25 results on '"Adriano Santana Fonseca"'
Search Results
2. Synovial Sarcoma in Head and Neck: A Case Report
- Author
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Adriano Santana Fonseca, Amanda Canário Andrade Azevedo, Fabíola Moreira Magalhães, and Nilvano Alves de Andrade
- Subjects
sarcoma ,synovial ,deglutition disorders ,Medicine ,Otorhinolaryngology ,RF1-547 - Abstract
Abstract Introduction Synovial sarcoma is a malignant tumor of mesenchymal pluripotent cells. Objectives We present a case of synovial sarcoma in the posterolateral wall of the oropharynx. Resumed report The patient, a 23-year-old woman, was admitted with a history of dysphagia and difficulty in breathing for 8 months, resulting in progressive deterioration and onset of snoring, muffled voice, and local pain. An oropharyngeal tumor in the left posterolateral wall touched the base of the ipsilateral tongue. The patient underwent endoscopic pharyngectomy to remove the lesion. Pathologic examination revealed synovial sarcoma with positive margins, and Mohs technique was proposed for margin control. The margins were disease-free, without the need for total laryngectomy. The pharynx was reconstructed with a microvascular forearm flap. The patient developed postoperative stability. Conclusion Despite its name, synovial sarcoma is rarely sourced directly from synovial membranes. It is most commonly found in the vicinity of large joints. The location at the head and neck, a location poor in synovial tissue, is unusual. Synovial sarcoma in the head and neck has an aggressive nature and poor prognosis. Resection with negative margins remains the foundation of therapy, which is not so easily achieved in the head and neck. It is important for the otorhinolaryngologist and head and neck surgeon to be familiar with this aggressive tumor, which carries high mortality and morbidity. The appropriate diagnosis and treatment can improve prognosis and patient survival.
- Published
- 2014
- Full Text
- View/download PDF
3. Ewing's sarcoma of the head and neck
- Author
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Adriano Santana Fonseca, Raquel Mezzalira, Agrício Nubiato Crespo, Antônio Emílio Bortoleto Junior, and Jorge Rizzato Paschoal
- Subjects
Sarcoma ,Ewing's. Pharynx ,Mandible ,Head and Neck Surgery ,Otolaryngology ,Medicine - Abstract
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.
- Published
- 2000
- Full Text
- View/download PDF
4. Mixoma maxilo-mandibular em neonato Maxillomandibular myxoma in neonates
- Author
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Adriano Santana Fonseca, Vanessa Rolim Barreto Cavalcante, and Anderson Castelo Branco
- Subjects
anormalidades maxilo-mandibulares ,mixoma ,neoplasias maxilo-mandibulares ,jaw abnormalities ,myxoma ,jaw neoplasms ,Otorhinolaryngology ,RF1-547 - Published
- 2010
- Full Text
- View/download PDF
5. Angioleiomioma de septo nasal Angioleiomyoma of the nasal septum
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Carlos Roberto Ribeiro Navarro Júnior, Adriano Santana Fonseca, José Rodrigo Lordello de Mattos, and Nilvano Alves de Andrade
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leiomioma ,neoplasias nasais ,septo nasal ,leiomyoma ,nose neoplasms ,nasal septum ,Otorhinolaryngology ,RF1-547 - Published
- 2010
- Full Text
- View/download PDF
6. Clinical versus computed tomography evaluation in the diagnosis and management of deep neck infection
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Agricio Nubiato Crespo, Carlos Takahiro Chone, Adriano Santana Fonseca, Maria Carolina Montenegro, Rodrigo Pereira, and João Altemani Milani
- Subjects
Drainage ,Abscess ,Infection ,Neck ,X-ray computed tomography scanners ,Medicine - Abstract
CONTEXT: Deep neck infections have high potential for severe complications and even death, if not properly managed. The difference between clinical and computed tomography findings may demonstrate that clinical evaluation alone underestimates disease extent, which may lead to conservative treatment with worse prognosis. OBJECTIVE: To compare clinical and computed tomography findings from neck spaces affected by deep neck infections and to determine the main clinical and radiological features associated with these. TYPE OF STUDY: Non-randomized retrospective study. SETTING: Department of Otolaryngology and Head and Neck, Universidade Estadual de Campinas. METHODS: Medical charts of 65 patients with deep neck infections were evaluated. Age, gender, clinical complaints, physical findings, computed tomography scan and x-ray imaging, microbiology, treatment and outcome were analyzed. All clinical signs and symptoms were evaluated and stratified in order of frequency. The frequency of neck space involvement in such infections was also assessed from the clinical and tomographic evaluation. All clinical and computed tomography findings were compared with surgical observation. RESULTS: The most frequent clinical findings were neck swelling, local pain, erythema and locally increased temperature. Physical evaluation showed that the most affected site was the submandibular triangle (49.2% of cases). However, computed tomography showed this to be the lateropharyngeal space (65% of cases) and that more than one deep cervical space was compromised in 90% of cases, as demonstrated by the extent of swelling and increased contrast signs in soft tissue. DISCUSSION: The most frequent clinical symptoms of deep cervical infections were cervical pain, increased cervical volume and fever. The important signs seen via computed tomography were increased contrast in soft neck tissues and swelling. Such examination is the most important method for correct evaluation of cervical spaces involved in infection, and thus for correct surgical drainage. CONCLUSIONS: The most frequent clinical findings were cervical mass, neck pain, local erythema and locally increased temperature. Computed tomography demonstrated that the lateropharyngeal space was the most affected neck space. More than one deep neck space was compromised in 90% of cases. Clinical evaluation underestimated the extent of deep neck infection in 70% of patients.
