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International Archives of Otorhinolaryngology    Follow    
  This is an Open Access Journal Open Access journal
     ISSN (Print) 1809-9777 - ISSN (Online) 1809-4864
     Published by Thieme Publishing Group Homepage  [157 journals]
  • Sphenoid Sinus Inverted Papilloma: A Case Report and Literature Review
    • Authors: Rabelo; Gustavo Figueiredo Nunes, Freitas, Vinícius Antunes, Santos, Bruno Hollanda, Ferreira, Diego Costa de Souza, Magalhães, Ana Elisa Mota Silveira, Castro, Mírian Cabral Moreira de
      Abstract: Introduction Inverted papilloma is a rare benign tumor of the nasal fossa, which usually originates from its lateral wall. Only 5% of cases demonstrate exclusive sinus involvement. Primary sphenoid sinus involvement is even rarer. Although considered a benign lesion, the tumor has a potentially invasive nature and has also been found to have an associated malignancy rate of 7 to 15%. Objectives To report a case of inverted nasal papilloma originating in a rare location: the sphenoid sinus. Resumed Report a 56-year-old woman, presented to our outpatient clinic complaining of frontal headache, occasional otalgia and recent forgetfulness. She was initially evaluated by a neurologist and then submitted to a head magnetic resonance imaging. A lesion was found to be filling both sphenoid sinuses. Sinus computed tomography showed an opacified sphenoid sinus with apparent bony integrity. The patient underwent sphenoidotomy through a transnasal endoscopic approach. A bleeding papillomatous lesion was identified. A biopsy was performed and histopathologic study suggested inverted papilloma. The lesion was then completely resected. The patient has been followed for 60 days after surgery; no signs of recurrence were found upon flexible nasofibroscope examination. Conclusion Inverted Papilloma exclusively involving the sphenoid sinus is a rare entity. Non specific symptomatology and Clinical presentation make this kind of tumor a diagnostic and therapeutic challenge. The Endoscopic Sphenoidotomy has been the treatment of choice. Close follow-up is required in order to detect possible recurrences and malignant transformation.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-11T16:42:50+01:00
      DOI: 10.1055/s-0034-1370761
  • Screening of Connexin 26 in Nonsyndromic Hearing Loss
    • Authors: Moreira; Danielle, Silva, Daniela da, Lopez, Priscila, Mantovani, Jair Cortez
      Abstract: Introduction The first locus for nonsyndromic autosomal recessive hearing loss is on chromosome 13q11–22. The 35delG mutation is present in 80% of cases in which GJB2 is involved, which makes the study of this mutation very important. The viability and benefits of screening for mutations in the connexin 26 gene are now beginning to change the diagnostic evaluation and identification of the etiology of hearing loss. Objective To investigate the occurrence of the 35delG mutation in patients with nonsyndromic sensorineural hearing loss and their first degree relatives. Methods This transversal study included 72 patients from the local hospital. The patients were divided into three groups: group A, sensorineural hearing loss (n = 58); group B, first-degree relatives of group A with sensorineural hearing loss (n = 09); and group C, first-degree relatives of patients from group A without hearing loss (n = 05). All patients had audiological evaluation and genetic testing of the 35delG mutation. Results The 35delG mutation was found in four heterozygous mutations (three of them found in the same family). The other heterozygous mutation was found in a female patient with bilateral, moderate, prelingual, sensorineural hearing loss. A single homozygous mutation was found in a male patient, with severe sensorineural hearing loss in his right ear and profound hearing loss in the left ear. Conclusions The 35delG mutation was found in 7% of the cases. The test is easy to perform and inexpensive, but it is necessary to investigate other genes related to hearing loss.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-11T16:28:30+01:00
      DOI: 10.1055/s-0034-1373783
  • Implantable and Semi-Implantable Hearing Aids: A Review of History,
           Indications, and Surgery
    • Authors: Bittencourt; Aline Gomes, Burke, Patrick Rademaker, Jardim, Isabela de Souza, Brito, Rubens de, Tsuji, Robinson Koji, Fonseca, Anna Carolina de Oliveira, Bento, Ricardo Ferreira
      Abstract: Introduction The complaints associated with the use of conventional amplifying hearing aids prompted research at several centers worldwide that ultimately led to the development of implantable devices for aural rehabilitation. Objectives To review the history, indications, and surgical aspects of the implantable middle ear hearing devices. Data Synthesis Implantable hearing aids, such as the Vibrant Soundbridge system (Med-El Corporation, Innsbruck, Austria), the Maxum system (Ototronix LLC, Houston, Texas, United States), the fourth-generation of Carina prosthesis (Otologics LLC, Boulder, Colorado, United States), and the Esteem device (Envoy Medical Corporation - Minnesota, United States), have their own peculiarities on candidacy and surgical procedure. Conclusion Implantable hearing aids, which are currently in the early stages of development, will unquestionably be the major drivers of advancement in otologic practice in the 21st century, improving the quality of life of an increasingly aged population, which will consequently require increased levels of hearing support.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-09T16:08:22+01:00
      DOI: 10.1055/s-0033-1363463
  • Primary Extranodal Non-Hodgkin Lymphoma of the Head and Neck in Patients
           with Acquired Immunodeficiency Syndrome: A Clinicopathologic Study of 24
           Patients in a Single Hospital of Infectious Diseases in Argentina
    • Authors: Corti; Marcelo, Villafañe, María, Bistmans, Alicia, Narbaitz, Marina, Gilardi, Leonardo
      Abstract: Introduction Extranodal non-Hodgkin lymphomas (NHLs) are commonly described in patients with acquired immunodeficiency syndrome (AIDS) and are related with an atypical morphology and aggressive clinical course. AIDS-associated lymphomas are characterized by their rapid progression, frequent extranodal manifestations, and poor outcome. Objective The aim of this article is to remake the clinical features of head and neck (HN) NHL in patients with AIDS to facilitate early diagnosis and treatment. Methods We evaluated the epidemiologic, clinical, immunologic, virologic, and histopathologic characteristics of 24 patients with human immunodeficiency virus (HIV)/AIDS with primary HN NHL treated at a single institution between 2002 and 2012. Histopathologic diagnosis was made according to the criteria of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. Additional immunohistochemical stains were applied in all cases. Results Eighteen patients (75%) were men and the median of age was 39 years. The gingiva and the hard palate were the most common sites of the lesions (15 patients, 62.5%). Lactate dehydrogenase levels were elevated in 16 cases (84%). Bone marrow infiltration was detected only in 4 cases (16.6%). The median CD4 T-cell count was 100 cells/µL. According to the histopathologic evaluation, the most common subtype was diffuse large B-cell lymphoma (12 cases, 50%), followed by plasmablastic lymphoma (9 cases, 37.5%) and Burkitt lymphoma (3 cases, 12.5%). Conclusion HN NHL is a severe complication of advanced HIV/AIDS disease. Early diagnosis followed by chemotherapy plus highly active antiretroviral treatment is necessary to improve the prognosis and the survival of these patients.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-09T15:45:01+01:00
      DOI: 10.1055/s-0034-1373782
  • Dichotic Hearing in Elderly Hearing Aid Users Who Choose to Use a
           Single-Ear Device
    • Authors: Ribas; Angela, Mafra, Nicoli, Marques, Jair, Mottecy, Carla, Silvestre, Renata, Kozlowski, Lorena
      Abstract: Introduction Elderly individuals with bilateral hearing loss often do not use hearing aids in both ears. Because of this, dichotic tests to assess hearing in this group may help identify peculiar degenerative processes of aging and hearing aid selection. Objective To evaluate dichotic hearing for a group of elderly hearing aid users who did not adapt to using binaural devices and to verify the correlation between ear dominance and the side chosen to use the device. Methods A cross-sectional descriptive study involving 30 subjects from 60 to 81 years old, of both genders, with an indication for bilateral hearing aids for over 6 months, but using only a single device. Medical history, pure tone audiometry, and dichotic listening tests were all completed. Results All subjects (100%) of the sample failed the dichotic digit test; 94% of the sample preferred to use the device in one ear because bilateral use bothered them and affected speech understanding. In 6%, the concern was aesthetics. In the dichotic digit test, there was significant predominance of the right ear over the left, and there was a significant correlation between the dominant side with the ear chosen by the participant for use of the hearing aid. Conclusion In elderly subjects with bilateral hearing loss who have chosen to use only one hearing aid, there is dominance of the right ear over the left in dichotic listening tasks. There is a correlation between the dominant ear and the ear chosen for hearing aid fitting.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-04T20:47:43+01:00
      DOI: 10.1055/s-0034-1372508
  • Intraoperative Neural Response Telemetry and Neural Recovery Function: a
           Comparative Study between Adults and Children
    • Authors: Carvalho; Bettina, Hamerschmidt, Rogerio, Wiemes, Gislaine
      Abstract: Introduction Neural response telemetry (NRT) is a method of capturing the action potential of the distal portion of the auditory nerve in cochlear implant (CI) users, using the CI itself to elicit and record the answers. In addition, it can also measure the recovery function of the auditory nerve (REC), that is, the refractory properties of the nerve. It is not clear in the literature whether the responses from adults are the same as those from children. Objective To compare the results of NRT and REC between adults and children undergoing CI surgery. Methods Cross-sectional, descriptive, and retrospective study of the results of NRT and REC for patients undergoing IC at our service. The NRT is assessed by the level of amplitude (microvolts) and REC as a function of three parameters: A (saturation level, in microvolts), t0 (absolute refractory period, in seconds), and tau (curve of the model function), measured in three electrodes (apical, medial, and basal). Results Fifty-two patients were evaluated with intraoperative NRT (26 adults and 26 children), and 24 with REC (12 adults and 12 children). No statistically significant difference was found between intraoperative responses of adults and children for NRT or for REC's three parameters, except for parameter A of the basal electrode. Conclusion The results of intraoperative NRT and REC were not different between adults and children, except for parameter A of the basal electrode.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-02T20:24:08+01:00
      DOI: 10.1055/s-0034-1372509
  • Improvement of Vocal Pathologies Diagnosis Using High-Speed
    • Authors: Tsuji; Domingos Hiroshi, Hachiya, Adriana, Dajer, Maria Eugenia, Ishikawa, Camila Cristina, Takahashi, Marystella Tomoe, Montagnoli, Arlindo Neto
      Abstract: Introduction The study of the dynamic properties of vocal fold vibration is important for understanding the vocal production mechanism and the impact of organic and functional changes. The advent of high-speed videolaryngoscopy (HSV) has provided the possibility of seeing the real cycle of vocal fold vibration in detail through high sampling rate of successive frames and adequate spatial resolution. Objective To describe the technique, advantages, and limitations of using HSV and digital videokymography in the diagnosis of vocal pathologies. Methods We used HSV and digital videokymography to evaluate one normophonic individual and four patients with vocal fold pathologies (nodules, unilateral paralysis of the left vocal fold, intracordal cyst, and adductor spasmodic dysphonia). The vocal fold vibration parameters (glottic closure, vibrational symmetry, periodicity, mucosal wave, amplitude, and glottal cycle phases) were assessed. Results Differences in the vocal vibration parameters were observed and correlated with the pathophysiology. Conclusion HSV is the latest diagnostic tool in visual examination of vocal behavior and has considerable potential to refine our knowledge regarding the vocal fold vibration and voice production, as well as regarding the impact of pathologic conditions have on the mechanism of phonation.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-04-02T20:19:02+01:00
      DOI: 10.1055/s-0034-1372512
  • Möbius Syndrome: Misoprostol Use and Speech and Language
    • Authors: Guedes; Zelita Caldeira Ferreira
      Abstract: Introduction Möbius syndrome (MS; VI and VII palsy) is a rare disease that in Brazil has a great frequency because of the use of misoprostol during pregnancy. Objective Verify if the speech and language performance of children with MS whose mothers reported use of misoprostol (Cytotec, Pfizer, Connecticut, USA) are different from the performance of children of mothers who did not report use. Methods The stomatognathic system beyond receptive and expressive language and speech was evaluated in children with MS, and their mothers were questioned whether they used misoprostol during the pregnancy. Results During the interview, 61.11% of mothers reported that they took misoprostol during the pregnancy. Most of the subjects (83.3%) whose mothers took misoprostol presented bilateral palsy beyond bad mobility of the tongue (90.9%) and speech disorders (63.6%). Conclusion The number of mothers who took misoprostol without knowing the risk for MS was great. The lack of facial expressions and speech disorders were common characteristics of the individuals with MS, whether the mothers took misoprostol during the pregnancy or not.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-03-21T17:16:30+0100
      DOI: 10.1055/s-0033-1363466
  • Central Vestibular Dysfunction in an Otorhinolaryngological Vestibular
           Unit: Incidence and Diagnostic Strategy
    • Authors: Mostafa; Badr E., Kahky, Ayman O. El, Kader, Hisham M. Abdel, Rizk, Michael
      Abstract: Introduction Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis. Objective The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit. Methods This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction. All patients completed a structured questionnaire and received bedside and vestibular examination and neuroimaging as required. Results There were 69 women and 31 men. Their ages ranged between 28 and 73 (mean 42.48 years). Provisional videonystagmography (VNG) results were: 40% benign paroxysmal positional vertigo (BPPV), 23% suspicious of central causes, 18% undiagnosed, 15% Meniere disease, and 4% vestibular neuronitis. Patients with an unclear diagnosis or central features (41) had magnetic resonance imaging (MRI) and Doppler studies. Combining data from history, VNG, and imaging studies, 23 patients (23%) were diagnosed as having a central vestibular lesion (10 with generalized ischemia/vertebra basilar insufficiency, 4 with multiple sclerosis, 4 with migraine vestibulopathy, 4 with phobic postural vertigo, and 1 with hyperventilation-induced nystagmus). Conclusions Combining a careful history with clinical examination, VNG, MRI, and Doppler studies decreases the number of undiagnosed cases and increases the detection of possible central lesions.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-03-21T17:12:48+0100
      DOI: 10.1055/s-0034-1370884
  • Analysis of the Level of Dysphagia, Anxiety, and Nutritional Status Before
           and After Speech Therapy in Patients with Stroke
    • Authors: Drozdz; Daniela, Mancopes, Renata, Silva, Ana Maria Toniolo, Reppold, Caroline
      Abstract: Introduction: The rehabilitation in oropharyngeal dysphagia evidence-based implies the relationship between the interventions and their results. Objective: Analyze level of dysphagia, oral ingestion, anxiety levels and nutritional status of patients with stroke diagnosis, before and after speech therapy. Method: Clinical assessment of dysphagia partially using the Protocol of Risk Assessment for Dysphagia (PARD), applying the scale Functional Oral Intake Scale for Dysphagia in Stroke Patients (FOIS), Beck Anxiety Inventory (BAI) and the Mini Nutritional Assessment MNA®. The sample consisted of 12 patients, mean age of 64.6 years, with a medical diagnosis of hemorrhagic and ischemic stroke and without cognitive disorders. All tests were applied before and after speech therapy (15 sessions). Statistical analysis was performed using the chi-square test or Fisher's exact test, McNemar's test, Bowker's symmetry test and Wilcoxon's test. Results: During the pre-speech therapy assessments, 33.3% of patients had mild to moderate dysphagia, 88.2% did not receive food orally, 47.1% of the patients showed malnutrition and 35.3% of patients had mild anxiety level. After the therapy sessions, it was found that 33.3% of patients had mild dysphagia, 16.7% were malnourished and 50% of patients had minimal level of anxiety. Conclusion:  There were statistically significant evolution of the level of dysphagia (p = 0.017) and oral intake (p = 0.003) post-speech therapy. Although not statistically significant, there was considerable progress in relation to the level of anxiety and nutritional status.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-03-13T14:06:15+0100
      DOI: 10.1055/s-0033-1364169
  • Applicability and Effectiveness of Closed Reduction of Nasal Fractures
           under Local Anesthesia
    • Authors: Vilela; Fernando, Granjeiro, Ronaldo, Maurício, Carlos, Andrade, Patrícia
      Abstract: Introduction A significant portion of patients treated in emergency departments have nasal fracture. It is important that the otolaryngologist know how to treat such damage. Objectives To evaluate the effectiveness of nasal fracture reduction under local anesthesia and tolerance to the procedure. Methods Twenty-four patients treated in the emergency department with closed reduction under local anesthesia were prospectively followed. Epidemiologic information and data regarding pain and complications during the management were noted. The degree of satisfaction was researched by visual analog scale. Results The majority of patients were male (75%), and the most common cause of injury was motor vehicle accident. We found a significant association between time to reduction and referred pain during the procedure. In patients in whom the procedure was delayed (over 3 days), there was less pain, and those who bled during the procedure had a shorter average time to reduction than the group of patients who did not bleed. Most patients were very satisfied, with more than 95% of these willing to undergo the same process again, if necessary. Conclusions The closed approach in the clinic under local anesthesia was effective and safe in restoration of the nose.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-03-13T14:02:51+0100
      DOI: 10.1055/s-0034-1368138
  • Epidemiologic Profile of Patients with Snoring and Obstructive Sleep Apnea
           in a University Hospital
    • Authors: Mendes; Felipe Almeida, Marone, Silvio Antonio Monteiro, Duarte, Bruno Bernardo, Arenas, Ana Carolina Parsekian
      Abstract: Introduction There are several studies on the pathophysiology and prevalence of Obstructive Sleep Apnea Syndrome (OSAS), however, few studies address the epidemiological profile of these patients. Objective The aim of this study is to analyze the epidemiological profile of patients diagnosed with OSAS referred to the Sleep Medicine clinic. Methods Cross-sectional individualized study covering 57 patients who were referred from the general ENT clinic to the Sleep Medicine clinic. Results Classification of OSAS: 16% had primary snoring, 14% mild OSAS, 18% moderate OSAS, and 52% severe OSAS. Distribution according to weight: 7% had normal weight, 2% were overweight (BMI 2530), 37% grade I obesity (BMI 25.1 to 30); 9% grade II obesity (BMI 30.1 to 35) and grade III obesity (BMI greater than 35) in 45% of cases. Distribution Friedmann stage: 9% were classified as grade I, 35% were considered grade II, 54% as grade III and 2% as grade IV. Treatment adopted: 46% were treated with CPAP; 19% were treated with surgery; oral appliance was designed for 14% patients, 7% were given roncoplastic injection and 7% positional therapy. A new polysomnography was asked to 5% of patients. To 2% of patients given the oral appliance was due to treatment failure with roncoplastic injection. Conclusion Most of the patients are male, obese and with moderate or severe OSAS. Snoring and daytime excessive sleepiness were the most common symptoms. The surgical procedures employed in this service (roncoplastic injection, UPPP and lateral pharyngoplasty) followed the recommendations of the available literature.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-28T19:26:21+0100
      DOI: 10.1055/s-0033-1359309
  • Vestibular Findings in Military Band Musicians
    • Authors: Zeigelboim; Bianca Simone, Gueber, Crislaine, Silva, Thanara Pruner da, Liberalesso, Paulo Breno Noronha, Gonçalves, Claudia Giglio de Oliveira, Faryniuk, João Henrique, Marques, Jair Mendes, Jurkiewicz, Ari Leon
      Abstract: Introduction Exposure to music is the subject of many studies because it is related to an individual's professional and social activities. Objectives Evaluate the vestibular behavior in military band musicians. Methods A retrospective cross-sectional study was performed. Nineteen musicians with ages ranging from 21 to 46 years were evaluated (average = 33.7 years and standard deviation = 7.2 years). They underwent anamnesis and vestibular and otolaryngologic evaluation through vectoelectronystagmography. Results The most evident otoneurologic symptoms in the anamnesis were tinnitus (84.2%), hearing difficulties (47.3%), dizziness (36.8%), headache (26.3%), intolerance to intense sounds (21.0%), and earache (15.7%). Seven musicians (37.0%) showed vestibular abnormality, which occurred in the caloric test. The abnormality was more prevalent in the peripheral vestibular system, and there was a predominance of irritative peripheral vestibular disorders. Conclusion The alteration in vestibular exam occurred in the caloric test (37.0%). There were changes in the prevalence of peripheral vestibular system with a predominance of irritative vestibular dysfunction. Dizziness was the most significant symptom for the vestibular test in correlation with neurotologic symptoms. The present study made it possible to verify the importance of the labyrinthine test, which demonstrates that this population should be better studied because the systematic exposure to high sound pressure levels may cause major vestibular alterations.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-28T19:23:33+0100
      DOI: 10.1055/s-0034-1368140
  • Use of Hearing Aids and Functional Capacity in Middle-Aged and Elderly
    • Authors: Carioli; Juliana, Teixeira, Adriane Ribeiro
      Abstract: Introduction Hearing loss is among the sensory changes strongly associated with loss of functional capacity. Objective It aims to determine whether the use of hearing aid contributes to the improvement of instrumental activities of daily living (IADL) for middle aged and elderly hearing-impaired individuals. Methods This is a descriptive, longitudinal, and interventional study. We evaluated 17 subjects, 13 (76.5%) female, aged between 58 and 96 years old (mean 77.1 ± 10.4 years). All were new users of hearing aids. Evaluation included social history, pure tone audiometry, and scale of IADL developed by Lawton and Brody. The subjects were presented daily life situations and were expected to respond if they could do them without assistance (3 points), partially assisted (2 points) or if they were unable to perform them (1 point). IADL was applied before the use of hearing aids adaptation and after a three- and six-month period of use. Results Data analysis revealed that before the use of hearing aids the average score obtained by the subjects was 22.94 ± 4.04 points. Three months after beginning the use the average score was 23.29 ± 4.12 and after six months the average score was 23.71 ± 3.69 points. Statistical analysis revealed a significant difference between scores obtained before the use of hearing aids and six months post-fitting (p = 0.015*) Conclusion The use of hearing aids among the subjects evaluated promoted positive changes in performing IADL, especially to using the telephone.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-28T19:18:01+0100
      DOI: 10.1055/s-0034-1368136
  • The Role of Speech Therapy in Patients Who Underwent Laryngeal
           Microsurgery due to Phonotraumatic Lesions and Lesions Unrelated to
    • Authors: Macedo; Claudia de Assis Corrêa de, Macedo, Evaldo Dacheux de, Malafaia, Osvaldo, Catani, Guilherme Simas do Amaral, Ido, Jorge Massaki, Stahlke, Henrique Jorge
      Abstract: Introduction The role of the speech-language pathology in the multiprofessional team dealing with laryngology and the voice has been recognized for a long time. Scientific studies in this field recommend therapies for laryngeal microsurgeries; few of the studies, however, effectively evaluate the result of postoperative speech therapy. Objective To compare speech therapy evaluation and treatment among patients with phonotraumatic lesions and patients with lesions unrelated to phonotrauma who underwent laryngeal microsurgery. Methods This study was performed at IPO Hospital (Paranaense Institute of Otorhinolaryngology, Curitiba, Paraná, Brazil) between February 2010 and February 2011. Of 254 patients who underwent laryngeal microsurgery, 208 patients were included in the study and divided in two groups: group A with phonotraumatic lesions (n = 131) and group B with lesions unrelated to phonotrauma (n = 77). The number of sessions and the functional result after speech therapy were evaluated. Results The number of postoperative phonotherapy sessions after microsurgery was up to 10 sessions in 89.31% and 87.71% for groups A and B, respectively. Phonotherapy treatment showed a better functional evolution in group A (92.37%). Conclusion A significant difference was observed only in functional evolution, which was better in the group with phonotraumatic lesions (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-28T19:14:23+0100
      DOI: 10.1055/s-0033-1364204
  • Babies' Portal Website Hearing Aid Section: Assessment by Audiologists
    • Authors: Bastos; Bárbara Guimarães, Ferrari, Deborah Viviane
