological findings of case group subjects when compared to controls. Thorough audiological examination including high frequency audiometry is required for subjects with diabetes mellitus type 1.

Hipertrofia benigna do músculo masseter

A hipertrofia idiopatica do musculo masseter (HIM) e uma patologia pouco frequente e de causa desconhecida. Alguns autores correlacionam tal condicao com habitos de mascar gomas, disfuncao da articulacao temporomandibular (ATM), hipertrofias congenitas e funcionais, e disturbios emocionais (nervosismo e ansiedade). A maioria dos pacientes queixa-se da alteracao estetica decorrente da assimetria facial, tambem chamada face quadrada, no entanto, sintomas como trismo, protrusao e bruxismo tambem podem ocorrer. Os objetivos deste estudo foram: relatar um caso de HIM e descrever a sintomatologia e o tratamento realizado. O paciente relatava aumento bilateral na regiao do ângulo da mandibula de evolucao lenta e progressiva. Negava dor ou desconforto, porem se queixava de otalgia bilateral, trismo noturno e ansiedade. Ao exame fisico, observou-se hipertrofia bilateral de masseter sem alteracoes inflamatorias no local. Foi indicado tratamento cirurgico com abordagem extra-oral. Exames complementares sao indicados na duvida diagnostica. A conduta terapeutica varia de conservadora a cirurgica, sendo que esta depende principalmente da experiencia e da habilidade do cirurgiao.

Efeito da mitomicina C tópica na cicatrização de prega vocal em modelo suíno

several adjuvant therapies to surgery have been used to modulate the healing process of vocal folds, including topic mitomycin (MTC). AIM: to evaluate the effect of topical MTC in the healing process of vocal folds 30 days after the exeresis of a mucosal fragment with CO2 laser in a swine model (control group without mitomycin and study group with topical MTC), with collagen deposition measurement. STUDY TYPE: prospective experimental in swine. METHODS: two groups of 6 swine each were subjected to exeresis of a mucosal fragment of the vocal fold with CO2 laser. Immediately after the procedure MTC was applied topically for three minutes on the study group. Thirty days later the animals were slaughtered and samples of the vocal folds were collected for histological analysis, with the purpose of quantifying collagen deposition by Picrosirius Red stain. RESULTS: the average area of total collagen in the vocal folds in the control group was 2.648,03 µm2, whereas in the study group it was 2.200,30 µm2 (p = 0.0043). CONCLUSION: topical application of MTC after the exeresis of a mucous fragment of vocal fold with CO2 laser in swine significantly decreased total collagen deposition.

Topical mitomycin C effect on swine vocal folds healing.

UNLABELLEDnSeveral adjuvant therapies to surgery have been used to modulate the healing process of vocal folds, including topic mitomycin (MTC).nnnAIMnto evaluate the effect of topical MTC in the healing process of vocal folds 30 days after the exeresis of a mucosal fragment with CO2 laser in a swine model (control group without mitomycin and study group with topical MTC), with collagen deposition measurement.nnnSTUDY TYPEnprospective experimental in swine.nnnMETHODSntwo groups of 6 swine each were subjected to exeresis of a mucosal fragment of the vocal fold with CO2 laser. Immediately after the procedure MTC was applied topically for three minutes on the study group. Thirty days later the animals were slaughtered and samples of the vocal folds were collected for histological analysis, with the purpose of quantifying collagen deposition by Picrosirius Red stain.nnnRESULTSnthe average area of total collagen in the vocal folds in the control group was 2.648,03 microm2, whereas in the study group it was 2.200,30 microm2 (p=0.0043).nnnCONCLUSIONntopical application of MTC after the exeresis of a mucous fragment of vocal fold with CO2 laser in swine significantly decreased total collagen deposition.

The impact of tinnitus on the quality of life in patients with temporomandibular dysfunction.

INTRODUCTIONnThe most common otological symptoms in patients with temporomandibular disorders (TMD) are ear fullness, tinnitus and ear pain.nnnOBJECTIVEnTo evaluate the impact of tinnitus on the quality of life for patients with TMD.nnnMETHODnThis is a quantitative, cross-sectional retrospective study. The sample consisted of 19 individuals with TMD, 17 (89.47%) females and 2 (10.53%) male, mean age 53.5 years. Data collection consisted of: anamnesis, pure tone audiometry, acuphenometry and application of the Portuguese version of the Tinnitus Handicap Inventory (Brazilian THI).nnnRESULTSn63.12% had had tinnitus for less than five years, and 15.79% had tinnitus that sounded like whistling, rain and/or a cricket. There was a predominance of laterality in the right ear (42.11%). 52.63% of the subjects reported that their tinnitus is continuous, while 31.58% stated that it lasts for days, and 47.37% report that it is common. The audiometry revealed mean audiometric thresholds above 25 dB HL in the high frequencies (3000, 4000, 6000 and 8000 Hz) bilaterally. In acuphenometry, the average loudness of the tinnitus was 21 dB SL the right ear and 17.85 dB SL in the left ear, and the average tinnitus pitch was 3775 Hz in the right ear and 3750 Hz in the left ear. The total THI score was 37.8 points. It appears that there is significant correlation between the THI scale, time of tinnitus duration and its occurrence.nnnCONCLUSIONnTinnitus reported in patients with TMD caused moderate impact on quality of life and can be seen in the presence of background noise although daily activities can still be performed.

