2022 – JOURNAL OF CONTEMPORARY DISEASES AND ADVANCED MEDICINE

EVIDENCE-BASED OTOPLASTY WITH AUGMENTED REALITY: FIXATION OF THE REMNANT CONCHA IN THE MASTOID REGION

Administrador — Tue, 05 Sep 2023 17:05:19 +0000

This article demonstrates the evolution of knowledge transmission through augmented reality (AR) for a safer procedure for otoplasty surgery. The fixation of the remaining concha in the mastoid region is a fundamental step, as it allows solving the bad positioning of the auricular pavilion, providing its retropositioning, simultaneously, with the superior rotation. This page contains Augmented Reality content. To access it, download the NEPARBOOKS app and

RETROSPECTIVE ANALYSIS OF NASAL FRACTURE TREATMENT AT IPO HOSPITAL

Administrador — Tue, 05 Sep 2023 17:04:16 +0000

Among the emergencies otorhinolaryngologists most commonly see in the emergency room are nasal fractures, often regarded of minor importance, though with the chance of significant cosmetic and functional damage. This study aimed to outline a profile of the patients seen and treated in a reference service in the city of Curitiba, state of Paraná. A retrospective study related to the pathology was performed with the investigation of variables such as sex, age, semiology, etiology, diagnostic tools, intervention time, postoperative complaints, and rate of secondary surgeries. 205 records were included. There was a predominance of males (56.6%). The most affected age group was between 21 and 30 years old (27.8%). Most fractures were caused by physical assault (28%). The most prevalent symptom, directly linked to surgical indication, was rhinoscoliosis. Patients were treated in an average period of 8 to 14 days. Among surgical patients, 17% were dissatisfied and only 7.2% underwent reoperation. The data found were consistent with the medical literature and reached satisfactory results. However, it would be beneficial to promote a new study, this time a prospective one, to support the creation of a protocol to address this emergency with the aim of standardizing conduct and optimizing results.

EVIDENCE OF THE VALUE OF USING THE BUTTERFLY AND SPREADER GRAFT TECHNIQUES IN FUNCTIONAL RHINOPLASTY FOR THE CORRECTION OF INTERNAL NASAL VALVE COLLAPSE: A 32-YEAR SYSTEMATIC REVIEW IN ENGLISH

Administrador — Tue, 05 Sep 2023 17:03:23 +0000

Nasal obstruction due to internal nasal valve collapse is relatively common. This paper systematically reviews the existing literature that supports the efficiency and value of using the traditional spreader graft and butterfly graft techniques in functional rhinoplasty for the correction of internal nasal valve incompetence.

PROFILE OF PATIENTS WHO UNDERWENT CATARACT SURGERY AT THE HOSPITAL PARANAENSE DE OTORRINOLARINGOLOGIA – IPO, IN THE YEAR 2022

Administrador — Tue, 05 Sep 2023 17:02:21 +0000

Cataract is the name given to any opacity of the crystalline lens, and is the leading cause of treatable blindness in developing countries. Its main cause is related to aging. This study intends to provide a survey of patients’ profile data regarding age, gender, operated eye, onset of symptoms, level of visual impairment and risk factors of patients who underwent cataract surgery at the Hospital Paranaense de Otorrinolaringologia – IPO between September and October 2022. A descriptive and prospective study was conducted upon approval by IPO’s Research Ethics Committee, based on the analysis of 103 patients indicated for cataract surgery, totaling 154 eyes. The most affected age group was 60- to 69-year-olds, comprising 39 (37.9%) patients; the female gender was 57 (55.3%); the most affected eye was the right one in 80 (51.9%) patients; the onset of symptoms was of 2.2 years on average; the number of eyes already presenting some level of visual impairment was 147 (95.45%); among the systemic diseases the presence of arterial hypertension was found in 56 (54.36%) patients and diabetes mellitus in 30 (29.12%); the use of corticoids was from 3 (2.9%) of the patients. According to the study data and the literature, there was major similarity between the two, especially in there being a predominance of the female gender, mostly elderly, being unilateral or bilateral. Almost all patients had some degree of visual impairment. The most prevalent diseases in the patients studied were arterial hypertension and diabetes mellitus, and some patients used corticosteroids.

