RESUMO
BACKGROUND: Creating the ideal aesthetic eyebrow shape and position is an important goal in facial rejuvenation. One challenge of an eyebrow lift is to find a predictable procedure that balances the advantages and disadvantages of the available strategies. The gliding brow lifting (GBL) is a technique that provides minimal incisions, an effective and stable eyebrow lift, and offers the advantage of precise reshaping of the eyebrow. METHODS: In a retrospective review, 124 patients, who underwent GBL technique from November 2015 through April 2016, were evaluated. With minimal incisions and tumescent infiltration, the subcutaneous plane of the forehead, eyebrows and temporal face is undermined releasing the skin from the underlying frontalis muscle, orbicularis oculi muscle, corrugator muscle and temporal parietal fascia. Fixation of the repositioned and reshaped eyebrow is achieved with the use of a hemostatic net for temporary cutaneous fixation. RESULTS: The average follow-up period was 17 months. Adequate brow repositioning and/or reshaping was achieved in 118 patients. Six patients had bilateral or unilateral recurrence of ptosis. Of these patients with recurrence, four patients had the same procedure re-performed within 1 month postoperatively with successful repositioning and/or reshaping of their brow. There was no incidence of hematoma, seroma, infection, permanent sensory changes, motor dysfunction, skin flap necrosis or alopecia. CONCLUSION: The "gliding brow lifting" (GBL), which combines subcutaneous frontal undermining with minimal incisions, elevation and reshaping of eyebrow and use of a temporary cutaneous fixation with hemostatic net (Net), allows effective, long-lasting results with low rates of complications and satisfactory results. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Assuntos
Sobrancelhas , Ritidoplastia/métodos , Adulto , Idoso , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ritidoplastia/instrumentaçãoRESUMO
Abstract Introduction Feeding, swallowing and breathing are fundamental activities for the survival and well-being of humans; these functions are performed by themost complex neuromuscular unit of the human body, which, when altered, may raise morbidity and mortality rates. Objective To evaluate deglutition in patients with mental disability in order to determine the incidence and the severity of dysphagia. Methods A total of 189 institutionalized adult patients with mental disability were analyzed using a 3.2 mm flexible fiberscope (Machida, Japan 1995). The following food consistencies were tested: pasty, thickened liquid and liquid. Results Among the total of 189 patients, 101 (53.4%) were female aged between 14 and 55 years old. Most of them 120 (63.5%) had profound mental deficiency, 58 (30.7%) had severe mental deficiency, 9 (4.8%) had moderate mental deficiency, and 2 (1.1%) had mild mental deficiency. Gender and the degree of mental deficiency did not influence significantly the degree of dysphagia. Age, degree of disability and interaction between age groups and degrees of disability influenced significantly the degree of dysphagia. Younger patients are more likely to present more severe dysphagia. Stabilization occurs between 31 and 40 years of age, and above this age, a greater chance of less severe dysphagia, because the increase in the degree of mental deficiency decreases the probability of more severe dysphagia. Conclusion The population that mostly presented severe dysphagia was characterized by being mostly female, with profound mental deficiency, with an average age of 36.7 years. There was no relationship between gender and the degree of mental disability concerning the degree of dysphagia. (AU)
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Transtornos de Deglutição/complicações , Transtornos de Deglutição/diagnóstico por imagem , Endoscopia/métodos , Deficiência Intelectual/complicações , Transtornos de Deglutição/epidemiologia , Modelos Logísticos , Incidência , Estudos Transversais , Endoscópios , Gravidade do PacienteRESUMO
RESUMEN El doble píloro es una comunicación anormal entre el antro gástrico y el bulbo duodenal y representa un raro hallazgo endoscópico. Se presentó un paciente de 80 años de edad, con antecedentes de hipertensión arterial, fumador inveterado, tomador de aspirina, que presentó melena aproximadamente 15 días antes del ingreso. La videoendoscopia reveló la existencia de dos orificios similares en el antro, que se comunicaban con el bulbo duodenal de manera independiente que fueron catalogados como píloros. La comunicación se constató con el paso del endoscopio a su través. Se impuso tratamiento médico con inhibidores de la bomba de protones y la evolución fue favorable. Es el cuarto caso reportado en la literatura en nuestro país y el primero en la provincia de Matanzas.
ABSTRACT Double pylorus is an abnormal communication between the gastric antrum and the duodenal bulb and represents a rare endoscopic finding. It is presented the case of a patient aged 80 years, with a background of arterial hypertension, inveterate smoker, taking aspirin, who presented melena about 15 days before the admission. The video-endoscopy revealed the existence of two similar orifices in the antrum that were independently communicating with the duodenal bulb and they went catalogued like pylori. The communication was proved by passing the endoscope through it. He was treated with IBP (the Spanish acronym for proton bomb inhibitors) and the evolution was favorable. It is the fourth case reported in the literature in Cuba and the first one in Matanzas.
Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Piloro/anormalidades , Piloro/fisiopatologia , Piloro/diagnóstico por imagem , Endoscopia Gastrointestinal/métodos , Divertículo do Colo/diagnóstico por imagem , Úlcera Duodenal/diagnóstico por imagem , Inibidores da Bomba de Prótons/uso terapêutico , Aspirina/uso terapêutico , Melena/diagnóstico , Enema Opaco/métodos , Fumantes , Hipertensão/diagnósticoRESUMO
Introduction Feeding, swallowing and breathing are fundamental activities for the survival and well-being of humans; these functions are performed by the most complex neuromuscular unit of the human body, which, when altered, may raise morbidity and mortality rates. Objective To evaluate deglutition in patients with mental disability in order to determine the incidence and the severity of dysphagia. Methods A total of 189 institutionalized adult patients with mental disability were analyzed using a 3.2 mm flexible fiberscope (Machida, Japan 1995). The following food consistencies were tested: pasty, thickened liquid and liquid. Results Among the total of 189 patients, 101 (53.4%) were female aged between 14 and 55 years old. Most of them 120 (63.5%) had profound mental deficiency, 58 (30.7%) had severe mental deficiency, 9 (4.8%) had moderate mental deficiency, and 2 (1.1%) had mild mental deficiency. Gender and the degree of mental deficiency did not influence significantly the degree of dysphagia. Age, degree of disability and interaction between age groups and degrees of disability influenced significantly the degree of dysphagia. Younger patients are more likely to present more severe dysphagia. Stabilization occurs between 31 and 40 years of age, and above this age, a greater chance of less severe dysphagia, because the increase in the degree of mental deficiency decreases the probability of more severe dysphagia. Conclusion The population that mostly presented severe dysphagia was characterized by being mostly female, with profound mental deficiency, with an average age of 36.7 years. There was no relationship between gender and the degree of mental disability concerning the degree of dysphagia.
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Abstract Introduction Eustachian tube (ET) dysfunction plays an important role not only in the pathophysiology of various middle ear disorders, but also in predicting the outcome of the treatment. As there is no single test that assesses both the anatomic and physiological functions of the ET, a combination of tympanometry and dynamic slow motion video endoscopy may improve the sensitivity of ET function assessment. Objective To find out if there is any correlation between dynamic slow motion nasal video endoscopy and impedance audiometry in assessing ET function in patients with middle ear diseases. Methods Ours was a descriptive study performed with 106 patients attending the Ear, Nose and Throat (ENT) Outpatient Department of a tertiary care center in South India with features suggestive ofmiddle ear disease. All patients underwent impedance audiometry and dynamic slow motion nasal video endoscopy, and were graded based on the severity of the ET pathology. Results A total of 47 out of 97 patients with abnormal endoscopy findings also had abnormal impedance audiometry. The correlation was greater among the patients with higher grades of ET dysfunction. The endoscopy findings of 106 cases, when correlated with middle ear manometry, revealed that 56 cases showed complete agreement, and 50 cases showed disagreement. The nasal endoscopy results, when correlated with middle ear manometry studies by using McNemar's chi-squared (χ2) test, showed a significant association between the 2 tests (p = 0.017). Conclusion There is a significant alteration in middle ear pressure as the severity of the ET tube dysfunction increases. Impedance audiometry and nasal endoscopy provide a better measure of ET function.
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Introduction Eustachian tube (ET) dysfunction plays an important role not only in the pathophysiology of various middle ear disorders, but also in predicting the outcome of the treatment. As there is no single test that assesses both the anatomic and physiological functions of the ET, a combination of tympanometry and dynamic slow motion video endoscopy may improve the sensitivity of ET function assessment. Objective To find out if there is any correlation between dynamic slow motion nasal video endoscopy and impedance audiometry in assessing ET function in patients with middle ear diseases. Methods Ours was a descriptive study performed with 106 patients attending the Ear, Nose and Throat (ENT) Outpatient Department of a tertiary care center in South India with features suggestive of middle ear disease. All patients underwent impedance audiometry and dynamic slow motion nasal video endoscopy, and were graded based on the severity of the ET pathology. Results A total of 47 out of 97 patients with abnormal endoscopy findings also had abnormal impedance audiometry. The correlation was greater among the patients with higher grades of ET dysfunction. The endoscopy findings of 106 cases, when correlated with middle ear manometry, revealed that 56 cases showed complete agreement, and 50 cases showed disagreement. The nasal endoscopy results, when correlated with middle ear manometry studies by using McNemar's chi-squared (χ 2 ) test, showed a significant association between the 2 tests ( p = 0.017). Conclusion There is a significant alteration in middle ear pressure as the severity of the ET tube dysfunction increases. Impedance audiometry and nasal endoscopy provide a better measure of ET function.
