Biomedical subjects

Richard Louis Voegels

Publications and source records attributed to Richard Louis Voegels.

9 recordsLinked to original sources

PubMed2005

Endoscopic repair of CSF rhinorrhea: experience of 44 cases.

UNLABELLED: Cerebrospinal fluid (CSF) rhinorrhea is a leakage of fluid from the subarachnoid space to the frontal, sphenoidal or ethmoidal sinuses. CSF rhinorrhea is a known potential complication with significant morbidity and mortality. It may present a significant challenge in diagnosis, localization and management. STUDY DESIGN: Series study. MATERIAL AND METHOD: Between 1993 and 2004, 44 patients with cerebrospinal rhinorrhea were operated on using intranasal endoscopic approach in the University Hospital of the University of Sao Paulo, Medical School. The charts of all patients treated in our hospital were reviewed. RESULTS: Forty-four patients, 16 women (36%) and twenty-eight men (64%), were included in the study. Patients' ages ranged from 2 to 68 years (mean: 40.3 years). Etiology, site of leakage, diagnosis, technique, cause of failure and follow-up are discussed. CONCLUSION: The authors concluded that transnasal endoscopic surgery for CSF rhinorrhea had high success rate, low morbidity and stable long-term results.

Adolescent↗

PubMed2005

Acoustic rhinometry: anatomic correlation of the first two notches found in the nasal echogram.

UNLABELLED: The graphic obtained by acoustic rhinometry in Caucasian adult individuals with no nasal affections clearly shows two notches at the beginning of the nasal echogram. However, there are controversies in the literature concerning their anatomic correlation. AIM: The aim of this study was to obtain data that would contribute to the anatomic correlation of these two notches. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: We analyzed the nasal echogram of 35 volunteers in basal conditions, after decongestion and after obstruction of the nasal valve by using cotton impregnated with Vaseline. RESULTS: We identified statistically significant reduction and increase of the cross-sectional area only for the second notch after obstruction of the nasal valve and after decongestion, respectively. CONCLUSION: The analysis of the results suggested that the first notch of the nasal echogram refers to the nostril and the second notch refers to the nasal valve as a whole.

Adolescent↗

PubMed2005

Expression of interleukins in patients with nasal polyposis.

OBJECTIVE: To correlate the levels of interleukins 1beta, 3, 4, and 5 before and after surgery and compare the levels between patients with and without recurrence of nasal polyposis. STUDY DESIGN AND SETTING: Thirty-nine patients with NP were selected, 13 of them allergic and 26 nonallergic. A control group of 11 individuals was also studied. The concentrations of interleukins were measured by enzyme-linked immunosorbent assay. RESULTS: There was a higher incidence of NP after the fourth decade of life and among men. The clinical symptoms were similar in both groups of patients with nasal polyposis and characterized by nasal obstruction and anosmia. A significant reduction of all interleukins studied was observed after surgical treatment. CONCLUSION: Levels of interleukins 1beta, 3, 4, and 5 were significantly reduced after surgery and the levels of interleukins 1beta and 5 were significantly lower in patients without recurrence of nasal polyposis after surgery when compared to those with recurrence.

Adolescent↗

PubMed2002

Bilateral congenital choanal atresia in a 13-year-old patient.

Congenital choanal atresia (CCA) is the developmental failure of the nasal cavity to communicate with the nasopharynx. Surgical repair is recommended in the first weeks of life in bilateral cases, because in newborns this is a life-threatening situation. This is a case report of a 13-year-old patient complaining of long-term bilateral nasal obstruction and rhinorrea, in whom bilateral choanal atresia was diagnosed by endoscopic exploration and CT scan, and who was treated by an endonasal endoscopic surgical technique. Bilateral choanal atresia is a life-threatening disease in newborns; however, it can be diagnosed in adults with bilateral nasal obstruction and rhinorrea.

Adolescent↗

PubMedDate not supplied

Microbiology of the maxillary and ethmoid sinuses in patients with chronic rhinosinusitis submitted to functional endoscopic sinus surgery.

UNLABELLED: Chronic rhinosinusitis microbiology studies show the presence of aerobe and anaerobe microorganisms, fungus and virus and their incidence vary according to each study. These studies guide us on choosing the most adequate antimicrobial agent to eliminate the infectious process, thus, helping in restoring rhinosinusal mucosa. STUDY DESIGN: Clinical prospective. AIM: This work aimed at studying the microbiology of the maxillary and/or ethmoid sinuses of patients with chronic rhinosinusitis and with indication of functional endoscopic sinus surgery. MATERIALS AND METHODS: During surgery, we collected secretion and/or fragments of maxillary and/or ethmoid sinus mucosa from 41 patients to perform Gram stain, fungus direct research, aerobe and anaerobe microorganism culture and fungus culture. RESULTS: We identified the presence of aerobe microorganisms in 21 patients (51.2%), anaerobe microorganisms in 16 (39%) and fungus in 1 (2.4%). In the studied population, only 12 patients (29.2%) presented microorganisms considered pathogenic when analyzed together with the semi-quantitative leukocyte count. Staphylococcus coagulase-negative and Staphylococcus aureus were the most frequent microorganisms found, in 5 (12.18%) and in 4 (9.75%) patients respectively. CONCLUSION: This study reveals that Staphylococcus coagulase-negative and Staphylococcus aureus were the most frequent microorganisms isolated from patients with chronic rhinosinusitis.