      Abstract: Introduction The family has ultimate responsibility for decisions about the use and care during the daily routine and problem solving in the manipulation of hearing aids (HA) in infants and children. Objective The purpose of the study was to assess technical and content quality of Babies' Portal website Hearing Aid section by audiologists. Methods Letters and e-mails were sent inviting professionals to surf the website and anonymously fill out an online form with 58 questions covering demographic data as well as the website's technical (Emory questionnaire with the subscales of accuracy, authorship, updates, public, navigation, links, and structure) and content quality. Results A total of 109 professionals (tree men and 106 women) with mean age of 31.6 years participated in the study. Emory percentage scores ranged from 90.1 to 96.7%. The Hearing Aid section contents were considered good or very good. Conclusion The website was deemed to have good technical and content quality, being suitable to supplement informational counseling to parents of hearing-impaired children fitted with hearing aids.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-17T20:28:38+0100
      DOI: 10.1055/s-0034-1368139
  • Detection of Respiratory Viruses in Nasopharyngeal Swab and Adenoid Tissue
    • Authors: Biill Primo; Osvaldo Vinícius, Lourenço, Edmir Américo, Passos, Saulo Duarte
      Abstract: Introduction The presence of respiratory viruses in lymphoid tissues of the nasopharynx and oropharynx and its impact on recurrent infections and hypertrophy of these tissues are not yet fully understood. Objective To identify and determine the prevalence of major respiratory viruses in nasopharyngeal secretions and adenoid tissue pre- and postoperatively of children undergoing adenoidectomy. Methods A prospective observational study was conducted in 36 patients under 12 years of age with upper airway lymphoid hypertrophy who were undergoing adenoidectomy, in which various respiratory viruses were investigated using real-time polymerase chain reaction in adenoid tissue and nasopharyngeal secretions collected preoperatively and 30 days postoperatively. Results At least 1 viral agent was isolated in any of the samples collected in 58.3% of children and 25.9% of total samples. Respiratory viruses were identified in 33.8% of preoperative nasopharyngeal specimens and in 19.8% of postoperative secretion. Of the 21 patients with positive results for any respiratory virus, 6 (28.6%) had more than 1 virus. Considering all 36 respiratory viruses found, the main agent isolated was rhinovirus (27.8%), followed by bocavirus (22.2%). Conclusion The virus found more frequently in all samples was rhinovirus. After removal of adenoid tissue, there was a decrease in the prevalence of the virus contained in nasopharyngeal secretion 30 days after surgery.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-17T20:25:38+0100
      DOI: 10.1055/s-0034-1368135
  • Role of Modified Endoscopic Medial Maxillectomy in Persistent Chronic
           Maxillary Sinusitis
    • Authors: Thulasidas; Ponnaiah, Vaidyanathan, Venkatraman
      Abstract: Introduction Functional endoscopic sinus surgery has a long-term high rate of success for symptomatic improvement in patients with medically refractory chronic rhinosinusitis. As the popularity of the technique continues to grow, however, so does the population of patients with postsurgical persistent sinus disease, especially in those with a large window for ventilation and drainage. In addition, chronic infections of the sinuses especially fungal sinusitis have a higher incidence of recurrence even though a wide maxillary ostium had been performed earlier. This subset of patients often represents a challenge to the otorhinolaryngologist. Objectives To identify the patients with chronic recalcitrant maxillary sinusitis and devise treatment protocols for this subset of patients. Methods A retrospective review was done of all patients with persistent maxillary sinus disease who had undergone modified endoscopic medial maxillectomy between 2009 and 2012. We studied patient demographics, previous surgical history, and follow-up details and categorized the types of endoscopic medial maxillectomies performed in different disease situations. Results We performed modified endoscopic medial maxillectomies in 37 maxillary sinuses of 24 patients. The average age was 43.83 years. Average follow-up was 14.58 months. All patients had good disease control in postoperative visits with no clinical evidence of recurrences. Conclusion Modified endoscopic medial maxillectomy appears to be an effective surgery for treatment of chronic, recalcitrant maxillary sinusitis.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-13T14:55:12+0100
      DOI: 10.1055/s-0034-1368137
  • Nasolacrimal Duct Mucocele: Case Report and Literature Review
    • Authors: Britto; Fernanda Carneiro Corujeira de, Rosier, Vitor Veloso, Luz, Tovar Vicente, Verde, Raquel Crisóstomo Lima, Lima, Clara Mônica Figueiredo de, Lessa, Marcus Miranda
      Abstract: Introduction Mucoceles are benign expansive cystic formations, composed of a mucus-secreting epithelium (respiratory or pseudostratified epithelium). Nasolacrimal mucocele occurs in a small proportion of children with nasolacrimal duct obstruction and is characterized by a cystic mass in the medial canthus with dilation of the nasolacrimal duct; although dacryocystoceles are rare in adults, they have been reported in patients with trachoma. Objective Discuss clinical aspects, diagnosis, and therapeutic management of mucocele of nasolacrimal duct based on literature review. Resumed Report The authors report a case of bilateral congenital nasolacrimal duct cysts in a 30-year-old man, identified as a tumor in the topography of both lacrimal sacs since birth without associated symptoms. The patient underwent successive surgical treatments, leading to recurrence of the tumor at the right side and recurrent local infections. Conclusion Endoscopic dacryocystorhinostomy has been increasingly used with good results and success rates similar to the external access.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-13T14:52:18+0100
      DOI: 10.1055/s-0034-1366978
  • Update on Middle Ear Barotrauma after Hyperbaric Oxygen
           Therapy—Insights on Pathophysiology
    • Authors: Lima; Marco Antônio Rios, Farage, Luciano, Cury, Maria Cristina Lancia, Bahamad, Fayez
      Abstract: Introduction Middle ear barotrauma is the most common side effect of hyperbaric oxygen therapy. Knowledge and understanding of its pathophysiology are crucial for an accurate diagnosis and proper decision making about treatment and prevention. Objective Describe up-to-date information on pathophysiology of middle ear barotrauma after hyperbaric oxygen therapy considering the physiology of pressure variation of the middle ear. Data Synthesis Middle ear barotrauma occurs especially during the compression phase of hyperbaric oxygen therapy. The hyperoxic environment in hyperbaric oxygen therapy leads to ventilatory dysfunction of the eustachian tube, especially in monoplace chambers, where the patients are pressurized with 100% O2, favoring middle ear barotrauma. Conclusion The eustachian tube, the tympanic cavity, and mastoid work together in a neural controlled feedback system in which various mechanisms concur for middle ear pressure regulation.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-10T17:36:18+0100
      DOI: 10.1055/s-0034-1366974
  • Language in Children with Neonatal Hypoxic-Ischemic Encephalopathy
    • Authors: Martinez; Chenia, Carneiro, Luciana, Vernier, Luíza, Cesa, Carla, Guardiola, Ana, Vidor, Deisi
      Abstract: Introduction Neonatal hypoxic-ischemic encephalopathy (NHIE) is a common neurologic injury, and it may compromise the child's language and cognition. Understanding the process of language acquisition becomes possible with concise knowledge about children's global development. Objective The aim of this study was to observe if language acquisition and development are impaired in children with NHIE. Methods Seventy children with NHIE from 1 to 24 months old were analyzed in a Pediatric Neurology Service of Hospital of Porto Alegre, South of Brazil using the Brunet-Lezine Scale. Statistical analysis used SPSS 13.0 software. Results Twenty-four (60%) of the subjects were boys, with mean gestational age of 35.8 weeks (standard deviation of 4.6) and mean Apgar score of 6.0 at 1 minute and 7.1 at 5 minutes. The variables age versus language showed significant inverse correlation (r =  − 0.566; p = 0.028). As the subjects aged, language tasks became more specific and dependent on the subject's direct action, rather than the subjective interpretation of their guardian. This correlation seems to be closely associated with scale configuration and with consequences of neurologic disorder, evincing the delays in language development. Conclusion This study achieved the goals proposed and highlights the necessity of greater attention by professionals to language skills during the initial period of child development.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-10T17:09:27+0100