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INTRODUÇÃO: A videoendoscopia tem se estabelecido como procedimento de escolha no tratamento da ptose do supercílio e das rugas da região frontal. O acesso minimamente invasivo produz vantagens em relação à tradicional incisão coronal. Diversos métodos de fixação são relatados na literatura, apresentando resultados semelhantes. Nesta série de casos, descrevemos a fixação direta com agulha. OBJETIVO: Avaliar o prognóstico da videocirurgia, utilizando-se a técnica direta com agulha. MÉTODO: Avaliação fotográfica computadorizada de 37 pacientes submetidos à videoendoscopia da região frontal com a fixação direta com agulha, realizada em dois hospitais privados na cidade de Porto Alegre-RS. Resultados: A elevação média do supercílio foi de 5,7 mm no terço lateral e de 4,4 mm no terço medial. Após um pequeno descenso da elevação, no primeiro mês pós-operatório, o reposicionamento do supercílio permaneceu inalterado nas medidas subsequentes até 24 meses. CONCLUSÃO: A fixação direta com agulha é capaz de produzir resultados duráveis, seguros e reprodutíveis no período em que foram realizadas as medições.
INTRODUCTION: Video endoscopy has become a procedure of choice for the treatment of eyebrow ptosis and forehead wrinkles. This minimally invasive technique has several advantages over traditional coronal incision. Several fixation methods are reported in the literature, with similar results. In this study, we describe direct needle fixation. OBJECTIVE: To evaluate the prognosis of video endoscopic surgery using a direct needle technique. METHOD: Computerized photographic evaluations of 37 patients undergoing video endoscopy of the frontal region with needle direct fixation were conducted in two private hospitals in the city of Porto Alegre in Rio Grande do Sul, Brazil. RESULTS: The mean eyebrow elevations were 5.7 and 4.4 mm in the lateral and middle third measurements. After a small dip in elevation in the first month after surgery, the repositioning of the eyebrow remained unchanged in subsequent measurements up to 24 months later. CONCLUSION: Direct needle fixation produced lasting, reliable, and reproducible results during the period in which measurements were made.
Assuntos
Humanos , Feminino , Adulto , História do Século XXI , Periósteo , Rejuvenescimento , Cirurgia Plástica , Processamento de Imagem Assistida por Computador , Prontuários Médicos , Estudos Retrospectivos , Cílios , Revisão , Cirurgia Vídeoassistida , Estudo de Avaliação , Difusão de Inovações , Face , Ossos Faciais , Fotografia , Fixação Ocular , Agulhas , Periósteo/cirurgia , Cirurgia Plástica/métodos , Processamento de Imagem Assistida por Computador/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Prontuários Médicos/normas , Cílios/fisiologia , Cirurgia Vídeoassistida/efeitos adversos , Cirurgia Vídeoassistida/métodos , Face/cirurgia , Ossos Faciais/cirurgia , Fixação Ocular/fisiologia , Agulhas/efeitos adversosRESUMO
Descreve-se um caso de perfuração de reto como complicação de ovariosalpingohisterectomia (OSH)via cirurgia endoscópica transluminal por orifícios naturais (NOTES) total transvaginal em cadela. Paraa ovariosalpingohisterectomia, realizou-se incisão da mucosa vaginal onde alocou-se uma cânula de11mm, através da qual foi introduzido um endoscópio rígido com canal de trabalho. Devido a repleçãodo intestino grosso, a extremidade do endoscópio ocasionou a perfuração da porção final do reto. Semremover o endoscópio, converteu-se o procedimento para celiotomia mediana associada à osteotomiapúbica para exposição do sítio de perfuração e síntese intestinal. Conclui-se que a perfuração intestinal éuma complicação passível de ocorrer durante a cirurgia de NOTES total, sendo a conduta cirúrgica adotadasatisfatória no controle da infecção abdominal e no manejo dessa complicação.AU
Describes a case of rectal perforation as a complication of ovariosalpingohisterectomy (OSH) via transluminalendoscopic surgery by natural orifices (NOTES) total transvaginal on bitches. For the OSH, theyperformed an incision of the vaginal mucosa which was allocated through a 11mm cannula, throughwhich a rigid endoscope was introduced as the working channel. Due to the repletion of the large intestine,the endoscope extremity resulted in the perforation of the final portion of the rectum. Without removingthe endoscope, the procedure was converted to median celiotomy associated with pubic osteotomyfor the exposure of the perforation site and intestinal synthesis. The authors conclude that intestinal perforationis a complication liable to occur during the total NOTES surgery, whereas the adopted surgicalprocedure was satisfactory in the control and management of this complication.AU
