RESUMO
OBJECTIVE: To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017. METHODS: Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed. RESULTS: Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (nâ¯=â¯3), infectious diseases (non-granulomatous nâ¯=â¯220; granulomatous nâ¯=â¯155), autoimmune diseases (nâ¯=â¯24), neoplasms (benign nâ¯=â¯13; malignant, nâ¯=â¯103), and unclassified epithelial/soft tissue diseases (nâ¯=â¯102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months. CONCLUSIONS: Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies. LEVEL OF EVIDENCE: Level 3.
Assuntos
Doenças da Boca , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Doenças da Boca/epidemiologia , Adulto Jovem , Adolescente , Criança , Idoso , Prevalência , Pré-Escolar , Mucosa Bucal/patologia , Brasil/epidemiologia , Lactente , Idoso de 80 Anos ou mais , Doenças Faríngeas/epidemiologia , Estudos RetrospectivosRESUMO
Abstract Objective To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017. Methods Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed. Results Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (n = 3), infectious diseases (non-granulomatous n = 220; granulomatous n = 155), autoimmune diseases (n = 24), neoplasms (benign n = 13; malignant, n = 103), and unclassified epithelial/soft tissue diseases (n = 102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months. Conclusions Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies. Level of evidence: Level 3.
RESUMO
Introdução: A miíase é uma afecção produzida pela infestação de larvas de moscas em pele e outros tecidos, sendo mais frequente nos países subdesenvolvidos e tropicais. Além disso, quando diagnosticada e tratada tardiamente pode levar o paciente a óbito. Objetivo: Há várias formas de tratamento descritas e a escolha da terapia varia a cada caso, segundo o número de larvas e o tecido envolvido. O intuito deste trabalho é relatar dois casos clínicos de miíase envolvendo a região maxilofacial, demonstrando a eficiência e a segurança da terapia escolhida. Relato de caso: Dois pacientes foram tratados através da remoção mecânica das larvas com auxílio de pinça e administração, por via oral, de antiparasitário (Ivermectina 12mg, dose única). Observou-se uma redução total de larvas nas feridas sem nenhuma intercorrência significativa. Conclusão: A remoção mecânica das larvas associada com Ivermectina em dose única é uma opção viável para o tratamento de miíase na região maxilofacial.
Introduction: Myiasis is a condition caused by infestation of fly larvae on skin and other tissues, being more frequent in underdeveloped and tropical countries. In addition, when diagnosed and treated late, it can lead to death. Objective: there are several forms of treatment described, the choice of therapy varies according to the number of larvae, and the tissue involved. The purpose of this paper is to report two clinical cases of myiasis involving the maxillofacial region, demonstrating the efficiency and safety of the therapy chosen. Case report: Two patients were treated by mechanical removal of the larvae using clamp and oral administration of antiparasitic (Ivermectin 12mg, single dose). A total reduction of worm larvae was observed with no significant intercurrence. Conclusion: The mechanical removal of larvae associated with single dose Ivermectin is a viable option for the treatment of myiasis in the maxillofacial region.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Parasitologia , Cirurgia Bucal , Ivermectina , Cirurgiões Bucomaxilofaciais , MiíaseRESUMO
INTRODUCTION: Laryngeal tuberculosis (LTB) is the most frequent granulomatous disease of the larynx and represents less than 2% of extrapulmonary TB cases. There are no pathognomonic clinical and endoscopic features of this disease and studies on LTB that can assist in its diagnostic characterization are lacking. OBJECTIVE: To identify factors associated with clinical and topographical features of LTB. METHOD: a retrospective cross-sectional study was conducted from the medical records of 36 patients with confirmed LTB diagnosis. RESULTS: Dysphonia and cough were the main symptoms presented by patients and the true vocal folds the most frequently affected site. The average of the duration of the disease evolution was significantly higher in patients with dysphonia than in patients without this symptom. We observed association between dysphonia and true vocal fold lesions and between odynophagia and lesions in the epiglottis, arytenoids and aryepiglottic folds. Odynophagia was more frequent in individuals with lesions in four or more laryngeal sites. Weight loss equal or above 10% of the body weight was more frequent in patients with odynophagia as first symptom and in patients with ulcerated lesion. Dyspnea on exertion was more frequent in individuals with more extensive laryngeal lesions. The percentage of smokers with lesions in four or more laryngeal sites was greater than that found in non-smokers. Laryngeal tissue fragment bacilloscopy and culture examinations were less positive than sputum ones. CONCLUSIONS: Smoking appears to be associated with the development of more extensive LTB lesions, and LTB with dyspnea on exertion and odynophagia with consequent impairment of nutritional status. We emphasize the need for histopathologic confirmation, once positive sputum bacteriological examinations seem not to necessarily reflect laryngeal involvement.