      DOI: 10.1055/s-0034-1366976
  • The Audiometric Findings among Curitiba and Metropolitan Area Students
    • Authors: Klas; Regina, Lacerda, Adriana
      Abstract: Introduction Hearing loss can compromise the language, learning process, and socialization of students. Objective Study the audiometric findings among Curitiba and Metropolitan Area students. Methods Analysis of data collected at the hearing health service of Paraná State special education and inclusion department. Results The sample consisted of 646 students, children and teenagers of both genders (38.2% female and 61.8% male), with average age of 8.12 years (range 2 to 15); all were students of public or private schools of Curitiba and Metropolitan Area. The justifications to refer the students to audiometric evaluation were: otolaryngologists diagnosis (73.1%), school difficulties (39.6%), and midlevel hearing problems (32%). Audiometric results showed that 29.5% of the students had hearing loss. Conductive hearing losses showed the greatest occurrence among preschool students (right ear 38.6%, left ear 39.8%). The predominant hearing loss degree was mild (RE 20.5%, LE 19.3%) to slight (RE 17%, LE 19.3%), as was the horizontal configuration (RE 81.5%, LE 78.4%). A significant relationship (p = 0.0000) between hearing loss and poor school performance was noted. Conclusion Considering the available data, especially the high number of findings of conductive losses, it is necessary to highlight prevention and diagnosis of early hearing alteration. Nevertheless, Brazil, as an emerging country, has been pursuing improvement in health and life quality of all citizens.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-02-10T16:56:30+0100
      DOI: 10.1055/s-0034-1366975
  • Angioleiomyoma of the Nasal Cavity
    • Authors: Arruda; Milena Moreira, Monteiro, Daniela Yasbek, Fernandes, Atilio Maximino, Menegatti, Vanessa, Thomazzi, Emerson, Hubner, Ricardo Arthur, Lima, Luiz Guilherme Cernaglia Aureliano de
      Abstract: Introduction Vascular leiomyoma of the nasal cavity is an extremely rare tumor that represents less than 1% of all vascular leiomyomas. It is more prevalent in women between the fourth and sixth decades, reaching primarily the inferior nasal turbinates. Objectives Reporting and assisting the systematization of more accurate diagnostic methods in clinical and complementary investigation of vascular leiomyoma in the nasal cavity. Resumed Report We present the case of a 49-year-old woman diagnosed with vascular leiomyoma in the nasal cavity, which manifested mainly with nasal obstruction. During investigation, computer tomography was not diagnostic, the cytologic study was not conclusive, and according to the biopsy, it was a squamous papilloma. Conclusion We suggest that the technical difficulty in obtaining an adequate amount of material for preoperative biopsy, associated with the topography of the lesion in the vestibular nasal region, may have contributed to changing the postoperative diagnosis. Thus, pathologic study of the surgical fragment is the more accurate method for diagnosis.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-21T14:12:07+0100
      DOI: 10.1055/s-0033-1364173
  • Epidemiology of Intratemporal Complications of Otitis Media
    • Authors: Maranhão; André, Andrade, José, Godofredo, Valéria, Matos, Rafaela, Penido, Norma
      Abstract: Introduction Despite the advent of antibiotics and immunizations in the last century, complications of otitis media remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otorhinolaryngologist. Objective To establish the annual incidence of intratemporal complications of otitis media and prospectively evaluate patients via an analysis of epidemiologic and clinical aspects. Methods Prospective, observational study. Between February 2010 and January 2011, patients admitted to a tertiary care, university-based otology practice with diagnosis of otitis media and an associated intratemporal complication (ITC) were included in the study. The following data were evaluated: age, sex, type of ITC, treatment, imaging tests findings, type and degree of hearing loss, and clinical outcome. The overall incidence of all complications and of each complication individually was determined. Results A total of 1,816 patients were diagnosed with otitis media. For 592 (33%) individuals, the diagnosis was chronic otitis media; for 1,224 (67%), the diagnosis was acute otitis media. ITCs of otitis media were diagnosed in 15 patients; thus, the annual incidence of intratemporal complications was 0.8%. We identified 19 ITC diagnoses in 15 patients (3 patients had more than one diagnosis). Labyrinthine fistulae were diagnosed in 7 (36.8%) individuals, mastoiditis in 5 (26.3%), facial palsy in 4 (21.1%), and labyrinthitis in 3 (15.8%). Conclusion The incidence of intratemporal complications in Brazil remains significant when compared with developed countries. Chronic otitis media with cholesteatoma is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-21T14:07:34+0100
      DOI: 10.1055/s-0033-1364172
  • Level of User Satisfaction with Hearing Aids and Environment: The
           International Outcome Inventory for Hearing Aids
    • Authors: Kozlowski; Lorena, Almeida, Gleide, Ribas, Angela
      Abstract: Introduction The main function of hearing is to enable oral communication. Hearing loss impairs communication skills. Objective To evaluate the level of user satisfaction with hearing aids. Methods This is a cross-sectional group study comprising 108 subjects (56% men and 44% women). The average age of the subjects was 77 years. These subjects had been recently fitted with their hearing aids and showed sensorineural (90%) and mixed (10%) hearing loss as determined via the Questionnaire International Outcome Inventory for Hearing Aids Outcome Inventory (IOI-HA), which determined the benefit and satisfaction obtained by sound amplification. Results The hearing aids improved the quality of life of 52.78% of the patients, which was revealed by their high scores (mean = 27.3). The relationship of the user with the environment was significantly better (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-16T14:32:34+0100
      DOI: 10.1055/s-0033-1363782
  • Sudden Hemianopsia Secondary to Ethmoid Sinus Mucocele
    • Authors: Morganti; Ligia, Evangelista, Leandro, Guimaraes, Roberto, Crosara, Paulo
      Abstract: Paranasal sinus mucoceles are benign cystic lesions, filled with mucus, occurring due to an obstruction of involved sinus ostium. They are indolent, locally expansive, and destructive. Surgical treatment must be performed and, when done at the correct time, may prevent sequelae. We present a case of ethmoid sinus mucocele with orbit involvement and permanent optical nerve injury.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-16T14:29:22+0100
      DOI: 10.1055/s-0033-1364168
  • Intracochlear Schwannoma: Diagnosis and Management
    • Authors: Bittencourt; Aline Gomes, Alves, Ricardo Dourado, Ikari, Liliane Satomi, Burke, Patrick Rademaker, Gebrim, Eloisa Maria Santiago, Bento, Ricardo Ferreira
      Abstract: Introduction Schwannomas of the eighth cranial nerve are benign tumors that usually occur in the internal auditory canal or the cerebellopontine angle cistern. Rarely, these tumors may originate from the neural elements within the vestibule, cochlea, or semicircular canals and are called intralabyrinthine schwannomas. Intracochlear schwannomas (ICSs) represent a small percentage of these tumors, and their diagnosis is based on high-resolution magnetic resonance imaging (MRI). Objectives To report the clinical and radiologic features and audiometric testing results of an ICS in a 48-year-old man after a 22-month follow-up period. Resumed Report A patient with an 8-year history of persistent tinnitus in his right ear, combined with ipsilateral progressive hearing loss and aural fullness. Audiometry revealed normal hearing in the left ear and a moderate to severe sensorineural hearing loss in the right ear, with decreased speech reception threshold and word recognition score, compared with the exam performed 5 years previously. MRI showed a small intracochlear nodular lesion in the modiolus, isointense on T1 with a high contrast enhancement on T1 postgadolinium images. During the follow-up period, there were no radiologic changes on imaging studies. Thus, a wait-and-scan policy was chosen as the lesion remained stable with no considerable growth and the patient still presents with residual hearing. Conclusions Once diagnosed, not all ICS patients require surgery. Treatment options for ICS include stereotactic radiotherapy and rescanning policy, depending on the tumor's size, evidence of the tumor's growth, degree of hearing loss, intractable vestibular symptoms, concern about the pathologic diagnosis, and the patient's other medical conditions.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-07T20:47:01+0100
      DOI: 10.1055/s-0033-1364170
  • Gout of the Temporomandibular Joint: Report of a Case
    • Authors: Oliveira; Isaac Nilton Fernandes, Gomes, Renata Caroline Ferreira, dos Santos, Raiane Rodrigues, Oliveira, Thiago de Paula, Pereira, Larissa Loiuse Cândida, Mainenti, Pietro
      Abstract: Introduction Gout is an illness characterized by the deposition of monosodium urate crystals in the joints or in soft tissues. The clinical manifestation results from inflammation of limb joints and pain with a rare presentation in the temporomandibular joint (TMJ). Case Report This study describes a 66-year-old white man with a chief complaint of “occasional pain in the left temporal muscle region.” The case disclosed a gout manifestation in the TMJ after physical, radiographic, and ultrasonographic exams, and the patient was referred to proper treatment. Conclusion Gout manifestation in the TMJ is an unusual presentation, and few reports in the English literature address to the subject. Gout in the TMJ should be included as a differential diagnosis for joint disorders.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-07T20:37:57+0100
      DOI: 10.1055/s-0033-1363464
  • Elaboration and Evaluation of Contents about Hearing Health Inserted in
    • Authors: Corrêa; Camila de Castro, Silva, Ricelly Avila da, Blasca, Wanderléia Quinhoneiro
      Abstract: Introduction Cybertutor (electronic tutor) is a type of information and communication technology to disseminate knowledge about hearing, aiming at the prevention of hearing alterations and, when needed, early treatment, in addition to social inclusion of the hearing impaired. However, it is important to evaluate the level of language used in the content and the subjective perception of the target public regarding improvements of the tool. Objective To improve content about hearing health inserted in a cybertutor and to evaluate the level of legibility and the quality of the content and material made available. Method For the construction of the content, text and audiovisual resources were used, based on scientific publications, and were evaluated objectively with Flesch Reading Ease test and subjectively with a questionnaire created by the authors and answered by 10 ninth-year pupils. Results Two modules on hearing health were created, “Hearing Health” and “Intervention and Rehabilitation,” which received Flesch scores of 50.8 and 51.4%, respectively, making it necessary to have a sixth- to ninth-year education to understand the material. The students' evaluation in reference to language and material showed that 55.5% considered the contents excellent; 38.2% classified the contents as satisfactory; 6.3% considered them reasonable; and 0% classified them as unsatisfactory. Conclusion The contents inserted in the cybertutor about hearing health presented a language level considered easy for the age group of the target population, in addition to receiving good subjective evaluation from the pupils, facilitating access to the information.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-07T20:37:51+0100
      DOI: 10.1055/s-0033-1358578
  • Tracheal Decannulation Protocol in Patients Affected by Traumatic Brain
    • Authors: Zanata; Isabel de Lima, Santos, Rosane Sampaio, Hirata, Gisela Carmona
      Abstract: Introduction The frequency of tracheostomy in patients with traumatic brain injury (TBI) contrasts with the lack of objective criteria for its management. The study arose from the need for a protocol in the decision to remove the tracheal tube. Objective To evaluate the applicability of a protocol for tracheal decannulation. Methods A prospective study with 20 patients, ranging between 21 and 85 years of age (average 33.55), 4 of whom were women (20%) and 16 were men (80%). All patients had been diagnosed by a neurologist as having TBI, and the anatomical region of the lesion was known. Patients were evaluated following criteria for tracheal decannulation through a clinical evaluation protocol developed by the authors. Results Decannulation was performed in 12 (60%) patients. Fourteen (70%) had a score greater than 8 on the Glasgow Coma Scale and only 2 (14%) of these were not able to undergo decannulation. Twelve (60%) patients maintained the breathing pattern with occlusion of the tube and were successfully decannulated. Of the 20 patients evaluated, 11 (55%) showed no signs suggestive of tracheal aspiration, and of these, 9 (82%) began training on occlusion of the cannula. The protocol was relevant to establish the beginning of the decannulation process. The clinical assessment should focus on the patient's condition to achieve early tracheal decannulation. Conclusion This study allowed, with the protocol, to establish six criteria for tracheal decannulation: level of consciousness, respiration, tracheal secretion, phonation, swallowing, and coughing.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-06T17:11:12+0100
      DOI: 10.1055/s-0033-1363467
  • Temporal Resolution Ability in Students with Dyslexia and Reading and
           Writing Disorders
    • Authors: Chaubet; Juliana, Pereira, Liliane, Perez, Ana Paula
      Abstract: Introduction The Gaps-in-Noise (GIN) test assesses the hearing ability of temporal resolution. The development of this ability can be considered essential for learning how to read. Objective Identify temporal resolution in individuals diagnosed with reading and writing disorders compared with subjects with dyslexia. Methods A sample of 26 subjects of both genders, age 10 to 15 years, included 11 diagnosed with dyslexia and 15 diagnosed with reading and writing disorders. Subjects did not display otologic, neurologic, and/or cognitive diseases. A control group of 30 normal-hearing subjects was formed to compare thresholds and percentages obtained from the GIN test. The responses were obtained considering two measures of analysis: the threshold gap and the percentage of correct gap. Results The threshold was lower in the GIN for the typical group than for the other groups. There was no difference between groups with dyslexia and with reading and writing disorders. The GIN results of the typical group revealed a higher percentage of correct answer than in the other groups. No difference was obtained between the groups with dyslexia and with reading and writing disorders. Conclusion The GIN test identified a difficulty in auditory ability of temporal resolution in individuals with reading and writing disorders and in individuals with dyslexia in a similar way.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-06T17:04:14+0100
      DOI: 10.1055/s-0033-1363465
  • Evaluating the Effectiveness of the Lateral Intercrural Suture to Decrease
           the Interdomal Distance to Improve the Definition of the Nasal Tip in
           Primary Rhinoplasty
    • Authors: Soares; Caio Márcio Correia, Mocelin, Marcos, Pasinato, Rogerio, Berger, Cezar Augusto Sarraf, Grocoske, Francisco Luiz Busato, Issa, Maria Julia Abrão
      Abstract: Introduction Several surgical techniques emphasizing sutures on the lower lateral cartilage have been studied by surgeons as instruments to improve nasal tip remodeling. It is already known that the domal divergence angle and its definition angle can be modified by lateral intercrural suture (LIS). Techniques for measuring these structures are not yet standardized. Objectives Assess the efficacy of LIS using polydioxanone 4–0 absorbable thread by interdomal distance and systematize the LIS technique to improve nasal tip definition. Materials and Methods This prospective study measured and analyzed interdomal distances measured preoperatively and perioperatively compared with 3- and 6-month postoperative measurements. Results LIS was efficient on reducing interdomal distances. Conclusion LIS is statistically safe and efficient and has low morbidity when utilized in patients with mild to moderate deformities, because it reduces the domal divergence angle, effectively sustaining the nasal tip.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-06T17:02:04+0100
      DOI: 10.1055/s-0033-1352505
  • Nostril Morphometry Evaluation before and after Cleft Lip Surgical
           Correction: Clinical Evidence
    • Authors: Feijo; Mario Jorge Frassy, Brandão, Stella Ramos, Pereira, Rui Manoel Rodrigues, Santos, Mariana Batista de Souza, Justino da Silva, Hilton
      Abstract: Introduction The purpose to this work is to review systematically the morphological changes of the nostrils of patients undergoing surgery for correction of cleft lip and identify in the literature the issues involved in the evaluation of surgical results in this population. Review of Literature A review was conducted, searching for clinical evidence from MEDLINE. The search occurred in January 2012. Selection criteria included original articles and research articles on individual subjects with cleft lip or cleft palate with unilateral nostril anthropometric measurements before and after surgical correction of cleft lip and measurements of soft tissues. There were 1,343 articles from the search descriptors and free terms. Of these, five articles were selected. Discussion Most studies in this review evaluated children in Eastern countries, using different measurement techniques but with the aid of computers, and showed improved nostril asymmetry postoperatively compared with preoperatively. Conclusion There is a reduction of the total nasal width postoperatively compared with preoperative measurements in patients with cleft lip.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-06T16:57:15+0100
