ABSTRACT Objectives: To verify the role of adenoid hypertrophy (AH) and otitis media with effusion (OME) in adult patients, in relation to the diagnosis of clinically asymptomatic nasopharyngeal carcinoma (NPC). Methods: One hundred and six adult patients were enrolled in this retrospective study. Of 256 cases who underwent nasopharyngeal biopsy for suspected nasopharyngeal malignancy in our clinic between January 2009 and July 2014, this subset met our criteria. We divided the patients into two groups—patients with AH only and those with synchronous presence of OME, and AH. Results: Two patients out of 68 (2.9%) in the first group (only AH) and one patient out of 38 (2.6%) in the second group had NPC. There was no statistically significant difference. Conclusion: We found that asymmetric AH in adult patients seems an important risk factor for NPC, and we strongly suggest that biopsy be done to rule out nasopharyngeal carcinoma, whether or not they synchronously have OME even in the absence of other clinical symptoms that would arouse suspicion of a nasopharyngeal malignancy, such as neck mass, epistaxis and cranial nerve impairment.

Abstract Introduction Angioleiomyoma is a rare neoplasm that represents ∼ 0.2 % of all head and neck benign tumors and ∼ 2% of total cases of tumors of the sinonasal tract. It was once considered a possible subtype of leiomyoma, but, in the 2020 World Health Organization (WHO) classification of soft tissue tumors, it is accepted as a singular entity. Objective To systematically review the existing literature on angioleiomyoma in the light of the new classification of soft tissue tumors. Data Synthesis The present study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search in the PubMed, Cochrane, Scopus, and Google Scholar databases was performed in January 2022. The search items included the following keywords: nasal angioleiomyoma OR sinonasal angioleiomyoma OR nasal vascular leiomyoma OR sinonasal vascular leiomyoma. A total of 87 patients were evaluated. He age of the patients in the studies ranged from 15 to 88 years (mean age at diagnosis: 55.6 years). The most common site of involvement was the nasal septum (28.4 %), followed by the inferior turbinate (22.5%). The most common symptom was nasal obstruction (66.7%), followed by epistaxis (47.1%). Surgical excision represented the main treatment, and there was recurrence of pathology in only 1 case (0.9%). Conclusion To our knowledge, only 87 cases of sinonasal-tract angioleiomyoma have been previously described. The results of the present review seem to confirm the rarity and the benign nature of this neoplasm, and they seem to confirm the necessity to improve the available data about sinonasal-tract angioleiomyoma. 02 0 2 0. tract but 202 WHO (WHO entity MetaAnalyses Meta Analyses PRISMA (PRISMA statement PubMed Cochrane Scopus 2022 keywords 8 evaluated mean diagnosis 556 55 6 55. years. . years) 28.4 284 28 4 (28. %, , %) 22.5%. 225 22.5% 22 5 (22.5%) 66.7%, 667 66.7% 66 7 (66.7%) 47.1%. 471 47.1% 47 (47.1%) treatment 0.9%. 09 0.9% 9 (0.9%) knowledge sinonasaltract described 20 28. (28 22.5 (22.5% 66.7 (66.7% 47.1 (47.1% 0.9 (0.9% (2 22. (22.5 66. (66.7 47. (47.1 (0.9 ( (22. (66. (47. (0. (22 (66 (47 (0 (6 (4

