970 resultados para Circulación acervo
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The sinuses of the posterior wall of the tympanic cavity are formed between the bony ridges, bridges and other osseous prominences, remnants of the tympanum widening process. Anatomical limits and relationships of these sinuses were observed in 100 human temporal bones. Many morphological variabilities were found due to different levels of development of the middle ear posterior wall. The most important sinuses of this complex are the Sinus tympani and the Facial Sinus (Facial recess) seen in all cases. The Lateral tympanic sinus is well-formed in 83% of the cases and the Posterior tympanic sinus in 20% of our series.
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Non-neoplastic dysphagia originated from motor deficit in the pharynx and from several disorders in the upper esophagus is studied taking into account the basic mechanisms of deglutition in the pharingoesophageal segment. Three groups of patients with dysphagia were investigated with the purpose of discussing the causes of ths symptom. Clinical examinations and electromanometry of the upper digestive tree, test of the laringeal elevation and clinical test of the bolus propulsion through pharynx were carried out. Emotional alterations, gastroesophageal lesions and motor disturbances in the digestive tree, among other, may cause dysphagia and other associated and secondary symptoms. This study points out the role of Otolaryngology in the investigation of swallowing disorders.
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The authors studied the effect of temperature and humidity of inhaled gases on the respiratory tract of dogs submitted to mechanic ventilation. According to these two variables, fourty dogs were divided in five groups: -G1: 22-26°C and 17-20 mg H2O.l-1; G2: 27-31°C and 23-27 mg H2O.l-1; G3: 32-36°C and 30-36 mg H2O.l-1; G4: 37-41°C and 40-49 mg H2O.l-1; G5: 42-46°C and 59-65 mg H2O.l-1. The following parameters were evaluated: medial arterial pressure, cardiac frequency, venous pressure of inferior cava (CVP), endotracheal pressure, arterial pH, PaO2, PaCO2, rectal temperature, and the histology of the tracheobronchial tree. In the groups G1 and G5, the endotracheal pressure and CVP presented a slight raise. In the groups G1, G2 and G3, there was no histological modification or progressive hypothermia. The group G5 presented metabolic acidosis and great histological alteration; in this group the rectal temperature remained stable. The group G4 presented great histological alteration and hypothermia. In conclusion, the temperature and humidity of inhaled gases should not be higher than 36°C and 36 mm H2O.l-1, respectively. However, the stability of body temperature only is achieved when the temperature of the inhaled air is 42°C or higher.
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The authors present a rare case of vocal cord paralysis following thyroid cyst. The clinical diagnostic and evolution aspects are presented. The importance of precise evaluation of the thyroid gland in all cases of vocal cord paralysis is emphasized.
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Basaloid squamous carcinoma is an aggressive subtype of squamous carcinoma of superior aerodigestive tract. This tumor has been recently described and it seems to have higher incidence in tongue, hypopharynx and supraglottis. It has more agressive biological behavior than pure type of squamous cell carcinoma. We report 4 cases of this tumor and we present a review of the literature.
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Swallowing function may be impaired by a number of conditions involving primary or associated emotional distress. When psychogenic dysphagia is suspected, routine investigation using radiological and manometric examination is inappropriate. These cases demand an evaluation of the individual as a whole, interesting the disease as well as the patient's personal problems and concerns. Five cases of patients complaining of swallowing difficulty and showing concurrent emotional distress were studied. Four individuals were anxious and one was depressed. Because of our approach, a close medical-patient-relationship was established. Afterwards, an explanation about the normal swallowing mechanisms and the role of the emotions on it was provided. All patients showed improvement of the symptom in the following 24 hours. Dysphagia can be found in anxiety, depression and conversion hysteria, with high incidence in the urban population of the third world countries. However, several professionals are unaware of these disorders. Our results suggest that this plain approach is an useful tool in managing dysphagic patients and it has validity even in individuals bearing dysphagia due to comproved organic disease. The results also emphasize the importance of the medical patient relationship and the utility of a hollistic evaluation of the disease.
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The authors studied retrospectively 130 patients with thyroid tumors comparing the histopathologic diagnoses with fine needle aspirate (FNA) and frozen section results. FNA was performed in 118 patients with the following results: 75 (63.6%) benign, 21 (17.8%) malignant and 22 (18.6%) not conclusives. In seven cases false-negative result was obtained and there were six false-positive. These data reveals some drawbacks of this procedure. These results indicated that frozen as well as FNA are useful diagnostic procedure in helping to choose the most appropriate therapy in patients with thyroid tumors. On the other hand, traditional methods seems to be also important methods, such as scintilography, in the evaluation of thyroid diseases.
