Cases reported "Nasopharyngeal Diseases"

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1/24. Nonsurgical and nonextraction treatment of skeletal Class III open bite: its long-term stability.

    Two female patients, aged 14 years 5 months and 17 years 3 months with skeletal Class III open bite and temporomandibular dysfunction are presented. They had previously been classified as orthognathic surgical cases, involving first premolar removal. The primary treatment objective was to eliminate those skeletal and neuromuscular factors that were dominant in establishing their malocclusions. These included abnormal behavior of the tongue with short labial and lingual frenula, bilateral imbalance of chewing muscles, a partially blocked nasopharyngeal airway causing extrusion of the molars, with rotation of the mandible and narrowing of the maxillary arch. Resultant occlusal interference caused the mandible to shift to one side, which in turn produced the abnormal occlusal plane and curve of Spee. As a result, the form and function of the joints were adversely affected by the structural and functional asymmetry. These cases were treated by expanding the maxillary arch, which brought the maxilla downward and forward. The mandible moved downward and backward, with a slight increase in anterior facial height. Intruding and uprighting the posterior teeth, combined with a maxillary protraction, reconstructed the occlusal plane. A favorable perioral environment was created with widened tongue space in order to produce an adequate airway. myofunctional therapy after lingual and labial frenectomy was assisted by vigorous gum chewing during and after treatment, together with a tooth positioner. Normal nasal breathing was achieved.
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keywords = airway
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2/24. Primary nasopharyngeal tuberculosis in a patient with the complaint of snoring.

    Isolated nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. The most common presentation of nasopharyngeal tuberculosis is with a cervical lymphadenopathy followed by nasal discharge or obstruction. Here we present a 58-year-old patient with nasopharyngeal tuberculosis whose only complaint was snoring. Her oropharyngeal and anterior rhinoscopic examination was normal. On endoscopic examination, mucosal oedema and hyperaemia of the nasopharynx was observed. There was no cervical lymphadenopathy. The tuberculin skin test was positive and histopathological examination of the biopsy taken from posterior nasopharyngeal wall supported the diagnosis of tuberculosis. After anti-tuberculosis therapy, the snoring stopped and the nasopharyngeal examination was normal.
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ranking = 0.89274183386868
keywords = obstruction
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3/24. Nasopharyngeal amyloidosis.

    PURPOSE: To discuss the presentation of localized amyloidosis affecting the nasopharynx and discuss the management options. amyloidosis in the head and neck is a rare and benign condition that usually takes the form of localized amyloidosis. Because systemic amyloidosis markedly shortens life expectancy owing to its involvement with vital organs, rectal biopsy or fat aspiration of the anterior abdominal wall must be carried out to exclude systemic involvement. Localized amyloidosis in the head and neck can involve the orbit, sinuses, nasopharynx, oral cavity, salivary glands, and larynx. methods: We present the case of a patient with conductive hearing loss and serous otitis media with effusion secondary to nasopharyngeal amyloidosis, as well as present a review of the literature. RESULTS: Only a few cases of nasopharyngeal amyloidosis have thus far been reported. patients with this disease can also present with recurrent epistaxis, postnasal drip, nasal obstruction, and eustachian tube dysfunction. Localized amyloidosis of the nasopharynx, which is slow growing, has proved difficult to treat because it can persist or recur despite surgical treatment. Furthermore, bleeding may be a major complication in treating patients with nasopharyngeal amyloidosis by transpalatal excision because the amyloid deposits cause vascular wall fragility. Finally, there is no evidence that surgical treatment of nasopharyngeal amyloidosis can prolong survival or that localized amyloidosis can progress to systemic amyloidosis. For these reasons, we elected to treat our patient with a tympanostomy tube and observation. CONCLUSION: In the absence of systemic disease, localized amyloidosis of the nasopharynx may be treated conservatively.
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ranking = 0.89274183386868
keywords = obstruction
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4/24. tuberculosis of the nasopharynx: a rare entity revisited.

    OBJECTIVES: tuberculosis of the nasopharynx is uncommon. A large series of 17 cases is reported, and the clinical and pathological features are discussed. STUDY DESIGN: A retrospective review. methods: Seventeen archived cases of biopsy-proven nasopharyngeal tuberculosis were reviewed for patient age and sex, presenting complaint and duration, systemic symptoms, cervical lymphadenopathy, and chest x-ray findings. These findings were compared with a compilation of 40 cases reported in the English literature. RESULTS: There was a female predominance (13 women and 4 men), with age range of 20 to 74 years (mean age, 38 y). The most common presentation was enlargement of the cervical lymph nodes (53%), followed by hearing loss (12%), tinnitus, otalgia, nasal obstruction, and postnasal drip (6% each). The duration of the presenting symptoms ranged from 1 week to 1 year (mean duration, 16 wk). Ten patients (59%) had cervical lymphadenopathy, two (12%) had systemic symptoms (fever, weight loss, night sweats), and one patient (6%) had miliary pulmonary tuberculosis. Direct endoscopic examination showed nasopharyngeal mucosal irregularity or mass in the majority of patients (12 patients [70%]). These features were similar to those reported in the literature. CONCLUSIONS: Nasopharyngeal tuberculosis is uncommon, usually occurring without pulmonary or systemic involvement. Cervical lymphadenopathy occurs in more than half of the patients and is the most common presenting complaint; this, together with the nasopharyngeal findings of mass or mucosal irregularity, makes differentiation from carcinoma on clinical examination difficult, necessitating histological evaluation.
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ranking = 0.89274183386868
keywords = obstruction
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5/24. Resolution of severe sleep-disordered breathing with a nasopharyngeal obturator in 2 cases of nasopharyngeal stenosis complicating uvulopalatopharyngoplasty.

