Vanessa Zerpa | Universidad Central de Venezuela (original) (raw)
Papers by Vanessa Zerpa
Acta Otorrinolaringologica (english Edition), May 1, 2014
Acta Otorrinolaringologica (english Edition), May 1, 2014
Abstract Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepte... more Abstract Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. Methods This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007–2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. Results The mean age of the studied sample was 52.9 years (range: 11–88 years); 55.9% were men. The FNAC showed significant sensitivity of 57.1%, with a specificity of 95.1%, for detecting malignancy in parotid gland tumours. The positive and negative predictive values for malignancy were 50 and 96.3%, respectively. Conclusions FNAC is considered a simple test but of limited use for diagnostic guidance in tumour pathology of the parotid gland in our environment, mainly because of its low sensitivity. However, the high specificity and high negative predictive value of FNAC make it a more accurate test in benign or negative result cases.
Acta otorrinolaringológica española, May 1, 2014
Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evalu... more Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007-2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. The mean age of the studied sample was 52.9 years (range: 11 to 88 years); 55.9% were men. The FNAC showed significant sensitivity of 57.1%, with a specificity of 95.1%, for detecting malignancy in parotid gland tumours. The positive and negative predictive values for malignancy were 50 and 96.3%, respectively. FNAC is considered a simple test but of limited use for diagnostic guidance in tumour pathology of the parotid gland in our environment, mainly because of its low sensitivity. However, the high specificity and high negative predictive value of FNAC makes it a more accurate test in benign or negative result cases.
Journal of otolaryngology-ENT research, Oct 20, 2022
Idiopathic subglottic stenosis is a rare disease that occurs almost exclusively in women between ... more Idiopathic subglottic stenosis is a rare disease that occurs almost exclusively in women between 20 and 60 years of age and whose cause is unknown. It is a narrowing of the laryngeal lumen at the level of the cricoid cartilage in the upper airway. Idiopathic subglottic stenosis is a rare entity of unknown etiology, the incidence of which has not been established to date. The clinical case of a 75-year-old woman with progressive inspiratory dyspnea is presented. After nasofibrolaryngoscopy, a decrease in the subglottictracheal lumen is observed, an entity that has been highlighted for its low frequency in the otorhinolaryngology and head and neck areas.
Acta Otorrinolaringologica Espanola, Mar 2, 2014
Acta otorrinolaringologica espanola, 2014
INTRODUCTION AND OBJECTIVES Fine needle aspiration cytology (FNAC) is a globally accepted techniq... more INTRODUCTION AND OBJECTIVES Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. METHODS This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007-2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. RESULTS The mean age of the studied sample was 52.9 years (range: 11 to 88 years); 55.9% wer...
European Archives of Oto-Rhino-Laryngology, 2015
The aim of this study was to assess the surgical success rate of patients undergoing oropharyngea... more The aim of this study was to assess the surgical success rate of patients undergoing oropharyngeal surgery, selected through drug-induced sleep endoscopy. Secondly, to compare outcomes of the different oropharyngeal surgery techniques applied. The study design was retrospective case series of surgically treated patients from 2006 to 2013. All patients were diagnosed with either moderate or severe obstructive sleep apnea and did not tolerate conventional positive airway pressure. We performed five different surgical techniques to treat oropharyngeal collapse: partial palate resection, uvulopalatopharyngoplasty, Z-palatoplasty, lateral pharyngoplasty and expansion pharyngoplasty. Patients in whom multilevel surgery was performed were excluded. 53 patients were included in our study, 52.8 % were severe obstructive sleep apnea patients, mean age was 43.9 years, mean body mass index 27.5. The surgical success rate according to Sher's criteria was 71.7 %. 47.2 % had a postoperative apnea hypopnea index lower than 10. The highest success rate was measured in patients who underwent expansion pharyngoplasty (90 % according to Sher's criteria, 80 % with a postoperative apnea hypopnea index lower than 10) although it did not reach statistical significance. Our conclusion is that drug-induced sleep endoscopy is a good tool to select surgical candidates in patients with moderate-to-severe obstructive sleep apnea who are not compliant with the optimal therapy. Expansion pharyngoplasty was the surgical technique with the highest success rates.
