Expansion of the maxilla in adults with OSAS: myth or reality?

sem informação65170171sem informaçãosem informaçã

Ewing's Sarcoma Of The Head And Neck.

CONTEXT: Ewing's sarcoma is a rare neoplasm, which usually arises in long bones of the limbs and in flat bones of the pelvis, with the involvement of head and neck bones being very unusual. CASE REPORT: a case of Ewing's sarcoma occurring in the mandible of a 35-year-old female. Pain and swelling of the tumor were the main complaints. The early hypothesis was an undifferentiated malignant neoplasm, possibly a sarcoma. The CT scan depicted an expansive lesion, encapsulated, with septa and characteristics of soft tissue, involving the left side of the mandible and extending to the surrounding tissues. The patient underwent surgical excision of the lesion, the definitive diagnosis of Ewing's sarcoma was established, and the patient commenced on radiotherapy.118619820

Laryngeal Vocal And Endoscopic Alterations After Thyroidectomy Under Local Anesthesia And Hypnosedation

Vocal alterations after thyroidectomy are generally related to laryngeal nerve injury or laryngotracheal mobility disorders caused by postoperative fibrosis or strap muscle lesion. Aim: this study aims to evaluate the frequency of vocal and rima glottidis disorders after thyroidectomy. Materials and method: This is a prospective study based on 35 patients submitted to thyroidectomy under local anesthesia and hypnosedation. All patients underwent voice auditory perception evaluation, voice acoustic tests and videolaryngostroboscopy preoperatively, and at one week and at 30 days postoperatively. Bilateral cricothyroid muscle electromyography was performed on the thirtieth day after surgery to confirm the presence of injury in the external branch of the superior laryngeal nerve. Results: 14.3% of the patients presented posterior glottis deviation before surgery and normal electromyography findings. Transient and permanent vocal alteration occurred in 25.7% and 14.2% of the patients respectively. Conclusion: voice disorders evaluated after voice auditory perceptive evaluation and voice acoustic tests were more intense in the group with superior laryngeal nerve external branch injury than in the injury-free dysphonic patient group. Oblique glottis can be present in normal patients; however its onset after thyroidectomy is indicative of superior laryngeal nerve external branch lesion. © Revista Brasileira de Otorrinolaringologia. All Rights reserved.754511516Fernandez, F.H., Cervical block anesthesia in thyroidectomy (1984) Int Surg, 69, pp. 309-311Hochman, M., Fee Jr., W.E., Thyroidectomy under local anesthesia (1991) Arch Otolaryngol Head Neck Surg, 117, pp. 405-407Lo Gerfo, P., Ditkoff, B.A., Chabot, J., Feind, C., Thyroid surgery using monitored anesthesia care: An alternative to general anesthesia (1994) Thyroid, 4, pp. 437-439Sinagra, D.L., Montesinos, M.R., Tacchi, V.A., Moreno, J.C., Falco, J.E., Mezzadri, N.A., Debonis, D.L., Curutchet, H.P., Voice changes after thyroidectomy without recurrent laryngeal nerve injury (2004) Journal of the American College of Surgeons, 199 (4), pp. 556-560. , DOI 10.1016/j.jamcollsurg.2004.06.020, PII S1072751504009342Vellar, I.D., Thomas Peel Dunhill: Pioneer thyroid surgeon (1990) ANZ J Surg, 69, pp. 375-387Hisham, A., Richard, B., Reeve, T., Delbridge, L., Recognition of the avascular space medial to the upper pole of the thyroid and its surgical implications (2000) J Surg, 23 (1), pp. 86-89Lore, J.M., Kokocharov, S.I., Richmond, A., Kaufman, S., Sundquist, N., Thirty-eight-year evaluation of a surgical technique to protect the external branch of the superior laryngeal nerve during thyroidectomy (1998) Annals of Otology, Rhinology and Laryngology, 107 (12), pp. 1015-1022Carrara De Angelis, E., Netto, I.P., Fae, A., Vartanian, J.G., Barros, A.P.B., Correia, L.M., Toledo, R.N., Voice and vocal self-assessment after thyroidectomy (2006) Head & Neck, pp. 1106-1114Stojadinovic, A., Shaha, A.R., Orlikoff, R.F., Nissan, A., Kornak, M.-F., Singh, B., Boyle, J.O., Kraus, D.H., Prospective functional voice assessment in patients undergoing thyroid surgery (2002) Annals of Surgery, 236 (6), pp. 823-832. , DOI 10.1097/00000658-200212000-00015Robinson, J.L., Mandel, S., Sataloff, R.T., Objective voice measures in nonsinging patients with unilateral superior laryngeal nerve paresis (2005) Journal of Voice, 19 (4), pp. 665-667. , DOI 10.1016/j.jvoice.2005.04.001, PII S0892199705000408Hong, K.H., Kim, Y.K., Phonatory characteristics of patients undergoing thyroidectomy without laryngeal nerve injury (1997) Otolaryngol Head Neck Surg, 117, pp. 399-404Arnold, G.E., Physiology and pathology of the cricothyroid muscle (1961) Laryngoscope, 71, pp. 687-753Dedo, H.H., The paralysed larynx: An electromyographic study in dogs and humans (1970) Laryngoscope, 80, pp. 1455-1517Faaborg-Andersen, K., Jensen, A.M., Unilateral paralysis of the superior laryngeal nerve (1964) Acta Otolaryngolol, 57, pp. 155-159Ward, P.H., Berci, G., Calcaterra, T.C., Superior laryngeal nerve paralysis: An often overlooked entity (1977) Transactions of the American Academy of Ophthalmology and Otolaryngology, 84 (1), pp. ORL-78-89Adour, K.K., Schneider, G.D., Hilsinger, R.L., Acute superior laryngeal nerve palsy: Analysis of 78 cases (1980) Otolaryngol Head Neck Surg, 88, pp. 418-424Bevan, K., Griffiths, M.V., Morgan, M.H., Cricothyroid muscle paralysis: Its recognition and diagnosis (1989) Journal of Laryngology and Otology, 103 (2), pp. 191-195Jansson, S., Tisell, L.-E., Hagne, I., Sanner, E., Stenborg, R., Svensson, P., Partial superior laryngeal nerve (SLN) lesions before and after thyroid surgery (1988) World Journal of Surgery, 12 (4), pp. 522-527. , DOI 10.1007/BF0165543

