Abstract Introduction Many patients undergoing functional endoscopic sinus surgery still have an uncontrolled clinical disease in the late post-operative period. Up to 11.4% of the patients will require a revision surgery. Findings such as the residual uncinated process and the lateralization of the middle turbinate were considered by some studies as being responsible for failure in the primary surgery. Objectives To describe the tomographical findings in adult patients undergoing revision endoscopic sinus surgery, the profile of those patients, and verify the mucosal thickening level of the paranasal sinus. Methods Data were collected from medical records and computed tomography reports of 28 patients undergoing revision sinus surgery on a private service in the city of Blumenau between 2007 and 2014. The score of Lund-Mackay was used to verify the mucosal thickening level. Results Among the 28 patients, 23 were reoperated once, 3 were reoperated twice, and 2 were reoperated 3 times. The most relevant findings were mucosal thickening of the maxillary sinus (89.28%), deviated septum (75%), thickening of the ethmoid (50%) and sphenoidal sinuses (39.28%), and pneumatization of the middle turbinate (39.28%). The average obtained in the Lund-Mackay score was 5.71, withmost patients classified in the lower range of punctuation. Conclusion The analysis of the computed tomography scans showed persistent structures that may be responsible for the failure of the primary surgery. Computed tomography is a useful tool to plan the surgery and quantify the post-operative success.

<sec><title>Introduction</title><p> Isolated disease of the sphenoid is rare and has often been overlooked due to its remote location and difficult access.</p></sec><sec><title>Objective</title><p> A retrospective study of the main causes of isolated sphenoid sinus diseases with discussion of the most appropriate methods of diagnosis and treatment.</p></sec><sec><title>Methods</title><p> A total of 46 cases of isolated sphenoid disease treated between January 2008 and December 2013 were evaluated by objective ear, nose, and throat examination and video endoscopy, computed tomography of the paranasal sinuses, and, in some cases, magnetic resonance imaging. In each case, we decided between drug and/or endoscopic treatment.</p></sec><sec><title>Results</title><p> We identified 12 cases of isolated sphenoiditis (26.1% ), 3 cases of fungal sphenoiditis (6.5% ), 3 cases of sphenochoanal polyps (6.5% ), 22 cases of mucocele (47.8% ), 2 cases of cerebrospinal fluid leak (4.3% ), and 1 case each of meningoencephalocele (2.1% ), inverted papilloma (2.1% ), fibrous dysplasia (2.1% ), and squamous cell carcinoma (2.1% ).</p></sec><sec><title>Conclusion</title><p> A prevalence of inflammatory and infectious diseases was found, and endoscopic surgery for the sphenoid sinus approach is effective in treating various diseases of the isolated sphenoid, whether complicated or not.</p></sec>

Introduction Hemangiomas are vascular malformations, with slow blood flow, that can occur in any part on the body. They are more common in women and, predominantly, are isolated lesions. The malformation does not spontaneously regress. Subcutaneous hemangioma is a rare variant with an aggressive growth pattern that sometimes recurs after excision. Objective Case report of a subcutaneous cavernous hemangioma in the nasal dorsum treated with endoscopic rhinoplasty. Case Report A 27-year-old woman had a fibroelastic tumor mass in the midline of the nasal dorsum, which was pulsatile; she had obstruction and nasal congestion with associated rhinorrhea, with evolution and worsening over the previous 2 years. Computed tomography showed a tumor demarcated in the nasal dorsum without evidence of intracranial communication. Endoscopic rhinoplasty with septoplasty and associated paranasal sinus sinusectomy was performed without arteriography embolization, sclerotherapy, or laser. Pathologic diagnosis showed cavernous hemangioma. Postoperative follow-up shows no recurrence at 3 years. Discussion This case presented with atypical features, thus making the diagnosis a challenge. Imaging studies were required to confirm the vascular nature of the tumor. Excisional biopsy is the procedure of choice for pathologic examination. Subcutaneous hemangiomas never involute and always need treatment. The surgical approach is exceptional because there was no preoperative diagnosis. In addition, the closed technique provided best aesthetic results in this case. Conclusion Endoscopic rhinoplasty is suitable for nasal dorsum tumor resection and has superior aesthetic result to open techniques.

INTRODUCTION: The crista galli is part of the ethmoid bone and thus may suffer from the process of pneumatization. Pneumatization occurs in between 3% and 14% of patients, resulting from air cells in the frontal or ethmoid sinuses. AIM: To describe 3 cases of crista galli pneumatization in which the patients developed infection and were treated surgically by endoscopic techniques. METHOD: We present 3 case studies of patients complaining of severe frontal headaches. The patients underwent ENT evaluation, examination by video-endoscopy, and computed tomography, which identified crista galli pneumatization with mucosal thickening and the presence of fluid. Patients underwent treatment with antibiotics and corticosteroids; however, they showed no symptomatic improvement, displayed recurrence of symptoms, and maintained radiographic changes. Thus, patients then underwent drainage through the crista galli via an endoscopic procedure. DISCUSSION: During surgery, mucopurulence and/or mucosal thickening and edema were identified in the pneumatized crista galli. There were no complications during or after surgery. Postoperatively, headache was improved in patients after a minimum follow-up of 6 months. CONCLUSION: Crista galli pneumatization can result in infection, simulating rhinosinusitis. When there is little response to drug therapy, endoscopic surgical treatment is required; the current cases demonstrate that this technique is safe and effective.

INTRODUÇÃO: A vertigem é um sintoma de impacto sobre a qualidade de vida do indivíduo, fazendo com que deixe de realizar atividades da vida diária. Destacam-se a VPPB e a doença de Ménière, cujos sintomas são exacerbados quando aparecem associadas. Atualmente, a reabilitação vestibular demonstra ser um tratamento eficaz na redução das vertigens, especialmente quando aplicada em conjunto com outras terapias. OBJETIVO: Avaliar a qualidade de vida de pacientes com VPPB e DM pré e pós-reabilitação vestibular. MÉTODO: Estudo de casos descritivo observacional, quali-quantitativo, com amostra de 12 indivíduos com idade entre 35 a 86 anos. Todos tinham diagnóstico de VPPB associada a DM e tratamento em clínica de Otorrinolaringologia. O questionário DHI-brasileiro que avalia a qualidade de vida nos aspectos físico, emocional e funcional foi utilizado para coleta de dados. Foi respondido pelos pacientes antes da primeira sessão e após a quinta sessão de RV. Os dados foram submetidos aos testes de normalidade Shapiro-Wilk, de Wilcoxon, Friedman e correlação de Spearman (p<0,05). RESULTADOS: Observou-se uma melhora significativa nos escores de todos os aspectos, com valores medianos variando de 12 para 0 no físico, de 06 para 01 no emocional e de 11 para 01 no funcional. Não foram observadas correlações entre os escores e as características da amostra. CONCLUSÃO: A RV mostrou ser um método eficaz para o tratamento de pacientes com VPPB associada à DM, melhorando a qualidade de vida dos mesmos, com maior influência sobre o escore do aspecto físico, independente da idade ou gênero.

INTRODUCTION: Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV) and Meniere's disease (MD), which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR) is an effective treatment in reducing vertigo, especially in conjunction with other therapies. AIM: To evaluate the quality of life of patients with BPPV and MD before and after VR. METHOD: We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p < 0.05). RESULTS: There were significant improvements in scores for all aspects, with median changes ranging from 12 to 0 in the physical, 6 to 1 in the emotional, and 11 to 1 in the functional aspect. There were no correlations between the scores and sample characteristics. CONCLUSION: VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender.