Endoscopic Treatment of Sinonasal Papilloma: A Retrospective Clinical Study

Introduction: Sinonasal Papilloma is a benign tumor originating from the epithelium schneiderian lateral nasal wall. Its incidence is rare and according to literature accounts for 0.5 to 4% of all nasal tumors. Objective: To report our institution's experience in the treatment of sinonasal inverted papilloma using endoscopic approach and compare the results with the literature. Methods: A retrospective study of all patients with sinonasal papillomas who underwent a purely endoscopic surgery in the Otorhinolaryngology, Hospital das Clinicas, Federal University of Bahia (UFBA), from January 2004 to May 2010. Results: A total of 12 patients were included in this study. The median follow-up was 23 months. There was one case of recurrence. Malignant transformation has not occurred in these cases. Conclusion: The treatment of sinonasal papilloma has been largely benefited from the advances in endoscopic techniques, with recurrence rates equivalent to those reported for external access. Imaging exams are essential in preoperative planning and the decision of surgical technique. A regular follow-up and long term is essential for a good monitoring of the evolution of this pathology

Orbital and Intracranial Complication Resulting from Acute Rhinosinusitis: Case Report

Introduction: Among the rhinosinusitis complications, the orbital are the most frequent ones, occurring mostly in the youngsters and children. Simultaneous complications involving the intracranial orbit and space are extremely rare, but they must be severely treated for they have a high rate of morbidity and mortality. Case report: In this work, the authors report a case of a patient who appeared to have preseptal cellulites and epidural abscess, in the form of simultaneous complications of an acute rhinosinusitis. In the patient of this case, choice was made for a clinic treatment associated with a nasosinusal endoscopic surgery and neurosurgical drainage of the intracranial abscess. CT was enough to achieve the diagnosis of this case. Final commentaries: However, it is recommended that, in cases where patients have rhinosinusitis complications, an extensive intracranial investigation needs to be deepened even when this is not so evident in the beginning. Given the polymicrobial nature of these infections, an aggressive culture-guided antibiotic therapy and a multidisciplinary follow-up significantly increase the likelihood of success

Nasolacrimal Duct Mucocele: Case Report and Literature Review

Abstract Introduction Mucoceles are benign expansive cystic formations, composed of a mucus-secreting epithelium (respiratory or pseudostratified epithelium). Nasolacrimal mucocele occurs in a small proportion of children with nasolacrimal duct obstruction and is characterized by a cystic mass in the medial canthus with dilation of the nasolacrimal duct; although dacryocystoceles are rare in adults, they have been reported in patients with trachoma. Objective Discuss clinical aspects, diagnosis, and therapeutic management of mucocele of nasolacrimal duct based on literature review. Resumed Report The authors report a case of bilateral congenital nasolacrimal duct cysts in a 30-year-old man, identified as a tumor in the topography of both lacrimal sacs since birth without associated symptoms. The patient underwent successive surgical treatments, leading to recurrence of the tumor at the right side and recurrent local infections. Conclusion Endoscopic dacryocystorhinostomy has been increasingly used with good results and success rates similar to the external access

Mucosal leishmaniasis: A Retrospective Study of 327 Cases from an Endemic Area of Leishmania (Viannia) braziliensis

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-10-01T18:11:44Z No. of bitstreams: 1 Cincura C Mucosal....pdf: 110843 bytes, checksum: 7bc6c4c265c5463537220b1f0bc13017 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-10-01T18:25:43Z (GMT) No. of bitstreams: 1 Cincura C Mucosal....pdf: 110843 bytes, checksum: 7bc6c4c265c5463537220b1f0bc13017 (MD5)Made available in DSpace on 2018-10-01T18:25:43Z (GMT). No. of bitstreams: 1 Cincura C Mucosal....pdf: 110843 bytes, checksum: 7bc6c4c265c5463537220b1f0bc13017 (MD5) Previous issue date: 2017National Institutes of Health (NIH) grant AI30639Universidade Federal da Bahia. Hospital Universitário Prof. Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-Graduação em Ciências da Saúde. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Prof. Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-Graduação em Ciências da Saúde. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Prof. Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-Graduação em Ciências da Saúde. Salvador, BA, BrasilUniversidade Federal da Bahia. Programa de Pós-Graduação em Ciências da Saúde. Salvador, BA, BrasilWeill Cornell Medical College. Division of Infectious Diseases. New York, NY, USAUniversidade Federal da Bahia. Hospital Universitário Prof. Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-Graduação em Ciências da Saúde. Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Prof. Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Universidade Federal da Bahia. Programa de Pós-Graduação em Ciências da Saúde. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilMucosal leishmaniasis (ML) is observed only in about 3% of patients with American tegumentary leishmaniasis (ATL) but has a high potential for destructive, disfiguring, and disabling sequelae. Prior reports of clinical and epidemiologic features of ML are limited by small numbers of cases. In this study, we evaluated changes in the demographic features and clinical presentation of ML in an endemic area of Leishmania braziliensis transmission over a period of 20 years. The charts of 327 patients with ML diagnosed between 1995 and 2014 were reviewed. The majority of patients (67%) were male. Age ranged from 8 months to 103 years, with a median age of 38.5 years (interquartile range: 22-58 years). The greatest number of patients was between 19 and 39 years (31%). Over the study period, there was an increase in patients with ML more than 60 years of age, an increase in ML with concomitant cutaneous lesions, a decrease in the period of time between the documentation of cutaneous lesions and the diagnosis of mucosal disease, and an increase in the frequency of patients presenting with stage I and V of ML. Moreover, there was a positive correlation between severity of mucosal disease and both age and the period of time between cutaneous lesion and mucosal disease. Response to therapy of ML remained similar over a period of 20 years. Despite the improvement in medical care during the study period, the prevalence of ML did not change and severe disease continues to be a major challenge for the management of these patients

