RESUMO
O neuroblastoma olfatório, também conhecido como estesioneuroblastoma (ENB), é tumor maligno de crescimento lento, com origem principalmente na neuroectoderme da cavidade nasal. O pico de incidência do ENB é aos 53 anos, com a maioria dos casos ocorrendo entre os 40 e 70 anos, principalmente em homens. Há poucos relatos de ENB nos seios etmoidal, maxilar e esfenoidal, hipófise e nasofaringe. Esse tumor geralmenteapresenta-se como doença invasiva e tendência a recorrer tardiamente. A disseminação mais frequente do ENB é para os linfonodos cervicais e, se presente, significa pior prognóstico. Seus sintomas são inespecíficos, sendo a obstrução nasal o mais comum. Os exames de imagem são importantes no diagnóstico do ENB, juntamente com o histopatológico e o imuno-histoquímico, que também auxiliam no diagnóstico diferencial. O tratamento cirúrgico de ressecção craniofacial associado à radioterapia apresenta os melhores resultados na sobrevida. Descreve-se seguidamente um caso clínico ilustrativo dessa doença em paciente masculino de oito meses, faixa etária incomum da ENB, com queixa familiar inicial de obstrução nasal e coriza hialina com rajas de sangue...
Olfactory neuroblastoma, also known as esthesioneuroblastoma (ENB), is a slow-growing malignant tumor of that originates mainly in the neuroectodermal cells in the nasal cavity. The peak incidence of ENB is at age 53, with the majority of cases occurring between 40 and 70 years, and mostly among men. There are a few reports of ENB in the ethmoid, maxillary, and sphenoid sinuses, or in the pituitary and nasopharynx. This tumor usually presents as an invasive disease with a tendency for later recurrence. The most frequent dissemination of ENB is to the cervical lymph nodes, which represents a worse prognosis. Its symptoms are nonspecific and nasal obstruction is the most common complaint. Imaging tests are important for the diagnosis of ENB, along with histopathological and immunohistochemical tests to help in the differential diagnosis. Surgical treatment of craniofacial resection associated with radiotherapycan achieve the best results for survival. We present a discussion of an illustrative clinical case of the disease in a male patient aged eight months, an unusual age for ENB, brought to attention by an initial family complaint of nasal obstruction and bloodstained hyaline rhinorrhea...
Assuntos
Humanos , Masculino , Lactente , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/epidemiologiaRESUMO
UNLABELLED: Rhinoplasty is one of the most challenging surgical procedures, due both to the diversity of the techniques and to the difficulty in foreseeing long-term outcomes. Each patient has a different nasal anatomy, dictated by genetic inheritance--race, thus requiring a different technique for each case. The international literature emphasizes the techniques used for the Caucasian nose, which is rarely seen in our region. AIM: Evaluate and discuss surgical maneuvers used on rhinoplasty procedures performed on local patients at our ENT residency services. MATERIALS AND METHODS: We evaluated the operative notes from all patients submitted to rhinoplasty at the Residency Program on Otorhinolaryngology at the Federal University of Uberlândia, from December 2003 to June 2004. RESULTS: One hundred and sixty-six patients were submitted to rhinoplasty, in which marginal incisions were performed in 118 (71.1%), with the delivery technique performed on the inferior lateral cartilages and some procedures carried out on them (strut, sheen, sutures, etc). Only 45 patients (27.1%) were submitted to basic rhinoplasty and 3 (1.8%) to open rhinoplasty. CONCLUSION: Most of our patients demanded additional procedures, and the "basic rhinoplasty", commonly performed on the Caucasian nose was an exception on our patients.
Assuntos
Nariz/anatomia & histologia , Rinoplastia/métodos , Cartilagem/transplante , Humanos , Internato e Residência , Osso Nasal/anatomia & histologia , Osso Nasal/cirurgia , Nariz/cirurgia , Osteotomia , Estudos RetrospectivosRESUMO
Na ritidoplastia clássica, o centro médio da face melhora pouco. A correção estética da ptose da proeminência malar, do acentuado sulco nasolabial e da linha do jaw, em grande parte dos casos, requer um acesso diferente, adotando a técnica de ritidoplastia subperiosteal. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de ritidoplastia subperiosteal no nosso serviço. PACIENTES E MÉTODOS: De janeiro de 2001 a dezembro de 2005, 25 pacientes, entre 44 e 60 anos de idade, 24 do sexo feminino, foram submetidos à ritidoplastia subperiosteal. Retrospectivamente foram avaliados resultados e complicações. RESULTADOS: Destes, 20 apresentaram resultados satisfatórios, 4 apresentaram déficit estético notado tanto pelo paciente quanto pelo cirurgião e 1 apresentou déficit estético necessitando cirurgia revisional. Todos os pacientes apresentaram melhora do sulco nasolabial, eminência malar e melhor definição da linha do jaw. A cirurgia revisional foi necessária em um paciente que referia pouca melhora. Quatro pacientes apresentaram uma retração de pele na região malar em decorrência das suturas de suspensão. Um paciente apresentou paralisia transitória do ramo frontal do nervo facial. CONCLUSÃO: A ritidoplastia subperiosteal com acesso temporal se mostrou uma técnica que produz resultados satisfatórios na grande maioria dos casos.
