Poliposis nasosinusal en adultos, eficacia del tratamiento médico en base a la correlación clínica con hallazgos tomográficos y endoscópicos, Hospital Teodoro Maldonado Carbo, 2014-2016
No hay miniatura disponible
Fecha
2017
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Los pólipos nasosinusales constituyen pseudomasas de tipo inflamatorio crónico de carácter benigno, de etiología desconocida, caracterizados por la degeneración edematosa multifocal y bilateral de la mucosa nasosinusal, afectan mayormente a la población adulta joven, provocando obstrucción nasal, rinorrea, hiposmia progresiva, cefalea, entre otros. El principal objetivo fue determinar la eficacia del tratamiento médico de poliposis nasosinusal, en pacientes adultos atendidos en el Hospital Teodoro Maldonado Carbo, mediante la correlación clínica e imagenológica tomográfica y endoscópica, periodo 2014-2016. Se realizó un estudio de tipo descriptivo, observacional, longitudinal y retrospectivo, en Consulta Externa, desde el diagnóstico inicial con controles de imagen, ejecutados a igual periodicidad. La información se tomó del Sistema AS-400, procesada en los programas EpiInfo V7.2.2.1 y Microsoft Excel 2016. Se evaluaron a 84 pacientes cuya clínica más manifiesta fue Obstrucción Nasal con 96,43%, hubo predominio de Poliposis Grado 2 con 47%, el Estadio tomográfico IV con 36,90%. La Mometasona spray nasal fue utilizada en todos los pacientes; combinada con Prednisona en el 60,71%; en casos de Rinosinusitis se usó Claritromicina en el 66,67% y Amoxicilina + Ácido Clavulánico en el 27,38%, en Rinitis Alérgica, Loratadina, que fue la primera Enfermedad Asociada en 85,71%. El Grupo Etario más frecuente fue 36 a 50 años con 41,67%, el Sexo Masculino con 71,43%. El ambiente laboral más habitual, Acumulación de Polvo 86,90%, se encontró que el 21,43% labora en Construcción. El análisis estadístico entre Grado de Poliposis y Respuesta Terapéutica mostró Significancia; una Remisión Completa y Parcial que suman 52,38%. Los Controles de imagen revelaron relación significativa, en la mejoría del grado de poliposis comparándolos con su diagnóstico inicial. Entre la Clínica con Respuesta Terapéutica y con Controles imagenológicos; no hubo relación estadísticamente significativa para afirmar la utilidad del tratamiento, igualmente con Factores de Riesgo. Se concluyó que la eficacia del tratamiento
VI
médico pudo ser objetivado en las imágenes tomográficas y endoscópicas; respecto a la Clínica en el presente estudio no hubo evidencia estadísticamente significativa ya que se vio persistencia de los síntomas en diferente intensidad, independientemente del grado de poliposis.
Palabras Claves: poliposis nasosinusal, endoscopía nasal, tomografía de senos paranasales, resultado del tratamiento médico.
etiology, characterized by multifocal and bilateral edematous degeneration of the sinonasal mucosa, mainly affecting the young adult population, causing nasal obstruction, rhinorrhea, progressive hyposmia, headache, others. The main objective was to determine the efficacy of the medical treatment of sinonasal polyposis, in adult patients treated at Teodoro Maldonado Carbo Hospital, through the clinical and imaging tomographic and endoscopic correlation, 2014-2016 period. A descriptive, observational, longitudinal and retrospective study was carried out, in External Consultation, from the initial diagnosis with image controls, executed at the same periodicity. The information was taken from the AS-400 System, processed in the EpiInfo V7.2.2.1 and Microsoft Excel 2016 programs. 84 patients were evaluated whose most evident symptoms were Nasal Obstruction with 96.43%, there was a predominance of Poliposis Grade 2 with 47%, tomographic Stage IV with 36.90%. The Mometasona nasal spray was used in all patients; combined with Prednisone in 60.71%; in cases of Rhinosinusitis Clarithromycin was used in 66.67% and Amoxicillin + Clavulanic Acid in 27.38%, in Allergic Rhinitis, Loratadine, which was the first Associated Disease in 85.71%. The most frequent Age Group was 36 to 50 years with 41.67%, the Male Sex with 71.43%. The most common work environment, Powder Accumulation 86.90%, found that 21.43% work in Construction. Statistical analysis between Polyposis Degree and Therapeutic Response showed Significance; a Complete and Partial Remission totaling 52.38%. The Image Controls revealed a significant relationship in the improvement of the degree of polyposis comparing them with their initial diagnosis. Between the Clinic with Therapeutic Response and with Imaging Controls; there was no statistically significant relationship to affirm the usefulness of the treatment, also with Risk Factors. It was concluded that the efficacy of medical treatment could be observed in tomographic and endoscopic images; VII Regarding the Clinic in the present study, there was no statistically significant evidence since the symptoms persisted at different intensity, regardless of the degree of polyposis. Key words: nasosinusal polyposis, nasal endoscopy, sinus tomography, result of medical treatment.
etiology, characterized by multifocal and bilateral edematous degeneration of the sinonasal mucosa, mainly affecting the young adult population, causing nasal obstruction, rhinorrhea, progressive hyposmia, headache, others. The main objective was to determine the efficacy of the medical treatment of sinonasal polyposis, in adult patients treated at Teodoro Maldonado Carbo Hospital, through the clinical and imaging tomographic and endoscopic correlation, 2014-2016 period. A descriptive, observational, longitudinal and retrospective study was carried out, in External Consultation, from the initial diagnosis with image controls, executed at the same periodicity. The information was taken from the AS-400 System, processed in the EpiInfo V7.2.2.1 and Microsoft Excel 2016 programs. 84 patients were evaluated whose most evident symptoms were Nasal Obstruction with 96.43%, there was a predominance of Poliposis Grade 2 with 47%, tomographic Stage IV with 36.90%. The Mometasona nasal spray was used in all patients; combined with Prednisone in 60.71%; in cases of Rhinosinusitis Clarithromycin was used in 66.67% and Amoxicillin + Clavulanic Acid in 27.38%, in Allergic Rhinitis, Loratadine, which was the first Associated Disease in 85.71%. The most frequent Age Group was 36 to 50 years with 41.67%, the Male Sex with 71.43%. The most common work environment, Powder Accumulation 86.90%, found that 21.43% work in Construction. Statistical analysis between Polyposis Degree and Therapeutic Response showed Significance; a Complete and Partial Remission totaling 52.38%. The Image Controls revealed a significant relationship in the improvement of the degree of polyposis comparing them with their initial diagnosis. Between the Clinic with Therapeutic Response and with Imaging Controls; there was no statistically significant relationship to affirm the usefulness of the treatment, also with Risk Factors. It was concluded that the efficacy of medical treatment could be observed in tomographic and endoscopic images; VII Regarding the Clinic in the present study, there was no statistically significant evidence since the symptoms persisted at different intensity, regardless of the degree of polyposis. Key words: nasosinusal polyposis, nasal endoscopy, sinus tomography, result of medical treatment.
Descripción
Palabras clave
Poliposis nasosinusal, Endoscopía, Tomografía, Epidemiología descriptiva, Estudios retrospectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador