{"id":1019398,"date":"2025-12-10T22:45:06","date_gmt":"2025-12-10T19:45:06","guid":{"rendered":"https:\/\/analyse.optim.biz\/?p=1019398"},"modified":"2025-12-10T22:45:06","modified_gmt":"2025-12-10T19:45:06","slug":"ce-poate-ascunde-o-obstructie-nazala-unilaterala","status":"publish","type":"post","link":"https:\/\/analyse.optim.biz\/?p=1019398","title":{"rendered":"Ce poate ascunde o obstruc\u021bie nazal\u0103 unilateral\u0103?"},"content":{"rendered":"<div class=\"entry-content\">\n<div id=\"attachment_318271\" class=\"wp-caption alignright\"><img decoding=\"async\" aria-describedby=\"caption-attachment-318271\" loading=\"lazy\" class=\"size-medium wp-image-318271\" src=\"https:\/\/analyse.optim.biz\/wp-content\/uploads\/2025\/12\/bobeica-madalina-300x197-1.png\" width=\"300\" height=\"197\" title=\"bobeica-madalina-300x197-1\"><\/p>\n<p id=\"caption-attachment-318271\" class=\"wp-caption-text\"><a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/bobeica-madalina#medinfo\">Dr. M\u0103d\u0103lina Bobeic\u0103<\/a>, medic primar ORL, <a href=\"http:\/\/www.arcadiamedical.ro\">Arcadia<\/a><\/p>\n<\/div>\n<p>O pacient\u0103 \u00een v\u00e2rst\u0103 de 38 de ani s-a prezentat la un consult ORL \u00een Re\u021beaua Medical\u0103 Arcadia pentru <strong>obstruc\u021bie nazal\u0103 unilateral\u0103 st\u00e2ng\u0103<\/strong> de aproximativ 6 luni, cu evolu\u021bie lent\u0103, obstruc\u021bia fiind \u00eenso\u021bit\u0103 de <strong>hiposmie<\/strong> (sc\u0103derea intensit\u0103\u021bii mirosului) \u0219i <strong>senza\u021bie de presiune facial\u0103 st\u00e2ng\u0103.<\/strong><\/p>\n<p>\u00cen cadrul examenului clinic ORL, la <strong>rinoscopia anterioar\u0103 completat\u0103 de fibroscopie nazal\u0103<\/strong> s-a vizualizat fosa nazal\u0103 st\u00e2ng\u0103 ocupat\u0103 par\u021bial de o <strong>forma\u021biune polipoid\u0103 gri-albicioas\u0103, neted\u0103,<\/strong> cu punct de plecare la nivelul meatului mijlociu. De asemenea, s-a observat o <strong>devia\u021bie u\u0219oara a septului nazal la st\u00e2nga,<\/strong> rinofaringele fiind liber.<\/p>\n<p>Ulterior s-a efectuat un <strong>CT rinosinusal<\/strong> care a descris <strong>opacifierea complet\u0103 a sinusului maxilar st\u00e2ng, cu extindere spre fosa nazal\u0103 \u2013 meatul mijlociu,<\/strong> pere\u021bi oso\u0219i aparent integri, f\u0103r\u0103 semne de invazie local\u0103.<\/p>\n<p>Conduita terapeutic\u0103 recomandat\u0103 \u00een cazul pacientei este <strong>tratamentul chirurgical de excizie a forma\u021biunii de la nivelul fosei nazale \u0219i al sinusului maxilar st\u00e2ng, sub control endoscopic (FESS),<\/strong> cu trimiterea de fragmente c\u0103tre serviciul de anatomie patologic\u0103 pentru diagnostic histologic.<\/p>\n<p>P\u00e2n\u0103 la interven\u021bia chirurgical\u0103, pacienta trebuie s\u0103 efectueze toaleta nasului cu ap\u0103 de mare \u0219i s\u0103 aplice corticoterapie topic\u0103 local\u0103 pentru reducerea inflama\u021biei.<\/p>\n<p>\u00a0<\/p>\n<p><strong>Forma\u021biunile rinosinusale unilaterale impun o evaluare atent\u0103,<\/strong> deoarece pot varia de la leziuni inflamatorii benigne, cum sunt polipii, p\u00e2n\u0103 la tumori maligne incipiente. \u00cen acest context, corelarea datelor clinice cu investiga\u021biile imagistice \u0219i confirmarea histopatologic\u0103 reprezint\u0103 etape esen\u021biale pentru stabilirea diagnosticului corect.<\/p>\n<p>\u00cen cazul prezentat, <strong>aspectul clinic \u0219i cel imagistic sugereaz\u0103 o leziune benign\u0103, cel mai probabil polip antrochoanal,<\/strong> abordarea chirurgical\u0103 minim invaziv\u0103 prin chirurgie endoscopic\u0103 func\u021bional\u0103 a sinusurilor (FESS) fiind necesar\u0103 pentru confirmarea diagnosticului \u0219i preven\u021bia recuren\u021bei.<\/p>\n<p><strong>Polipii antrochoanali<\/strong> sunt forma\u021biuni benigne, solitare, care apar \u00een sinusul maxilar, travers\u00e2nd \u0219i m\u0103rind ostiumul sinusal, cu extindere spre fosa nazal\u0103. Ace\u0219tia reprezint\u0103 doar aproximativ 5% din polipii rinosinusali, cel mai frecvent fiind observa\u021bi la adul\u021bii tineri.<\/p>\n<p><strong>Chirurgia endoscopic\u0103 func\u021bional\u0103 a sinusurilor (FESS)<\/strong> este o <strong>procedur\u0103 minim invaziv\u0103 utilizat\u0103 pentru tratarea afec\u021biunilor cronice ale sinusurilor, <\/strong>precum sinuzita recurent\u0103, polipoza nazal\u0103 sau obstruc\u021biile nazale care nu r\u0103spund la tratamentele medicamentoase. Interven\u021bia se realizeaz\u0103 <strong>sub anestezie general\u0103, f\u0103r\u0103 incizii externe, deci f\u0103r\u0103 cicatrici vizibile, folosind un endoscop<\/strong> \u2013 un tub sub\u021bire dotat cu o camer\u0103 video \u2013 care permite chirurgului ORL s\u0103 vizualizeze \u0219i s\u0103 acceseze cu precizie cavit\u0103\u021bile nazale \u0219i sinusale. Obiectivul interven\u021biei este <strong>restabilirea drenajului \u0219i ventila\u021biei normale a sinusurilor,<\/strong> prin \u00eendep\u0103rtarea \u021besuturilor inflamate, a polipilor sau a altor obstruc\u021bii.<\/p>\n<p>\u00cen cadrul Spitalului Multidisciplinar Arcadia, interven\u021biile de chirurgie endoscopic\u0103 func\u021bional\u0103 a sinusurilor sunt efectuate \u00een siguran\u021b\u0103. Pentru program\u0103ri, pacien\u021bii au la dispozi\u021bie num\u0103rul de telefon<strong> 0232 920, Call Center Arcadia.<\/strong><\/p>\n<p><a href=\"http:\/\/www.arcadiamedical.ro\">www.arcadiamedical.ro<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Dr. M\u0103d\u0103lina Bobeic\u0103, medic primar ORL, Arcadia O pacient\u0103 \u00een v\u00e2rst\u0103 de 38 de ani s-a prezentat la un consult ORL \u00een Re\u021beaua Medical\u0103 Arcadia pentru obstruc\u021bie nazal\u0103 unilateral\u0103 st\u00e2ng\u0103 de aproximativ 6 luni, cu evolu\u021bie lent\u0103, obstruc\u021bia fiind \u00eenso\u021bit\u0103 de hiposmie (sc\u0103derea intensit\u0103\u021bii mirosului) \u0219i senza\u021bie de presiune facial\u0103 st\u00e2ng\u0103. \u00cen cadrul examenului clinic [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1019399,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89],"tags":[174],"class_list":["post-1019398","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-romania","tag-suceavanews-ro"],"_links":{"self":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1019398","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1019398"}],"version-history":[{"count":0,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1019398\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/media\/1019399"}],"wp:attachment":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1019398"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1019398"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1019398"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}