RESUMO: As neoplasias sinonasais representam cerca de 1% de todas as neoplasias e constituem um grande desafio para o tratamento. O tratamento de tumores nasais deve ser local e a radioterapia pode ser uma boa opção nesses casos. O objetivo do trabalho foi avaliar a resposta terapêutica das neoplasias sinonasais caninas à radioterapia de megavoltagem e, consequentemente, sua influência na sobrevida e qualidade de vida desses animais. Foram incluídos 26 cães diagnosticados com neoplasias sinonasais por meio de exame histopatológico e/ou citológico. Os cães foram tratados com radioterapia nas doses totais de 42 a 54 Gy (para carcinomas) e 45Gy (para sarcomas) em 15 a 18 frações de 2.8Gy a 3.0Gy, respectivamente. O estadiamento tumoral foi realizado com base na tomografia de crânio. Os sinais clínicos mais frequentes foram espirros, ruído nasal e epistaxe. Os efeitos colaterais agudos foram mais frequentes e todos de leve intensidade. A sobrevida foi avaliada de acordo com o estágio do tumor obtendo-se uma média de sobrevida global de 329 dias e mediana de 252.5 dias (intervalo de confiança de 95%; IC = 229-428). Animais em estágio T3/T4 apresentaram tempos de sobrevida significativamente menores quando comparados aos pacientes em estágio T1/T2 (P < 0.05). Dos animais tratados 86.4% apresentaram melhora clínica. A radioterapia foi bem tolerada pelos cães e se mostrou eficaz no controle das neoplasias sinonasais. RESUMO 1 casos consequentemente 2 eou ou citológico 4 5 carcinomas sarcomas 28Gy 8Gy 30Gy 3 0Gy 3.0Gy respectivamente crânio espirros epistaxe intensidade obtendose obtendo 32 2525 252 252. intervalo 95% 95 229428. 229428 229 428 . 229-428) T3T4 TT T3 T4 T T3/T T1T2 T1 T2 T1/T P 0.05. 005 0.05 0 05 0.05) 864 86 86.4 clínica 25 9 22942 22 229-428 T3T T1T 00 0.0 8 86. 2294 229-42 0. 229-4 229-

ABSTRACT: Sinonasal neoplasms represent approximately 1% of all neoplasms and represent a major challenge for treatment. The treatment of nasal tumors must be local, and radiotherapy can be a good option in these cases. This study evaluated the therapeutic response of canine sinonasal neoplasms to megavoltage radiotherapy, and consequently, its influence on the survival and quality of life of these animals. We included 26 dogs with sinonasal neoplasms through histopathological and cytological examination. Dogs were treated with radiotherapy at total doses of 42-54 Gy (for carcinomas) and 45 Gy (for sarcomas) in 15-18 fractions of 2.8-3.0 Gy. Tumor staging was performed based on skull tomography. The most frequent clinical signs of sinonasal neoplasms were sneezing, nasal noise, and epistaxis. Acute side effects were mild and more frequent. Survival was evaluated based on tumor stage, obtaining a mean overall survival of 329 days (95% confidence interval, 229-428) and a median of 252.5 days. The survival time in animals in stage T3/T4 was significantly shorter than that in those in stage T1/T2 (P < 0.05). Moreover, 86.4% of the treated animals showed clinical improvement. Radiotherapy was well tolerated by dogs and effective in controlling sinonasal neoplasms. ABSTRACT 1 local cases consequently 2 examination 4254 42 54 42-5 carcinomas 4 sarcomas 1518 15 18 15-1 2.83.0 2830 2.8 3.0 8 3 0 2.8-3. tomography sneezing noise epistaxis 32 95% 95 (95 interval 229428 229 428 229-428 2525 252 5 252. T3T4 TT T3 T4 T T3/T T1T2 T1 T2 T1/T P 0.05. 005 0.05 . 05 0.05) Moreover 864 86 86.4 improvement 425 42- 151 15- 83 2.83. 283 28 2. 30 3. 2.8-3 9 (9 22942 22 229-42 25 T3T T1T 00 0.0 86. 2.83 2.8- ( 2294 229-4 0. 229-

Abstract Objective To analyze variability in the distance between the Anterior Ethmoidal Artery (AEA) and the anterior Skull Base (SB), as well as the frequency of lateral asymmetry in a Latin American population using computed tomography. Methods A total of 250 computed tomography scans of paranasal sinuses in coronal reconstruction (500 AEAs) were analyzed. After determining the image with the best anatomical view of the artery, the distance between its midpoint and the ethmoidal roof was measured, and the images were independently interpreted by 2 physicians. Results Of the 500 AEAs, 279 (55.8%) adhered to or passed through the SB at a distance of 0 mm. A total of 221 AEAs (44.2%) were at some distance from the SB, of which 107 (48.4%) were on the right side, ranging from 1.18 to 6.75 mm, and 114 (51.5%) were on the left side, ranging from 1.15 to 6.04 mm. The overall mean distance between the AEA and SB was 1.22 (SD = 1.57) mm, increasing to 2.77 (SD = 1.14) when the arteries adhered to the SB were excluded. Seventy-six individuals (30.4%) had a lateral distance variation > 1 mm. Conclusion Our study includes the largest sample of AEA analyzed with computed tomography scans of paranasal sinuses. There was some distance between the AEA and SB in almost half the patients, and we found a high rate of lateral variability >1 mm. Level of evidence: Level 3. (AEA , (SB) 25 (50 artery measured physicians 50 27 55.8% 558 55 8 (55.8% mm 22 44.2% 442 44 (44.2% 10 48.4% 484 48 4 (48.4% side 118 18 1.1 675 6 75 6.7 11 51.5% 515 51 5 (51.5% 115 15 604 04 6.0 122 1.2 SD 1.57 157 57 277 77 2.7 1.14 14 excluded Seventysix Seventy six 30.4% 304 30 (30.4% patients evidence 3 (SB (5 55.8 (55.8 44.2 (44.2 48.4 (48.4 1. 67 7 6. 51.5 (51.5 60 12 1.5 2. 30.4 (30.4 ( 55. (55. 44. (44. 48. (48. 51. (51. 30. (30. (55 (44 (48 (51 (30 (4 (3