    Obstructive sleep apnea-hypopnea syndrome (OSAHS) is characterized by episodic decrements in airflow due to upper airway obstruction. Uvulopalatopharyngoplasty (UPPP) is a potential therapy for OSAHS. Nasopharyngeal stenosis is a rare complication of UPPP that worsens OSAHS. We report two patients referred for OSAHS worsened by nasopharyngeal stenosis complicating UPPP. Both patients were treated with carbon dioxide laser release of adhesions and placement of a nasopharyngeal obturator. Follow-up polysomnograms demonstrated resolution of OSAHS correlating with subjective resolution of symptoms. Nasopharyngeal stenosis complicating UPPP can be successfully treated with scar removal and nasopharyngeal stenting. Polysomnographic demonstration of the effectiveness of this therapy has not previously been reported. Future questions include duration of nasopharyngeal stenting and timing of follow-up polysomnography.
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ranking = 13.297347432862
keywords = airway obstruction, obstruction, airway
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6/24. Gastric heterotopia in the nasopharynx causing airway obstruction in the newborn.

    We describe a newborn boy with a gastric heterotopia located in the nasopharynx, which caused airway obstruction soon after delivery. Gastric heterotopia is an uncommon lesion generally found throughout the alimentary tract, but nasopharynx is an exceptional location. To our knowledge, this is the second reported case of gastric heterotopia located in the nasopharynx, and the first one presenting in a newborn with symptoms at birth and with an associated central nervous system mass.
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ranking = 66.486737164311
keywords = airway obstruction, obstruction, airway
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7/24. Sinonasal and nasopharyngeal adenoidcystic carcinoma: report of four cases.

    Four cases of sinonasal and nasopharyngeal adenoidcystic carcinoma that came to the RIMS Hospital, Imphal during the period of July, 2002 to March, 2003 are reported in this article. The age incidence ranged from 30 to 80 years and the mean age was 47.5 years; with male to female ratio of 1:1. The average duration from first sympton in the patient to the date of his medical consultation was 17.8 months. nasal obstruction was the first symptom two cases; lump sensation in the throat and headache in the third and fourth cases respectively. Despite the evidence of rapid and extensive local spread there were definitely delays from the patients' end to consult a clinician. Whereas the tumour itself is not common, the usual sites, if it occurs, are palate and minor salivary glands and rarely mucous and seromucinous glands elsewhere.
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ranking = 0.89274183386868
keywords = obstruction
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8/24. Nasopharyngeal actinomycosis: a rare cause of nasal airway obstruction.

    Nasopharyngeal actinomycosis is a rare clinical disease. It can occur after nasal trauma or surgical manipulation. It is also reported to occur without prior trauma, making diagnosis difficult. We report a case of nasopharyngeal actinomycosis that presented as nasal airway obstruction causing snoring and mimicking nasopharyngeal carcinoma. To our knowledge, only a few other cases of nasopharyngeal actinomycosis have previously been published, most coming after mucosal trauma. diagnosis is made by observing the bacteria or its associated sulfur granules in the biopsy specimen. This anaerobic organism is difficult to culture. Treatment consists of wide debridement and prolonged antibiotic therapy, with good prognosis.
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ranking = 66.486737164311
keywords = airway obstruction, obstruction, airway
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9/24. Nasopharyngeal hamartoma: importance of routine complete nasal examination.

    The authors report clinical experience in managing an 82-year-old female presenting with long-standing bilateral nasal obstruction resulting from a nasopharyngeal mass. The patient had undergone a number of treatments including surgery. The previous examinations, investigations and treatment had all been performed within the previous 10 years and although examination had been documented there was no evidence on review of the notes that the nasopharynx had been inspected either by nasendoscopy or indirectly. The mass was removed via a combined nasal and oral approach. Histopathological examination of the specimen was consistent with mesenchymal hamartoma. In addition to describing a rare presentation the authors believe this case highlights the importance of complete examination in all patients with nasal symptoms.
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ranking = 0.89274183386868
keywords = obstruction
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10/24. Respiratory epithelial adenomatoid hamartoma in the nasopharynx.

    We present a case report of a female patient with complaints of single-sided nasal obstruction. A polypoid structure was seen in the nasopharynx. Histologic examination showed a respiratory epithelial adenomatoid hamartoma -- a rare, benign lesion. Therapy consisted of complete excision. In line with previous reports, the lesion did not recur during 13 months of follow up. The clinical and pathological features of this abnormality are discussed.
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ranking = 0.89274183386868
keywords = obstruction
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