Position statement of the Brazilian Academy of Rhinology on the use of antihistamines, antileukotrienes, and oral corticosteroids in the treatment of inflammatory sinonasal diseases

Introduction: Inflammatory conditions of the nose and paranasal sinuses are very prevalent in the general population, resulting in marked loss of quality of life in affected patients, as well as significant work, leisure, and social activity losses. These patients require specific and specialized treatment. A wide range of oral medications are available. Objective: The present document is aimed to clarify, for professionals treating patients with inflammatory sinonasal diseases, both specialists and general practitioners, specific oral therapies in noninfectious nasal inflammatory conditions. Methods: The methodology used to create this article included the search for the key words: oral corticosteroids, antihistamines, antileukotrienes, rhinitis, rhinosinusitis in the MEDLINE and EMBASE databases in the last 5 years. Since no relevant article was found for the text on the subject of interest in the last 5 years, the search was extended for another 5 years, and so on, according to the authors' needs. Results: Relevant literature was found regarding the use of antihistamines, antileukotrienes and oral corticosteroids in these conditions. The Brazilian Academy of Rhinology emphasizes, after extensive discussion by the collegiate, key points in the treatment with these drugs. Conclusion: There is support in the literature for the use of these drugshowever, final considerations about the role of each of them have been made. (C) 2017 Published by Elsevier Editora Ltda. on behalf of Associacao Brasileira de Otorrino-laringologia e Cirurgia Cervico-Facial.Univ Sao Paulo, Disciplina Otorrinolaringol, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med, Dept Otorrinolaringol, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med Ribeirao Preto, Dept Otorrinolaringol, Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Ciencias Saude, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Otorrinolaringol, Sao Paulo, SP, BrazilUniv Fed Minas Gerais, Fac Med, Belo Horizonte, MG, BrazilUniv Sao Paulo, Fac Med Ribeirao Preto, Ribeirao Preto, SP, BrazilUniv Fed Bahia, Fac Med, Disciplina Otorrinolaringol, Salvador, BA, BrazilHosp Inst Paranaense Otorrinolaringol, Centro Rinite & Alergia, Curitiba, PR, BrazilUniv Estado Rio De Janeiro, Rio De Janeiro, RJ, BrazilUniv Brasilia, Fac Med, Brasilia, DF, BrazilUniv Fed Sao Paulo, Dept Otorrinolaringol & Cabeca & Pescoco, Sao Paulo, SP, BrazilUniv Luterana Brasil, Fac Med, Otorrinolaringol, Canoas, RS, BrazilMt Sinai Hosp, Dept Othorhinolaryngol, Toronto, ON, CanadaUniv Sao Paulo, Fac Med, Ciencias, Sao Paulo, SP, BrazilUniv Sao Paulo, Fac Med Ribeirao Preto, Dept Oftalmol Otorrinolaringol & Cirurgia Cabeca, Ribeirao Preto, SP, BrazilUniv Fed Sao Paulo, Ciencias Saude, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Otorrinolaringol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Otorrinolaringol & Cabeca & Pescoco, Sao Paulo, SP, BrazilWeb of Scienc

Functional avaliation in patients with noise induced hearing loss: research by vectoelectronistagmography

Diversas consequencias de exposicao cronica a ruidos sobre o organismo humano sao conhecidas, entretanto, as alteracoes vestibulares decorrentes dessa exposicao foram tema de poucos estudos. O objetivo da presente pesquisa e verificar se os pacientes com perda auditiva induzida pelo ruido (PAIR) tem alteracoes de funcao vestibular quando analisados por meio de vectoeletronistagmografia. Este estudo analisou um grupo de 45 pacientes com perda auditiva induzida pelo ruido na faixa etaria de 24 a 60 anos por meio de anamnese, exame otorrinonaringologico, audiometria tonal e vocal, pesquisa do equilibrio estatico e dinamico, pesquisa de nistagmo e vertigem de posicao e vectoeletronistagmografia (VENG). A idade media do grupo estudado foi de 34,5 anos 7,5) e o tempo medio de exposicao ocupacional a ruidos foi de 9,9 anos 4,9). Apresentavam queixa de tonturas 55,6 por cento dos pacientes (25 casos) e 66,7 por cento de zumbidos (30 casos). Esses sintomas estiveram associados em 42,2 por cento dos pacientes (l9 casos). O exame VENG evidenciou que 31,1, por cento (l4 pacientes) apresentavam sindrome vestibular periferica irritativa e 13,3 por cento (6 pacientes) sindrome vestibular periferica deficitaria, representando uma prevalencia total de 44,4 por cento de disturbios vestibulares. Apresentaram uma maior prevalencia de disturbios vestibulares os pacientes com queixas de tontura (60 por cento) e zumbidos (56,7 por cento), em relacao aos que nao apresentavam essas queixas. Uma prevalencia elevada (73,9 por cento) de disturbios vestibulares foi observada nos pacientes com associacao das queixas de tontura e zumbidos. Observou-se uma tendencia de correlacao entre o grau de perda auditiva e a prevalencia de disturbios vestibulares, visto que 35,3 por cento (6 casos) dos pacientes com perda Grau I e 50 por cento (11 casos) dos pacientes com perda Grau II apresentavam disturbios vestibulares, Nao foi observada uma tendencia de correlacao entre a prevalencia de disturbios vestibulares e o tempo de exposicao a ruidos. Diante do observado concluimos que parcela relevante dos pacientes com PAIR apresentam alteracoes de funcao vestibularBV UNIFESP: Teses e dissertaçõe