Assuntos
Animais , Feminino , Cães , Perfuração Intestinal/cirurgia , Perfuração Intestinal/veterinária , RetoRESUMO
Descreve-se um caso de perfuração de reto como complicação de ovariosalpingohisterectomia (OSH)via cirurgia endoscópica transluminal por orifícios naturais (NOTES) total transvaginal em cadela. Paraa ovariosalpingohisterectomia, realizou-se incisão da mucosa vaginal onde alocou-se uma cânula de11mm, através da qual foi introduzido um endoscópio rígido com canal de trabalho. Devido a repleçãodo intestino grosso, a extremidade do endoscópio ocasionou a perfuração da porção final do reto. Semremover o endoscópio, converteu-se o procedimento para celiotomia mediana associada à osteotomiapúbica para exposição do sítio de perfuração e síntese intestinal. Conclui-se que a perfuração intestinal éuma complicação passível de ocorrer durante a cirurgia de NOTES total, sendo a conduta cirúrgica adotadasatisfatória no controle da infecção abdominal e no manejo dessa complicação.
Describes a case of rectal perforation as a complication of ovariosalpingohisterectomy (OSH) via transluminalendoscopic surgery by natural orifices (NOTES) total transvaginal on bitches. For the OSH, theyperformed an incision of the vaginal mucosa which was allocated through a 11mm cannula, throughwhich a rigid endoscope was introduced as the working channel. Due to the repletion of the large intestine,the endoscope extremity resulted in the perforation of the final portion of the rectum. Without removingthe endoscope, the procedure was converted to median celiotomy associated with pubic osteotomyfor the exposure of the perforation site and intestinal synthesis. The authors conclude that intestinal perforationis a complication liable to occur during the total NOTES surgery, whereas the adopted surgicalprocedure was satisfactory in the control and management of this complication.
Assuntos
Feminino , Animais , Cães , Perfuração Intestinal/cirurgia , Perfuração Intestinal/veterinária , RetoRESUMO
Se efectuó un estudio descriptivo y transversal de los 1 742 pacientes mayores de 18 años en los que se realizó de forma satisfactoria la videoendoscopia del tracto digestivo superior en el Centro Médico de Diagnóstico de Alta Tecnología "Las Heroínas de Mérida" del Estado Mérida (Venezuela), desde el 2008 hasta el 2011, con vistas a describir los hallazgos a través de dicho procedimiento. En la casuística predominaron el sexo femenino (63,3 %) y el grupo etario de 46-61 años, con una edad promedio de 55,8 años; además, 30,6 % de las pruebas resultaron normales. El dolor epigástrico (48,6 %), la dispepsia (43,5 %) y el reflujo gastroesofágico (8,6 %) fueron las principales causas de remisión, en tanto la gastritis (32,4 %) constituyó el diagnóstico endoscópico más frecuente, específicamente sus variedades eritematosa y eritemato-erosiva, con 66,0 y 13,0 %, respectivamente. Del total, 10 pacientes presentaron cáncer gástrico y 9, cáncer esofágico. Se pudo concluir que el procedimiento permitió el diagnóstico preciso de las enfermedades del tracto digestivo superior, así como una atención terapéutica adecuada.
A descriptive and cross-sectional study was conducted in 1 742 patients over 15 years, in whom the video endoscopy of upper gastrointestinal tract was successfully performed at the Diagnostic Medical Center of High Technology "Las Heroínas de Mérida" of Mérida state (Venezuela), from 2008 to 2011, with the purpose of describing the findings through this procedure. Female sex (63.3%) and age group of 46-61 years with a mean age of 55.8 years predominated in the case material, and 30.6% of the tests were normal. Epigastric pain (48.6%), dyspepsia (43.5%) and gastroesophageal reflux (8.6%) were the main reasons for referrals, while gastritis (32.4%) constituted the most frequent endoscopic diagnosis, specifically its erythematous and erythematous-erosive varieties, with 66.0 and 13.0%, respectively. Of the total, 10 patients had gastric cancer and 9, esophageal cancer. It was concluded that the procedure allowed accurate diagnosis of upper gastrointestinal tract diseases as well as an appropriate therapeutic care.