DEVELOPMENT OF A MOBILE APPLICATION TO MONITOR THE CLINICAL RESPONSE TO IMMUNOTHERAPY IN PATIENTS WITH ALLERGIC RHINITIS AT A REFERENCE CENTER IN SOUTHERN BRAZIL

Administrador — Tue, 05 Sep 2023 17:01:15 +0000

Allergic rhinitis (AR) is a worldwide public health problem as it affects the quality of life of patients. There is great concern with its correct diagnosis, as well as with the development of suitable instruments for its monitoring. The use of apps on smartphones and tablets has had a profound impact on medicine. A natural trend of modern medicine is to empower patients, while encouraging and educating them so that they are able to better understand and treat their condition. This is an original study aimed at the development of a specific application to monitor the clinical response to immunotherapy in patients with allergic rhinitis. Based on studies already validated in the literature, such as the ISAAC and ARIA questionnaires, three questionnaires were included in the developed application with simple and accessible questions for patients. Through the data collected by the application, stratification will be possible regarding allergic and non-allergic symptoms, age group at the onset of the disease, triggering factors for AR, environmental context, comorbidities, in addition to factors related to the use of immunotherapy, frequency of use, adverse events, and need for rescue medication.

ASSESSMENT OF NASAL IRRIGATION WITH XYLITOL IN THE POSTOPERATIVE ENDOSCOPIC SURGERIES OF PARANASAL SINUSES

Administrador — Tue, 05 Sep 2023 17:00:08 +0000

Chronic rhinosinusitis is a condition of nasal inflammation that requires multifactorial treatment, including surgery, with indication of nasal irrigation to reduce nasal symptoms. Xylitol can be associated with nasal irrigation due to its therapeutic effect. Our study aims to assess the relationship between the effects of nasal irrigation with saline solution compared to xylitol through clinical questionnaires (visual analogue scale, NOSE and SNOT-22). Fifty-two patients, divided into two groups (26 in the “Xylitol” group and 26 in the “Saline” group) answered validated questionnaires in Portuguese about their nasal symptoms (nasal obstruction, runny nose, need to blow out sneezes, among others), and general symptoms, before and after endoscopic endonasal surgery, after a period of 30 days of nasal irrigation. The “Xylitol” group showed significant improvement in pain symptoms and nasal symptoms after surgery and irrigation using a xylitol solution. The “Saline” group also showed improvement in symptoms, but to a lesser extent. Our study suggests that xylitol solutions can be used in the postoperative period of endoscopic endonasal surgery, as it leads to a greater reduction in nasal symptoms without incurring higher costs to patients.

STUDY OF THE HEIGHT MEASUREMENT OF THE SUPERIOR NASAL CONCHA IN RELATION TO THE SKULL BASE IN PATIENTS WHO UNDERWENT ENDOSCOPIC NASAL SURGERY AT IPO HOSPITAL

Administrador — Tue, 05 Sep 2023 16:58:57 +0000

The nasal conchae are able to increase the volume of the nasal mucosa and regulate the respiratory flow. In embryology, while the inferior turbinate is a separate structure, the middle, superior, and supreme turbinates originate from the uppermost portion of the septum. In surgical access to the posterior sinuses, especially the sphenoid sinus, and in the access to the skull base, the identification of the superior turbinate is very important, as this structure is connected superiorly to the skull base and is in front of the anterior wall of the sphenoid sinus. Based on this premise, in this study we investigated the measurement of the height of the superior nasal concha in relation to the skull base, in the intraoperative period and CT scans of facial sinuses, in 20 patients who underwent endoscopic nasal surgery at the IPO Hospital. Then, we averaged and compared those data. We concluded that tomographic measurements do not adequately predict intraoperative measurements. Therefore, we must consider the mean intraoperative measurement of the height of the superior nasal concha in relation to the skull base as an important parameter in order to avoid complications during the surgical procedure — an unprecedented data in the medical literature to date.

