RESUMO
OBJECTIVE: Primary objective of this study was to find a statistical link between the most worldwide comorbidities affecting the elderly population (hypertension, diabetes, osteoarthrosis, osteoporosis and depression) and recurrent episodes of BPPV. Secondary objective was defining possible "groups of risk" for people suffering recurrent positional vertigo related to the presence of a well documented comorbidity. METHODS: This was an observational, cross-sectional, multicenter, spontaneous, non-pharmacological study. The data of 1092 patients suffering BPPV evaluated in 11 different Departments of Otolaryngology, Otoneurology and Neurology, referring Centers for positional vertigo evaluation, were retrospectively collected. RESULTS: Regarding evaluated comorbidities (hypertension, diabetes, osteoarthrosis, osteoporosis and depression), data analysis showed the presence of at least one comorbid disorder in 216 subjects (19.8%) and 2 or more in 408 subjects (37.4%). Moreover there was a statistical significant difference between the number of comorbidities and the number of recurrences, otherwise said as comorbidity disorders increased the number of relapses increased too. CONCLUSION: The presence of a systemic disease may worsen the status of the posterior labyrinth causing a more frequent otolith detachment. This condition increases the risk for patients suffering BPPV to have recurrent episodes, even if correctly managed by repositioning maneuvers. The combination of two or more of aforementioned comorbidities further increases the risk of relapsing BPPV, worsened by the presence of osteoporosis. On the basis of this results it was possible to define "groups of risk" useful for predicting BPPV recurrence in patients with one or more comorbidity.
Assuntos
Vertigem/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Vertigem Posicional Paroxística Benigna , Comorbidade , Estudos Transversais , Transtorno Depressivo/epidemiologia , Diabetes Mellitus/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Osteoartrite/epidemiologia , Osteoporose/epidemiologia , Recidiva , Estudos Retrospectivos , Fatores de Risco , Canais Semicirculares/fisiopatologia , América do Sul/epidemiologia , Vertigem/fisiopatologiaRESUMO
UNLABELLED: Primary malignant lymphomas in the salivary glands are relatively rare. Clinical presentation is not characteristic and the disease is often overlooked resulting in diagnosis and treatment delays. AIM: To stress the importance of the diagnostic process and combined management, we present a series of eight patients with malignant lymphoma of the parotid who were diagnosed only after surgery and managed with radiation and chemotherapy. METHODS: Retrospective series of patients with primary malignant lymphoma of the parotid gland managed with radiotherapy and diagnostic surgical partial resection. RESULTS: After treatment completion we achieved a loco-regional control rate of 87.5%. Toxicity was charted according to the Common Toxicity Criteria and it was seen in six patients (75%). Six patients are still alive without evidence of recurrent disease in their last follow-up. CONCLUSION: Our study confirms that primary early stage Non-Hodgkin Lymphoma of the parotid gland is a disease with an excellent prognosis and a good local control rate, with minimal morbidity.
Assuntos
Linfoma não Hodgkin/terapia , Neoplasias Parotídeas/terapia , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada/métodos , Feminino , Humanos , Linfoma não Hodgkin/diagnóstico , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/diagnóstico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Primary malignant lymphomas in the salivary glands are relatively rare. Clinical presentation is not characteristic and the disease is often overlooked resulting in diagnosis and treatment delays. AIM: To stress the importance of the diagnostic process and combined management, we present a series of eight patients with malignant lymphoma of the parotid who were diagnosed only after surgery and managed with radiation and chemotherapy. METHODS: Retrospective series of patients with primary malignant lymphoma of the parotid gland managed with radiotherapy and diagnostic surgical partial resection. RESULTS: After treatment completion we achieved a loco-regional control rate of 87.5 percent. Toxicity was charted according to the Common Toxicity Criteria and it was seen in six patients (75 percent). Six patients are still alive without evidence of recurrent disease in their last follow-up. CONCLUSION: Our study confirms that primary early stage Non-Hodgkin Lymphoma of the parotid gland is a disease with an excellent prognosis and a good local control rate, with minimal morbidity.
Linfomas primários das glândulas salivares são relativamente raros. Sua apresentação clínica não écaracterística e, frequentemente, a doença passa despercebida, resultando em atrasos no diagnóstico e tratamento. OBJETIVO: Enfatizar a importância do diagnóstico e tratamento combinado. Apresentamos uma casuística de oito pacientes com linfoma maligno da parótida, que foram diagnosticados somente após a cirurgia e tratados com radio e quimioterapia. MÉTODOS: Estudo retrospectivo de pacientes com linfoma maligno primário da glândula parótida, tratados com radioterapia e ressecção cirúrgica parcial diagnóstica. RESULTADOS: Após a conclusão do tratamento, atingimos uma taxa de controle loco-regional de 87,5 por cento. A toxicidade foi classificada de acordo com os Critérios Comuns de Toxicidade e afetou seis pacientes (75 por cento). Seis pacientes ainda estão vivos, sem evidência de doença na mais recente consulta de acompanhamento. CONCLUSÃO: Nosso estudo confirma que o Linfoma primário Não-Hodgkin em estágios iniciais da glândula parótida é uma doença com excelente prognóstico e boa taxa de controle local, com mínima morbidade.