Abstract Introduction Low exposure of the larynx can make laryngeal microsurgery difficult or even impossible. The application of rigid and contact endoscopy enabled oblique and retrograde angled visualization, allowing transoperative staging with greater reach of the anatomical areas. However, there is difficulty or even impossibility of performing the surgical act, due to the incompatibility of the angled path with the straight surgical tools. Objective To demonstrate the efficiency of the variant of the technique for laryngeal microsurgery in cases of difficult laryngoscopy and to analyze the new surgical instruments specific to the endoscopic procedure. Methods This is a cross-sectional retrospective study, based on the analysis of 30 medical records of patients treated surgically at a philanthropic hospital in the state of Sergipe, Brazil, between the years of 2014 and 2015. Results The technical variant used 30- and 70-degree endoscopes that provided complete oblique view of the endolarynx. The association of angled instruments (forceps, suction pumps, retractors and scissors) enabled the execution of the surgical procedures. Conclusion The association of rigid endoscopy with angled instruments promoted full visualization of the surgical lesion and operative resolution.

Abstract Introduction Adenotonsillar hypertrophy is more common in children with sickle cell disease, and can lead to sleep-disordered breathing. Objectives To determine the frequency of adenotonsillar hypertrophy in pre-school children with sickle cell disease and assess the diagnostic accuracy of the sleepdisordered breathing subscale in the Sleep Disturbance Scale for Children. Method Observational study with a group of 48 children with sickle cell disease and a control group of 35 children without the disease. The children underwent oropharingoscopy and video nasal endoscopy. The parents and/or guardians answered the questions of the subscale. Results Adenotonsillar hypertrophy was observed in 25% of the children in the study group, and in 20% of the children in the control group, with no statistical difference between the groups. The subscale score ranged from 3 to 11 in both groups. There was a statistical significance in the study group. The average was 4.79 (standard deviation [SD] ± 2.50), with 4.19 (SD ± 1.72) among the children without adenotonsillar hypertrophy, and 6.5 (SD ± 3.40) among the children with adenotonsillar hypertrophy. There was also a statistical significance in the control group. The average was 5.23 (SD ± 2.81), with 4.44 (SD ± 2.2) among the children without adenotonsillar hypertrophy, and 7.87 (SD ± 2.89) among the children with adenotonsillar hypertrophy. Conclusion Adenotonsillar hypertrophy was not associated with sickle cell disease in pre-school children. The subscale of sleep-disordered breathing in the Sleep Disturbance Scale for Children was a useful tool for the diagnostic suspicion of adenotonsillar hypertrophy in children in this age group.

Quanto maior o conhecimento do terapeuta acerca das especificidades culturais dos seus doentes, maior a sua capacidade de conceptualizar e tratar os problemas de saúde mental de uma forma culturalmente sensível. São objectivos desta revisão avaliar a literatura sobre a eficácia e especificidades dos tratamentos cognitivo-comportamentais (TCC) aplicados a populações latinas, culturalmente próximas da população portuguesa e discutir eventuais recomendações para a prática clínica. Foram realizadas pesquisas nas seguintes bases de dados electrónicas, até Junho de 2016: Cochrane library, Pubmed, Psychology & Behavioral Sciences Collection, Sciencedirect, PsycARTICLES, PePSIC (portal de Periódicos Electrónicos de Psicologia), EBSCO PUBLISHING, Scielo (Scientific Electronic Library Online), LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde). Depois de filtrada a pesquisa, foram analisados um total de 15 estudos empíricos e 12 artigos que discutiam abertamente aspectos relacionados com a prática clínica. Os estudos enfatizam a necessidade de incorporar explicitamente os valores culturais do doente na TCC. São fornecidas recomendações clínicas, mais adaptadas ao contexto cultural, no sentido de optimizar as intervenções em saúde mental baseadas na TCC.

The greater the therapist's knowledge about the cultural specificities of their patients, the greater its ability to conceptualize and treat mental health problems in a culturally sensible manner. This review aims to provide a critical overview of the current knowledge on the efficacy and specificity of Cognitive-Behavioral Therapies (CBT) applied to Latino populations, culturally close to the Portuguese population and to discuss possible recommendations for clinical practice. We searched the following electronic databases until June 2016: Cochrane library, Pubmed, Psychology & Behavioral Sciences Collection, ScienceDirect, PsycARTICLES, PePSIC (portal de Periódicos Electrónicos de Psicologia), EBSCO PUBLISHING, SciELO (Scientific Electronic Library Online), LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde). After filtering the results, we analyzed a total of 15 empirical studies and 12 articles discussing aspects related to clinical practice. These studies emphasize the need to explicitly incorporate the cultural values of patients into CBT. They provide clinical recommendations, better adapted to the cultural context, in order to optimize mental health interventions based on CBT.

Introduction Premalignant lesions are considered both a hyperplastic and dysplastic stage of epithelial lesions in the glottic larynx that may or may not progress into an invasive carcinoma. The evolution of laryngoscopic procedures in outpatients has provided better access to important information for safe and easy diagnosis of laryngeal pathologies. Objective The goal of this study was to determine the accuracy of the preoperative exam for diagnosis of premalignant laryngeal lesions and their connection with benign diseases of the vocal folds, as well as to assess their epidemiologic characteristics. Methods This is a retrospective and longitudinal cohort study performed through the review of surgical records of patients who underwent laryngeal microsurgery performed by a single surgeon from 1990 to 2009. Results Preoperative assessment of outpatients was 64.4% accurate. Vocal fold cysts were the most frequently associated benign lesions. The patients who apparently had premalignant lesions represented 10.57% of those who underwent laryngeal microsurgery. Premalignant lesions prevailed in men (69.49%) age from 41 to 50 years (32.20%). Conclusion Although the evolution of laryngoscopic procedures in outpatients has provided better access to important information for safe and easy diagnosis of laryngeal pathologies, about one-third of premalignant lesions are diagnosed just during the laryngeal microsurgery. Cysts were the most prevalent concomitant benign lesion of the vocal folds. Males were more prevalent than females and the predominant age bracket was between 41 and 50 years.

O ameloblastoma é um tumor bastante incomum na cavidade nasal. Surge a partir do epitélio odontogênico, podendo estender-se ao seio maxilar, órbitas e base de crânio. Apresentamos dois casos de ameloblastoma em fossa nasal direita, associados a sintomas nasossinusais e seus principais achados, clínicos e cirúrgicos.

Ameloblastoma is a very unusual tumor in the nasal cavity. It arises from the odontogenic epithelium and extends up to the maxillary sinus, orbits and skull base. We have presented two cases of ameloblastoma, both in the right nasal cavity, associated with nasal and sinusal symptoms, and reported the main surgical and clinical findings.