1/75. Gingival lesions and nasal obstruction in an immunosuppressed patient post-liver transplantation.Although rare, metastatic hepatocellular carcinoma (HCC) presenting only to the mandible, gingiva, and nasal cavity in patients subsequently found to have primary HCC has been reported. In the age of transplantation, certain HCC patients may receive treatment with an orthotopic liver transplant. Due to the proclivity of HCC for early micrometastases, immunosuppressive therapy can induce significant metastatic lesions. Nasal mass obstruction, gingival lesions, or facial growths in this population must be considered metastatic until proven otherwise.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/75. A rare case of upper airway obstruction in an infant caused by basal encephalocele complicating facial midline deformity.A four-month-old male infant with basal encephalocele of the transsphenoidal type presented with upper airway obstruction and facial midline deformity, including cleft lip, cleft palate, hypertelorism and exophthalmos. Basal encephalocele is a rare disease, and usually not detectable from the outside. In this case, initially the cause of an upper airway obstruction was considered to be posterior rhinostenosis, and posterior rhinoplasty with inferior nasal conchectomy was scheduled. However, in preoperative examination, computed tomography (CT) and magnetic resonance imaging (MRI) revealed a bony defect in the sphenoidal bone and a cystic mass in communication with cerebrospinal fluid, herniating into the nasal cavity through the bony defect. The mass was diagnosed as a transsphenoidal encephalocele, the scheduled operation cancelled, and tracheostomy performed for airway management. The possibility of basal encephalocele should be considered in the case of upper airway obstruction with facial midline deformity.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
3/75. Sinonasal lymphomas. Case report.In the field of Otorhinolaryngology sinonasal lymphomas are relatively uncommon and represent less than 1% of all head and neck malignancies. Nowadays, they are regarded as consisting of two distinct subgroups, characterised by phenotype, location, prognosis and treatment. Lymphomas of the B-Cell phenotype are the most frequent type found in the paranasal sinuses. They are less aggressive and carry a relatively better prognosis. T/NK-Cell lymphomas are mostly found in the nasal cavity. They are more aggressive and carry a relatively worse prognosis. We present a case of a 65-year-old patient, who complained with unilateral right-sided nasal obstruction associated with a sensation of right aural fullness. CT scan demonstrated opacity of the posterior ethmoid and sphenoid sinuses on the right side, with evidence of erosion of the anterior wall of the sphenoid. Nasal endoscopy revealed a smooth purple mass, arising from the right superior meatus, which bled on contact, and which was subsequently shown to be, on histological assessment, a malignant high grade lymphoma, non-hodgkin's B-cell phenotype. Following a discussion of the case we will present a review of these tumours, which have a poor overall prognosis, focusing on epidemiology, sites of origin, symptoms, investigation and management.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/75. Endoscopic treatment of sinonasal disease in patients who have had orthognathic surgery.Certain skeletofacial patterns may be predisposed to aggravated sinonasal disease postoperatively. These may include, but are not limited to, facial skeletal asymmetries with high septal deviations and those with obstructive nasal respiration and mouth breathing that leads to skeletal growth disturbances such as vertical maxillary hyperplasia and apertognathism. These sinonasal diseases may partly be the result of osteomeatal blockage by pre-existing structures, or synechial shelves and webs blocking normal maxillary antral mucosal flow. The use of nasal antral windows placed anteriorly in the lateral nasal wall at the time of downfracture LeFort (Hosaka window) do not seem to benefit the drainage of the maxillary antrum. This is because physiological flow often bypasses this region. If patients present postoperatively with new sinonasal disease or the aggravation of pre-existing symptoms, evaluation by both endoscopically assisted intranasal and axially and coronal computed tomography (CT) is recommended. Functional endoscopic sinus surgery by the minimally invasive Messerklinger technique, combined with intranasal use of laser-assisted turbinoplasty and soft tissue lysis, have been successfully used for most of these patients. Because the anatomical positioning of the midfacial structure can potentially affect patients with a predisposition to sinonasal physiological disturbances, consideration should be given to preoperative evaluation and discussion of potential consequences.- - - - - - - - - - ranking = 0.027502705333934keywords = mouth (Clic here for more details about this article) |
5/75. Pyogenic granuloma, a cause of congenital nasal mass: case report.This is a case report of a 45-day-old Nigerian boy who presented with obstruction of the left nasal cavity since birth caused by a pyogenic granuloma which was successfully removed.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
6/75. Giant benign sinonasal squamous papilloma: report of a case.We treated a patient with a giant squamous papilloma in the nasal cavity and maxillary sinus that extended through a bony defect into the oral cavity. The mass was excised with a combined endoscopic, Caldwell-Luc, and transoral approach. Lesions of this type are rare, but when they do occur, the rate of recurrence is high. Therefore, long-term followup, including endoscopic examination, is important.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
