Faci al traumas are frequent in emergencies, and they require the diagnosis of fractures and associated lesions. Aim:To analyze epidemiological data concerning facial trauma care. Materials and Methods:Three hundred and fifty-five charts from patients with facial trauma treated by the Service of Otorhinolaryngology, from January 2002 to December 2008, were revised. The following data was collected: age, gender, etiology, anatomical localization of the fracture, associated injuries, alcohol consumption, treatment, and hospitalization.Study Design: A retrospective historical longitudinal study. Results:Most of the patients are young adult men (p<0.05) with a male:female ratio of 4:1(p<0.05). Interpersonal violence is the most prevalent cause of facial trauma (27.9%), followed by motor vehicle accidents (16.6%) (p<0.05). The mandible is the most prevalent facial bone fractured (44.2%), followed by nasal fracture (18.9%) (p<0.05). 41.1% of the patients consumed alcohol with a male:female ratio of 11.2:1 (p<0.05). Seventy-seven percent of the patients required surgical intervention (p<0.05) and 84.5% were hospitalized (p<0.05). Conclusion:Young male adults are the most prevalent victims of facial trauma, and interpersonal violence is responsible for the majority of the facial injuries. Most of the cases of facial trauma are associated with the consumption of alcohol. Further studies will be necessary to provide a clear understanding of the trends in the etiology of facial trauma. Braz J Otorhinolaryngol. 2010;76(5):565-74. ORIGINAL ARTICLE BJORL

No abstract

Mal es with obstructive sleep apnea syndrome (OSAS) may present decreased testosterone serum levels because of hypoxemia. Aim:To correlate testosterone levels in OSAS patients with laboratory parameters. Material and methods:103 registries of OSAS patients were reviewed from 2002 to 2009. The following data collected: age when polysomnography was done, hematocrit and hemoglobin levels, total testosterone serum levels, BMI, apnea/hypopnea index (AHI), and O2 saturation.Study Design: A cross-sectional retrospective case study.Results: 79 patients (77%) had no hormonal changes, and 24 patients (23%) had decreased serum levels. In patients with normal testosterone levels, 70% were overweight; 63% with altered testosterone levels had obesity grade I (p<0.05). Patients with altered testosterone levels had significantly lower average doses of Ht, Hb and androgen compared to patients without altered androgen levels. The average BMI of patients with altered hormone levels was significantly higher compared to patients with normal hormone levels. Conclusions:The relationship between morning testosterone levels and obesity, and to a lesser degree age, AHI and hypoxemia may be the cause of central suppression of testosterone in these patients. Decreased blood HT and HB levels may be related to lower levels of circulating testosterone. Braz J Otorhinolaryngol. 2011;77(1):88-95. BJORL ORIGINAL ARTICLE

There was no difference in the prevalence of the 102T-C polymorphism between patients with OSAS and the control group. Serotoninergic system dysfunction appeared to be related to OSAS. The -1438G-A polymorphism and OSAS are related in this studied Brazilian population.

Juvenile nasopharyngeal angiofibroma (JNA) is a vascular tumor of the nasopharynx that accounts for 0.5% of all cancers of the head and neck. It primarily affects males aged 14-25 years. Of the many genes that mediate the development of JNA, GSTM1 has been most frequently associated with this vascular tumor. The loss of expression of GSTM1 (null genotype) is linked to the development of these tumors. The aim of this cross-sectional case study was to examine the prevalence of the GSTM1-null genotype in Brazilian patients with JNA. DNA was extracted from the leukocytes of blood samples from 10 patients. GSTM1 genotypes were analyzed using a PCR-based assay that was designed to identify the wild-type allele of GSTM1. All 10 patients (100%) were males, with a mean age of 17.8 years. The null genotype for GSTM1 was noted in 4 patients (40%)-1 (10%) at Fisch stage I, 1 (10%) at stage III, and 2 (20%) at stage II. No patient with this genotype had stage IV disease. There was no correlation between Fisch classification and GSTM1 genotype (P = .5695). The correlation between age at diagnosis and GSTM1 genotype was not significant (P = .728). The present findings indicate that there is evidence of an association between the GSTM1-null genotype and JNA in this studied Brazilian population.

Obstructive sleep apnea syndrome (OSAS) is one of the most complex disorders of sleep; it involves several genetic factors that contribute to the phenotype. Serotonin (5-HT) regulates a variety of visceral and physiological functions, including sleep. Gene 5-HTR2A polymorphisms may change the transcription of several receptors in the serotoninergic system, thereby contributing to OSAS. Aim To investigate the prevalence of T102C and -1438G/A polymorphisms in the 5-HTR2A gene of patients with and without OSAS. Material and Method A molecular study of 100 index-cases and 100 controls of both genders. DNA was extracted from blood leukocytes samples and the regions that enclose both polymorphisms were amplified with PCR-RFLP. Study design A cross-sectional case study. Results There was a significant prevalence of males in index cases compared to controls (p<0.0001). No significant genotypic differences between cases and controls were found in T102C polymorphisms ( p =1.000). There were significant differences between the AA genotype of -1438G/A polymorphisms and patients with OSAS (OR:2.3; CI95%:1.20-4.38, p =0.01). Conclusion Serotonergic mechanisms may be related to OSAS. There were no differences in the prevalence of T102C polymorphisms in patients with OSAS and the control group. There is evidence of an association between the -1438G/A polymorphism and OSAS.

Introduction: The complexity of the nasal tip structures and the impact of surgical maneuvers make the prediction of the final outcome very difficult. Therefore, no single technique is enough to correct the several anatomical presentations, and adequate preoperative planning represents the basis of rhinoplasty. Objective: To present results of rhinoplasty, through the gradual surgical approach to nasal tip definition based on anatomical features, and to evaluate the degree of patient satisfaction after the surgical procedure. Methods: Longitudinal retrospective cohort study of the medical charts of 533 patients of both genders who underwent rhinoplasty from January of 2005 to January of 2012 was performed. Cases were allocated into seven groups: (1) no surgery on nasal tip; (2) interdomal breakup; (3) cephalic trim; (4) domal suture; (5) shield-shaped graft; (6) vertical dome division; (7) replacement of lower lateral cartilages. Results: Group 4 was the most prevalent. The satisfaction rate was 96% and revision surgery occurred in 4% of cases. Conclusion:The protocol used allowed the implementation of a gradual surgical approach to nasal tip definition with the nasal anatomical characteristics, high rate of patient satisfaction with the surgical outcome, and low rate of revision. PALAVRAS-CHAVE

The protocol used allowed the implementation of a gradual surgical approach to nasal tip definition with the nasal anatomical characteristics, high rate of patient satisfaction with the surgical outcome, and low rate of revision.