Navegando por Palavras-chave "cholesteatoma"
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- ItemAcesso aberto (Open Access)Análise dos padrões histopatológicos do colesteatoma adquirido da orelha média(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2008-12-01) Alves, Adriana Leal; Pereira, Celina Siqueira Barbosa; Ribeiro, Fernando De Andrade Quintanilha [UNIFESP]; Fregnani, Jose Humberto Tavares Guerreiro; SCSP FCM Depto. Morfologia; Universidade Federal de São Paulo (UNIFESP); SCSP FCM Depto. de Otorrinolaringologia; Fundação Antônio PrudenteMiddle ear cholesteatomas are characterized by the presence of stratified squamous epithelium in this cavity with highly invasive properties causing bone destruction and it may lead to complications. AIM: To study the histopathological features in acquired cholesteatomas of the middle ear, correlating this data with patient age. Study design:clinical and experimental cross-sectional study. MATERIAL AND METHODS: Samples were obtained from 50 patients submitted to otologic surgery for the removal of middle ear cholesteatomas from 2006 to 2007. Thirty four patients were adults and 16 were children. Samples were studied by histological analysis. RESULTS: we found the presence of epithelial atrophy (78%), epithelial acanthosis (88%), hyperplasia of the basal layer (88%) and formation of epithelial cones (62%). There was a positive and significant correlation between histopathological variables (such as epithelial acanthosis, hyperplasia of the basal layer and formation of epithelial cones). Histopathological variables presented no statistical significant difference in both age groups (p>0,05). CONCLUSION: Cholesteatomas have hyperproliferating characteristics with epithelial acanthosis, hyperplasia of the basal layer and the presence of epithelial cones in the matrix.
- ItemAcesso aberto (Open Access)Colesteatoma causando paralisia facial(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2003-10-01) Testa, Jose Ricardo Gurgel [UNIFESP]; Vicente, Andy De Oliveira [UNIFESP]; Abreu, Carlos E.c. [UNIFESP]; Benbassat, Simone F. [UNIFESP]; Antunes, Marcos L. [UNIFESP]; Barros, Flávia A.; Universidade Federal de São Paulo (UNIFESP)Facial paralysis caused by cholesteatoma is uncommon. The portions most frequently involved are horizontal (tympanic) and second genu segments. When cholesteatomas extend over the anterior epitympanic space, the facial nerve is placed in jeopardy in the region of the geniculate ganglion. The aetiology can be related to compression of the nerve followed by impairment of its blood supply or production of neurotoxic substances secreted from either the cholesteatoma matrix or bacteria enclosed in the tumor. AIM: To evaluate the incidence, clinical features and treatment of the facial palsy due cholesteatoma. STUDY DESIGN: Clinical retrospective. MATERIAL AND METHOD: Retrospective study of 10 cases of facial paralysis due cholesteatoma selected through a survey of 206 decompressions of the facial nerve due various aetiologies realized in the last 10 years in UNIFESP-EPM. RESULTS: The incidence of facial paralysis due cholesteatoma in this study was 4,85%, with female predominance (60%). The average age of the patients was 39 years. The duration and severity of the facial palsy associated with the extension of lesion were important for the functional recovery of the facial nerve. CONCLUSION: Early surgical approach is necessary in these cases to improve the nerve function more adequately. When disruption or intense fibrous replacement occurs in the facial nerve, nerve grafting (greater auricular/sural nerves) and/or hypoglossal facial anastomosis may be suggested.
- ItemAcesso aberto (Open Access)Epidemiology of middle ear and mastoid cholesteatomas. Study of 1146 cases(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2011-05-01) Aquino, Jose Evandro Andrade Prudente de; Cruz Filho, Nelson Alvares; Aquino, Julia Negro Prudente de [UNIFESP]; Beneficencia Portuguesa Hosp; Cema; Universidade Federal de São Paulo (UNIFESP)Middle ear cholesteatoma is an important and relatively common disorder which may have serious consequences.Aim: The purpose was to conduct a retrospective study of the statistics of 1,146 middle ear surgical procedures for middle ear cholesteatoma in adults and children of low income living in distant areas from our city.Methods: From 1962 to 1988 there were 1,146 surgeries for unilateral or bilateral cholesteatomas in children and adults, which were reviewed for the following criteria: total number of surgeries, sex, onset of the first symptoms, duration of the disease, the site of perforation, the cholesteatoma site, changes in the ossicular chain, the contralateral ear, bilateral cholesteatomas, the site of residual cholesteatoma, and complications.Results: Results are shown graphically on a pie chart.Conclusion: The etiology of cholesteatomas remains unknown. Epidemiological and statistical data, surgical reports, and conclusions of experimental studies are welcome, as they may provide support for clarifying the pathogenesis of cholesteatoma. Our results were compared with internationally published papers. We found no published papers on the epidemiology of cholesteatoma in the Brazilian literature.