ANALYSIS OF THE EFFECT OF ARNICA MONTANA ON EDEMA AND ECCHYMOSIS IN RHINOPLASTY

Administrador — Tue, 05 Sep 2023 16:57:44 +0000

Introduction: Edema and ecchymosis are the two most common complications that occur in the immediate postoperative period after rhinoplasties. Arnica montana is a homeopathic medicine used in wound healing and to improve edema and ecchymosis. The purpose of this study is to compare the benefit of Arnica montana used topically with the oral route after rhinoplasty. Methods: In this clinical trial, study subjects were divided into three groups. The first group received topical Arnica montana gel, the second group received it orally, and the third was the control group. Patients had photographs taken to analyze the edema and ecchymosis on the 1st and 7th postoperative days. The photographs were analyzed by two peer reviewers, who classified the edema and ecchymosis in degrees. Results: The mean age was 27.08 years, ranging from 16 to 53 years old. Female individuals predominated. For the two variables analyzed (edema and ecchymosis), results indicate there is no significant difference between the groups at both assessment times. Conclusion: In our prospective study, we found no significant differences between patients who underwent rhinoplasty who received the perioperative homeopathic medicine Arnica montana orally and topically from those in the control group.

MAIN RISK FACTORS FOR THE TREATMENT OF EPISTAXIS AT IPO HOSPITAL SURGICAL CENTER

Administrador — Tue, 05 Sep 2023 16:56:13 +0000

Introduction: Epistaxis is considered one of the main emergencies within the specialty of otorhinolaryngology. It is estimated that 60% of the population has gone through or will go through at least 1 episode of epistaxis during their lifetime. Only 6%, however, require medical intervention. Still, in some cases the severity is such that patients require emergency intervention at risk of death. Objectives: Evaluate the main risk factors and identify the epidemiological profile – age, sex, comorbidities of patients with epistaxis who have required intervention in a surgical center. Methodology: This is a retrospective analytical study with a quantitative approach of patients treated in the emergency department of IPO Hospital, who required surgical intervention between January 1, 2020 and December 31, 2020. Results: A total of 58 medical records were reviewed according to inclusion and exclusion criteria, with 38 male patients (65.5%) and 20 female patients (34.5%). The age group of patients ranged from 10 to 88 years, the most prevalent being from 21 to 30 years, 22.4%. The predisposing factors were: recent nasal surgery (74.1%), systemic arterial hypertension (13.7%), coagulopathies (1.7%). The main procedures were: cauterization of the precise bleeding site (84.4%), cauterization of the sphenopalatine artery (10.3%) and cauterization of the anterior ethmoidal artery (5.3%). Conclusion: The main predisposing factors associated with epistaxis were nasal surgeries, systemic arterial hypertension and coagulopathies. Early intervention in a surgical center is indicated for patients with severe epistaxis and predisposing factors, while avoiding prolonged hospitalization and morbidities associated with nasal packing.

TOMOGRAPHIC STUDY OF THE MEAN DISTANCE BETWEEN THE ANTERIOR ETHMOIDAL ARTERY AND THE MIDDLE TURBINATE AXILLA FOR GUIDANCE IN ENDONASAL SURGERIES

Administrador — Tue, 05 Sep 2023 14:51:45 +0000

The anatomical knowledge of structures such as vessels, nerves and the skull base is essential for endonasal surgeries to be performed safely. The anterior ethmoidal artery is an important anatomical landmark that has three segments: intraorbital, intranasal and intracranial. Inadvertent injuries to this structure may evolve to blindness and cerebrospinal fluid fistula. This study aims to provide the mean distance between the anterior ethmoidal artery and the middle turbinate axilla, through the analysis of the coronal section of 66 CT scans of facial sinuses in patients over 18 years of age undergoing endonasal surgery at IPO Hospital. Thirty-eight patients were male (57.57%) and 28 were female (42.42%). The mean age for males was 37 years; for females it was 38.1 years. The mean distance for males was 23.9 mm on the right side and 24.0 mm on the left side. For females, the mean was 22.7 mm on the right side and 23.9 mm on the left side. We concluded that the tomographic measurement of the anterior ethmoidal artery to the middle turbinate axilla is easy to obtain preoperatively, and it contributes for endonasal surgeries to be performed safely.