Sinusite fúngica alérgica: atualização Allergic fungal sinusitis: an update

Sinusite fúngica alérgica é uma modalidade de sinusite fúngica reconhecida há aproximadamente 20 anos. Os critérios diagnósticos ainda não estão bem definidos e muitas dúvidas existem com relação à sua fisiopatogenia e tratamento. Com o intuito de rever os mais modernos conceitos desta nova entidade clínica, foi realizada uma pesquisa utlilizando como fontes de referências bibliográficas o Medline e o Lilacs, abrangendo os últimos 20 anos. A sinusite fúngica alérgica vem sendo reconhecida como uma importante causa de rinossinusite crônica e a integração entre otorrinolaringologistas, imunologistas e patologistas faz-se necessária para seu manuseio adequado.<br>Allergic fungal sinusitis is a well recognized form of fungal sinusitis first described 20 years ago. This entity hasn't a well defined diagnostic criteria and many questions rise about its true fisiopathology and treatment. The authors have performed a MEDLINE and LILACS search, comprising the last 20 years, in order to review the most moderns concepts about this new clinical entity. Allergic fungal sinusitis has been considered an important cause of chronic rhinosinusitis and a good relation envolving otolaryngologists, immunologists and pathologists is essential for its correct management

Selecting the best approach to the frontal sinus

The Messerklinger technique is an endoscopic approach to sinus surgery designed to be minimally invasive and preserve mucosa and hence physiological function. More recently there have been advocates for more radical endoscopic approaches to the frontal sinus such as the Modified Lothrop. This review discusses different approaches to frontal sinus surgery including any advantages and disadvantages to each approach. After examining the evidence from the literature, meticulously performed endoscopic frontal sinusotomy with or without computer guidance appears to be the most effective minimally invasive procedure for treating chronic frontal sinusitis secondary to outflow tract obstruction. Properly performed, it is almost always effective in dealing with even the most diseased frontal sinus. It offers clear advantages in reducing complications and recurrence rates in frontal sinus disease, even for revision cases

Laser/Light Applications in Otolaryngology

Lasers have been ubiquitous in otolaryngology since Jako and Strong first introduced the CO2 laser in 1970. Since that time lasers have traditionally been used like a scalpel, able to cut and cauterize precisely. More recently, the role of lasers has been expanded in otolaryngology depending on the specific laser wavelength and dosimetry parameters. Not only can lasers be utilized to extirpate cancer, but also used to recover hearing, improve the airway, treat epistaxis, and even break up salivary stones for easy removal. The individual characteristics of the laser are important for the specific application. However, the otolaryngologist often works in areas that are either difficult to access using classic methods or require extreme precision, and the mechanism and method for delivering the laser energy is often equally important. In this chapter, we describe the many ways lasers are used in otolaryngology treat both benign conditions to life-threatening diseases. New and innovative applications are also discussed