RESUMO
UNLABELLED: Facial paralysis can result from a variety of etiologies; the most common is the idiopathic type. Evaluation and treatment are particularly complex. The treatment of acute facial paralysis may require facial nerve decompression surgery. Any structure near the path of the facial nerve is at risk during transmastoid decompression surgery. AIM: This is a retrospective study, carried out in order to evaluate hearing loss after transmastoid decompression and how idiopathic cases evolved in terms of their degree of paralysis in the last 15 years. MATERIALS AND METHODS: We selected the charts from 33 patients submitted to transmastoid facial nerve decompression in the past 15 years and we assessed their hearing loss and facial paralysis. RESULTS: There was a high percentage (61%) of patients with some degree of hearing loss after the procedure and in all cases there was improvement in the paralysis. DISCUSSION: The values obtained are similar to those reported in the literature. One possible explanation for this hearing loss is the vibration transmission by drilling near the ossicular chain. CONCLUSION: The surgical procedure is not risk free; indications, risks and benefits should be explained to patients through an informed consent form.
Assuntos
Descompressão Cirúrgica/efeitos adversos , Paralisia Facial/cirurgia , Perda Auditiva Neurossensorial/etiologia , Doença Aguda , Adolescente , Adulto , Idoso , Criança , Doenças do Nervo Facial/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto JovemRESUMO
A paralisia facial pode resultar de uma variedade de etiologias, sendo a mais comum a idiopática. A avaliação e o tratamento são particularmente complexos. O tratamento da paralisia facial aguda pode envolver cirurgia de descompressão do nervo facial. Qualquer estrutura perto do trajeto do nervo facial está em risco durante a cirurgia de descompressão via transmastoidea. OBJETIVO: Estudo retrospectivo que irá avaliar a perda auditiva após descompressão via transmastoidea e a evolução do grau de paralisia nos casos idiopáticos dos últimos 15 anos. MATERIAL E MÉTODO: Foram selecionados prontuários de 33 pacientes submetidos à descompressão do nervo facial via transmastoidea nos últimos 15 anos e avaliou-se a perda auditiva e a paralisia facial. RESULTADOS: Observou-se alta porcentagem (61%) dos pacientes com algum grau de perda auditiva após o procedimento e, em todos os casos, houve melhora da paralisia. CONCLUSÃO: O procedimento cirúrgico não é isento de riscos. Indicações, riscos e benefícios devem ser esclarecidos aos pacientes por meio de consentimento informado.
Facial paralysis can result from a variety of etiologies; the most common is the idiopathic type. Evaluation and treatment are particularly complex. The treatment of acute facial paralysis may require facial nerve decompression surgery. Any structure near the path of the facial nerve is at risk during transmastoid decompression surgery. AIM: This is a retrospective study, carried out in order to evaluate hearing loss after transmastoid decompression and how idiopathic cases evolved in terms of their degree of paralysis in the last 15 years. MATERIALS AND METHODS: We selected the charts from 33 patients submitted to transmastoid facial nerve decompression in the past 15 years and we assessed their hearing loss and facial paralysis. RESULTS: There was a high percentage (61%) of patients with some degree of hearing loss after the procedure and in all cases there was improvement in the paralysis. DISCUSSION: The values obtained are similar to those reported in the literature. One possible explanation for this hearing loss is the vibration transmission by drilling near the ossicular chain. CONCLUSION: The surgical procedure is not risk free; indications, risks and benefits should be explained to patients through an informed consent form.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Descompressão Cirúrgica/efeitos adversos , Paralisia Facial/cirurgia , Perda Auditiva Neurossensorial/etiologia , Doença Aguda , Doenças do Nervo Facial/cirurgia , Estudos Retrospectivos , Índice de Gravidade de DoençaRESUMO
CONTEXT AND OBJECTIVE: Iron deficiency anemia is an important public health problem in Brazil. In the municipality of Embu, a population study in 1996 found anemia prevalence of 68.5% among children aged one to two years. From these data, prescription of prophylactic ferrous sulfate was instituted in 1998 for children under two years old followed up within the children's healthcare program. After five years of intervention, the prevalence of anemia and associated factors were investigated among children aged 12 to 18 months to whom guidance for prophylactic ferrous sulfate use had been given. DESIGN AND SETTING: Cross-sectional study covering October 2003 to June 2004 at a primary healthcare unit in Embu. METHODS: A randomized sample of children aged 12 to 18 months to whom guidance for prophylactic ferrous sulfate use had been given was obtained. Hemoglobin was measured in capillary blood, using HemoCue apparatus. Hemoglobin < 11 g/100 dl was taken to indicate anemia. RESULTS: The sample comprised 118 children and anemia was found in 41.5%. There was no statistically significant association between anemia presence and the variables of sex, birth weight, neonatal intercurrences, chronic diseases, breastfeeding or iron supplementation use. There was a statistically significant association (p = 0.03) between anemia presence and per capita income, such that the higher the income was, the lower the prevalence of anemia was. CONCLUSION: The prophylaxis program against iron deficiency anemia did not achieve the expected results. New strategies must be considered in the light of the magnitude of the problem.
