RESUMO
A randomized, prospective trial was carried out to compare the rate of hemorrhagic complications after removal of nasal packing left for 24 and 48 hours. A total of 104 patients underwent nasal surgery and were randomly assigned to 1 of 2 groups: group 1, 24 hours of nasal packing; group 2, 48 hours of nasal packing. No statistical difference was observed between the groups in terms of occurrence of hemorrhagic complications. Hypertension was the only prognostic factor for postoperative bleeding. The routine use of 48-hour postoperative nasal packing after nasal surgery is not justified because of the low incidence of bleeding and the potential associated morbidity. At the end of the procedure, surgeons should evaluate the risk of postoperative bleeding (ie, presence of hypertension) and decide whether 24-hour nasal packing is enough.
Assuntos
Septo Nasal/cirurgia , Doenças Nasais/terapia , Hemorragia Pós-Operatória/terapia , Rinoplastia/métodos , Tampões Cirúrgicos , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
To call attention to complications of chronic otitis media, the case of a patient who simultaneously developed lateral sinus thrombosis and Bezold's abscess is reported. A 7 year old boy presented with fever, drowsiness, cervical mass and otorrhea not responding to medical management. Work-up revealed lateral sinus thrombosis and cervical abscess secondary to right ear cholesteatoma. After treatment with surgery and antibiotics, he had a favorable outcome. We review the literature regarding the diagnosis and management of these complications and concluded that although less frequent they remain a clinical challenge.
Assuntos
Abscesso/etiologia , Colesteatoma da Orelha Média/complicações , Otite Média com Derrame/complicações , Trombose dos Seios Intracranianos/complicações , Abscesso/diagnóstico por imagem , Abscesso/terapia , Antibacterianos/uso terapêutico , Otorreia de Líquido Cefalorraquidiano/etiologia , Criança , Colesteatoma da Orelha Média/cirurgia , Humanos , Masculino , Otite Média com Derrame/tratamento farmacológico , Faringe/diagnóstico por imagem , Faringe/cirurgia , Trombose dos Seios Intracranianos/cirurgia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To focus on two rare complications of cholesteatomatous chronic otitis media. METHODS: A case of two simultaneous complications of cholesteatoma (lateral sinus thrombophlebitis and Bezold's cervical abscess) in a 7 year-old boy is reported. Thereafter, a review of the international literature about both complications is carried out. RESULTS: A 7 year-old white male patient was referred for assessment with high fever, obnubilation, cervical mass and otorrhea, being non-responsive to the clinic treatment, with the diagnostic hypothesis of infectious parotitis. The clinical examination and radiologic study demonstrated lateral sinus thrombophlebitis and cervical abscess due to cholesteatoma in the right ear. After being submitted to surgery and prolonged intravenous antibiotic therapy, the patient presented a favorable outcome, with little morbidity. CONCLUSION: Despite the incidence of complications of otitis had decreased in the last decades, they are still a challenge for the clinician, especially because of the insidious manner of presentation, usually hidden with the indiscriminate use of antibiotics.
RESUMO
The authors report the case of a female newborn infant, who had seizures and vesicles at the nose and inferior lip since the fifth day of life. CSF changes suggested an encephalitis. Signs of neurologic and respiratory deterioration were followed by death. Partial cranial autopsy showed a necrohemorrhagic temporal encephalitis without intranuclear inclusions. Immunohistochemical examination by the avidin-biotin-peroxidase technique with polyclonal antibodies against Herpes simplex type 1 and type 2 was positive to type 2 Herpes simplex virus.