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- View/download PDF
7. Laryngeal papillary carcinoma with unexpected evolution: case report
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Adriano Santana Fonseca, Carlos Takihiro Chone, Agrício Nubiato Crespo, and Albin Altemani
- Subjects
Laryngeal neoplasms ,Papillary carcinoma ,Radiotherapy ,Prognosis ,Lymphatic metastasis ,Medicine - Abstract
CONTEXT: According to the literature, laryngeal papillary carcinoma is rare and has a benign prognosis. CASE REPORT: In this report we present a surprising case with nodal metastasis at the time of diagnosis. Computed tomography showed infiltration of the lesion and metastatic lymph nodes. The resected specimen was submitted to histopathological study that confirmed the diagnosis of papillary squamous cell carcinoma.
- Full Text
- View/download PDF
8. Synovial Sarcoma in Head and Neck: A Case Report
- Author
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Nilvano Alves de Andrade, Fabíola Moreira Magalhães, Amanda Canário Andrade Azevedo, and Adriano Santana Fonseca
- Subjects
medicine.medical_specialty ,sarcoma ,medicine.medical_treatment ,lcsh:Medicine ,Article ,Lesion ,Tongue ,medicine ,business.industry ,lcsh:R ,Pharynx ,deglutition disorders ,Pharyngectomy ,lcsh:Otorhinolaryngology ,medicine.disease ,lcsh:RF1-547 ,Dysphagia ,Synovial sarcoma ,Surgery ,Laryngectomy ,medicine.anatomical_structure ,Otorhinolaryngology ,Sarcoma ,medicine.symptom ,synovial ,business - Abstract
Introduction Synovial sarcoma is a malignant tumor of mesenchymal pluripotent cells. Objectives We present a case of synovial sarcoma in the posterolateral wall of the oropharynx. Resumed report The patient, a 23-year-old woman, was admitted with a history of dysphagia and difficulty in breathing for 8 months, resulting in progressive deterioration and onset of snoring, muffled voice, and local pain. An oropharyngeal tumor in the left posterolateral wall touched the base of the ipsilateral tongue. The patient underwent endoscopic pharyngectomy to remove the lesion. Pathologic examination revealed synovial sarcoma with positive margins, and Mohs technique was proposed for margin control. The margins were disease-free, without the need for total laryngectomy. The pharynx was reconstructed with a microvascular forearm flap. The patient developed postoperative stability. Conclusion Despite its name, synovial sarcoma is rarely sourced directly from synovial membranes. It is most commonly found in the vicinity of large joints. The location at the head and neck, a location poor in synovial tissue, is unusual. Synovial sarcoma in the head and neck has an aggressive nature and poor prognosis. Resection with negative margins remains the foundation of therapy, which is not so easily achieved in the head and neck. It is important for the otorhinolaryngologist and head and neck surgeon to be familiar with this aggressive tumor, which carries high mortality and morbidity. The appropriate diagnosis and treatment can improve prognosis and patient survival.