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Rhinoliths are rares and, in general, develop in response to foreign body lodged in the nose. This study briefly comments the clinics features of one case of rhinolithiasis that occurred during two years period. The etiology of rinoliths, differencial diagnosis and a review of the literature are also included. The authors concluded that the presence of calcified stones must be considered in cases of sinusitis or rhinitis not responding to medical therapy.
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Neonatal high risk children present high incidence for communication disorders and delay development of language. The present study aimed to evaluate the incidence of communication disorders and long term follow up of neonatal high risk children. Twenty-one children were followed up to age of four years old and were evaluated for the development of linguistics aspects. The main high risk neonatal factors were: prematurity, mechanical ventilation, long time in the incubator and severe hypoxia. In 47,62% of the cases, the following communication disorder were found: articulation disorders (9,52%), simple (9,52%) and small and (14,29%) with delay development of language. The incidence of these disorders was greater among male children (57,14%).
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The accurate investigation of the oropharyngeal dysphagia demands a systematic sequence of physical examinations. The aim of the present work is to propose a practical rule to facilitate the clinical investigation and the management of dysphagic patients. After a detailed anamnesis, an endoscopic examination is carried out and several manouvers to observe the oral, pharyngeal and laryngeal functions are performed by the patient. Following, a second endoscopy is performed during swallows of several consistencies of food, to verify the impairment of the laryngeal and or pharyngeal activities. The elevation of the laryngeal cartilage is also evaluated.
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The laryngeal mask has been demonstrating to be a new option for the maintenance of the airway permeability in anesthetized patients. It permits easy and fast insert. The authors made a review about the laryngeal mask including the main indications, advantages and possible injuries associated to its use.
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Introduction: The study of otolaryngologic manifestations in children HIV + can lead to early diagnosis of AIDS, allowing specific treatment, responsible by reduced morbidity and mortality. Objectives: Detect the otolaryngologic manifestations in children with AIDS and alert to the importance of the early diagnosis. Study design: Clinical prospective. Material and method: We evaluated 22 children with AIDS assisted at Faculdade de Medicina de Botucatu (São Paulo, Brasil). The medical records were reviewed and the children were submitted to otolaryngologic and hearing acuity exams. Results: We evaluated 12 boys and 10 girls, whose ages ranged from 8 months to 12 years. In B and C clinical classification were included 18 children who were using anti-retroviral medicaments. Physical examination mainly indicated cervical lymphadenopathy (18 cases), paleness of the nasal mucous membrane with abundant mucous secretion over the nasal epithelium (15 cases) and retraction of tympanic membranes (seven cases). The main otolaryngologic diagnoses were: rhinosinusitis (16 cases), oral candidiasis (13 cases), inadequate eustachian tube function (seven cases) and recurrent tonsillar infections (six cases). Conductive hearing loss were detected in 4 children. No child presented sensorineural hearing loss. Conclusions: The main otolaryngologic manifestations presented by the children with HIV virus were rhinosinusitis, oral candidiasis, inadequate eustachian tube function and recurrent tonsillar infections. The allergic aspect of the nasal mucous membrane and the cervical lymphadenopathy were frequent signs and could alert the otolaryngologyst to AIDS during the exam.
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Introduction: Children with Moebius syndrome may present paralysis of cranial nerves III, IV, V, VI, VII, VIII, IX, X and XII, compromising motor and sensorial functions. Hands and feet defects (syndactyly, equinovarus and arthrogryposis) are frequently associated. These manifestations can be attributed to the use of misoprostol during pregnancy to induce abortion. Study design: Clinical prospective. Aim: To evaluate the main clinical manifestations, hearing acuity and possible etiologic factors in children with Moebius syndrome. Material and method: The children were submitted to clinical, otolaryngological and hearing acuity assessment. Hearing acuity was evaluated through behavioral tests, pure tone audiometry, tympanometry and auditory brainstem response (ABR). We investigated possible etiologic factors. Results: Three boys and two girls were evaluated. The main manifestations were: facial paralysis, paralysis of masseter muscle, defects in dental occlusion, retraction of tympanic membrane, equinovarus, oblique palpebral fissure and tongue atrophy. Conductive hearing loss was detected in three children and sensorineural hearing loss in one child. The use of misoprostol during pregnancy was reported by four mothers. Conclusions: The children with Moebius syndrome evaluated in the present study manifested palsies of various cranial nerves, especially V, VII and XII nerves, responsible for motor and sensorial alterations. Inadequate eustachian tube function associated to conductive hearing loss was frequent. The use of misoprostol during pregnancy was reported by the mothers and it was considered a possible etiologic factor.
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