Acta Otorrinolaringológica Española, 2014
Fiberoptic examination of the pharynx under drug-induced sleep is a test that helps to detect the... more Fiberoptic examination of the pharynx under drug-induced sleep is a test that helps to detect the areas of vibration and collapse in patients with sleep-disordered breathing. This article is a review of the available literature on the subject, aimed at helping otolaryngologists to understand the procedure and to resolve some controversies surrounding it.
Sleep and Breathing, 2015
Identifying the sites of obstruction of the upper airway in patients with obstructive sleep apnea... more Identifying the sites of obstruction of the upper airway in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) is paramount for surgical planning. The aim of this study is to compare wake physical exam findings to the ones obtained during drug-induced sedation endoscopy (DISE) in the diagnosis of severe collapse of the upper airway in OSAHS patients. A retrospective chart review of OSAHS patients who underwent DISE at our institution during the 2006-2010 period was conducted. All the patients had previously undergone a physical examination that included modified Mallampati index (MMI), the Müller maneuver (MM), and the Friedman staging system. Level and severity of airway collapse were evaluated. A severe collapse was attributed to obstructions equal or greater than 75 % of the airway. A total of 138 patients were included in the study. The incidence of severe airway collapse was compared between DISE and MM; at retropalatal level, no significant difference was found. At retrolingual level, 69 % of patients had severe collapse with DISE in comparison to a 28 % with the MM (p < 0.05). No relationship was found either with the MMI or with the Friedman staging system when compared to the incidence of severe retrolingual collapse diagnosed by DISE. Concordance was low between awake and DISE exploration in both retropalatal and retroglossal level. The Müller maneuver underestimates tongue base severe obstruction diagnosis when compared to that obtained after DISE in OSAHS patients. The wake patient exploration does not accurately correlate to DISE exploration.
Acta otorrinolaringológica española, 2014
Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepted techniq... more Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. Methods This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007–2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. Results The mean age of the studied sample was 52.9 years (range: 11–88 years); 55.9% were m...
Sleep and Breathing, 2016
Sleep and Breathing, 2016
Apnea obstructiva del sueño; Diagnóstico; Videoendoscopia del sueño inducido; Revisión Resumen La... more Apnea obstructiva del sueño; Diagnóstico; Videoendoscopia del sueño inducido; Revisión Resumen La exploración fibroscópica de la faringe mediante sueño inducido es una prueba que ayuda a conocer las zonas de vibración y colapso de los pacientes con trastornos respiratorios del sueño. En este artículo se realiza una revisión de la literatura disponible sobre el tema para ayudar al otorrinolaringólogo a conocer la prueba y resolver algunas controversias existentes sobre la misma.
Acta Otorrinolaringológica Española, 2015
Tonsillectomy represents one of the main surgical procedures for the otolaryngologist, with haemo... more Tonsillectomy represents one of the main surgical procedures for the otolaryngologist, with haemorrhage being the most common postoperative. The objective of this study was to determine the post-tonsillectomy haemorrhage rate, and relate the surgical technique, diagnosis and patient age. This was a retrospective study, from April 2012 to January 2014, covering 429patients. We used the following surgical-dissection techniques: cold, Colorado needle and monopolar forceps. Haemostasis was carried out in every case with monopolar forceps and gauze compression. Post- tonsillectomy haemorrhage rate was 6.99%. According to the surgical technique used, with Colorado needle dissection, the bleeding rate we found was 7.07%; with monopolar forceps dissection, the rate was 20.4%; and with cold dissection, 2.9%. Of all haemorrhages, only 9 (2.09%) needed reintervention, of which 40% were performed with monopolar forceps dissection. The group with the largest bleeding rate was that of more than 14 years old. The diagnosis most associated with bleeding was peritonsillar abscess. The lowest bleeding rate was found with cold dissection and monopolar forceps haemostasis (2.09%). Consequently, based on our experience and the results obtained in the study, we consider that surgical technique does influence post-tonsillectomy haemorrhage.