      DOI: 10.1055/s-0033-1352506
  • Reducing Postoperative Pain from Tonsillectomy Using Monopolar
           Electrocautery by Cooling the Oropharynx
    • Authors: Vieira; Lucas, Nissen, Leonardo, Sela, Gustavo, Amara, Yara, Fonseca, Vinicius
      Abstract: Objective Evaluate intraoperative cooling of the oropharynx to reduce postoperative pain in tonsillectomy using monopolar electrocautery. Methods Sixty-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. Results Pain after tonsillectomy assessed by VAS was significantly lower in the experimental group at days 0, 5, and 6 (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2014-01-06T16:50:33+0100
      DOI: 10.1055/s-0033-1363783
  • Auditory Effects of Exposure to Noise and Solvents: A Comparative Study
    • Authors: Lobato; Diolen Conceição Barros, Lacerda, Adriana Bender Moreira De, Gonçalves, Cláudia Giglio De Oliveira, Coifman, Herton
      Abstract: Introduction Industry workers are exposed to different environmental risk agents that, when combined, may potentiate risks to hearing. Objective To evaluate the effects of the combined exposure to noise and solvents on hearing in workers. Methods A transversal retrospective cohort study was performed through documentary analysis of an industry. The sample (n = 198) was divided into four groups: the noise group (NG), exposed only to noise; the noise and solvents group (NSG), exposed to noise and solvents; the noise control group and noise and solvents control group (CNS), no exposure. Results The NG showed 16.66% of cases suggestive of bilateral noise-induced hearing loss and NSG showed 5.26%. The NG and NSG had worse thresholds than their respective control groups. Females were less susceptible to noise than males; however, when simultaneously exposed to solvents, hearing was affected in a similar way, resulting in significant differences (p 
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-12-03T17:35:35+0100
      DOI: 10.1055/s-0033-1361083
  • Language Disorders in Children with Unilateral Hearing Loss: A Systematic
    • Authors: José; Maria Renata, Mondelli, Maria Fernanda Capoani Garcia, Feniman, Mariza Ribeiro, Lopes-Herrera, Simone Aparecida
      Abstract: Introduction Childhood is a critical period for language development and maturation of the central auditory system. Unilateral hearing loss (UHL) is considered a minimal impairment, and little is discussed regarding its impact on the development of language, communication, and school performance. Objectives A bibliographical survey of scientific articles published from 2001 to 2011 was performed to verify which language disorders can occur in children with UHL and which tests were performed to identify them. Data Synthesis Three databases were used: PubMed, Lilacs, and The Cochrane Library. As inclusion criteria, the articles should have samples of children with UHL, without other impairments, aged between 3 months and 12 years, and reference to language tests applied in this population. Out of 236 papers initially selected, only 5 met the inclusion criteria. In the articles studied, 12 tests were used for language assessment in children with UHL, out of which 9 were directed toward expressive language, and 3 toward receptive language. Children with UHL demonstrated lower scores on receptive and expressive language tests when compared with children with normal hearing. However, they obtained better scores on expressive language tests than children with bilateral hearing loss. Conclusion The findings of this survey showed that only a small number of studies used language tests in children with UHL or addressed language alterations resulting from this type of impairment. Therefore we emphasize the importance of investments in new studies on this subject to provide better explanations related to language difficulties presented by children with UHL.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-12-03T17:19:59+0100
      DOI: 10.1055/s-0033-1358580
  • Masticatory Changes in Oral Breath Secondary to Allergic Rhinitis:
           Integrative Review
    • Authors: Bezerra; Luciana Ângelo, Silva, Hilton Justino da, Melo, Ana Carolina Cardoso de, Moraes, Klyvia Juliana Rocha de, Cunha, Renata Andrade da, Cunha, Daniele Andrade da, Medeiros, Décio
      Abstract: Introduction The III Brazilian Consensus on Rhinitis (2012) defines allergic rhinitis as a nasal mucosa inflammation, mediated by immunoglobulin E, after exposure to allergens. The classic signs and symptoms of allergic rhinitis are nasal obstruction, watery rhinorrhea, sneezing, and nasal itching, often reversible either spontaneously or with treatment, and mouth breathing (breathing predominantly through the mouth, regardless of the cause, due to a nasal breathing impairment) in some cases. Objective To evaluate the literature on masticatory changes in children with mouth breathing due to allergic rhinitis. Methods We conducted a search of the past 10 years, at Bireme and MEDLINE databases, for articles that covered masticatory changes in children with mouth breathing secondary to allergic rhinitis. Results We found 1,986 articles, including 15 repeated in databases, but only two articles met the inclusion criteria fully. Discussion We found few studies to answer the question raised in this review, and those studies have some methodological limitations. Most articles claimed no have statistically significant differences in masticatory changes in this population. Conclusion A better controlled study (isolating diseases, exposure time), with a larger sample (sample calculation appropriate), would be necessary to examine such changes.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-11-25T14:06:17+0100
      DOI: 10.1055/s-0033-1358585
  • Adenoid Cystic Carcinoma Mimicking an Oroantral Fistula: A Case Report
    • Authors: Monteiro; Bárbara Vanessa de Brito, Grempel, Rafael Grotta, Gomes, Daliana Queiroga de Castro, Godoy, Gustavo Pina, Miguel, Márcia Cristina da Costa
      Abstract: Introduction Adenoid cystic carcinoma (ACC) is one of the most frequent malignant salivary gland tumors, which commonly affects the minor salivary glands of the mouth and is rare in the nose and paranasal sinuses. In the maxillary sinus, ACC can mimic inflammatory diseases and has a poor prognosis. Objective To report a case of a 50-year-old man with ACC of the maxillary sinus whose clinical findings in the alveolar ridge mimicked an oroantral fistula. Case Report An excisional biopsy was performed and histopathologic analysis revealed ACC. Lung metastases and residual tumor in the maxillary sinus were detected by imaging methods. In view of the poor general health of the patient, no new surgical intervention was performed and he was only treated by radiotherapy and follow-up. Conclusion Although rare in the maxillary sinus, ACC should be included in the differential diagnosis of lesions affecting this site.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-11-05T15:22:39+0100
      DOI: 10.1055/s-0033-1352507
  • Synchronous Bilateral Warthin Tumors: A Case Report
    • Authors: Nascimento; Luiz Augusto, Ferreira, Julia Alessandra Santos, Pio, Raquel Baptista, Takano, Gustavo Henrique Soares, Miziara, Hélcio Luiz
      Abstract: Introduction Warthin tumor is described as papillary cystadenoma lymphomatosum and is the second most common tumor of the parotid glands. Bilateral synchronous incidence is rare, occurring in 7 to 10% of the cases. It is more common in males between 60 and 70 years of age and is closely related to smoking. There is slow growth and the condition is a delimited nodule of regular outlines; it has low rates of malignant progression and recurrence. Objective Report a case of synchronous bilateral Warthin tumor occurring in an elderly patient, and review incidence and peculiarities of this tumor. Case Report A 78-year-old man who used to smoke had a history of mild pain in the topography of right parotid three weeks ago. Patient with hypertension, diabetes and a longtime smoker (smoking a pack per day for 32 years) noticed a progressive bulging in the right parotid region for about 2.5 years ago, and noticed another progressive bulging (althought in the left parotid region), for about one year ago. Patient denied fever, redness, skin lesions and pain during this period until last three weeks, when he sought medical attention for a mild pain in the right facial region. The patient underwent cervical magnetic resonance imaging that showed tumor lesions in both parotids. Fine needle aspiration revealed a typical lesion of epithelial oxyphilic cells associated with reactive lymphoid proliferation, suggesting Warthin tumor. The patient underwent two superficial parotidectomies, and the histopathologic result from both tumors of parotid glands showed papillary cystadenoma lymphomatosum. Conclusion The occurrence of synchronous bilateral Warthin tumor is extremely rare, and anamnesis and physical examination, as well as some complementary examinations, are important means for diagnostic evaluation. Confirmation of the diagnosis can only be obtained through a histopathologic study. A superficial or total parotidectomy is the recommended treatment for the disease.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-11-05T14:32:04+0100