Adolescent↗

PubMedDate not supplied

Effects of physical exercise in nasal volume.

UNLABELLED: The nasal permeability has been demonstrated using several exams. Nasal structures produces a resistance to the nasal air flux that represents over 50% of the total respiratory resistance. Physical exercises is a factor that brings a vasoconstrictor effect over nasal mucosa. AIMS: Evaluate the improvement degree of nasal volume after aerobic physical exercises and time to return to previous levels. SUBJECTS AND METHODS: Nineteen healthy subjects were submitted to aerobic exercise in ergometric bike. The nasal volume was obtained by Acoustic Rhinometry performed in rest, after aerobic exercise, 10o and 20o minutes after the aerobic exercise. RESULTS: Rhynometrics results shows a statically and significant increase of nasal volume (p<0,001). The nasal volume, in twenty minutes, returns nearby the rest levels. CONCLUSIONS: Aerobic exercises, generally, increases the nasal volume. However, the increase of nasal volume was transitory, and occurs a major reduction of increase in the first ten minutes after the exercises ends, and perform a greater vasoconstrictor effect over nasal mucosa, Twenty minutes after the physical exercises finish, total nasal volume returns, closely, to the basal levels.

Adolescent↗

PubMedDate not supplied

Endoscopic anatomy of the anterior ethmoidal artery: a cadaveric dissection study.

INTRODUCTION: The anterior ethmoidal artery (AEA) is an important point of anatomical reference in order to locate the frontal sinus and the skull base. Notwithstanding, despite numerous endoscopic studies in cadavers, we still lack an anatomical study on the AEA in the western population. AIM: to determine reference points used to locate the artery, study its relationship with the skull base and its degree of dehiscence, as well as to study intra and inter individual variations. MATERIALS AND METHODS: we dissected the nasal fossae belonging to 25 cadavers. RESULTS: the average intranasal length of the anterior ethmoidal artery was 5.2 mm. The anterior ethmoidal canal presented some degree of dehiscence in 66.7%. The average distance between the artery middle point to the anterior nasal spine was of 61.72 mm (sd=4.18 mm); to the lateral nasal wall (nasal axilla) was of 64.04 mm (sd=4.69 mm); and from the anterior axilla to the middle turbinate was of 21.14 mm (sd=3.25 mm). For all the measures there was no statistically significant measures when both sides were compared (p>0.05). CONCLUSIONS: We concluded that the middle conchae axilla is the most reliable point of reference to locate the AEA.

Adult↗

PubMedDate not supplied

Endoscopic dacryocystrhinostomy.

UNLABELLED: Endonasal endoscopic dacryocystorhinostomy (EN-DCR) is now a well-established procedure to relieve nasolacrimal duct obstruction, becoming its domain for the ENT surgeons indispensable. AIM: The aim of the present study is to report the experience of the Otorhinolaryngology Department of the University of São Paulo Medical School in the management of the obstruction of the drainage of the nasolacrimal system by EN-DCR, comparing with the results in literature. STUDY DESIGN: clinical retrospective. MATERIAL AND METHOD: We reviewed the medical records of 17 patients (17 eyes) that were submitted to EN-DCR between april 2001 and july 2004. We analysed: sex, age at the time of diagnosis, etiology, clinical findings, surgical technique, use of silicone tubes, follow-up and complications. RESULTS: Eight men and nine women, the age range was from 29 to 79 years (mean 42.6413.1 years), mean follow-up time: 15 months, presented a lacrimal clinic with epiphora. Powered DCR was performed in 06 cases and YAG LASER in 01 patient. Silicone tubes were used in all cases and left in place mean 7.9 weeks. The surgical success rate was 82,3%. CONCLUSION: EN-DCR showed one safe technique, with advantages in relation to the external technique. So ophthalmologists and ENT physicians must work in harmony to offer more benefits to its patients.

Adult↗

PubMedDate not supplied

Antibiotics in septoplasty: is it necessary?

UNLABELLED: The use of antibiotics is a common practice among otorhinolaryngogists for surgical procedures. The majority of the American Rhinology Society members uses post-operative antibiotics routinely in septoplasties, which is considered unnecessary by many authors. AIM: To study the real necessity of the antibiotic usage in septoplasties, as well as the main post-operative complications described in the literature. STUDY DESIGN: clinical prospective with transversal cohort. MATERIAL AND METHOD: We studied prospectively 35 patients who were undergone to septoplasty with or without turbinectomy, in the Clinical Hospital of the University of São Paulo. The patients were split in three groups: Group A: without antibiotics; Group B: antibiotics (cefazolin) only during the anesthesic induction; Group C: antibiotics both in the anesthesic induction and post-operatively for seven days. A questionnaire was applied in the immediate post-operatory, in the 7th post-operative day and in the 30th post-operative day asking for bleeding, fever, pain, nausea, vomits and followed by physical and endoscopic evaluation looking for hematoma, septal abscess and purulent secretion which as quantified. RESULT: We do not observed significative difference among the groups concerning to pain, fever, nausea, vomits, bleeding and purulent secretion. None of the patients had hematoma or septal abscess. The groups also do not differ in respect to the quantity of purulent secretion. CONCLUSION: The nasal surgeries are clean contamined and do not need antibioticprophilaxy because of the low infection risk.

Adolescent↗