Abstract We present the clinical case of a 58-year-old woman who consulted for episodes of self-limited epistaxis in the right nostril associated with hypersensitivity to manipulation of this nostril. Examination revealed a nodular mucosal lesion in the nasal septum, with a hard consistency and purplish appearance. The lesion was excised endonasally, with histopatho-logical result of a glomus tumor (GT) of the nasal septum. The GT is a benign perivascular neoplasm, derived from smooth muscle cells present in the glomus body; structure with thermoregulatory function, formed by a shunt between arterioles and venules, without the presence of capillary network. Glomus bodies are mostly present in the extremities (nail bed). Glomus tumors are truly exceptional in the ENT area, with only about thirty cases published to date at the nasosinusal level. Most cases occur between the 5th and 6th decade of life and more frequently in women. It raises differential diagnosis fundamentally with two entities: paraganglioma (with which it should not be confused from the terminological or histological point of view) and with solitary fibrous tumor (former hemangiopericytoma). The behavior is benign and the treatment is surgery.

Resumen Presentamos el caso clínico de una mujer de 58 años que consulta por episodios de epis-taxis autolimitadas por fosa nasal derecha asociados a hipersensibilidad al manipular dicha fosa nasal. A la exploración se evidenció en el septum nasal una lesión mucosa nodular, de consistencia dura y aspecto violáceo. Se llevó a cabo exéresis de la misma por vía endonasal, con resultado histopatológico de tumor glómico (TG) del septum nasal. El TG es una neoplasia benigna perivascular, derivada de las células musculares lisas presentes en el cuerpo glómico; estructura con función termorreguladora, formada por un shunt entre arteriolas y vénulas, sin presencia de red capilar. Los cuerpos glómicos están presentes, mayoritariamente, en extremidades (lecho ungueal). Los tumores glómicos son, verdaderamente, excepcionales en el área ORL, existiendo sólo una treintena de casos publicados hasta la fecha a nivel nasosinusal. La mayoría de casos se presentan entre la 5ᵃ y 6ᵃ década de la vida y más, frecuentemente, en mujeres. Plantea diagnóstico diferencial, fundamentalmente, con dos entidades: el paraganglioma (con el que no debe ser confundido desde el punto de vista terminológico ni histológico), y con el tumor fibroso solitario (antiguo hemangiopericitoma). El comportamiento es benigno y el tratamiento es la cirugía

Human intoxication by long-acting anticoagulant rodenticides, known as superwarfarins, causes coagulopathy that is difficult to manage. We present the case of a 42-year-old man who ingested a toxic dose of rodenticide in a suicide attempt, evolving with epistaxis, INR of 11.6, and needing hospitalization. For seven days, serial controls of coagulation tests were carried out, with optimization of different doses of Vitamin K supplementation. The case highlights this type of anticoagulant's potency and prolonged half-life (approximately six weeks), which requires regular clinical control and satisfactory treatment adherence.