Speech Rehabilitation After Total Laryngectomy: Long-term Results With Indwelling Voice Prosthesis Blom-singer®

To evaluate long-term use of indwelling Blom-Singer voice prosthesis (VP) for vocal rehabilitation of patients submitted to total laryngectomy (TL). We studied the influence of time of performance of tracheo-esophageal puncture (TEP), use of radiotherapy (XRT), patients' age and length of follow-up, on the rate of success of use of VP. Study Design: clinical prospective. Material and Method: Seventy-one patients were submitted to TL and rehabilitated with indwelling VP. Both otolaryngologist and speech pathologist evaluated all patients for the vocal functional issues during the follow-up. The relative data on time of placement of VP, time of use of PF, use of XRT, age, length of follow-up and interval of duration of each VP were recorded during the follow-up. Results: There was 87% of patients with primary TEP and 13% with secondary. The follow-up varied from 12 to 87 months, with average of 38 months for primary and 51 months for secondary TEP. There were 59% of patients submitted to XRT. The general rate of success was of 94%. In primary TEP it was of 97% and in the secondary, it was 78% (p=0.07) and after two years, the success rate was of 96% in primary TEP and 75% in secondary TEP (p=0.07). The use of XRT and patient age did not influence the success of use of VP among primary and secondary TEP, independently of length of follow-up. Conclusion: Tendency to greater success rate in voice rehabilitation after TL with primary TEP was observed. Postoperative XRT and age did not influence success rate.714504509Hamaker, R.C., Singer, M.J., Blom, E.D., Daniels, H.A., Primary voice restoration at laryngectomy (1985) Arch Otolaryngol, 111, pp. 182-186Maves, M.D., Lingeman, R.E., Primary vocal rehabilitation using the Blom-Singer and Pange voice prostheses (1982) Ann Otol Rhinol Laryngol, 91, pp. 458-460Singer, M.I., Blom, E.D., An endoscopic technique for restoration of voice after laryngectomy (1980) Ann Otol Rhinol Laryngol, 89, pp. 529-533Graville, D., Gross, N., Andersen, P., Everts, E., Cohen, J., The long-term indwelling tracheoesophageal prosthesis for a laryngeal voice rehabilitation (1999) Arch Otolaryngol Head Neck Surg, 125, pp. 288-292Blom, E.D., Hamaker, R.C., Tracheoesophageal voice restoration following total laryngectomy (1996) Cancer of the Head and Neck. Third Ed., pp. 839-852. , Myers EN, Suen JY. Philadelphia: W. B. Saunders CoBlom, E.D., Singer, M.I., Hamaker, R.C., A prospective study of tracheoesophageal speech (1986) Arch Otolaryngol Head Neck Surg, 112, pp. 440-447Hoffman, H.T., Fischer, H., Van Denmark, D., Peterson, K.L., McCulloch, T.M., Karnell, L.H., Funk, G.F., Botulinum toxin injection after total laryngectomy (1997) Head Neck, 19, pp. 92-97Lau, W.F., Wei, W.I., Ho, C.M., Lam, K.H., Immediate tracheoesophageal puncture for voice restoration in laryngopharyngeal resection (1988) Am J Surg, 156, pp. 269-272Lavertu, P., Guay, M.E., Meeker, S.S., Kmiecik, J.R., Secic, M., Wanamake, J.R., Eliachar, I., Wood, B.G., Secondary tracheoesophageal puncture: Factors predictive of voice quality and prosthesis use (1996) Head Neck, 18, pp. 