Assuntos
Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/epidemiologia , Compostos Ferrosos/uso terapêutico , Hematínicos/uso terapêutico , Peso ao Nascer , Estatura , Brasil/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Hemoglobinas/análise , Humanos , Lactente , Masculino , Adesão à Medicação , Prevalência , Atenção Primária à Saúde , Fatores de Risco , Fatores SocioeconômicosRESUMO
CONTEXT AND OBJECTIVE: Iron deficiency anemia is an important public health problem in Brazil. In the municipality of Embu, a population study in 1996 found anemia prevalence of 68.5 percent among children aged one to two years. From these data, prescription of prophylactic ferrous sulfate was instituted in 1998 for children under two years old followed up within the children's healthcare program. After five years of intervention, the prevalence of anemia and associated factors were investigated among children aged 12 to 18 months to whom guidance for prophylactic ferrous sulfate use had been given. DESIGN AND SETTING: Cross-sectional study covering October 2003 to June 2004 at a primary healthcare unit in Embu. METHODS: A randomized sample of children aged 12 to 18 months to whom guidance for prophylactic ferrous sulfate use had been given was obtained. Hemoglobin was measured in capillary blood, using HemoCue® apparatus. Hemoglobin < 11 g/100 dl was taken to indicate anemia. RESULTS: The sample comprised 118 children and anemia was found in 41.5 percent. There was no statistically significant association between anemia presence and the variables of sex, birth weight, neonatal intercurrences, chronic diseases, breastfeeding or iron supplementation use. There was a statistically significant association (p = 0.03) between anemia presence and per capita income, such that the higher the income was, the lower the prevalence of anemia was. CONCLUSION: The prophylaxis program against iron deficiency anemia did not achieve the expected results. New strategies must be considered in the light of the magnitude of the problem.
CONTEXTO E OBJETIVO: A anemia ferropriva é um importante problema de saúde pública no Brasil. No município de Embu, estudo populacional realizado em 1996 verificou prevalência de anemia de 68,5 por cento em crianças de um a dois anos. A partir desses resultados, o uso de sulfato ferroso profilático foi introduzido em 1998 no Programa de Saúde da Criança para as crianças a partir do desmame até os dois anos de idade. Após cinco anos de intervenção, avaliou-se a prevalência de anemia e os fatores associados, em crianças de 12 a 18 meses de idade que receberam orientação para uso profilático de sulfato ferroso. TIPO DE ESTUDO E LOCAL: Estudo transversal analítico realizado no período de 10/2003 a 06/2004 em Unidade Básica de Saúde, Embu. MÉTODO: Amostra aleatória de crianças entre 12 a 18 meses que receberam orientação do uso de ferro profilático. Mensuração de hemoglobina em sangue capilar através do aparelho portátil HemoCue®. Hemoglobina < 11 g/100 dl foi considerada anemia. RESULTADOS: A amostra foi composta por 118 crianças. A prevalência de anemia foi de 41,5 por cento. Não foi observada associação estatisticamente significativa entre a anemia e as variáveis: sexo, peso ao nascer, intercorrências neonatais, doenças crônicas, internação anterior, aleitamento materno, uso de suplementação de ferro, estado nutricional. Verificou-se associação estatisticamente significante (p = 0,03) entre a presença de anemia e renda per capita, em que a maior renda associou-se a menor prevalência de anemia. CONCLUSÃO: O programa de profilaxia da anemia ferropriva não alcançou os resultados esperados. Novas estratégias devem ser consideradas frente à magnitude do problema.