In classic rhytidectomy, there is little improvement in the center portion of the face. Aesthetic correction of malar prominence ptosis, accentuated nasolabial line, and jawl line, in most of the cases, require different approaches, such as the subperiosteal facelift. AIM: to show the cases and to evaluate the results and complications of subperiosteal facelift in the our service. PATIENTS AND METHODS: From January of 2001 to December of 2005, 25 patients, ranging from 44 to 60 years, 24 females, were submitted to subperiosteal facelift. Results and complications were retrospectively appraised. RESULTS: Of these, 20 presented satisfactory results, 4 presented aesthetic deficits noticed both by the patients and by the surgeon, and 1 presented aesthetic deficit needing revision surgery. All the patients presented improvement of nasolabial line, malar prominence and better definition of the jawl line. Revision surgery was necessary in one patient that referred little improvement. Four patients presented skin retraction in malar area due to the suspension sutures. A patient presented transitory paralysis of the front branch of the facial nerve. CONCLUSION: Subperiosteal facelift with temporal access has shown satisfactory results in the great majority of the cases.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Ritidoplastia/métodos , Estudos Retrospectivos , Ritidoplastia/efeitos adversos , Fatores de Tempo , Resultado do TratamentoRESUMO
A rinoplastia é uma das mais desafiadoras cirurgias, seja pela diversidade de técnicas que podem ser utilizadas, seja por seus resultados pouco previsíveis em longo prazo. Cada paciente apresenta uma anatomia nasal diferente, influenciada pela hereditariedade e, portanto, pela raça, requerendo uma cirurgia específica para cada caso. Na literatura internacional predominam dados relativos às técnicas usadas em nariz caucasiano, os quais são raramente encontrados em nossa região. OBJETIVO: Avaliar quais foram as manobras cirúrgicas mais comumente realizadas nas rinoplastias dos pacientes da região, no nosso serviço. MATERIAL E MÉTODO: Foram avaliadas retrospectivamente as fichas operatórias de todos os pacientes submetidos à rinoplastia no Serviço de Residência de Otorrinolaringologia da Universidade Federal de Uberlândia, no período de dezembro de 2003 a junho de 2004. RESULTADOS: Foram operados 166 pacientes, sendo que 118 (71,1 por cento) foram submetidos à incisão marginal com "delivery" das cartilagens laterais inferiores e algum tipo de procedimento sobre elas (poste, escudo cartilaginoso de Sheen, suturas, etc.). Apenas 45 pacientes (27,1 por cento) foram submetidos à "rinoplastia básica" e 3 (1,8 por cento), à rinoplastia aberta. CONCLUSÃO: A maioria dos pacientes necessitou de algum tipo de procedimento adicional, sendo a "rinoplastia básica", realizada freqüentemente no nariz caucasiano, uma exceção aos nossos pacientes.
Rhinoplasty is one of the most challenging surgical procedures, due both to the diversity of the techniques and to the difficulty in foreseeing long-term outcomes. Each patient has a different nasal anatomy, dictated by genetic inheritance - race, thus requiring a different technique for each case. The international literature emphasizes the techniques used for the Caucasian nose, which is rarely seen in our region. AIM: Evaluate and discuss surgical maneuvers used on rhinoplasty procedures performed on local patients at our ENT residency services. MATERIALS AND METHODS: We evaluated the operative notes from all patients submitted to rhinoplasty at the Residency Program on Otorhinolaryngology at the Federal University of Uberlândia, from December 2003 to June 2004. RESULTS: One hundred and sixty-six patients were submitted to rhinoplasty, in which marginal incisions were performed in 118 (71.1 percent), with the delivery technique performed on the inferior lateral cartilages and some procedures carried out on them (strut, sheen, sutures, etc). Only 45 patients (27.1 percent) were submitted to basic rhinoplasty and 3 (1.8 percent) to open rhinoplasty. CONCLUSION: Most of our patients demanded additional procedures, and the "basic rhinoplasty", commonly performed on the Caucasian nose was an exception on our patients.
Assuntos
Humanos , Nariz/anatomia & histologia , Nariz/cirurgia , Rinoplastia/métodos , Cartilagem/transplante , Internato e Residência , Osso Nasal/anatomia & histologia , Osso Nasal/cirurgia , Osteotomia , Estudos RetrospectivosRESUMO
UNLABELLED: In classic rhytidectomy, there is little improvement in the center portion of the face. Aesthetic correction of malar prominence ptosis, accentuated nasolabial line, and jawl line, in most of the cases, require different approaches, such as the subperiosteal facelift. AIM: to show the cases and to evaluate the results and complications of subperiosteal facelift in the our service. PATIENTS AND METHODS: From January of 2001 to December of 2005, 25 patients, ranging from 44 to 60 years, 24 females, were submitted to subperiosteal facelift. Results and complications were retrospectively appraised. RESULTS: Of these, 20 presented satisfactory results, 4 presented aesthetic deficits noticed both by the patients and by the surgeon, and 1 presented aesthetic deficit needing revision surgery. All the patients presented improvement of nasolabial line, malar prominence and better definition of the jawl line. Revision surgery was necessary in one patient that referred little improvement. Four patients presented skin retraction in malar area due to the suspension sutures. A patient presented transitory paralysis of the front branch of the facial nerve. CONCLUSION: Subperiosteal facelift with temporal access has shown satisfactory results in the great majority of the cases.