393-398Stiernberg, C.M., Bailey, B.J., Calhoun, K.H., Perez, D.G., Primary traqueoesophageal fistula procedure for voice restoration: The University of Texas medical branch experience (1987) Laryngoscope, 97, pp. 820-824Yoshida, G.Y., Hamaker, R.C., Singer, M.I., Blom, E.D., Charles, G.A., Primary voice restoration at laryngectomy: 1989 Update (1989) Laryngoscope, 99, pp. 1093-1095McIvor, J., Evans, P.F., Perry, A., Cheesman, A.D., Radiological assessment of post laryngectomy speech (1990) Clin. Radiol., 41, pp. 312-316Guily, J.L.S., Angelard, B., El-bez, M., Julien, N., Debry, C., Fichaux, P., Gondret, R., Postlaryngectomy voice restoration: A prospective study in 83 patients (1992) Arch Otolaryngol Head Neck Surg, 118, pp. 252-255Kao, W.W., Mohr, R.M., Kimmel, C.A., Getch, C., Silverman, C., The outcome and techniques of primary and secondary tracheoesophageal puncture (1994) Arch Otolaryngol Head Neck Surg, 120, pp. 301-307Maniglia, A.J., Lundy, D.S., Casiano, R.C., Swim, S.C., Speech restoration and complications of primary versus secondary tracheoesophageal puncture following total laryngectomy (1989) Laryngoscope, 99, pp. 489-491Trudeau, M.D., Hirsch, S.M., Schuller, D.E., Vocal restorative surgery: Why wait? (1986) Laryngoscope, 96, pp. 975-977Aust, M.R., McCaffrey, T.V., Early speech results with the Provox prosthesis after laryngectomy (1997) Arch Otolaryngol Head Neck Surg, 123, pp. 966-968Akbas, Y.I., Dursun, G., Voice restoration with low pressure blom singer voice prosthesis after total laryngectomy (2003) Yonsei Med J, 44, pp. 615-618Fagan, J.J., Lentin, R., Oyarzabal, M.F., Isaacs, S., Sellars, S.L., Tracheoesophageal speech in a developing world community (2002) Arch Otolaryngol Head Neck Surg, 128, pp. 50-53Ferrer Ramírez, M.J., Guallart Doménech, F., Brotons Durbán, S., Carrasco Llatas, M., Estellés Ferriol, E., López Martínez, R., Surgical voice restoration after total laryngectomy: Long-term results (2001) Eur Arch Otorhinolaryngol, 258, pp. 463-466De Raucourt, D., Rame, J.P., Daliphard, F., Le Pennec, D., Béquignon, A., Luquet, A., Voice rehabilitation with a voice prosthesis. Study of 62 patients with 5 years follow-up (1998) Rev Laryngol Otol Rhinol, 119, pp. 297-300. , BordVan Den Hoogen, F.J., Van Den Berg, R.J., Oudes, M.J., Manni, J.J., A prospective study of speech and voice rehabilitation after total laryngectomy with the low-resistance Groningen, Nijdam and Provox voice prostheses (1998) Clin Otolaryngol, 23, pp. 425-431Labruna, A., Klatsky, I., Huo, J., Weiss, M.H., Tracheoesophageal puncture in irradiated patients (1995) Ann Otol Rhinol Laryngol, 104, pp. 279-281Trudeau, M.D., Schuller, D.E., Hall, D.A., The effects of radiation on tracheoesophageal puncture (1989) Arch Otolaryngol Head Neck Surg, 115, pp. 1116-1117Baugh, R.F., Jewis, J.S., Baker, S.B., Vocal rehabilitation of tracheoesophageal speech failures (1990) Head Neck, 12, pp. 69-73Baugh, R.F., Jewis, J.S., Baker, S.B., Preoperative assessment of tracheoesophageal speech (1987) Laryngoscope, 97, pp. 461-466Blom, E.D., Singer, M.I., Hamaker, R.C., An improved esophageal insufflation test (1985) Arch Otolaryngol, 111, pp. 211-212Crary, M.A., Glowalski, A.L., Using botulinum toxin A to improve speech and swallowing function following