      DOI: 10.1055/s-0033-1351676
  • Evaluation of Respiratory Muscle Strength in Mouth Breathers: Clinical
    • Authors: Andrade da Cunha; Renata, Andrade da Cunha, Daniele, Assis, Roberta Borba, Bezerra, Luciana Ângelo, Justino da Silva, Hilton
      Abstract: Introduction The child who chronically breathes through the mouth may develop a weakness of the respiratory muscles. Researchers and clinical are seeking for methods of instrumental evaluation to gather complementary data to clinical evaluations. With this in mind, it is important to evaluate breathing muscles in the child with Mouth Breathing. Objective To develop a review to investigate studies that used evaluation methods of respiratory muscle strength in mouth breathers. Data Synthesis  The authors were unanimous in relation to manovacuometry method as a way to evaluate respiratory pressures in Mouth Breathing children. Two of them performed with an analog manovacuometer and the other one, digital. The studies were not evaluated with regard to the method efficacy neither the used instruments. Conclusion There are few studies evaluating respiratory muscle strength in Mouth Breathing people through manovacuometry and the low methodological rigor of the analyzed studies hindered a reliable result to support or refuse the use of this technique.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-11-05T14:32:04+0100
      DOI: 10.1055/s-0033-1351682
  • Pleomorphic Adenoma of the Tongue Base: Case Report and Review
    • Authors: Nascimento; Luiz Augusto, Vilela, Thais Gonçalves Pinheiro
      Abstract: Introduction Pleomorphic adenoma, also known as mixed tumor, is the most common benign tumor of the major and minor salivary glands. The occurrence of pleomorphic adenoma of the tongue base is very rare, and very few cases have been reported in the literature. Objective The authors present a rare case of pleomorphic adenoma of the tongue base and a review of the literature. Case Report A 55-year-old woman had an extensive cervical mass, with little pain, from the submental level to the level below the hyoid bone. Fiberoptic endoscopic examination showed an extensive mass at the base of the tongue with considerable reduction in the airway. Magnetic resonance image scan revealed a contrast-enhancing mass of heterogeneous density over the base of the tongue of 8 × 8 × 7 cm and a reduction of the hypopharyngeal airway. Biopsy of the lesion was performed along with a tracheostomy due to the bulging tongue base and acute respiratory failure. Histologic examination with an immunohistochemistry study revealed a diagnosis of pleomorphic adenoma. The excision of the tumor was performed by a lateral pharyngotomy approach and the total mass was excised. Conclusion The authors consider the rarity of this case and show that this is the 11th and the largest pleomorphic adenoma reported in the English-language medical literature.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-11-05T14:32:03+0100
      DOI: 10.1055/s-0033-1351683
  • Isolated Schwannoma of the Olfactory Groove: A Case Report
    • Authors: Nascimento; Luiz Augusto, Settanni, Flávio Aurélio Parente, Filho, José Franscisco de Góis, Sanchez, Isabela Naria Dias, Cavalcante, Bruna Barros, Stávale, João Noberto
      Abstract: Introduction Schwannoma of the olfactory groove is an extremely rare tumor that can share a differential diagnosis with meningioma or neuroblastoma. Objectives The authors present a case of giant schwannoma involving the anterior cranial fossa and ethmoid sinuses. Case Report The patient presented with a 30-month history of left nasal obstruction, anosmia, and sporadic ipsilateral bleeding. Computed tomography of the paranasal sinuses revealed expansive lesion on the left nasal cavity extending to nasopharynx up to ethmoid and sphenoid sinuses bilaterally with intraorbital and parasellar extension to the skull base. Magnetic resonance imaging scan confirmed the expansive tumor without dural penetration. Biopsy revealed no evidence of malignancy and probable neural cell. Bifrontal craniotomy was performed combined with lateral rhinotomy (Weber-Ferguson approach), and the lesion was totally removed. The tumor measured 8.0 × 4.3 × 3.7 cm and microscopically appeared as a schwannoma composed of interwoven bundles of elongated cells (Antoni A regions) mixed with less cellular regions (Antoni B). Immunohistochemical study stained intensively for vimentin and S-100. Conclusion Schwannomas of the olfactory groove are extremely rare, and the findings of origin of this tumor is still uncertain but recent studies point most probably to the meningeal branches of trigeminal nerve or anterior ethmoidal nerves.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-11-05T14:32:02+0100
      DOI: 10.1055/s-0033-1353368
  • Subcutaneous Cavernous Hemangioma in the Nasal Dorsum: Report of Case
           Treated with Endoscopic Rhinoplasty
    • Authors: Socher; Jan Alessandro, Marchi, Maurício F. de Sá, Rickli, Jeniffer C. Kozechen
      Abstract: Introduction Hemangiomas are vascular malformations, with slow blood flow, that can occur in any part on the body. They are more common in women and, predominantly, are isolated lesions. The malformation does not spontaneously regress. Subcutaneous hemangioma is a rare variant with an aggressive growth pattern that sometimes recurs after excision. Objective Case report of a subcutaneous cavernous hemangioma in the nasal dorsum treated with endoscopic rhinoplasty. Case Report A 27-year-old woman had a fibroelastic tumor mass in the midline of the nasal dorsum, which was pulsatile; she had obstruction and nasal congestion with associated rhinorrhea, with evolution and worsening over the previous 2 years. Computed tomography showed a tumor demarcated in the nasal dorsum without evidence of intracranial communication. Endoscopic rhinoplasty with septoplasty and associated paranasal sinus sinusectomy was performed without arteriography embolization, sclerotherapy, or laser. Pathologic diagnosis showed cavernous hemangioma. Postoperative follow-up shows no recurrence at 3 years. Discussion This case presented with atypical features, thus making the diagnosis a challenge. Imaging studies were required to confirm the vascular nature of the tumor. Excisional biopsy is the procedure of choice for pathologic examination. Subcutaneous hemangiomas never involute and always need treatment. The surgical approach is exceptional because there was no preoperative diagnosis. In addition, the closed technique provided best aesthetic results in this case. Conclusion Endoscopic rhinoplasty is suitable for nasal dorsum tumor resection and has superior aesthetic result to open techniques.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-10-25T15:54:54+01:00
      DOI: 10.1055/s-0033-1351675
  • Superior Semicircular Canal Dehiscence Syndrome without Vestibular
    • Authors: Teixeira; Emidio Oliveira, Fonseca, Marconi Teixeira
      Abstract: Introduction Superior semicircular canal dehiscence syndrome is mainly characterized by vestibular symptoms induced by intense sound stimuli or pressure changes, which occur because of dehiscence of the bony layer covering the superior semicircular canal. Case Report Here, we report a case of the syndrome with pulsatile tinnitus and ear fullness, in the absence of vestibular symptoms. Discussion Signs and symptoms of the syndrome are rarely obvious, leading to the requirement for a minimum workup to rule out or make diagnosis more probable and thus avoid misconduct.
      Citation: Int. Arch. Otorhinolaryngol. ; : -
      PubDate: 2013-10-25T15:54:52+01:00
      DOI: 10.1055/s-0033-1351670
  • Laryngopharyngeal Reflux: Diagnosis, Treatment, and Latest Research
    • Authors: Campagnolo; Andrea Maria, Priston, Jaqueline, Thoen, Rebecca Heidrich, Medeiros, Tatiana, Assunção, Aída Regina
      Pages: 184 - 191
      Abstract: Introduction Laryngopharyngeal reflux (LPR) is a highly prevalent disease and commonly encountered in the otolaryngologist's office. Objective To review the literature on the diagnosis and treatment of LPR. Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin. Conclusion Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.
      Citation: Int. Arch. Otorhinolaryngol. ; : 184-191
      PubDate: 2013-11-05T14:32:00+0100
      DOI: 10.1055/s-0033-1352504
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