Acta Otorrinolaringologica (english Edition), May 1, 2014
Acta Otorrinolaringologica (english Edition), May 1, 2014
Abstract Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepte... more Abstract Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. Methods This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007–2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. Results The mean age of the studied sample was 52.9 years (range: 11–88 years); 55.9% were men. The FNAC showed significant sensitivity of 57.1%, with a specificity of 95.1%, for detecting malignancy in parotid gland tumours. The positive and negative predictive values for malignancy were 50 and 96.3%, respectively. Conclusions FNAC is considered a simple test but of limited use for diagnostic guidance in tumour pathology of the parotid gland in our environment, mainly because of its low sensitivity. However, the high specificity and high negative predictive value of FNAC make it a more accurate test in benign or negative result cases.
Acta otorrinolaringológica española, May 1, 2014
Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evalu... more Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007-2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. The mean age of the studied sample was 52.9 years (range: 11 to 88 years); 55.9% were men. The FNAC showed significant sensitivity of 57.1%, with a specificity of 95.1%, for detecting malignancy in parotid gland tumours. The positive and negative predictive values for malignancy were 50 and 96.3%, respectively. FNAC is considered a simple test but of limited use for diagnostic guidance in tumour pathology of the parotid gland in our environment, mainly because of its low sensitivity. However, the high specificity and high negative predictive value of FNAC makes it a more accurate test in benign or negative result cases.
Journal of otolaryngology-ENT research, Oct 20, 2022
Idiopathic subglottic stenosis is a rare disease that occurs almost exclusively in women between ... more Idiopathic subglottic stenosis is a rare disease that occurs almost exclusively in women between 20 and 60 years of age and whose cause is unknown. It is a narrowing of the laryngeal lumen at the level of the cricoid cartilage in the upper airway. Idiopathic subglottic stenosis is a rare entity of unknown etiology, the incidence of which has not been established to date. The clinical case of a 75-year-old woman with progressive inspiratory dyspnea is presented. After nasofibrolaryngoscopy, a decrease in the subglottictracheal lumen is observed, an entity that has been highlighted for its low frequency in the otorhinolaryngology and head and neck areas.
Acta Otorrinolaringologica Espanola, Mar 2, 2014
Acta otorrinolaringologica espanola, 2014
INTRODUCTION AND OBJECTIVES Fine needle aspiration cytology (FNAC) is a globally accepted techniq... more INTRODUCTION AND OBJECTIVES Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. METHODS This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007-2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. RESULTS The mean age of the studied sample was 52.9 years (range: 11 to 88 years); 55.9% wer...
European Archives of Oto-Rhino-Laryngology, 2015
The aim of this study was to assess the surgical success rate of patients undergoing oropharyngea... more The aim of this study was to assess the surgical success rate of patients undergoing oropharyngeal surgery, selected through drug-induced sleep endoscopy. Secondly, to compare outcomes of the different oropharyngeal surgery techniques applied. The study design was retrospective case series of surgically treated patients from 2006 to 2013. All patients were diagnosed with either moderate or severe obstructive sleep apnea and did not tolerate conventional positive airway pressure. We performed five different surgical techniques to treat oropharyngeal collapse: partial palate resection, uvulopalatopharyngoplasty, Z-palatoplasty, lateral pharyngoplasty and expansion pharyngoplasty. Patients in whom multilevel surgery was performed were excluded. 53 patients were included in our study, 52.8 % were severe obstructive sleep apnea patients, mean age was 43.9 years, mean body mass index 27.5. The surgical success rate according to Sher&amp;#39;s criteria was 71.7 %. 47.2 % had a postoperative apnea hypopnea index lower than 10. The highest success rate was measured in patients who underwent expansion pharyngoplasty (90 % according to Sher&amp;#39;s criteria, 80 % with a postoperative apnea hypopnea index lower than 10) although it did not reach statistical significance. Our conclusion is that drug-induced sleep endoscopy is a good tool to select surgical candidates in patients with moderate-to-severe obstructive sleep apnea who are not compliant with the optimal therapy. Expansion pharyngoplasty was the surgical technique with the highest success rates.
Acta Otorrinolaringológica Española, 2014
Fiberoptic examination of the pharynx under drug-induced sleep is a test that helps to detect the... more Fiberoptic examination of the pharynx under drug-induced sleep is a test that helps to detect the areas of vibration and collapse in patients with sleep-disordered breathing. This article is a review of the available literature on the subject, aimed at helping otolaryngologists to understand the procedure and to resolve some controversies surrounding it.