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O propósito desta pesquisa foi avaliar, neste grupo de indivíduos, se ocorreram mudanças no padrão respiratório e na porcentagem do espaço aéreo llivre bucofaringeano e nasofaringeano, bem como, se existia alguma relação entre a resistência nasal total e o espaço livre da bucofaringe e da nasofaringe, e entre os dados obtidos pela visão endoscópica clínica e o programa de análise de imagem da via aérea superior, após o tratamento ortopédico com o aparelho bionator de Balters. A amostra constou de 13 pacientes leucodermas, do sexo feminino e masculino, na faixa etária de 8 a 12 anos, com dentadura mista e má oclusão de Classe II divisão 1ª Angle, do Departamento de Clínica Infantil da Faculdade de Odontologia de Araraquara (UNESP) e que não tinham sido submetido a tratamento ortodôntico. A resistência nasal foi avaliada, por meio da rinomanometria anterior ativa, já a bucofaringe e a nasofaringe foram avaliadas, por meio da nasofibroscopia. Para calcular o espaço aéreo total e livre bucofaringeano e nasofaringeano foi utilizada o programa UTSHCSA desenvolvido pelo "Department of Dental Diagnostic Science at The University of Texas Health Science Center". As médias e o desvio padrão de cada variável estudada foi obtida utilizando o teste t de Student ou de Wilcoxon. Desta forma, conclui-se após o tratamento com o bionator de Balters, que: a) houve uma diminuição em torno de 15% da resistência nasal total após a aplicação da solução vasoconstritora tópica; b) houve uma diminuição em torno de 5% da resistência nasal unilateral e total; c) 8 pacientes (57,14%) apresentaram valores de resistência nasal total acima da variação da normalidade; d) não houve uma diferença estatisticamente significante da resistência nasal unilateral e total; e) houve um aumento estatisticamente significante, em torno de 12%, nos espaços aéreos da bucofaringe e da nasofaringe; f) o exame de nasofibroscopia, permitiu o diagnóstico dos fatores etiológicos que ocasionaram a obstrução e a diminuição da função naso-respiratória de todos os pacientes; g) houve uma forte correlação (r > 0,90) estatisticamente significante entre as variáveis obtidas de forma visual e por meio do programa de análise de imagem; h) os diagnósticos obtidos pelo médico otorrinolaringologista, em comparação com os resultados obtidos pelo programa de análise de imagem, tiveram uma concordância maior do que 90%
The aim of this work wasa to evaluate the occurrence of changes in the respiratory pattern: in the free buccopharyngeal and nasopharyngeal airspace, if there was any relation between the total nasal resistance and the free buccopharyngeal and nasopharyngeal airspace, and if there was any relation between the data obtained by the clinical endoscopic view and the image analysis software of the upper airway after orthopedic treatment with Balters' bionator in this group of individuals. The sample was composed of 13 patients caucasian descendents, both male and female between 8 and 12 years old, with mixed denture and Angle Class II Division 1 malocclusion, from the Infant Clinic Department of Araraquara School of Dentistry (UNESP), and that had not been submitted to orthodontic treatment. The nasal resistance was measured by active anterior rhinomanometry, and the bucopharynx and nasopharynx were measured by nasopharyngeal airspace, it was analised the nasofibroscopy image using the software Image Tools, developed by the Department of Dental Diagnostic Science at The University of Texas Health Science Center. The averages and standard deviation of each variable studied were obtained using the Student-t test or the Wilcoxon test. So, it was concluded that after treatment with Balters' bionator: a) was observed that after applying the topic vasoconstrictor solution, there was a 15% reduction in the total nasal resistance; b) there was about 5% reduction in the unilateral and total nasal resistance; c) 8 patients (57,14%) presented total nasal resistance values above the variations of the normality, d) there was no statistically significant difference between the unilateral and total nasal resistance; e) the etiologic factors that were responsible for the obstruction and the reduction of the nasorespiratory function in all the patients were diagnosed by the nasofibroscopy, f) there was a statistically significant increase, around 12%, in all the buccopharyngeal and nasopharyngeal airspace, g) the relation between the variables obtained visually and through the image analysis software was statistically significant, a strong correlation (r > 0,90), h) the diagnoses obtained by the otolaryngologist had a higher conformity than the 90% in relation to the results obtained by the image analysis software