RESUMEN La intoxicación humana por rodenticidas anticoagulantes de acción prolongada, conocidos como superwarfarinas, provoca coagulopatía de prolongado manejo. Presentamos el caso de un hombre de 42 años que ingirió una dosis tóxica de rodenticida en un intento suicida, evolucionando con epistaxis, INR de 11,6 y necesidad de hospitalización. Durante 7 días se realizaron controles seriados de pruebas de coagulación, con optimización de diferentes dosis de suplementación de Vitamina K. El caso destaca la potencia y vida media prolongada (aproximadamente 6 semanas) de este tipo de anticoagulantes, hecho que requiere un control clínico regular y una adherencia al tratamiento satisfactoria.

Resumen El manejo del sangrado en CEF es fundamental, ya que aumenta la tasa de complicaciones. El principal objetivo del manejo perioperatorio es lograr una buena hemostasia, es por esto que se realizó una revisión de las principales recomendaciones de la literatura internacional, que incluye medidas preoperatorias, intraoperatorias y postoperatorias.

Abstract Bleeding is an important factor in FESS since it increases the rate of complications. The main objective of perioperative management is to achieve good hemostasis. This is a review of the main recommendations of the international literature, that includes preoperative, intraoperative and postoperative measures.

RESUMO: Mineralização dos tecidos moles e ulceração epitelial são achados comuns em cães com uremia, sendo geralmente observados no trato gastrointestinal, pulmões e pleura. O objetivo desse relato é reportar um caso de mineralização e ulceração da mucosa nasal contribuindo para epistaxe recorrente em um cão com insuficiência renal crônica e uremia. Um cão com epistaxe recorrente e aumento da ureia e creatinina foi hospitalizado. A contagem plaquetária e os testes de coagulação não tinham alterações. Foi diagnosticado insuficiência renal crônica, e o cão foi submetido a eutanásia. Na necropsia, o cão tinha os rins diminuídos, com superfície irregular. As conchas nasais estavam levemente avermelhadas. Histologicamente, foi diagnosticada uma glomerulonefrite crônica com mineralização gástrica e hiperplasia das paratireoides. As conchas nasais tinham mineralização da parede de vasos e membrana basal, úlceras e hemorragia. Os achados histopatológicos indicam que a mineralização e ulceração nasal foram causadas pela uremia. A severidade das lesões histológicas sugere que a mineralização/ulceração nasal pode ter causado, ou pelo menos contribuído, para a epistaxe deste cão. Espera-se, com esse relato, estimular futuros estudos que investiguem uma possível associação entre uremia, mineralização/ulceração nasal e epistaxe em cães.

ABSTRACT: Soft tissue mineralization and epithelial ulceration are common findings in dogs with uremia, being commonly reported in the gastrointestinal tract, lungs and pleura. This report described a case of nasal mucosal mineralization and ulceration contributing to recurrent epistaxis in a dog with chronic renal failure and uremia. A dog with recurrent epistaxis accompanied by elevated urea and creatinine was hospitalized. Platelet count and coagulation tests were within normal limits. Chronic renal failure was diagnosed, and the dog was euthanized. On necropsy, the kidneys were small, with an irregular capsular surface. The nasal conchae were slightly reddish. Histopathology revealed chronic glomerulonephritis, with gastric mineralization and bilateral parathyroid hyperplasia. Vascular and basal lamina mineralization, epithelial ulceration and hemorrhage were seen in the nasal conchae. The observed findings indicated that nasal mineralization and ulceration were caused by uremia. The severity of histopathological findings suggested that nasal mineralization/ulceration may have caused or at least contributed to epistaxis in this dog. We hope to stimulate further investigations into possible association between uremia, nasal mucosa mineralization/ulceration and epistaxis in dogs.

Abstract Objectives: The aim of the study was to compare lecture-based teaching and simulation-based hybrid training for ENT induction and objectively assess the performance of trainees in a simulated environment. Methods: This is a prospective interventional study that included 60 interns in their rotatory internship with no prior exposure to ENT emergencies. The interns came in batches of 5–6 for their 15-days ENT postings. On the first day, a pre-test questionnaire, lecture-based teaching on three scenarios and then allocation into one of the three simulation groups- Group A (Tracheostomy group), Group B (Nasogastric tube group), and Group C (Epistaxis group) was done. Hands-on simulation training was given only to the assigned group. At the end of 15-days, post-test questionnaire and an objective assessment of the three scenarios in a simulated environment was conducted. The same training was repeated for each batch of participants who attended the posting. Results: The participants had significant improvement in the post-test scores in all three scenarios (p < 0.05), and these improvements were marked in those who had received simulated training. On comparing simulation scores, the participants who received hands-on training on a particular scenario outperformed other (p < 0.05). Conclusion: Simulation-based training improves cognition and overall confidence in managing ENT skills and emergencies. In simulation training, objective and standardized assessment is the key to achieve specific learning objectives to improve the psychomotor and cognitive skill. Level of evidence: II. Objectives lecturebased lecture based simulationbased Methods 6 emergencies 56 5 5– 15days days 15 postings day pretest pre test groups Tracheostomy group, group , Nasogastric Epistaxis done Handson Hands 15days, days, posttest post conducted posting Results p 0.05, 005 0.05 0 05 0.05) handson hands 0.05. . Conclusion Simulationbased Simulation skill evidence II 1 00 0.0 0.

ABSTRACT This review aimed to provide an overview of pulmonary arteriovenous malformations, including the major clinical and radiological presentations, investigation, and treatment algorithm of the condition. The primary etiology of pulmonary arteriovenous malformations is hereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, with mutations in the ENG gene on chromosome 9 (HHT type 1) or in the ACVRL1/ALK1 complex (HHT type 2). Epistaxis should always be evaluated when repeated, when associated with anemia, and in some cases of hypoxemia. In the investigation, contrast echocardiography and chest CT are essential for evaluating this condition. Embolization is the best treatment choice, especially for correction in cases of hypoxemia or to avoid systemic infections. Finally, disease management was addressed in special conditions such as pregnancy. CT follow-up should be performed every 3-5 years, depending on the size of the afferent and efferent vessels, and antibiotic prophylactic care should always be oriented. Ultimately, knowledge of the disease by health professionals is a crucial point for the early diagnosis of these patients in clinical practice, which can potentially modify the natural course of the disease. presentations investigation condition HHT, HHT , (HHT) RenduOslerWeber Rendu Osler Weber syndrome 1 ACVRL1ALK1 ACVRLALK ACVRL1 ALK1 ACVRL ALK ACVRL1/ALK 2. 2 . 2) repeated anemia choice infections Finally pregnancy followup follow up 35 3 5 3- years vessels oriented Ultimately practice ACVRL1ALK

RESUMO Esta revisão teve como objetivo fornecer uma visão geral das malformações arteriovenosas pulmonares, incluindo as principais apresentações clínicas e radiológicas, investigação e algoritmo de tratamento da condição. A principal etiologia das malformações arteriovenosas pulmonares é a telangiectasia hemorrágica hereditária (THH), também conhecida como síndrome de Rendu-Osler-Weber, com mutações no gene ENG no cromossomo 9 (THH tipo 1) ou no complexo ACVRL1/ALK1 (THH tipo 2). A epistaxe sempre deve ser avaliada quando repetida, quando associada à anemia e em alguns casos de hipoxemia. Na investigação, a ecocardiografia e TC de tórax com contraste são essenciais para avaliar essa condição. A embolização é a melhor escolha terapêutica, especialmente para correção em casos de hipoxemia ou para evitar infecções sistêmicas. Por fim, o manejo da doença foi abordado em condições especiais, como a gravidez. O acompanhamento por TC deve ser feito a cada 3-5 anos, dependendo do tamanho dos vasos aferentes e eferentes, e a antibioticoprofilaxia deve sempre ser orientada. Em última análise, o conhecimento da doença pelos profissionais de saúde é um ponto crucial para o diagnóstico precoce desses pacientes na prática clínica, o que pode potencialmente modificar o curso natural da doença. radiológicas condição THH, THH , (THH) RenduOslerWeber, RenduOslerWeber Rendu Osler Weber, Weber Rendu-Osler-Weber 1 ACVRL1ALK1 ACVRLALK ACVRL1 ALK1 ACVRL ALK ACVRL1/ALK 2. 2 . 2) repetida terapêutica sistêmicas fim especiais gravidez 35 3 5 3- anos eferentes orientada análise clínica ACVRL1ALK