Sleep and Breathing, 2015
Identifying the sites of obstruction of the upper airway in patients with obstructive sleep apnea... more Identifying the sites of obstruction of the upper airway in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) is paramount for surgical planning. The aim of this study is to compare wake physical exam findings to the ones obtained during drug-induced sedation endoscopy (DISE) in the diagnosis of severe collapse of the upper airway in OSAHS patients. A retrospective chart review of OSAHS patients who underwent DISE at our institution during the 2006-2010 period was conducted. All the patients had previously undergone a physical examination that included modified Mallampati index (MMI), the Müller maneuver (MM), and the Friedman staging system. Level and severity of airway collapse were evaluated. A severe collapse was attributed to obstructions equal or greater than 75 % of the airway. A total of 138 patients were included in the study. The incidence of severe airway collapse was compared between DISE and MM; at retropalatal level, no significant difference was found. At retrolingual level, 69 % of patients had severe collapse with DISE in comparison to a 28 % with the MM (p < 0.05). No relationship was found either with the MMI or with the Friedman staging system when compared to the incidence of severe retrolingual collapse diagnosed by DISE. Concordance was low between awake and DISE exploration in both retropalatal and retroglossal level. The Müller maneuver underestimates tongue base severe obstruction diagnosis when compared to that obtained after DISE in OSAHS patients. The wake patient exploration does not accurately correlate to DISE exploration.
Acta otorrinolaringológica española, 2014
Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepted techniq... more Introduction and objectives Fine needle aspiration cytology (FNAC) is a globally accepted technique in the preoperative evaluations of head and neck tumours; however, the effectiveness in the interpretation of salivary glands neoplastic lesions is still controversial. The objective of this study consisted of assessing the efficacy of FNAC in preoperative diagnosis of parotid tumours. Methods This retrospective study was conducted using 93 patient samples with parotid gland tumoral pathology, treated at the Otorhinolaryngology Department in our institution during the 2007–2011 period. Preoperative FNAC was employed and the patients subsequently submitted to surgical excision with histopathological diagnosis of the specimen. Cytology results were classified as negative for malignancy, positive for malignancy or insufficient sample, and later compared with the definitive histological diagnosis. Results The mean age of the studied sample was 52.9 years (range: 11–88 years); 55.9% were m...
Sleep and Breathing, 2016
Sleep and Breathing, 2016
Apnea obstructiva del sueño; Diagnóstico; Videoendoscopia del sueño inducido; Revisión Resumen La... more Apnea obstructiva del sueño; Diagnóstico; Videoendoscopia del sueño inducido; Revisión Resumen La exploración fibroscópica de la faringe mediante sueño inducido es una prueba que ayuda a conocer las zonas de vibración y colapso de los pacientes con trastornos respiratorios del sueño. En este artículo se realiza una revisión de la literatura disponible sobre el tema para ayudar al otorrinolaringólogo a conocer la prueba y resolver algunas controversias existentes sobre la misma.
Acta Otorrinolaringológica Española, 2015
Tonsillectomy represents one of the main surgical procedures for the otolaryngologist, with haemo... more Tonsillectomy represents one of the main surgical procedures for the otolaryngologist, with haemorrhage being the most common postoperative. The objective of this study was to determine the post-tonsillectomy haemorrhage rate, and relate the surgical technique, diagnosis and patient age. This was a retrospective study, from April 2012 to January 2014, covering 429patients. We used the following surgical-dissection techniques: cold, Colorado needle and monopolar forceps. Haemostasis was carried out in every case with monopolar forceps and gauze compression. Post- tonsillectomy haemorrhage rate was 6.99%. According to the surgical technique used, with Colorado needle dissection, the bleeding rate we found was 7.07%; with monopolar forceps dissection, the rate was 20.4%; and with cold dissection, 2.9%. Of all haemorrhages, only 9 (2.09%) needed reintervention, of which 40% were performed with monopolar forceps dissection. The group with the largest bleeding rate was that of more than 14 years old. The diagnosis most associated with bleeding was peritonsillar abscess. The lowest bleeding rate was found with cold dissection and monopolar forceps haemostasis (2.09%). Consequently, based on our experience and the results obtained in the study, we consider that surgical technique does influence post-tonsillectomy haemorrhage.