Clinical and tomography evolution of frontal osteomyelitis: Case report

Introduction: The frontal osteomyelitis is a complication of rhinosinusitis which can evolve to acute or chronicle. There is inflammatory reaction by the increasing of intraosseous pressure, ischemia and local necrosis, leading to bone abscess formation. There is no drainage, it will occur detachment of the periosteum, soft tissue invasion and worsening of ischemia with subsequent bone sequestration. Method: Case report of an inpatient in an emergency service of another institution by the complication of rhinosinusitis who was referred to the Otorhinolaryngology Service of University Hospital Professor Edgard Santos of Federal University of Bahia. Case Report: Male patient, 16 years-old, presented himself to the ER of another institution with cephalea, vomits and fever which evolved to periorbital edema and frontal to the left, moving to palpebral fluctuation and frontal. Subjected to frontal and palpebral abscess drainage, with broad-spectrum antibiotic therapy with no improvement. He was referred to our service keeping edema and fluctuation in region frontal and light edema in left periorbital region. The nasal endoscopy showed edema in meatus to the left and the computerized tomography showed fronto-ethmoid sinusitis to the left and signs of frontal osteomyelitis with bone sequestration and epidural empyema. Subjected to sinasal endoscopy surgery, external Access or removal of the frontal one affected and epidural empyema drainage. Evolved to the remission of the disease. Final Considerations: Failure in the diagnosis and rhinosinusitis complication treatment can lead to sequalae and fatal complications. The diagnosis of the frontal osteomyelitis is confirmed by the clinical suspicion and confirmed by radiological examination. The surgery is indicated when the evolution is insidious, there is bone sequestration and intracranial complications

A proposed new clinical staging system for patients with mucosal leishmaniasis

Arruda, Sérgio Marcos “Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento”.Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-05-29T18:04:27Z No. of bitstreams: 1 Lessa Hélio H A a proposed new clinical... .pdf: 1671947 bytes, checksum: d4616b09532540c082cbb7b27995bd5e (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-05-29T18:16:55Z (GMT) No. of bitstreams: 1 Lessa Hélio H A a proposed new clinical... .pdf: 1671947 bytes, checksum: d4616b09532540c082cbb7b27995bd5e (MD5)Made available in DSpace on 2017-05-29T18:16:55Z (GMT). No. of bitstreams: 1 Lessa Hélio H A a proposed new clinical... .pdf: 1671947 bytes, checksum: d4616b09532540c082cbb7b27995bd5e (MD5) Previous issue date: 2012US National Institutes of Health.Universidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, BrasilUniversidade Federal da Bahia. Complexo Hospitalar Universitário Professor Edgard Santos. Serviço de Imunologia. Salvador, BA, Brasil / Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais. Salvador, BA, BrasilMucosal leishmaniasis (ML) occurs mainly in areas where Leishmania braziliensis is transmitted. It affects predominantly the nasal mucosa and, in more severe forms, can lead to significant tissue destruction. There is no standard method for grading the severity of disease. We categorised 50 patients with ML according to a proposed new clinical staging system. Their age ranged from 10 to 86 y (mean ± SD: 36 ± 16 y) and 43 (86%) patients were male. The different degrees of evolution of mucosal disease, from the initial stage to the more severe long-term cases, enabled ML to be graded into five stages. Stage I is characterised by nodular lesions of the mucosa without ulceration. Stage II is represented by superficial mucosal ulcerations with concomitant fine granular lesions. Stage III is characterised by deep mucosal ulcerations with granular tissue formation. In stage IV there are irreversible lesions leading to perforation of the cartilaginous nasal septum with necrosis. In stage V the nasal pyramid is compromised with alterations of facial features as a consequence of severe tissue destruction. These stages may be useful in characterising the severity of the lesion and optimising therapeutic outcome

A Spatial Analysis of the Spread of Hyperendemic Sporotrichosis in the State of Rio de Janeiro, Brazil

Sporotrichosis is a subacute/chronic subcutaneous mycosis. Since the late 1990s, there has been a hyperendemic zoonotic transmission in the state of Rio de Janeiro, involving Sporothrix brasiliensis, the most virulent causative species, and a “belt” was described along the limits between the capital and its outskirts (“Baixada Fluminense”). This study analyzes the distribution of sporotrichosis using secondary data from the Notifiable Diseases Information System (Sinan) of the Rio de Janeiro State Health Department (SES/RJ) from 2011 to 2015 and from the INI Electronic Patient Record System (Sipec) from 2008 to 2015. Cases diagnosed since the onset of the hyperendemic exceed all previously reported case series of the disease and there is a progressive expansion in the state of Rio de Janeiro. The study suggests the spread of the mycosis to all regions of the state and the expansion of the previously described “belt”, despite public health measures and changes in its profile over the years, with great social impact