Description of tinnitus and its relation to discomfort level in a group of elderly hearing aid wearers

INTRODUCTIONnEvaluating quality of life for tinnitus patients has been an interest of several specialties that have seen the negative impact that the disorder has on people.nnnOBJECTIVEnTo assess and qualify tinnitus in a group of elderly hearing aid wearers.nnnMATERIALS AND METHODSnA descriptive cross-sectional study involving 53 elderly patients with tinnitus without remission after wearing hearing aids. All subjects were submitted to: a medical evaluation, an audiological evaluation, acuphenometry, an investigation of tinnitus annoyance level and quality of life.nnnRESULTSnThere were 20 men and 33 women. The mean age was 72.5 years. The sample was mostly characterized by having sensorineural hearing loss (84%), moderate to moderately severe (86%) and downward sloping (82%). With respect to the description of the tinnitus sound, the most common were a hissing sound (93%) of average pitch (84%). Regarding the subjects perception of tinnitus, it was found that subjects had varying levels of annoyance: mild (25%), moderate (33%), severe (22%), most severe (20%). Men are more bothered by tinnitus than women. Most of the sample reported being satisfied or very satisfied with their quality of life.nnnCONCLUSIONnIt was possible to evaluate and qualify tinnitus in the sample. Although tinnitus is a frequent audiological symptom that interferes in the life of the elderly, in the sample it did not weigh heavily in terms of quality of life.

Prevention of the Evolution of Workers' Hearing Loss from Noise-Induced Hearing Loss in Noisy Environments through a Hearing Conservation Program

Introductionu2003Noise-induced hearing loss (NIHL) is a serious problem for workers and therefore for businesses. The hearing conservation program (HCP) is a set of coordinated measures to prevent the development or evolution of occupational hearing loss, which involves a continuous and dynamic process of implementation of hearing conservation routines through anticipation, recognition, evaluation, and subsequent control of the occurrence of existing environmental risks or of those that may exist in the workplace and lead to workers hearing damage. Objectiveu2003The aim of this study was to evaluate the effectiveness of the HCP in preventing further hearing loss in workers with audiograms suggestive of NIHL. The audiometric tests and medical records of 28 furniture company workers exposed to noise were reviewed and monitored for 2 years. Methodsu2003This retrospective, cross-sectional study examined five audiometric tests in the medical records (on admission and every semester) of 28 workers in a furniture company (totaling 140 audiometric exams) following the introduction of the HCP. Resultsu2003Data analysis showed no differences between the audiometric tests conducted on admission and those performed every semester. Conclusionsu2003The HCP implemented was effective in preventing the worsening of hearing loss in workers already with NIHL when exposed to occupational noise. Therefore, such a measure could be useful for the employment of workers with hearing loss in job sectors that have noise exposure.

Reducing Postoperative Pain from Tonsillectomy Using Monopolar Electrocautery by Cooling the Oropharynx

Objectiveu2003Evaluate intraoperative cooling of the oropharynx to reduce postoperative pain in tonsillectomy using monopolar electrocautery. Methodsu2003Sixty-six patients, age 1 to 12 years, were selected for the study, 33 in the control group and 33 in the experimental group. After randomization, patients underwent subcapsular dissection and hemostasis with monopolar electrocautery. Patients in the experimental group had the oropharynx cooled after tonsil dissection and hemostasis for 10 minutes. The procedure was done through the oral cavity by irrigation with 500 mL of 0.9% saline, in temperatures between 5°C and 10°C, for 5 minutes. The evaluation of postoperative pain was made with the pain visual analog scale (VAS) for 10 days. As complementary data on the evaluation of pain, we recorded daily use of ketoprofen for pain relief. Resultsu2003Pain after tonsillectomy assessed by VAS was significantly lower in the experimental group at days 0, 5, and 6 (pu2009<u20090.05). There were no differences in the use of ketoprofen between the groups. Conclusionu2003Cooling of the oropharynx after tonsillectomy promotes clinically significant reduction in postoperative pain, without additional complications.

Comparing Individuals through the Speech Recognition Test Applied to Regional Live Voice and Recorded Speeches from Paraná State in Five Brazilian Counties

Introduction u2003Speech tests such as logoaudiometry measure the ability to perceive and recognize oral sounds. The Speech Recognition Index (SRI) is one of the speech tests adopted in clinical routine; it uses standardized live voice and recorded speeches. The live voice speech method can be influenced by intra and interspeaker variability, as well as by regionalism variability, whereas recorded tests show consistency in their presentation. Objective u2003Analyzing results of the SRI test applied to live voice and recorded speeches from Paraná State, in different Brazilian counties. Method u2003The sample comprised 125 individuals, 25 from each county (Rio de Janeiro, Florianópolis, Porto Alegre, Salvador and Curitiba), from both sexes, in the age group 20 to 70 years; the SRI was applied in both techniques. Results u2003The recorded speech method showed prevalence of hit improvement in Rio de Janeiro (40%), Salvador, Porto Alegre and Florianópolis (28%). Individuals from Salvador and Florianópolis subjected to the recorded speech method showed better results in the left ear. Individuals from Rio de Janeiro and Porto Alegre showed satisfactory results in both ears, whereas those from Curitiba did not show statistically significant difference between the left and the right ear. Conclusion u2003The recorded CD application method showed prevalence of hit improvement (%) in the SRI responses in comparison to the live voice speech technique in most of the studied counties. According to the hit rate measured in the herein investigated counties, Rio de Janeiro showed the best results in the recorded speech method.