- Published
- 2013
9. Tratamento cirúrgico de nasoangiofibroma sem embolização Surgical Treatment of Non-embolized Patients with Nasoangiofibroma
- Author
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Adriano Santana Fonseca, Eriko Vinhaes, Viviane Boaventura, Nilvano Alves de Andrade, Lislane Andrade Dias, Vyrna Medeiros, and Fernando Coifman
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juvenile nasopharyngeal angiofibroma ,treatment ,lcsh:R ,skull base ,base do crânio ,nasoangiofibroma ,lcsh:Medicine ,embolization ,tratamento ,lcsh:Otorhinolaryngology ,lcsh:RF1-547 ,embolização - Abstract
Nasoangiofibroma juvenil (NAFJ) é um tumor incomum que se localiza na região do forame esfenopalatino. A cirurgia combinada à embolização pré-operatória tem sido a opção terapêutica mais empregada nos pacientes com NAFJ sem invasão intracraniana. O objetivo desse estudo é avaliar a viabilidade do tratamento cirúrgico do nasoangiofibroma em pacientes estágios I- III de Fisch, sem uso de embolização pré- operatória. MATERIAL E MÉTODO: Estudo descritivo, retrospectivo, utilizando-se dados de revisão de prontuário de quinze pacientes com NAFJ estágio I a III de Fisch submetidos à cirurgia sem embolização pré-operatória, entre os anos de 2000 e 2005. RESULTADOS: Dos quinze pacientes, sete pacientes foram submetidos à cirurgia endoscópica, quatro via transmaxilar, três via endoscópica e transmaxilar e um via transmaxilar e transpalatina. Seis pacientes necessitaram de hemotransfusão no intra-operatório, com média geral de 1.3 bolsa/paciente. Nenhum caso de mortalidade ou morbidade significativa foi registrado. Onze dos quinze pacientes foram acompanhados por tempo médio de doze meses com taxa de recidiva de 27%. Quatro pacientes perderam seguimento. CONLUSÃO: A ressecção de NAFJ classes I- III foi realizada com segurança em pacientes não-embolizados, com taxa de sangramento intraoperatório, ocorrência de complicações e taxa de recorrência próximas dos valores pesquisados na literatura para pacientes embolizados.Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumor of the sphenopalatine foramen. Surgery combined with preoperative embolization has been the treatment of choice for JNA patients without intracranial invasion. This study aims to assess the viability of surgically treating non-embolized patients with JNA (types I-III according to Fisch). MATERIAL AND METHOD: This is a retrospective, descriptive study based on the medical records of 15 patients with histologically confirmed JNA (Fisch’s types I- III), who underwent surgical treatment without pre-op embolization in our institution between 2000 and 2005. RESULTS: Seven of the fifteen patients were approached endoscopically, four through the transantral approach, three were treated with the combined transmaxillary and endoscopic approach, and one with the combined transmaxillary and transpalatal approach. Six patients required intraoperatory blood transfusion, averaging volumes of 1.3 unit/patient. There were no cases of death or significant morbidity. Eleven of the fifteen patients were followed for an average of twelve months and 27% of them relapsed. Four patients did not comply with the follow-up scheme. CONCLUSION: Resection of JNF types I-III was safely completed in non-embolized patients. The observed levels of intraoperative bleeding, occurrence of complications, and rates of recurrence were close to those seen in embolized patients as found in the literature.
- Published
- 2008
10. Surgical Treatment of Non-embolized Patients with Nasoangiofibroma
- Author
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Vyrna Medeiros, Eriko Vinhaes, Adriano Santana Fonseca, Nilvano Alves de Andrade, Lislane Andrade Dias, Viviane Boaventura, and Fernando Coifman
- Subjects
medicine.medical_specialty ,Blood transfusion ,treatment ,Juvenile nasopharyngeal angiofibroma ,business.industry ,medicine.medical_treatment ,Medical record ,skull base ,base do crânio ,embolization ,Transantral approach ,Intraoperative bleeding ,embolização ,Surgery ,Resection ,juvenile nasopharyngeal angiofibroma ,medicine.anatomical_structure ,Otorhinolaryngology ,medicine ,nasoangiofibroma ,Sphenopalatine foramen ,Embolization ,tratamento ,business - Abstract
Nasoangiofibroma juvenil (NAFJ) é um tumor incomum que se localiza na região do forame esfenopalatino. A cirurgia combinada à embolização pré-operatória tem sido a opção terapêutica mais empregada nos pacientes com NAFJ sem invasão intracraniana. O objetivo desse estudo é avaliar a viabilidade do tratamento cirúrgico do nasoangiofibroma em pacientes estágios I- III de Fisch, sem uso de embolização pré- operatória. MATERIAL E MÉTODO: Estudo descritivo, retrospectivo, utilizando-se dados de revisão de prontuário de quinze pacientes com NAFJ estágio I a III de Fisch submetidos à cirurgia sem embolização pré-operatória, entre os anos de 2000 e 2005. RESULTADOS: Dos quinze pacientes, sete pacientes foram submetidos à cirurgia endoscópica, quatro via transmaxilar, três via endoscópica e transmaxilar e um via transmaxilar e transpalatina. Seis pacientes necessitaram de hemotransfusão no intra-operatório, com média geral de 1.3 bolsa/paciente. Nenhum caso de mortalidade ou morbidade significativa foi registrado. Onze dos quinze pacientes foram acompanhados por tempo médio de doze meses com taxa de recidiva de 27%. Quatro pacientes perderam seguimento. CONLUSÃO: A ressecção de NAFJ classes I- III foi realizada com segurança em pacientes não-embolizados, com taxa de sangramento intraoperatório, ocorrência de complicações e taxa de recorrência próximas dos valores pesquisados na literatura para pacientes embolizados. Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumor of the sphenopalatine foramen. Surgery combined with preoperative embolization has been the treatment of choice for JNA patients without intracranial invasion. This study aims to assess the viability of surgically treating non-embolized patients with JNA (types I-III according to Fisch). MATERIAL AND METHOD: This is a retrospective, descriptive study based on the medical records of 15 patients with histologically confirmed JNA (Fisch’s types I- III), who underwent surgical treatment without pre-op embolization in our institution between 2000 and 2005. RESULTS: Seven of the fifteen patients were approached endoscopically, four through the transantral approach, three were treated with the combined transmaxillary and endoscopic approach, and one with the combined transmaxillary and transpalatal approach. Six patients required intraoperatory blood transfusion, averaging volumes of 1.3 unit/patient. There were no cases of death or significant morbidity. Eleven of the fifteen patients were followed for an average of twelve months and 27% of them relapsed. Four patients did not comply with the follow-up scheme. CONCLUSION: Resection of JNF types I-III was safely completed in non-embolized patients. The observed levels of intraoperative bleeding, occurrence of complications, and rates of recurrence were close to those seen in embolized patients as found in the literature.