ABSTRACT Glomangiopericytoma is a rare vascular neoplasm of the nasal cavity and paranasal sinuses that occurs during the sixth or seventh decade of life. It is categorized as a borderline tumor with low malignant potential and classified as a distinct entity of sinonasal tumors with perivascular myoid phenotype by the World Health Organization (WHO). We report the case of a 50-year-old woman with nasal obstruction and severe epistaxis. The nasal sinuses computed tomography (CT), and magnetic resonance imaging (MRI) demonstrated a 3.1 cm soft tissue mass occupying the upper part of the left nasal cavity invading the left paranasal sinuses and nasal septum, and the left eye medial rectus muscle. A total mass resection was performed by nasal endoscopy. The histological and immunohistochemical examination yielded the diagnosis of glomangiopericytoma. This case report aims to contribute to the knowledge of nasal neoplasms. The need for more data on this entity is the main obstacle to developing standardized treatment guidelines. life WHO. WHO . (WHO) 50yearold yearold 50 year old epistaxis CT, CT , (CT) MRI (MRI 31 3 1 3. septum muscle endoscopy glomangiopericytoma neoplasms guidelines (WHO 5 (CT

Resumen La telangiectasia hemorrágica hereditaria (THH) es una displasia vascular multisistémica, de herencia autosómica dominante, caracterizada por el desarrollo de telangiectasias mucocutáneas y malformaciones arteriovenosas viscerales. El diagnóstico se realiza mediante los criterios de Curasao publicados en el año 2000 y su manejo requiere de un equipo multidisciplinario donde el rol del otorrinolaringólogo(a) es fundamental, puesto que la epistaxis se presenta en un 90%-95% de los pacientes siendo una de las primeras manifestaciones clínicas de la enfermedad y pudiendo amenazar la vida del paciente. En la literatura se describen múltiples alternativas de tratamiento médico y quirúrgico para la epistaxis, sin existir un tratamiento definitivo para la enfermedad. A continuación, presentaremos el caso de una paciente de 56 años con THH y epistaxis recurrentes severas que, tras no responder al tratamiento médico conservador y múltiples procedimientos quirúrgicos, se realizó el cierre nasal mediante el procedimiento de Young, constituyendo el primer caso reportado en nuestro país.

Abstract Hereditary hemorrhagic telangiectasia (HHT) is a multisystemic vascular dysplasia, of autosomal dominant inheritance, characterized by the development of mucocutaneous telangiectasias and visceral arteriovenous malformations. The diagnosis is made using the Curafao criteria published in 2000 and its management requires a multidisciplinary team where the role of the ENTs is fundamental, since epistaxis occurs in 90%-95% of patients, being one of the first clinical manifestations of the disease and may threaten the life of the patient. Multiple medical and surgical treatment alternatives for epistaxis are described in the literature without a definitive treatment for the disease. Here, we present the case of a 56-year-old patient with severe recurrent HHT and epistaxis who, after not responding to the initial conservative and surgical treatments, a nasal closure was performed, using the Young's procedure, constituting the first case reported in our country.

Abstract Introduction Choanal polyps are benign lesions arising from the sinonasal mucosa, extending through the choana into the nasopharynx. Though polyps arising from the maxillary sinus and extending to the choana are common, polyps arising from the sphenoid sinus ostium, posterior part of middle turbinate, and inferior and middle meatus are quite uncommon. Objective To document the site of origin of choanal polyps arising from unusual sites; their clinical, radiological, and histopathological characteristics, as well as diagnostic challenges and management. Methods This retrospective, single-center study included 14 patients aged 16 to 75-years-old with choanal polyps. After obtaining informed consent, their clinical, radiological and surgical details and histopathology reports were reviewed. Patients were followed for at least 6 months after surgery. Results The predominant symptoms were unilateral nasal obstruction (n = 9), snoring, rhinorrhea, and epistaxis. Though anterior rhinoscopy was unremarkable, a mass could be visualized during posterior rhinoscopy in the nasopharynx in 11 patients, and a mass could be directly visualized in the oropharynx in 2 patients. After diagnostic by nasal endoscopy, these polyps were noted to arise from the posterior aspect of the middle meatus (n = 6), middle turbinate (n = 3), posterior septum (n = 3), sphenoid sinus ostium (n = 1), and inferior meatus (n = 1). All patients were managed surgically. The histopathological examination revealed inflammatory polyp (n = 12), actinomycosis (n = 1), and rhinosporidiosis (n = 1). Patients were followed up for 6 to 22 months. We observed no complications or recurrence. Conclusion Diagnostic nasal endoscopy should be performed in all patients presenting with nasal obstruction, to rule out choanal polyps arising from unusual sites. Complete polyp removal and appropriate treatment based on histopathology prevents recurrence. mucosa common uncommon sites clinical characteristics management retrospective singlecenter single center 1 75yearsold yearsold 75 years old consent reviewed surgery n 9, 9 , 9) snoring rhinorrhea epistaxis unremarkable 6, 6) 3, 3 3) 1, 1) 1. . surgically 12, 12 12) recurrence 7