- ItemAcesso aberto (Open Access)Estudo comparativo entre achados radiológicos e cirúrgicos na otite média crônica(Fundação Otorrinolaringologia, 2011-03-01) Prata, Anelise Abrahao Salge; Antunes, Marcos Luiz [UNIFESP]; Abreu, Carlos Eduardo Cesario De [UNIFESP]; Frazatto, Ricardo [UNIFESP]; Lima, Bruno Thieme [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); faculdade de medicina do ABC; Hospital Estadual de DiademaINTRODUCTION: The chronic otitis media (COM) is a prevalent disease and the most frequent cause of indication to mastoidectomy. Many studies have evaluated the use of tomography (CT) of temporal bones for preoperative evaluation of COM and its indication in the preoperative approach is still controversial nowadays. OBJECTIVE: To evaluate the sensitivity of the clinical and radiological findings of COM according to the intraoperative surgical results and histopathological findings. METHOD: Transversal retrospective study through collection of record data of patients with COM submitted to mastoidectomy in the period from 2007 through 2008 in our service. RESULTS: From a total of 82 ears, 40.24% had cholesteatoma. The CT presented 72.73% of sensitivity in the identification of cholesteatoma, 56.67% in the identification of changes to the ossicular chain and 100% in that of erosion of the lateral semicircular canal. CONCLUSION: The clinical and radiological findings showed a high level sensitivity with intraoperative findings as regards to the presence of cholesteatoma, large changes of the ossicular chain and erosion of the lateral semicircular canal. For minor changes to the ossicular chain, the facial nerve canal and the tympanic tegmen they described low sensitivity.
- ItemAcesso aberto (Open Access)Impacto da endoscopia no tratameno do colesteatoma(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2013-08-01) Lima, Thiago de Oliveira [UNIFESP]; Araújo, Taís Figueiredo de; Soares, Letícia Clemente Alvim; Testa, Jose Ricardo Gurgel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Santa Marcelina; Otorhinus Clínica MédicaRecurrent cholesteatoma is relatively uncommon. Residual middle ear cholesteatomas account for most of the cases of recurrent disease. The limited role of microscopy in the visualization of tridimensional anatomic alterations of the temporal bone led to the use of endoscopic examination as an additional tool in the realm of ear surgery. Endoscopy has significantly aided in the management of chronic cholesteatomatous otitis media and in the prevention of recurrent disease. OBJECTIVE: To review the literature and assess the relevance of endoscopy in the surgical treatment of cholesteatomas and in the prevention of relapsing lesions. METHOD: Searches on databases MedLine and LILACS were carried out between March and June of 2011 to select studies in which endoscopy was used in the management of cholesteatomas. RESULTS: Three studies comparing surgery aided by endoscopy and surgery performed with the aid of a microscope met the inclusion criteria. CONCLUSION: Endoscopy has positively impacted the management of cholesteatomas and should be used in cholesteatoma surgery.
- ItemAcesso aberto (Open Access)Matriz Metaloproteinase 2: um importante marcador genético para colesteatomas(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-02-01) Morales, Douglas Salmazo Rocha; Penido, Norma de Oliveira [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; Stávale, João Norberto [UNIFESP]; Guilherme, Arnaldo [UNIFESP]; Fukuda, Yotaka [UNIFESP]; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Hospital do Servidor Público Estadual de São PauloAIM: This study is to determine the MMP2 s presence in cholesteatomas and whether complicating cholesteatomas show a higher immunohistochemical expression of matrix metalloproteinase 2. Cholesteatoma produces enzymesthat cause bone erosion like Matrixmetalloproteinase 2 (MMP2). MATERIAL AND METHODS: We analyzed the expression of MMP2 in invasive (causing complications) compared to latent cholesteatomas (not causing complications). A crosssectional study with nineteen slides and paraffin blocks of cholesteatomas derived from mastoidectomies were located and processed, including 8 invasive and 11 latent cholesteatomas. Immunohistochemical thecnique was empregated to MMP2. RESULTS: The results are expressed as 0, + (to low), ++ and +++(high) according to the quantity and color of the immunohistochemical staining of MMP2. Higher expression of MMP2 was observed in 7 (87.5%) of the 8 invasive cholesteatomas. With respect to latent cholesteatomas, higher expression of MMP2 was observed in 27.3% (3 cases), with Fisher s exact test indicating a significant difference (p=0.015). CONCLUSIONS: Cholesteatoamas express MMP2 and Invasive cholesteatomas had high MMP2 compared to latent cholesteatomas.