- Published
- 2008
11. Accessory Nerve Paresis as a Complication of Foreign Body
- Author
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Ramirez Ribeiro Fidelis, Gustavo Lino da Nobrega Silva, Gustavo Barreto da Cunha, Tatiane Costa Camurugy, Lorena Pinheiro Figueiredo, and Adriano Santana Fonseca
- Subjects
medicine.medical_specialty ,Otorhinolaryngology ,Accessory nerve ,business.industry ,medicine ,Foreign body ,medicine.symptom ,medicine.disease ,Complication ,business ,Paresis ,Surgery - Published
- 2014
12. Correlação entre tontura e disfunções do metabolismo da glicose Correlation between dizziness and impaired glucose metabolism
- Author
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Adriano Santana Fonseca and Silvia Angeleri Valente Davidsohn
- Subjects
vectoeletronistagmografia ,vertigo ,perda auditiva sensório-neural ,zumbido ,vectoelectronystagmography ,diabetes mellitus ,lcsh:R ,lcsh:Medicine ,tinnitus ,lcsh:Otorhinolaryngology ,vertigem ,lcsh:RF1-547 ,sensorioneural hearing loss - Abstract
INTRODUÇÃO: as alterações do metabolismo da glicose são caracterizadas por estados de hipoglicemia e hiperglicemia. OBJETIVO: A proposta deste trabalho é verificar a associação entre as alterações do metabolismo da glicose, por glicemia de jejum e teste de tolerância à glicose e à tontura, avaliada por sua queixa e exames clínicos e subsidiários. MÉTODO: O estudo foi efetivado num grupo de 33 pacientes divididos em 3 subgrupos: pacientes com queixa de tontura, pacientes diabéticos e pacientes assintomáticos. RESULTADOS: O grupo de pacientes com queixa espontânea ou questionada de tontura apresentava alterações no metabolismo da glicose em 65% dos casos. Já entre os pacientes dos 3 grupos sem queixa de tontura, 30% apresentavam alterações do metabolismo da glicose. 40% dos pacientes que apresentaram queixas de tonturas tinham o exame vestibular clínico e a vectoeletronistagmografia alterados, enquanto que entre os assintomáticos 7,5% apresentaram as alterações vestibulares referidas. CONCLUSÃO: A tontura é um bom indicador de alteração do metabolismo da glicose e a alteração do metabolismo da glicose é um bom indicador de alteração do exame vestibular. O estudo do metabolismo da glicose a partir dos níveis glicêmicos é eficaz e tem resultados próximos dos observados nos estudos que mensuram os níveis insulinêmicos.INTRODUCTION: Impaired glucose metabolism is characterized by conditions of hypo and hyperglycemia. AIM: The objective of the present study was to asses whether or not there is a relationship between impaired glucose metabolism and dizziness. In the clinical laboratory settings, patients were examined using vectoelectronystagmography in association with glycemic levels. METHODS: 33 patients were divided in 3 groups: diabetics; patients with dizziness and a control group. RESULTS: 65% of the patients with dizziness showed impaired glucose metabolism. 40% of the patients with dizziness had alterations in their vectoelectronystagmography results. CONCLUSION: Dizziness is a good indicator of glucose metabolism alterations and these may be a good indicator of alterations in vectoelectronystagmography responses. The study of glycemic levels after glucose overexposure is a good prognosis factor to evaluate dizziness and shows the same results as insulin level studies after glucose overexposure.
- Published
- 2006
13. Carcinoma papilífero de laringe com evolução inesperada: relato de caso
- Author
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Carlos Takihiro Chone, Agrício Nubiato Crespo, Adriano Santana Fonseca, and Albin Altemani
- Subjects
Adult ,Pathology ,medicine.medical_specialty ,Prognóstico ,Biopsy, Fine-Needle ,Lymphatic metastasis ,lcsh:Medicine ,Computed tomography ,Papillary carcinoma ,Carcinoma papilar ,Papillary Squamous Cell Carcinoma ,Lesion ,Radioterapia ,Metástase linfática ,medicine ,Humans ,In Situ Hybridization ,Radiotherapy ,medicine.diagnostic_test ,business.industry ,Nodal metastasis ,lcsh:R ,General Medicine ,Prognosis ,Carcinoma, Papillary ,Laryngeal neoplasms ,Neoplasias laríngeas ,Carcinoma, Squamous Cell ,Female ,Lymph ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
CONTEXT: According to the literature, laryngeal papillary carcinoma is rare and has a benign prognosis. CASE REPORT: In this report we present a surprising case with nodal metastasis at the time of diagnosis. Computed tomography showed infiltration of the lesion and metastatic lymph nodes. The resected specimen was submitted to histopathological study that confirmed the diagnosis of papillary squamous cell carcinoma. CONTEXTO: Segundo a literatura, o carcinoma pilífero de laringe é raro e tem um bom prognóstico, quando comparado aos outros carcinomas espinocelulares. RELATO DE CASO: Neste relato, apresentamos um caso já avançado ao diagnóstico, com acometimento linfonodal e invasão extracapsular bilateral. Tomografia computadorizada mostrou infiltração da lesão e metástase em linfonodos. Após cirurgia, o espécime ressecado foi submetido a estudo histopatológico, que confirmou o diagnóstico de carcinoma papilífero.
- Published
- 2006
14. Ewing's sarcoma of the head and neck
- Author
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Jorge Rizzato Paschoal, Raquel Mezzalira, A E Bortoleto, Adriano Santana Fonseca, and Agrício Nubiato Crespo
- Subjects
Adult ,medicine.medical_specialty ,lcsh:Medicine ,Context (language use) ,Sarcoma, Ewing ,Mandible ,Lesion ,Otolaryngology ,Ewing's. Pharynx ,medicine ,Humans ,Pelvis ,business.industry ,lcsh:R ,Ewing's sarcoma ,Soft tissue ,Sarcoma ,General Medicine ,medicine.disease ,Mandibular Neoplasms ,medicine.anatomical_structure ,Otorhinolaryngology ,Head and Neck Surgery ,Female ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
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.
- Published
- 2000
15. Angioleiomyoma of the nasal septum
- Author
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Carlos Roberto Ribeiro, Navarro Júnior, Adriano Santana, Fonseca, José Rodrigo Lordello de, Mattos, and Nilvano Alves de, Andrade
- Subjects
Angiomyoma ,Biopsy ,Nose Neoplasms ,Humans ,Endoscopy ,Female ,Middle Aged ,Nasal Septum - Published
- 2009
16. Maxillomandibular myxoma in neonates
- Author
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Adriano Santana, Fonseca, Vanessa Rolim Barreto, Cavalcante, and Anderson, Castelo Branco
- Subjects
Male ,Maxillary Neoplasms ,Mandibular Neoplasms ,Humans ,Infant ,Tomography, X-Ray Computed ,Myxoma - Published
- 2009
17. Bilateral hipoglossal nerve palsy in necrotizing otitis externa
- Author
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Miguel Leal Andrade Neto, Nilvano Alves de Andrade, Vyrna Medeiros de Moura Santos, and Adriano Santana Fonseca
- Subjects
Male ,medicine.medical_specialty ,nerve palsy ,medicine.drug_class ,medicine.medical_treatment ,Cefepime ,Antibiotics ,Mastoidectomy ,Disease ,Scintigraphy ,Tongue Diseases ,Necrosis ,Temporal bone ,medicine ,Humans ,Paralysis ,Pseudomonas Infections ,Aged ,medicine.diagnostic_test ,business.industry ,necrotizing otitis ,medicine.disease ,otitis externa ,eye diseases ,Surgery ,Skull ,medicine.anatomical_structure ,Otorhinolaryngology ,sense organs ,Osteitis ,business ,geographic locations ,medicine.drug - Abstract
Necrotizing otitis externa is a potentially lethal infection that starts in the external auditory canal and may progress to the skull base. It happens in elderly diabetic patients and is associated to a high morbi-mortality rate. The major causal agent is Pseudomonas aeruginosa, in 96 to 98% of the cases. The infection extends from the osteocartilaginous junction to the temporal bone by means of the Santorini fissures. The infection may progress towards the skull base and affect the facial, glossopharyngeal, vagus and accessory nerves. It may occasionally affect the hypoglossal, abducens and trigeminal nerves. Symptoms such as otalgia, headache, hypoacusis, otorrhea, in diabetic or immunosupressed patients are very relevant. Laboratory investigation reveals high ESR, with normal or mildly high white cell count. Clinical signs include ulceration on the floor of the EAC. CT scan shows bone destruction, and MRI shows both the location and extension of the infection, intracranial invasion and cranial nerve involvement. Scintigraphy with technetium and gallium has been used in order to assess cure criteria. Technetium scintigraphy is useful to diagnose osteitis, which is positive in cases of acute or chronic osteomyelitis, or trauma. It bears low specificity and may remain positive for one year. Galium-67 scintigraphy is used in the follow up and check of the therapeutic response, since galium has great affinity for acute phase leucocytes and proteins. Germ culture is necessary for proper treatment, however one should not wait for its result in order to start treatment. Two empirical antibiotics are used: aminoglycosides together with ciprofloxacin of cephtazidime. Alternative drugs are cefepime, cefoperazone, imipenem and aztreonam. Treatment lasts between 4 and 6 weeks. Otalgia reduction or cessation is an important control parameter. Most patients may be clinically treated, and surgery bears controversies, such as: progressive pain, cranial neuropathy and granulation persistence in the EAC. Mastoidectomy may be carried out, however in some cases it does not prevent skull base disease extension. CASE REPORT
- Published
- 2007
- Full Text
- View/download PDF
18. Correlação entre tontura e disfunções do metabolismo da glicose
- Author
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Silvia Angeleri Valente Davidsohn and Adriano Santana Fonseca
- Subjects