total laryngectomy (1996) Arch Otolaryngol Head Neck Surg, 122, pp. 760-763Lewin, J.S., Baugh, R.F., Baker, S.B., An objective method for prediction of tracheoesophageal speech production (1987) J Speech Hear Disord, 52, pp. 212-217Blom, E.D., Pauloski, B.R., Hamaker, R.C., Functional outcome after surgery for prevention of pharyngospasms in tracheoesophageal speakers. Part I: Speech characteristics (1995) Laryngoscope, 105, pp. 1093-1103Callaway, E., Truelson, J.M., Wolf, G.T., Kincaid, L.T., Cannon, S., Predictive value of objective esophageal insufflation testing for acquisition of tracheoesophageal speech (1992) Laryngoscope, 102, pp. 704-708Mahieu, H.F., Annyas, A.A., Schutte, H.K., Van Der Jagt, E.J., Pharyngoesophageal myotomy for vocal rehabilitation of laryngectomees (1987) Laryngoscope, 97, pp. 451-457Singer, M.I., Blom, E.D., Selective myotomy for voice restoration after total laryngectomy (1981) Arch Otolaryngol, 107, pp. 670-673Singer, M.I., Blom, E.D., Hamaker, R.C., Pharyngeal plexus neurectomy for alaryngeal speech rehabilitation (1986) Laryngoscope, 96, pp. 50-53Sloane, P.M., Griffin, J.M., O'Dwyer, T.P., Esophageal insufflation and videofluoroscopy for evaluation of esophageal speech in laryngectomy patients: Clinical implications (1993) Radiology, 181, pp. 433-437Hamaker, R.C., Blom, E.D., Botulinum neurotoxin for pharyngeal constrictor muscle spasm in tracheoesophageal voice restoration (2003) Laryngoscope, 113, pp. 1479-1482Lewin, J.S., Bishop-Leone, J.K., Forman, A.D., Diaz, E.M., Further experience with Botox injection for tracheoesophageal speech failure (2001) Head Neck, 23, pp. 456-460Blitzer, A., Komisar, A., Baredes, S., Brin, M.F., Stewart, C., Voice failure after tracheoesophageal puncture: Management with botulinum toxin (1995) Otolaryngol Head Neck Surg, 113, pp. 668-670Terell, J.E., Lewin, J.S., Esclamado, R., Botulinum toxin injection for postlaryngectomy tracheoesophageal speech failure (1995) Otolaryngol Head Neck Surg, 113, pp. 788-791Zormeier, M.M., Meleca, R.J., Simpsom, M.L., Dworkin, J.P., Klein, R., Gross, M., Mathog, D., Botulinum toxin injection to improve tracheoesophageal speech after total laryngectomy (1999) Otolaryngol Head Neck Surg, 120, pp. 14-19Quer, M., Burgués-Vila, J., Garcia-Crespillo, P., Primary tracheoesophageal puncture vs esophageal speech (1992) Arch Otolaryngology Head Neck Surg, 118, pp. 188-190Izdebsky, K., Reed, C.G., Ross, J.C., Hilsinger, R.L., Problems with tracheoesophageal fistula voice restoration in totally laryngectomized patients (1994) Arch Otolaryngol Head Neck Surg, 120, pp. 840-845Merwin, G.E., Goldstein, L.P., Rothman, H.B., A comparison of speech using artificial larynx and tracheoesophageal puncture with valve in the same speaker (1985) Laryngoscope, 95, pp. 730-734Robbins, J., Acoustic differentiation of laryngeal, esophageal, and tracheoesophageal speech (1984) J Speech Hear Res, 27, pp. 577-585Robbins, J., Fisher, H.B., Blom, E.C., Singer, M.I., A comparative acoustic study of normal, esophageal and tracheoesophageal speech production (1984) J Speech Hear Res, 49, pp. 202-210Willians, S.E., Watson, J.B., Speaking proficiency variation according to method of alaryngeal voicing (1987) Laryngoscope, 97, pp. 737-73

