Introdução: As complicações orbitárias das sinusites permanecem como tópico importante dentro da otorrinoloringologia, a despeito do decréscimo de sua prevalência observado após o advento da antibioticoterapia. Objetivo: Tendo por objetivo determinar as características clínicas e terapêuticas nos casos de sinusites complicadas. Forma de estudo: Clínico prospectivo randomizado. Material e método: Realizamos um estudo retrospectivo de 128 pacientes internados nos últimos 15 anos na Divisão de Clínica Otorrinolaringológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A maior parte destes pacientes eram crianças ou adultos jovens (82,81% dos pacientes tinham menos de 30 anos de idade) e 57,81% eram do sexo masculino. Todos os pacientes apresentaram evolução satisfatória, sem seqüelas tardias. Conclusão: Observamos que o diagnóstico precoce destas patologias é importante, bem como o é a instituição de terapêutica adequada e agressiva (clínica ou cirúrgica). É a ação conjunta destes dois fatores que irá promover uma diminuição da morbimortalidade destas afecções.
diagnosis and management of this rare disorder, and reviews the literature. Methods: A case report and literature review. Results: A 5-year-old girl presented with a 4-day history of fever, facial swelling, neck stiffness, and right-sided otalgia, which was not associated with trauma or any systemic disorders. On physical examination, the patient had significant right-sided facial swelling, trismus, malocclusion, and cervical adenopathy. ACT scan revealed an abscess of the right TMJ. Staphylococcal and streptococcal species were cultured from a needle aspirate of the abscess. Incision and drainage of the abscess was subsequently performed, and the patient recovered well. The etiology of the temporomandibular septic arthritis was not known. Conclusion: Septic arthritis of the TMJ is a rare disorder. Twenty-five cases have been reported, with only 4 cases occurring in children. This condition may be associated with occult head and neck infections, sexually transmitted diseases, systemic or autoimmune disorders, and trauma. A thorough history and physical examination, serologic evaluation, radiographic studies, and prompt surgical treatment are essential in patient management.
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