vectoeletronistagmografia ,Otorhinolaryngology ,perda auditiva sensório-neural ,zumbido ,diabetes mellitus ,vertigem - Abstract
INTRODUÇÃO: as alterações do metabolismo da glicose são caracterizadas por estados de hipoglicemia e hiperglicemia. OBJETIVO: A proposta deste trabalho é verificar a associação entre as alterações do metabolismo da glicose, por glicemia de jejum e teste de tolerância à glicose e à tontura, avaliada por sua queixa e exames clínicos e subsidiários. MÉTODO: O estudo foi efetivado num grupo de 33 pacientes divididos em 3 subgrupos: pacientes com queixa de tontura, pacientes diabéticos e pacientes assintomáticos. RESULTADOS: O grupo de pacientes com queixa espontânea ou questionada de tontura apresentava alterações no metabolismo da glicose em 65% dos casos. Já entre os pacientes dos 3 grupos sem queixa de tontura, 30% apresentavam alterações do metabolismo da glicose. 40% dos pacientes que apresentaram queixas de tonturas tinham o exame vestibular clínico e a vectoeletronistagmografia alterados, enquanto que entre os assintomáticos 7,5% apresentaram as alterações vestibulares referidas. CONCLUSÃO: A tontura é um bom indicador de alteração do metabolismo da glicose e a alteração do metabolismo da glicose é um bom indicador de alteração do exame vestibular. O estudo do metabolismo da glicose a partir dos níveis glicêmicos é eficaz e tem resultados próximos dos observados nos estudos que mensuram os níveis insulinêmicos.
- Published
- 2006
19. Correlation between dizziness and impaired glucose metabolism
- Author
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Adriano Santana Fonseca and Silvia Angeleri Valente Davidsohn
- Subjects
Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Labyrinth Diseases ,Carbohydrate metabolism ,Dizziness ,Gastroenterology ,vectoeletronistagmografia ,vertigo ,Internal medicine ,Diabetes mellitus ,vectoelectronystagmography ,Diabetes Mellitus ,medicine ,Humans ,tinnitus ,sensorioneural hearing loss ,Aged ,Glycemic ,Aged, 80 and over ,medicine.diagnostic_test ,perda auditiva sensório-neural ,business.industry ,zumbido ,Insulin ,Case-control study ,Electronystagmography ,Middle Aged ,medicine.disease ,vertigem ,Glycemic index ,Endocrinology ,Otorhinolaryngology ,Glycemic Index ,Case-Control Studies ,diabetes mellitus ,Female ,medicine.symptom ,business ,Tinnitus - Abstract
INTRODUÇÃO: as alterações do metabolismo da glicose são caracterizadas por estados de hipoglicemia e hiperglicemia. OBJETIVO: A proposta deste trabalho é verificar a associação entre as alterações do metabolismo da glicose, por glicemia de jejum e teste de tolerância à glicose e à tontura, avaliada por sua queixa e exames clínicos e subsidiários. MÉTODO: O estudo foi efetivado num grupo de 33 pacientes divididos em 3 subgrupos: pacientes com queixa de tontura, pacientes diabéticos e pacientes assintomáticos. RESULTADOS: O grupo de pacientes com queixa espontânea ou questionada de tontura apresentava alterações no metabolismo da glicose em 65% dos casos. Já entre os pacientes dos 3 grupos sem queixa de tontura, 30% apresentavam alterações do metabolismo da glicose. 40% dos pacientes que apresentaram queixas de tonturas tinham o exame vestibular clínico e a vectoeletronistagmografia alterados, enquanto que entre os assintomáticos 7,5% apresentaram as alterações vestibulares referidas. CONCLUSÃO: A tontura é um bom indicador de alteração do metabolismo da glicose e a alteração do metabolismo da glicose é um bom indicador de alteração do exame vestibular. O estudo do metabolismo da glicose a partir dos níveis glicêmicos é eficaz e tem resultados próximos dos observados nos estudos que mensuram os níveis insulinêmicos. INTRODUCTION: Impaired glucose metabolism is characterized by conditions of hypo and hyperglycemia. AIM: The objective of the present study was to asses whether or not there is a relationship between impaired glucose metabolism and dizziness. In the clinical laboratory settings, patients were examined using vectoelectronystagmography in association with glycemic levels. METHODS: 33 patients were divided in 3 groups: diabetics; patients with dizziness and a control group. RESULTS: 65% of the patients with dizziness showed impaired glucose metabolism. 40% of the patients with dizziness had alterations in their vectoelectronystagmography results. CONCLUSION: Dizziness is a good indicator of glucose metabolism alterations and these may be a good indicator of alterations in vectoelectronystagmography responses. The study of glycemic levels after glucose overexposure is a good prognosis factor to evaluate dizziness and shows the same results as insulin level studies after glucose overexposure.