Adult Rhabdomyoma of the Larynx

Introduction  Rhabdomyoma is a rare benign tumor derived from skeletal muscles. Laryngeal rhabdomyomas are even rarer, with only approximately 40 reported cases in world literature. Laryngeal rhabdomyomas usually are seen as masses covered by mucosa. They are often solitary asymptomatic tumors, but symptoms such as hoarseness can occur. The radiologic features are usually those typical of benign neoplasms, showing well-delineated borders. The differential diagnoses for laryngeal masses include cysts, laryngoceles, and benign and malignant neoplasms. The diagnosis is usually made using histopathologic findings, but in some cases some difficulties can be found. Immunohistochemical staining is of great value in the differentiation of similar tumors. Treatment of rhabdomyoma is surgical excision. Objective  To describe a case of rhabdomyoma of the larynx attended at Santa Casa de Misericórdia do Rio de Janeiro. Case Report  A 35-year-old man presented with progressive hoarseness in the preceding year. Laryngoscopy showed a large submucosal tumor at the supraglottic region of the larynx. The neck computed tomography scan confirmed the submucosal mass, with distinct borders. The patient was taken to the operating suite, where endoscopic extirpation of the mass was performed. Initial histologic diagnosis was suggestive of paraganglioma, which was not confirmed by studies with immunohistochemical markers, and diagnosis was changed to adult-type rhabdomyoma. The patient recovered well. His voice returned to normal after 3 months. Discussion  Although muscle tumors of the larynx are very rare, rhabdomyoma should be considered when there is a submucosal mass in the larynx

Post-piercing perichondritis

SummaryPiercing has become more and more popular among adolescents. The procedure is generally performed by unqualified professionals and carries its risk. Non-sterilized material or inappropiate hygiene increases the possibility of perichondritis and celulitis. The disease is characterized by erythema of the auricula pinna, unbearable pain and fever. Left untreated, the condition progresses with edema along the auricula and abscess formation that may result in ischemic necrosis and a cauliflower anesthetic deformation. The most common bacteria is Pseudomonas aeruginosa. In cases with abscesses, drainage is necessary along with antibiotic therapy guided by cultures and antibiogram. Aim: The aim of this case report was to review the past 10 years of published papers dealing with anatomical aspects of the auricular pinna, the history of piercing and its most common complications. Methods: A case report of perichondritis after “high” ear piercing that required surgical treatment and that progressed with no esthetic loss. Results: Theoretical and practical experience based on a review and a report of a case that progressed satisfactorily. Conclusions: The increased incidence of perichondritis in adolescents should require more elaborated primary prevention measures

Posicionamento da Academia Brasileira de Rinologia sobre terapias tópicas nasais Brazilian Academy of Rhinology position paper on topical intranasal therapy

Opresente documento tem por objetivo esclarecer àqueles que tratam das doenças nasossinusais, tanto especialistas quanto generalistas, sobre as terapêuticas tópicas nasais. Por meio de uma revisão das evidências científicas, a Academia Brasileira de Rinologia vem proporcionar sua visão prática e atualizada sobre as medicações tópicas nasais mais utilizadas, excetuando-se as medicações que possuam antibióticos tópicos na sua formulação.<br>This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas

Posicionamento da Academia Brasileira de Rinologia sobre terapias tópicas nasais

This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.Univ São Paulo FMUSP, Sch Med, São Paulo, BrazilUniv São Paulo, Otorhinolaryngol Program, BR-05508 São Paulo, BrazilUniv São Paulo, Sch Med, BR-05508 São Paulo, BrazilUniv São Paulo, Med Sch Ribeirao Preto, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniv Fed Rio Grande do Norte, Otorhinolaryngol Med Residency Program, BR-59072970 Natal, RN, BrazilSanta Casa Misericordia, Dept Otorhinolaryngol, Rio de Janeiro, BrazilFMUSP, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Otorhinolaryngol Program, São Paulo, BrazilMt Sinai Hosp, Dept Otolaryngol, Toronto, ON M5G 1X5, CanadaUniv Estado Rio de Janeiro, Rio de Janeiro, BrazilUniv Fed Rio de Janeiro, BR-21941 Rio de Janeiro, BrazilUniv Estado Rio de Janeiro, Sch Med Sci, Otorhinolaryngol Program, Rio de Janeiro, BrazilPoliclin Botafogo, Serv Otorhinolaryngol, Rio de Janeiro, BrazilUniv Fed Minas Gerais, Sch Med, Belo Horizonte, MG, BrazilUniv São Paulo Ribeirao Preto, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, Pediat Otorhinolaryngol Program, São Paulo, BrazilWeb of Scienc