7/75. Epithelial-myoepithelial carcinoma of the nasal cavity.A 22-year-old male presented with a 1-year history of nasal obstruction due to a polypoid mass in the right nasal cavity. Histopathologic examination revealed the tumor to consist of a mixture of a trabecular structure with a double-layered arrangement of inner dark cells and outer clear cells. Immunohistochemical examination showed the clear cells to be positive for alpha-smooth muscle actin and S-100 protein. Ultrastructural examination confirmed the myoepithelial cell origin. The tumor was excised and no recurrence or metastasis was found 40 months after surgery. We describe here a rare case of epithelial-myoepithelial carcinoma arising from the nasal cavity, one of the most unusual locations.- - - - - - - - - - ranking = 6keywords = cavity (Clic here for more details about this article) |
8/75. Sinonasal tract eosinophilic angiocentric fibrosis. A report of three cases.Eosinophilic angiocentric fibrosis (EAF) is a rare submucosal fibrosis without a well-developed differential diagnosis. Three cases of sinonasal tract EAF were identified in 2 women and 1 man, aged 49, 64, and 28 years, respectively. The patients experienced a nasal cavity mass, maxillary pain, or nasal obstructive symptoms of long duration. The process involved the nasal septum (n = 2), nasal cavity (n = 1), and/or the maxillary sinus (n = 1). There was no evidence for wegener granulomatosis, churg-strauss syndrome, Kimura disease, granuloma faciale, or erythema elevatum diutinum. Histologically, the lesions demonstrated a characteristic perivascular "onion-skin" fibrosis and a full spectrum of inflammatory cells, although eosinophils predominated. necrosis and foreign body-type giant cells were not identified. Surgical excision was used for all patients, who are all alive but with disease at last follow-up. Sinonasal tract EAF is a unique fibroproliferative disorder that does not seem to have systemic associations with known diseases. The characteristic histomorphologic features permit accurate diagnosis.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
9/75. Clinical applications of acoustic rhinometry.The clinical value of acoustic rhinometry (AR) is its ability to measure the dimensions of the nasal cavity in terms of a curve describing the cross-sectional areas as a function of distance. This curve describes nasal airway patency and gives an impression of the degree of nasal obstruction. The method provides values before and after decongestion which allow to evaluate the cause of the nasal obstruction as mainly skeletal or mucosal. This makes AR a tool for diagnosis and follow-up of treatment in both rhinology and rhinosurgery. Similarly, AR is a reliable method to show the dimensional changes of the nasal cavity before and after a given treatment. In the evaluation of a surgical intervention it is reasonable to use decongested values. Turbinate surgery, septo- and rhinoplasty, orthognatic surgery and paranasal sinus surgery and their influence on the dimensions of the nasal cavity may be reflected by AR. The absolute minimum cross-sectional area, and cross-sectional areas and volumes at fixed distances are the recommended parameters to show dimensional changes after nasal surgery. The predictive value of AR, in relation to nasal obstruction, should have high specificity and sensitivity to be used in a clinical setting. It seems that the single variables do not provide enough information for the diagnosis of obstruction, and it has been stressed that the results should be interpreted together with rhinoscopy and subjective complaints. A statistical model based on questionnaire, rhinoscopic findings and several variables from AR has been proposed to increase the diagnostic specificity and sensitivity of AR.- - - - - - - - - - ranking = 3keywords = cavity (Clic here for more details about this article) |
10/75. Unilateral rhinorrhea and nasal obstruction in an adult.BACKGROUND: choanal atresia is an uncommon malformation, consisting of congenital blockage of one of both choanae. Symptomatology varies according to the type of atresia and the age of the patient. The bilateral, or complete, form presents in newborns as respiratory distress while unilateral, or incomplete, forms present in older children or adults. CASE REPORT: a 16-year-old girl presented with a lifelong history of right-sided nasal blockage and unilateral watery rhinorrhea. The rhinorrhea increased when the patient bent her head forward. Treatment with antihistamines and topical nasal corticosteroid sprays produced little improvement. The patient's previous medical history was unremarkable except for the expulsion of a coagulated mass through the right nostril a few days after birth, and event that provoked her symptoms. physical examination was normal except for excoriation of the right external nasal margin. Anterior rhinoscopy revealed watery rhinorrhea, erythematous mucosa in the right nasal cavity and deviated nasal septum. No nasal masses or polyps were found. physical examination confirmed the absence of ventilation in the right nasal airway and nasal endoscopy indicated right choanal obstruction. Diagnostic test: skin prick tests with aeroallergens were positive for grass pollen and negative for all other allergens tested (mites, moulds, latex, and epithelia). Total IgE was normal (9 IU/ml). No eosinophilia was detected in the nasal secretion specimen. The results of laboratory tests including complete blood count and differential, erythrocyte sedimentation rate, and biochemical parameters were normal. The glucose level in nasal secretion was 4.6 mg/dl. x-rays of the paranasal sinuses and cavum showed no anomalies. Axial fine-cut computed tomography scans (3 3 mm) revealed choanal obstruction with bony and membranous components. CONCLUSIONS: a diagnosis of congenital choanal atresia should be considered in cases of unilateral blockage and rhinorrhea. Nasal endoscopy and computed tomography scans are essential to establish diagnosis.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
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