- Published
- 2006
20. Clinical versus computed tomography evaluation in the diagnosis and management of deep neck infection
- Author
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João Altemani Milani, Maria Carolina S. Montenegro, Adriano Santana Fonseca, Agrício Nubiato Crespo, Carlos Takahiro Chone, and Rodrigo Augusto Santinelo Pereira
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Adult ,Male ,medicine.medical_specialty ,Erythema ,Abscesso ,lcsh:Medicine ,Pescoço ,Context (language use) ,Tomógrafos computadorizados ,X-ray computed tomography scanners ,medicine ,Humans ,Abscess ,Retrospective Studies ,Neck pain ,Neck Pain ,business.industry ,Soft Tissue Infections ,lcsh:R ,Soft tissue ,Retrospective cohort study ,Submandibular triangle ,General Medicine ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Drenagem ,Otorhinolaryngology ,Drainage ,Female ,Radiology ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Infection ,Brazil ,Neck ,Infecção - Abstract
CONTEXT: Deep neck infections have high potential for severe complications and even death, if not properly managed. The difference between clinical and computed tomography findings may demonstrate that clinical evaluation alone underestimates disease extent, which may lead to conservative treatment with worse prognosis. OBJECTIVE: To compare clinical and computed tomography findings from neck spaces affected by deep neck infections and to determine the main clinical and radiological features associated with these. TYPE OF STUDY: Non-randomized retrospective study. SETTING: Department of Otolaryngology and Head and Neck, Universidade Estadual de Campinas. METHODS: Medical charts of 65 patients with deep neck infections were evaluated. Age, gender, clinical complaints, physical findings, computed tomography scan and x-ray imaging, microbiology, treatment and outcome were analyzed. All clinical signs and symptoms were evaluated and stratified in order of frequency. The frequency of neck space involvement in such infections was also assessed from the clinical and tomographic evaluation. All clinical and computed tomography findings were compared with surgical observation. RESULTS: The most frequent clinical findings were neck swelling, local pain, erythema and locally increased temperature. Physical evaluation showed that the most affected site was the submandibular triangle (49.2% of cases). However, computed tomography showed this to be the lateropharyngeal space (65% of cases) and that more than one deep cervical space was compromised in 90% of cases, as demonstrated by the extent of swelling and increased contrast signs in soft tissue. DISCUSSION: The most frequent clinical symptoms of deep cervical infections were cervical pain, increased cervical volume and fever. The important signs seen via computed tomography were increased contrast in soft neck tissues and swelling. Such examination is the most important method for correct evaluation of cervical spaces involved in infection, and thus for correct surgical drainage. CONCLUSIONS: The most frequent clinical findings were cervical mass, neck pain, local erythema and locally increased temperature. Computed tomography demonstrated that the lateropharyngeal space was the most affected neck space. More than one deep neck space was compromised in 90% of cases. Clinical evaluation underestimated the extent of deep neck infection in 70% of patients. CONTEXTO: Infecções profundas do pescoço têm um potencial alto para complicações graves e morte, se não corretamente diagnosticadas e tratadas. A diferença entre resultados de avaliação clínica e tomográfica pode demonstrar que a avaliação clínica isolada subestima a extensão de doença, o que pode conduzir a tratamento conservador e a pior prognóstico. OBJETIVO: Comparar achados clínicos à tomografia computadorizada de pescoço em relação aos espaços cervicais envolvidos e determinar as características clínicas e radiológicas principais associadas com infecção de espaço profundo de pescoço. TIPO DE ESTUDO: Estudo retrospectivo não randomizado. LOCAL: Departamento de Otorrinolaringologia - Cabeça e Pescoço, Universidade Estatal de Campinas, Brasil, um centro universitário, terciário. MÉTODOS: Foi avaliado prontuário médico de 65 pacientes com infecções profundas de pescoço. Foram analisados idade, gênero, queixas clínicas, exames físicos, resultados de raios-x e tomografia computadorizada, microbiologia, tratamento e resultados. Foram avaliados os sinais clínicos e sintomas, estratificados em ordem de freqüência. A freqüência de espaços cervicais profundos envolvidos nesta infecção também foram avaliados clínico e tomograficamente. Todos resultados clínicos e tomográficos foram comparados com a observação cirúrgica em relação aos espaços cervicais afetados por infecção. RESULTADOS: Os resultados clínicos mais freqüentes foram inchaço cervical, dor local, eritema cutâneo local e aumento localizado de temperatura. O local mais afetado de acordo com a avaliação física foi o triângulo de submandibular (49,2%), mas, à tomografia computadorizada cervical, foi o espaço látero-faríngeo (65%). Mais de um espaço cervical profundo foi acometido, de acordo com a tomografia computadorizada cervical, em 90% dos pacientes, como demonstrado pela extensão do edema e aumento de captação de tecidos moles, e em geral apenas um espaço à avaliação clínica isolada. DISCUSSÃO: Os sintomas clínicos mais freqüentes das infecções cervicais profundas foram dor cervical, aumento de volume cervical e febre. Sinais importantes da tomografia computadorizada, para avaliação desta infecção, foram aumento de captação de contraste em tecidos moles do pescoço e edema. O espaço profundo do pescoço mais afetado pela infecção foi o laterofaríngeo, pela tomografia computadorizada do pescoço. O espaço submandibular foi o mais freqüente, ao exame físico, mas foi o segundo mais freqüente, de acordo com a tomografia computadorizada do pescoço, uma vez que o láterofaríngeo é um espaço difícil de ser examinado. Este exame é o mais importante para avaliação correta dos espaços cervicais envolvidos para a sua correta drenagem cirúrgica. CONCLUSÕES: Os achados clínicos mais freqüentes foram massa cervical, dor de pescoço, eritema de pele local e aumento de temperatura local. Avaliação com tomografia computadorizada cervical, demonstrou o espaço láterofaríngeo como o espaço cervical mais afetado. Mais de um espaço profundo de pescoço esteve acometido em 90% dos pacientes à tomografia computadorizada cervical. Avaliação clínica subestima a extensão de infecção profunda do pescoço em 70% de pacientes.
