Browsing by Author "Ramos, Phoebe H."

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    Doble arco aórtico y fistula aortotraqueal como causa de hemorragia masiva fatal: una asociación rara y peligrosa
    (2024) Ramos, Phoebe H.; Cabello, Pablo; Contreras, Alondra; Albrich, Diego; Toso Milos, Alberto Antonio
    Vascular rings are unusual congenital malformations. Among them, double aortic arch (DAA) is often difficult to diagnose due to its low incidence of symptoms. DAA can be associated with tracheal or esophageal compression and, in severe cases, could require tracheal intubation or chronic use of a nasogastric tube. This scenario favors the development of aortotracheal fistulas (ATF) or aortoesophageal fistulas (AEF).
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    Management of Contralateral Reactive Vocal Fold Lesions, a Retrospective Study
    (2024) Alvarez, Matias L.; Ramos, Phoebe H.; Rosenbaum, Andres; Badia, Pedro; Leon, Norma; Napolitano, Carla A.
    Objective. To evaluate the anatomical and voice results of conservative management of patients diagnosed with contralateral reactive lesions (CRL) in our voice unit. Methods. A retrospective chart review was conducted of all new adult patients with benign vocal fold lesions with or without CRL, treated in the voice unit at Universidad Catolica Clinical Hospital between 2015 and 2019. Patients were divided into two groups, without CRL (group A) and with CRL (group B). Analysis of preoperaQuality of Life (VRQOL) surveys and management of CRL was conducted. Results. A total of 62 patients were included, 45 (72.6%) had CRL. When compared, bivariate and multivariate analysis revealed that age was significantly associated as a mild protective factor of presenting a CRL (P < 0.05). No significative differences were found between preoperative group A and B perceptual voice analysis or voice surveys. In terms of CRL management, 30 (66.6%) were injected, conservative management with observation was performed in 12 patients (26.7%) and, three (6.7%) were surgically resected. After 1 month follow-up, 32 (71.1%) had complete CRL resolution, eight (17.8%) had CRL persistence and, five (11.1%) had CRL recurrence. Postoperative vocal outcomes, GRBASI, VHI-10 and VRQOL showed significative improvement as compared with preoperative data for each group. No differences were seen between group A and B in terms of postoperative vocal outcomes. Conclusion. CRL are prevalent, and their management is controversial. On our study 72.6% of BFVL presented with CRL and 93.3% of them were conservatively managed. Improvement in perceptual voice analysis and quality of life surveys were similar in both groups.
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    Protection for otolaryngologic surgery in the COVID-19 Pandemic
    (2020) Lagos, Antonia E.; Ramos, Phoebe H.; Andrade, José Tomás
    Objective: The coronavirus disease 2019 (COVID-19) has placed unprecedented challenges on the world and the medical community. It is transmitted through droplets, contact, the fecal-oral route, and airborne transmission under certain conditions that allow droplets to combine with air particles to form an aerosol. Viral loads are higher in the nasal area and similar in symptomatic and asymptomatic patients. Medical situations have been classified into high and low risk of generating aerosols. Most procedures and surgery in otolaryngology correspond to high-risk medical situations. This review aims to gather the vast amount of available information and generate recommendations for different surgical procedures according to aerosolization risk and COVID-19 status, with use of specific personal protective equipment in each case. Data sources: PubMed, MEDLINE, and Embase. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, and Food and Drug Administration. Review methods: We conducted a review on the literature on personal protective equipment for otolaryngologic surgery and surgical indication restrictions during the COVID-19 pandemic. Conclusions: SARS-CoV-2 is an easily transmitted virus. Asymptomatic and symptomatic patients with COVID-19 present an upper airway high viral load, conferring otolaryngologic procedures a high risk of aerosolization. Surgical procedures must be categorized according to aerosolization risk and the possibility of COVID-19 diagnosis, according to use of personal protective equipment.Implications for practice: This review contributes to scientific knowledge regarding the detailed description of protective personal equipment and, most important, surgical recommendations to reduce the risk of infection in the otolaryngology community during the COVID-19 pandemic.