Abstract Introduction The endoscopic anatomy of the middle ear (ME) and of the external acoustic meatus (EAM) has been described in cadavers, in fresh temporal bones, or in vivo using conventional video recording, but not in dry bones or using an alternative inspection and recording technique. Objective To study the anatomy of the ME and of the EAM in dry temporal bones using a smartphone-endoscope system. Methods The EAM and the ME were studied in dry temporal bones using an endoscopic transcanal approach with a telescope connected to a smartphone (M-scope mobile endoscope app and adaptador, GBEF Telefonia, São Paulo, SP, Brazil). Results Out of 50 specimens, 2 had exostosis of the EAM and 3 contained remains of the tympanic membrane. The anterior wall of the EAM was prominent in 10/48 specimens (20.8%). Ossicles were seen in 13/45 (28.8%), stapes at the oval window were seen in 12/45 (26.6%), and the incus was seen in 1/45 (2.2%) specimens. The facial canal was open and protruding in 15/45 (33.3%) and in 7/45 (15.5%) specimens, respectively. Of the 45 MEs evaluated, type A was predominant for finiculus (93.3%), subiculum (100%), and ponticulus (95.6%). The rest were type B. None was classified as type C. According to its position in relation to the round window, the fustis was classified into type A (68.9%) or B (31.1%). The pyramidal eminence, the bony portion of the Eustachian tube, the semicanal of the tensor tympani muscle, and the cochleariform process were visualized completely or partially in all cases. Conclusion The use of a smartphone-based endoscopic transcanal procedure in dry temporal bones allowed the evaluation of anatomical variations in the EAM and in the ME.

A histopatologia nasal de portadores do HTLV-1 com rinite crônica é desconhecida. OBJETIVO: Descrever aspectos histopatológicos de portadores do HTLV-1 com rinite crônica. CASUÍSTICA E MÉTODOS: Amostras de mucosa nasal de 10 portadores do HTLV-1 com rinite crônica, sendo oito com rinite alérgica e dois com rinite não alérgica, foram estudadas por microscopia de luz. Amostras de 10 pacientes com rinite alérgica não infectados pelo HTLV-1 serviram como controle. RESULTADOS: Fibrose subepitelial foi maior nos pacientes com rinite alérgica infectados pelo HTLV-1 (p=0,01), enquanto o espessamento da membrana basal foi maior nos controles (p=0,03). Houve tendência a menor eosinofilia e edema entre os infectados pelo HTLV-1, sem significância estatística (p=0,2). Para o infiltrado linfocítico, não houve diferença entre os pacientes com rinite alérgica infectados e não infectados (p=1,0). Fibrose subepitelial com infiltrado linfocítico de intensidade leve a moderada foram os achados encontrados nos dois portadores do HTLV-1 com rinite não alérgica. CONCLUSÕES: O estudo sugere que a infecção pelo HTLV-1 pode modificar a histopatologia da rinite alérgica, sobretudo por maior fibrose, e pode estar relacionada a uma rinite crônica não alérgica com infiltrado linfocítico.

The nasal histopathology of HTLV-1 carriers with chronic rhinitis is unknown. OBJECTIVE: To describe the histopathological features of HTLV-1 carriers with chronic rhinitis. MATERIALS AND METHODS: Biopsies of nasal mucosa of ten HTLV-1 carriers with chronic rhinitis (eight patients with allergic rhinitis and two patients with non-allergic rhinitis) were studied using a light microscope. Samples from ten patients with allergic rhinitis not infected with HTLV-1 were used as controls. RESULTS: Subepithelial fibrosis was more pronounced in patients with allergic rhinitis infected with HTLV-1 (p=0.01), while the basement membrane thickness was greater in controls (p=0.03). There was a trend towards less eosinophilia and edema among those infected with HTLV-1, without statistical significance (p=0.2). For the lymphocytic infiltrate, there was no difference between infected and not infected patients with allergic rhinitis (p=1.0). Subepithelial fibrosis associated to moderate or small number of lymphocytes were found in the two HTLV-1 carriers with non-allergic rhinitis. CONCLUSIONS: This study suggests HTLV-1 may modify the histopathology of allergic rhinitis, especially by promoting subepithelial fibrosis, and may be related to chronic non-allergic rhinitis with lymphocytic infiltrate.

O granuloma reparativo de células gigantes é um tumor ósseo não-neoplásico incomum que representa menos que 7% dos tumores mandibulares, sua localização mais freqüente. Porém, já foi descrito em seios paranasais, ossos temporais e órbita. O presente trabalho descreve um paciente com granuloma reparativo de células gigantes em seios maxilar e etmoidal, comprometendo também, em menor extensão, os seios esfenoidal e frontal, e um outro paciente com acometimento circunscrito ao seio maxilar. Clinicamente, apresentam-se com proptose acentuada e macromala unilaterais, respectivamente. Os achados clínicos, tomográficos, histopatológicos e terapêuticos são descritos, ao lado de uma revisão da literatura com ênfase no diagnóstico diferencial, sobretudo com o tumor de células gigantes.

The giant cell reparative granuloma is a non-neoplasic and uncommon bone tumor that represents fewer than 7% of the mandibular tumors, its most frequent site. However, this tumor has been described in paranasal sinuses, temporal bones and orbit. The present article reports a patient with a maxillo-ethmoidal giant cell reparative granuloma affecting esphenoidal and frontal sinuses, clinically with unilateral severe proptosis and facial deformity, and other patient with maxillary disease associated to macromala. The clinical, tomographic, histophatological and therapeutical findings are described. In addition, a literature review with emphasis in differential diagnosis is offered, in particular with bone giant cell tumor.

O tamponamento nasal para epistaxe é comumente realizado com gaze lubrificada e sonda de Foley. O balonete de Foley, de látex, pode ser dissolvido pela vaselina ou parafina; entretanto, estes são excipientes de várias pomadas e cremes. OBJETIVO: Avaliar o efeito de potenciais lubrificantes sobre a integridade da sonda de Foley. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: Balonetes de 80 sondas foram eqüitativamente distribuídos e mantidos sob tração em contato com um dos seguintes produtos: duas pomadas, três cremes, um gel, vaselina e gaze seca, e inspecionados a cada 24 horas por cinco dias. Os lubrificantes foram testados quanto a hidrossolubilidade. RESULTADOS: Vinte balonetes romperam-se, dos grupos vaselina e uma pomada. Os produtos não associados à degeneração da sonda mostraram-se hidrossolúveis, a despeito da presença de petrolato. DISCUSSÃO: Conjectura-se que a gaze do tampão nasal anterior com lubrificante hidrofóbico contendo petrolato, justaposto ao balonete de Foley, pode lesá-lo. CONCLUSÕES: Considerando-se apenas a inocuidade à sonda de Foley, os cremes e a pomada Furacin® poderiam ser indicados para lubrificar a gaze do tampão nasal anterior associado ao balonete de Foley. Nossos resultados sugerem que cremes, pomadas e géis hidrossolúveis preservam a integridade da sonda de Foley, ainda que contenham derivados do petróleo.

Nasal packing for epistaxis is usually carried out using lubricated gauze and a Foley catheter. Lubricants such as Vaseline or paraffin can dissolve the Foley balloon of latex; however, they are excipients of various ointments and creams. AIM: To evaluate the effect of potential lubricants on the Foley catheter. STUDY DESIGN: Experimental. MATERIAL AND METHOD: Balloons from eighty Foley catheters were distributed into groups of equal size and kept under traction in contact with one of eight different products: two ointments, three creams, one gel, Vaseline and dry gauze. The balloons were inspected once every 24 hours for five days. The lubricants were tested regarding hydrosolubility. RESULTS: Twenty balloons ruptured, all of them in the Vaseline group or in the group of one of the ointments. The products that did not damage the latex balloon were soluble in water despite the petrolatum excipient. DISCUSSION: It is conjectured that hydrophobic lubricant contained petrolatum used to lubricate the gauze of nasal packing may damage the Foley catheter when in close contact with it. CONCLUSION: The creams tested in this study, as well as the Furacin® ointment, may be suggested as suitable for use as lubricants of the gauze used in the anterior nasal packing associated with the Foley balloon as they cause no deterioration to the nasal balloon. Our results suggest that hydro soluble creams, ointments and gels preserve to Foley catheter integrity although contained petroleum derivatives in excipient.