Chemical and spectroscopic characterization of humic acids extracted from the bottom sediments of a Brazilian subtropical microbasin

International audienceHumic substances (HS) perform a fundamental role in aquatic environments, exhibiting different levels of reactivity in retaining metal ions and organic pollutants. Also, they control the primary production of these ecosystems and act in the carbon sequestering process. In order to improve our understanding vis-à-vis the structural and functional features of HS from aquatic systems, this study aimed to chemically and spectroscopically characterize humic acids (HA) isolated from bottom sediment samples of a stream in a Brazilian subtropical microbasin by elemental analysis, and infrared (FT-IR), ultraviolet and visible (UV-Vis) and solid-state 13C nuclear magnetic resonance (CP-MAS 13C NMR) spectroscopies, thermogravimetry (TG), and scanning electron microscopy (SEM). Although all samples originated from the same environment, the data showed that the HA have distinct chemical and spectroscopic properties, and that the location and characteristics of the sampling points from which the sediments were collected played an important role in the differences observed. Furthermore, vascular plant matter is probably the main contributor to these samples

Relativistic calculations of isotope shifts in highly charged ions

The isotope shifts of forbidden transitions in Be- and B-like argon ions are calculated. It is shown that only using the relativistic recoil operator can provide a proper evaluation of the mass isotope shift, which strongly dominates over the field isotope shift for the ions under consideration. Comparing the isotope shifts calculated with the current experimental uncertainties indicates very good perspectives for a first test of the relativistic theory of the recoil effect in middle-Z ions

QED Effects in Heavy Few-Electron Ions

Accurate calculations of the binding energies, the hyperfine splitting, the bound-electron g-factor, and the parity nonconservation effects in heavy few-electron ions are considered. The calculations include the relativistic, quantum electrodynamic (QED), electron-correlation, and nuclear effects. The theoretical results are compared with available experimental data. A special attention is focused on tests of QED in a strong Coulomb field.Comment: 28 pages, 6 tables, 5 figure

Spin asymmetry A_1^d and the spin-dependent structure function g_1^d of the deuteron at low values of x and Q^2

We present a precise measurement of the deuteron longitudinal spin asymmetry A_1^d and of the deuteron spin-dependent structure function g_1^d at Q^2 < 1 GeV^2 and 4*10^-5 < x < 2.5*10^-2 based on the data collected by the COMPASS experiment at CERN during the years 2002 and 2003. The statistical precision is tenfold better than that of the previous measurement in this region. The measured A_1^d and g_1^d are found to be consistent with zero in the whole range of x.Comment: 17 pages, 10 figure

Gluon polarization in the nucleon from quasi-real photoproduction of high-pT hadron pairs

We present a determination of the gluon polarization Delta G/G in the nucleon, based on the helicity asymmetry of quasi-real photoproduction events, Q^2<1(GeV/c)^2, with a pair of large transverse-momentum hadrons in the final state. The data were obtained by the COMPASS experiment at CERN using a 160 GeV polarized muon beam scattered on a polarized 6-LiD target. The helicity asymmetry for the selected events is = 0.002 +- 0.019(stat.) +- 0.003(syst.). From this value, we obtain in a leading-order QCD analysis Delta G/G=0.024 +- 0.089(stat.) +- 0.057(syst.) at x_g = 0.095 and mu^2 =~ 3 (GeV}/c)^2.Comment: 10 pages, 3 figure

The Deuteron Spin-dependent Structure Function g1d and its First Moment

We present a measurement of the deuteron spin-dependent structure function g1d based on the data collected by the COMPASS experiment at CERN during the years 2002-2004. The data provide an accurate evaluation for Gamma_1^d, the first moment of g1d(x), and for the matrix element of the singlet axial current, a0. The results of QCD fits in the next to leading order (NLO) on all g1 deep inelastic scattering data are also presented. They provide two solutions with the gluon spin distribution function Delta G positive or negative, which describe the data equally well. In both cases, at Q^2 = 3 (GeV/c)^2 the first moment of Delta G is found to be of the order of 0.2 - 0.3 in absolute value.Comment: fits redone using MRST2004 instead of MRSV1998 for G(x), correlation matrix adde