Fundação Oswaldo Cruz (FIOCRUZ), Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Instituto Oswaldo Cruz (IOC), Laboratório de Imunoparasitologia, Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz (FIOCRUZ), Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Instituto Oswaldo Cruz (IOC), Laboratório de Imunoparasitologia, Rio de Janeiro, RJ, Brazil; Hospital Federal de Bonsucesso, Departamento de Broncoesofagolaringologia e Cirurgia de Cabeça e Pescoço, Rio de Janeiro, RJ, Brazil.
Braz J Otorhinolaryngol. 2024 May-Jun;90(3):101396. doi: 10.1016/j.bjorl.2024.101396. Epub 2024 Feb 1.
To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017.
Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed.
Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (n = 3), infectious diseases (non-granulomatous n = 220; granulomatous n = 155), autoimmune diseases (n = 24), neoplasms (benign n = 13; malignant, n = 103), and unclassified epithelial/soft tissue diseases (n = 102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months.
Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies.
Level 3.
确定 2005 年至 2017 年期间在埃文德罗·查加斯国家传染病研究所（INI-FIOCRUZ）耳鼻喉科就诊的患者的口腔或口咽黏膜病变（OOPML）的流行率、流行病学特征和临床特征。
对病历中的描述性数据（性别、年龄、教育水平、肤色、来源、吸烟、酗酒、HIV 合并感染、疾病演变时间、首发症状和 OOPML 位置）进行统计分析。
在就诊的 7551 名患者中，有 620 名（8.2%）纳入本研究。OOPML 分为发育异常（n=3）、传染病（非肉芽肿性 n=220；肉芽肿性 n=155）、自身免疫性疾病（n=24）、肿瘤（良性 n=13；恶性 n=103）和未分类的上皮/软组织疾病（n=102）。传染病（60.5%）和肿瘤（18.7%）所致 OOPML 最常见。OOPML 患者的主要人口统计学特征为：男性（63.5%）、白人（53.5%）和 50 至 60 岁年龄段（43.3%）。最常见的首发症状为局部疼痛（18.1%）和咽痛（15%），最常见的 OOPML 部位为腭扁桃体（28.5%）、硬腭（22.7%）和舌（20.3%）。中位病程为 3 个月。
感染性 OOPML 最常见，这在传染病参考中心是意料之中的，因此，在一般医疗保健和/或牙科服务中，它们的发生率可能较低。OOPML 可能报告不足，因为口腔/口咽检查通常不包括在常规体检中。口腔/口咽检查应由专家（如牙医和耳鼻喉科医生）进行，他们在识别 OOPML 方面具有专业知识，即使在初期/无症状病例中也是如此。鉴于 OOPML 可能出现在多种疾病中，多学科团队的诊断可能有助于鉴别诊断，并为新的临床流行病学研究提供信息。使用标准化的口腔/口咽系统检查病历可能为鉴别诊断提供相关工具，并提供有关新的临床流行病学研究的信息。
3 级。