RESUMO A fratura nasal é a mais frequente entre as fraturas dos ossos faciais, sendo capaz de gerar alterações estéticas importantes e, por sua vez, determinar alterações na funcionalidade, tratando-as imediatamente evita complicações para o paciente. Com o objetivo de caracterizar as fraturas nasais atendidas no pronto-socorro de cirurgia maxilofacial do hospital Carlos Manuel de Céspedes, foi realizado um estudo observacional descritivo que incluiu todos os pacientes (105) que foram atendidos ambulatorialmente com diagnóstico de fratura nasal recente no pronto-socorro no período de janeiro de 2018 a dezembro de 2019. As variáveis estudadas foram idade, sexo, origem, fatores etiológicos, sinais clínicos, classificação segundo deslocamento, exposição do foco da fratura e direção do trauma. Um formulário de coleta de dados foi preparado. Foram utilizados números completos, percentuais e tabelas estatísticas. Foram seguidos princípios éticos para a pesquisa humana. A população mais afetada foi entre 20 e 29 anos, de origem urbana e do sexo masculino. Foi encontrada associação entre sexo e fatores etiológicos, com aagressão física predominante em homens e quedas casuais nas mulheres. O principal sinal clínico presente nos pacientes foi a epistaxe. Fraturas nasais deslocadas, com desvios laterais e fechados predominaram em ambos os sexos.

ABSTRACT The nasal fracture is the most frequent among the fractures of the facial bones, being able to generate important aesthetic alterations and in turn determine changes in functionality, treating them immediately avoids complications for the patient. In order to characterize the nasal fractures treated in the maxillofacial surgery emergency service of the “Carlos Manuel de Céspedes” hospital, a descriptive observational study was carried out that included all the patients (105) who were seen outpatiently with a diagnosis of recent nasal fracture in the emergency department in the period from January 2018 to December 2019. The variables studied were age, sex, origin, etiological factors, clinical signs, classification according to displacement, exposure of the fracture site and direction of the trauma. A data collection sheet was prepared. Whole numbers, percentages and statistical tables were used. Ethical principles for human research were followed. The most affected population was between 20 and 29 years of age, of urban origin and male. An association was found between sex and etiological factors, predominantly physical aggression in men and accidental falls in women. The main clinical sign present in the patients was epistaxis. Displaced nasal fractures with lateral and closed deviations predominated in both sexes.

RESUMEN La fractura nasal es la más frecuente entre las fracturas de los huesos faciales, pudiendo generar alteraciones estéticas importantes y a su vez determinar cambios en la funcionalidad, tratarlas de forma inmediata evita complicaciones al paciente. Con el objetivo de caracterizar las fracturas nasales atendidas en el servicio de urgencias de cirugía maxilofacial del hospital “Carlos Manuel de Céspedes” se realizó un estudio observacional descriptivo que incluyó todos los pacientes (105) que fueron atendidos ambulatoriamente con diagnóstico de fractura nasal reciente en el servicio de urgencias en el período de enero 2018 a diciembre del 2019. Las variables estudiadas fueron edad, sexo, procedencia, factores etiológicos, signos clínicos, clasificación según desplazamiento, exposición del foco de fractura y dirección del trauma. Se confeccionó una planilla de recolección de datos. Se emplearon números enteros, porcentajes y tablas estadísticas. Se siguieron los principios éticos para la investigación en humanos. La población más afectada se encontró entre los 20 y 29 años de edad, de procedencia urbana y del sexo masculino. Se encontró asociación entre el sexo y los factores etiológicos, predominando las agresiones físicas en hombres y las caídas casuales en mujeres. El principal signo clínico presente en los pacientes fue la epistaxis. Las fracturas nasales desplazadas, con desviaciones laterales y cerradas predominaron en ambos sexos.