- Published
- 2004
21. Mixoma maxilo-mandibular em neonato
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Vanessa Rolim Barreto Cavalcante, Adriano Santana Fonseca, and Anderson Castelo Branco
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Pharmacology ,business.industry ,medicine ,Myxoma ,Jaw abnormality ,Anatomy ,medicine.disease ,Jaw neoplasm ,business - Published
- 2010
22. Angioleiomioma de septo nasal
- Author
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Nilvano Alves de Andrade, José Rodrigo Lordello de Mattos, Adriano Santana Fonseca, and Carlos Roberto Ribeiro Navarro Júnior
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Pharmacology ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Nose neoplasm ,Endoscopy ,Text mining ,medicine.anatomical_structure ,Leiomyoma ,Biopsy ,Angioleiomyoma ,medicine ,Nasal septum ,Radiology ,business - Published
- 2010
23. Paralisia bilateral do hipoglosso na evolução de otite externa necrotizante
- Author
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Nilvano Alves de Andrade, Miguel Leal Andrade Neto, Adriano Santana Fonseca, and Vyrna Medeiros de Moura Santos
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Otorhinolaryngology ,business.industry ,Medicine ,business - Published
- 2007
24. Paralisia bilateral do hipoglosso na evolução de otite externa necrotizante Bilateral hipoglossal nerve palsy in necrotizing otitis externa
- Author
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Adriano Santana Fonseca, Nilvano Alves de Andrade, Miguel Leal Andrade Neto, and Vyrna Medeiros de Moura Santos
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lcsh:R ,lcsh:Medicine ,lcsh:Otorhinolaryngology ,lcsh:RF1-547 - Published
- 2007
25. Surgical Treatment of Non-embolized Patients with Nasoangiofibroma
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Lislane Andrade Dias, Fernando Coifman, Eriko Vinhaes, Nilvano Alves de Andrade, Viviane Boaventura, Adriano Santana Fonseca, and Vyrna Medeiros
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Adult ,Male ,medicine.medical_specialty ,Blood transfusion ,Adolescent ,Juvenile nasopharyngeal angiofibroma ,medicine.medical_treatment ,embolization ,Angiofibroma ,Transantral approach ,Resection ,Young Adult ,juvenile nasopharyngeal angiofibroma ,medicine ,Humans ,Embolization ,Child ,Surgical treatment ,Neoplasm Staging ,treatment ,business.industry ,Medical record ,skull base ,Nasopharyngeal Neoplasms ,Embolization, Therapeutic ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Otorhinolaryngology ,Female ,Sphenopalatine foramen ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumor of the sphenopalatine foramen. Surgery combined with preoperative embolization has been the treatment of choice for JNA patients without intracranial invasion. This study aims to assess the viability of surgically treating non-embolized patients with JNA (types I-III according to Fisch). Materials And Method: This is a retrospective, descriptive study based on the medical records of 15 patients with histologically confirmed JNA (Fisch’s types I- III), who underwent surgical treatment without pre-op embolization in our institution between 2000 and 2005. Results: Seven of the fifteen patients were approached endoscopically, four through the transantral approach, three were treated with the combined transmaxillary and endoscopic approach, and one with the combined transmaxillary and transpalatal approach. Six patients required intraoperatory blood transfusion, averaging volumes of 1.3 unit/patient. There were no cases of death or significant morbidity. Eleven of the fifteen patients were followed for an average of twelve months and 27% of them relapsed. Four patients did not comply with the follow-up scheme. Conclusion: Resection of JNF types I-III was safely completed in non-embolized patients. The observed levels of intraoperative bleeding, occurrence of complications, and rates of recurrence were close to those seen in embolized patients as found in the literature.
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