Cases reported "Nose Diseases"

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1/74. Huge hamartoma with inverted papilloma in the nasal cavity.

    We report clinical experience in managing a 46-year-old Japanese man with long-standing nasal obstruction resulting from a huge left nasal mass. Computed tomography, magnetic resonance imaging and biopsy were used to make a provisional diagnosis of inverted papilloma. The mass was resected via a frontal approach combined with rhinotomy. Histopathologic examination of the resected specimen was consistent with a hamartoma that included an inverted papilloma on a portion of its surface. In addition to being rare tumors in the nasal cavity, we believe that our patient's tumor the largest nasal hamartoma ever reported.
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keywords = obstruction
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2/74. Rosai-Dorfman disease presenting as a pituitary tumour.

    A 45-year-old woman had pyrexia, headaches, collapse and hyponatraemia. Intracerebral abscess, bacterial meningitis and subarachnoid haemorrhage were excluded. She was given intravenous antibiotics and gradually recovered. One month later she was readmitted with diplopia, headache and vomiting. serum sodium was low (107 mmol/l) and a diagnosis of inappropriate ADH secretion was made. MRI scan showed a suprasellar tumour arising from the posterior pituitary gland. A skin rash gradually faded. serum cortisol, prolactin, gonadotrophins and thyroid hormone levels were low. A pituitary tumour was removed trans-sphenoidally, she had external pituitary radiotherapy, and replacement hydrocortisone and thyroxine. She was well for 12 months when she developed progressive weakness and numbness of both legs. Examination suggested spinal cord compression at the level of T2 where MRI scanning showed an intradural enhancing mass. This spinal tumour was removed and her neurological symptoms disappeared. Nine months after this she developed facial pain and nasal obstruction. CT scan showed tumour growth into the sphenoid sinus and nasal cavities. A right Cauldwell-Luc operation was done and residual tumour in the nasal passages was treated by fractionated external radiotherapy and prednisolone. Histological examination of the specimens from pituitary, spinal mass, and nasal sinuses showed Rosai-Dorfman disease, a rare entity characterized by histiocytic proliferation, emperipolesis (lymphophagocytosis) and lymphadenopathy. aged 48 she developed cranial diabetes insipidus. Although Rosai-Dorfman syndrome is rare, it is being reported with increasing frequency, and should be borne in mind as a possible cause of a pituitary tumour.
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keywords = obstruction
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3/74. 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.
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ranking = 21.26337360384
keywords = airway obstruction, obstruction, airway
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4/74. A case of extramedullary plasmacytoma arising from the nasal septum.

    A rare case of extramedullary plasmacytoma arising from the nasal septum with localized amyloid deposition is reported. A 75-year-old woman presented with a history of post-nasal discharge and nasal obstruction for several months. Endonasal endoscopic observation revealed the presence of a mass arising from her nasal septum with an extension to the nasopharynx. No cervical lymph nodes were palpable. The biopsy specimen was diagnosed as a plasmacytoma (IgG, lambda-light chain type). Both serum myeloma-protein and urine Bence-Jones protein were negative. bone marrow biopsy, a chest radiograph, total body skeletal survey and 67Ga- and 99mTc-scintigrams showed no other systemic lesions. These findings confirmed the diagnosis of extramedullary plasmacytoma in the nasal septum. The patient received irradiation of 40 Gy without clinically detectable reduction of tumour size. The patient eventually underwent complete resection of the tumour by KTP/532 laser under endonasal endoscopic control. Pathologically, the tumour mass was composed mainly of amyloid deposition with a marked reduction of tumour cells. This indicated the radiosensitiveness of tumour cells, which was clinically masked by the increased amyloid deposition. The clinical presentation, pathological features and surgical procedures are described with a review of the literature.
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ranking = 1
keywords = obstruction
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5/74. Septal replacement for severe anterior septal deviation.

    PURPOSE: To introduce a novel surgical technique for treatment of severe anterior septal deviation. MATERIALS AND methods: Retrospective case series set in a tertiary-care hospital. Ten patients were treated over an 18-month period. External septorhinoplasty and septal replacement for severe anterior septal deviation. Postoperative clinical nasal examination and photographic comparison. RESULTS: Ten patients were treated with septal replacement for severe anterior septal deviation over an 18-month period. All patients were followed for a minimum of 1 year. No postoperative complications were seen. All patients reported a subjective improvement in their nasal airway and nasal appearance. This was confirmed with clinical examination and photographic comparison. CONCLUSION: Septal replacement for severe anterior septal deviation is a viable option for select patients who can not be successfully treated with conventional techniques.
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ranking = 0.20676023839945
keywords = airway
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6/74. Rhinolith of the nasal septum.

    We report an unusual case of rhinolith in the nasal septum in an 11-year-old girl. The rhinolith was detected on X-radiographs made for the planning of an orthodontic treatment. There were no symptoms like nasal obstruction, chronic infection or epistaxis in the young patient. The histopathologic examination after surgical removal showed hyaline cartilage, local fibrosis and pronounced hemosiderosis, indicating possible prior bleeding. Therefore, an endogenic etiology of the intraseptal rhinolith, e.g. a prior trauma of the nasal septum, is assumed. A review of the literature is included.
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ranking = 1
keywords = obstruction
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7/74. nasal septal perforation: a rare extraintestinal manifestation of Crohn's disease.

    Nasal manifestations of Crohn's disease are quite rare. They are typified by chronic mucosal inflammation, obstruction, bleeding, and occasionally septal perforation--signs and symptoms that are common to many disease states of the nose. Nasal findings, much like oral lesions, can precede the more typical gastroenterologic manifestations of Crohn's disease. Otolaryngologists should be aware of such an association and consider the diagnosis of Crohn's disease in atypical cases of nasal disease. We report the case of a 12-year-old boy who had severe Crohn's disease and a nasal septal perforation, and we discuss this complication in the context of its otolaryngologic manifestations.
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ranking = 1
keywords = obstruction
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8/74. Oronasal fistula repair with three layers.

    We present an innovative method for closure of oronasal fistulas involving a three-layer repair, consisting of septal mucosa flap, bone or cartilage graft, and palatal mucosa flap. The septal mucosa flap closes the nasal side of the defect. This is an inferiorly based flap along the nasal floor and consists of septal mucosa from the side opposite the oronasal fistula. A slit is created in the remaining layers of the nasal septum, allowing the flap to be delivered into the defect. When the septal flap is folded down in this fashion, it exposes nasal septal bone and cartilage. The bone and cartilage are harvested and are used to create the middle layer of the three-layer fistula repair. The oral layer of the repair is provided by a palatal mucosa transposition flap. This method allows the bone/cartilage graft to be sandwiched between two vascular layers. We have successfully used the three-layer repair on three patients. All of the oronasal defects were 2 cm in size. All patients are at least 1 year after repair with 100 percent closure; thus, no oronasal leakage. The flaps both septal and palatal resulted in no morbidity once healed. Specifically, the surgically created slit in the nasal septum is well mucosalized and barely discernible. Also, no nasal obstruction occurs from the septal flap on the floor of the nose. We perform the procedure on an outpatient basis. The three-layer repair can be used in adult patients with oronasal fistulas of the middle and posterior hard palate up to 3 cm in size. This technique is not recommended for children.
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ranking = 1
keywords = obstruction
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9/74. Amyloidoma of the nose in a pediatric patient: a case report.

    Localized amyloidosis in the head and neck is a rare and benign disease. larynx is the most common site of involvement and accounts for 0.2% to 1.5% of benign laryngeal tumors. The oral cavity and pharynx may also be involved in localized amyloidosis of the head and neck. There are only 7 cases of localized nasopharyngeal amyloidosis, and 8 cases of localized nasal amyloidosis reported to date. Out of these 8 cases of nasal amyloidosis, only 1 of them is a pediatric patient. We present the second reported case of localized nasal amyloidosis in a pediatric patient. This case report describes a 10-year-old girl with a 1-year history of right-sided nasal obstruction and mucoid discharge. Examination revealed an irregular erythematous, waxy gray mass arising from the right inferior turbinate. Computed tomography and magnetic resonance imaging showed the mass arising from the inferior turbinates, whereas other investigations excluded systemic amyloidosis. histology from surgical excision revealed amyloidosis. This case illustrates that although amyloidoma of the nose is rare, it should also be considered as part of the differentials of a nasal mass even in pediatric patients. [editorial comment: These authors demonstrate that an index of suspicion and confirmation of that suspicion through biopsy and subsequent pathologic evaluations Maybe the only way to avoid missing this potentially important cause of nasal obstruction.]
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ranking = 2
keywords = obstruction
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10/74. Primary nasal tuberculosis.

    We present a case of a patient with primary nasal tuberculosis. Although this is a rare finding, it should be considered when a patient presents with a nasal obstruction. Smears for acid fast bacilli and cultures tend to be negative in nasal tuberculosis. diagnosis is often based on histo- pathologic findings. Nasal TB is known to respond well to the regular treatment for (pulmonary) tuberculosis.
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ranking = 1
keywords = obstruction
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