Abordaje endoscópico transesfenoidal de tumores hipofisarios en el Hospital Universitario de Gran Canaria Doctor Negrin en el periodo 2009- 2022

20 páginas.Trabajo fin de Máster en Rinología Avanzada y Base de Cráneo Anterior (2021-22). Tutor: Dr. D. Ramón Moreno Luna. Introducción Los tumores hipofisarios son la 3a neoplasia intracraneal más frecuente en adultos, siendo los adenomas hipofisarios el 13% de los tumores intracraneales, con una incidencia anual de 15/ 1.000.000 habitantes. Actualmente el abordaje endoscópico endonasal transesfenoidal es la técnica de elección en el tratamiento de la patología selar, que no se controla con tratamiento conservados, siendo una técnica mínimamente invasiva, con mejores resultados en la resección tumoral y un menor índice de morbimortalidad. Objetivo y metodología El objetivo principal de este estudio es analizar los resultados de los pacientes diagnosticados y tratados quirúrgicamente de patología hipofisaria tumoral en el Hospital Universitario de Gran Canaria Doctor Negrin (HUGCDN).Para ello, se incluirán en el estudio los pacientes sometidos a abordajes endoansales endoscópicos para el tratamiento de la patología hipofisaria de manera retrospectiva, analizando descriptiva las siguientes variables epidemiológicas, radiológicas, clínicas y quirúrgicas durante el periodo comprendido entre los años 2009-2022. Conclusiones El abordaje endoscópico endonasal transesfenoidal es seguro y efectivo para el tratamiento quirúrgico de la patología hipofisaria, consiguiendo una recuperación rápida con un impacto mínimo en la calidad de vida y reduciendo el tiempo quirúrgico, la estancia hospitalaria y la incidencia de complicaciones. La participación del otorrinolaringólogo resulta fundamental para un adecuado abordaje de las estructuras nasosinusales

Estimation of the age of majority through radiographic evaluation of the third molar maturation degree

Although the third molar is the tooth with the greatest anatomical and developmental variability, some authors consider it important to estimate whether a subject is of legal age or not. The Demirjian?s technique is the most widely used tool to estimate dental age and was therefore used in our study to assess possible correlation between the age of majority and the maturational degree of the lower third molars, evaluated through radiographic images. This observational transversal study was conducted on 180 panoramic radiographs from consecutive patients. The degree of maturation of the lower third molar was independently classified by two observers, according to the Demirjian´s maturational stage method. A total of 180 patients ? 65 men (36.12%) and 115 women (63.88%) ? were included (mean age 21.6 years; standard deviation 5.2). The age range of our subjects corresponded to maturational stages D to H in the Demirjian?s classification. A logistic regression analysis showed that subjects classified into the highest maturational stage H had a significantly higher probability of being considered of legal age by both observers, as compared with subjects in the lowest stage D. Inter-observer agreement was very high. Gender predictive capacity was not observed. Our results showed that subjects with the lower third molars in the highest maturational stage could be estimated to be older than 18 years and therefore considered of legal age, a finding also reported by other authorsThe Demirjian´s tooth maturational stage method, applied to the lower third molars, can be reliably used to estimate whether an individual is of legal age (18 years or older). High concordance between different observers using this method can be expected

Real-Life Effectiveness of Mepolizumab in Refractory Chronic Rhinosinusitis with Nasal Polyps

The aim of this study was to evaluate the efficacy of mepolizumab in patients affected by chronic rhinosinusitis with nasal polyps (CRSwNP) in real-life. A single-center retrospective observational study was conducted on severe CRSwNP patients treated with mepolizumab. Nasal endoscopic polyp score (NPS), visual analogue scale (VAS) symptom score, sinonasal outcome test (SNOT-22), asthma control test (ACT) score, fractional exhaled nitric oxide (FeNO), eosinophils blood cells and prednisone intake were assessed at baseline and after 6 months. A total of 55 patients were included; 49 patients (89%) presented with asthma; aspirin exacerbated respiratory disease (AERD) in 28 patients (51%). A statistically significant decrease in the SNOT-22 score was observed (median difference −63; 95% CI: −68; −58; p p p p < 0.001, were greater in patients with AERD. Mepolizumab treatment effects have been demonstrated with significantly reduced symptoms, polyp scores, blood eosinophils and systemic corticosteroid use, resulting in an increased health-related quality of life in patients with severe CRSwNP, regardless of the presence or absence of asthma or AERD