Search

BACKGROUND: Rhinoscleroma is a chronic granulomatous disease that commonly involves the upper respiratory tract., mainly the nasopharynx. The gramnegative bacillus involved is Klebsiella rhinoscleromatis and it mainly affects women. The clinical presentation is divided into three stages: catarrhal, proliferative or granulomatous, and sclerotic. CLINICAL CASE: A 9-year-old male patient., who showed an unusual presentation of nasal rhinoscleroma, with symptoms of bilateral nasal obstruction, recurrent, epistaxis, hyposmia, and headache. The physical examination showed a sinonasal tumor and a contrasted CT was performed, finding bilateral sinonasal occupation and bone erosion, a biopsy was taken without a definitive diagnosis. It was decided to perform a combined endoscopic and bilateral Caldwell-Luc approach, obtaining histopathological results of rhinoscleroma in proliferative and scarring phase. Antibiotic treatment was started with ciprofloxacin 250 mg every 12 hours per 6 months. Three months after surgery, a gadolinium-enhanced magnetic resonance evidenced again bilateral sinonasal occupation, for which an endoscopic biopsy was performed, finding turbinoseptal synechiae, abundant fibrous tissue, septal perforation, and a cobblestone-like mucosa. The histopathological study reported rhinoscleroma again. CONCLUSIONS: In tumor conditions of the airways, it is important to consider respiratory scleroma as part of the differential diagnosis, a chronic process that requires clinical, histopathological confirmation and imaging support. [ABSTRACT FROM AUTHOR]

Introduction: a foreign body embedded in the nose can be dangerous. We present a patient in whom a button battery was detected in the nasal passages and its extraction was successful. Clinical case: seven-year-old male patient. He went to the emergency department of a secondary care hospital due to a 10-hour history with intermittent unilateral rhinorrhea in the right nostril, as well as pain. The nasal discharge was described as serous-purulent and foulsmelling. The battery was removed without complications, after being identified by x-ray. Conclusions: the extraction of foreign bodies must be rapid, particularly when it is by batteries since they can cause anything from thickening of the mucosa to perforations of the nasal septum. [ABSTRACT FROM AUTHOR]

BACKGROUND: Solitary fibrous tumor is a rare tumor that usually occurs in the pleura. It is a tumor of a mesothelial or mesenchymal cell origin. This tumor occasionally has been reported in extrapleural sites including head and neck regions. Clinically, the extrapleural lesions may be present with symptoms related to the tumor site. CLINICAL CASE: A 51-year-old female patient with progressive unilateral left-sided nasal obstruction and rhinorrhea. Nasal endoscopy and imaging exams revealed a vascular mass filling the entire left nasal cavity extending up to the nasopharynx. The tumor had marked enhancement after the administration of contrast material. Biopsy specimen examination reported solitary fibrous tumor. Immuno-histochemical analyses confirmed the diagnosis. The patient was undergone preoperative embolization with posterior tumoral excision by transpalatal approach. CONCLUSIONS: Solitary fibrous tumor of nasal cavity is a very rare illness, which is difficult to differentiate with other diseases. [ABSTRACT FROM AUTHOR]

BACKGROUND: Rhinoliths are calcified masses formed in the nasal cavity by the deposit of mineral salts. The nest of a rhinolith is usually an exogenous foreign body forgotten in the nose during childhood (seeds, beads, cotton and insects). CLINICAL CASE: A 32-year-old male patient with chronic kidney disease. We were consulted as part of the protocol for the patient’s kidney transplant. Upon questioning, the patient began his current condition 12 years ago with left nasal obstruction, with no apparent triggering cause, accompanied by anterior and posterior left nasal discharge with mucopurulent, fetid characteristics, in moderate amount, with exacerbations and partial remissions to medical treatment with multiple antibiotic regimens at unspecified doses and durations. CONCLUSIONS: Because it is a rare entity, the diagnosis of a rhinolith must have a high clinical suspicion, directing the questioning to the patient and accompanying it with imaging studies; simple computed tomography is the study of choice. Treatment must be surgical, with complete resection of the foreign body, and resolution of the complications that it has generated. [ABSTRACT FROM AUTHOR]

BACKGROUND: Extramedullary plasmocytoma is a malignant neoplasm of plasmatic cells derived from B lymphocytes, it proliferates outside the bone marrow and might be part of multiple myeloma or it can grow as a solitary neoplasm. It is exceptional to find an extramedullary plasmocytoma as a primary tumor of the nasal cavity and paranasal sinuses, representing only 1% of the head and neck tumors; 80% are located at the upper respiratory tract, of which 60% compromises the nose and paranasal sinuses. CLINICAL CASE: A 70-year-old female patient, who was admitted with mucopurulent rhinorrhea, hyposmia, nasal obstruction, headache, epiphora and blurred vision. The imaging studies showed occupation of the right nasal cavity and paranasal sinuses, as well as bone lysis and remodeling. A resection and functional endoscopic sinus surgery were performed. The diagnosis was confirmed with histopathology and the patient continued management with radiotherapy. CONCLUSIONS: The incidence of sinonasal extramedullary plasmacytoma is very rare, so it is important to consider other diagnoses, since the clinical and imaging manifestations can be non-specific. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nasal T-cell/natural killer cell lymphomas are rare, aggressive neoplasms, predominantly in males, presenting between 40 and 80 years of age. Mexico and Peru are the countries with the highest incidence in Latin America. These lymphomas have an almost exclusively extranodal presentation, the classic presentation involves palatal perforation. The most affected sites in order of frequency are the gastrointestinal tract, skin, and testicles. In the skin, the nasal cavity, nasopharynx and palate are affected. CLINICAL CASE: A 24-year-old female patient began her condition with nasal obstruction, anosmia and epistaxis, later she presented an increase in volume in the region of the right nostril, local pain, as well as fever spikes quantified up to 39°C. The tumor extended to the oral cavity and included the floor of the maxillary sinus, anterior nasal spine and the palate with an ulceration of 1 cm in its anterior portion. The histopathological study of the biopsy reported a nasal-type extranodal T/NK cell lymphoma with extensive necrosis, so it was decided to send her to the Hematology service, where chemotherapy and radiotherapy were given. CONCLUSIONS: Extranodal T/NK lymphomas are a diagnostic challenge that require a high index of clinical suspicion; the differential diagnosis includes other neoplasms, citotósuch as nasopharyngeal squamous cell carcinoma, as well as infectious processes such as fungal. In this patient, mucormycosis was suspected at first, so antifungal treatment was started without response. [ABSTRACT FROM AUTHOR]

Neuroendocrine carcinomas are rare tumors of the nose and sinuses. They are considered primitive tumors and are the least differentiated from the diffuse neuroendocrine system. We report a 49-year-old female patient who attends the otolaryngology service at the Central Military Hospital referring mass in the left nasal cavity with a progressive growth over a period of 9 months, including epistaxis, as well as left nasal obstruction. Magnetic Resonance Imaging and Computed Tomography imaging studies showed a tumor occupying the entirety of the left nasal cavity to the nasopharynx, with heterogeneous uptake of the contrast medium. Tumor resection is decided by endoscopic approach (maxillary sinusotomy type III, left anterior and posterior ethmoidectomy, left sphenoid Draf type II, left frontal Draf IIa as well as posterior septectomy). The pathology service reported a moderately differentiated neuroendocrine carcinoma. The treatment was decided joint session with the medical oncology service. These types of tumors are a diagnostic challenge because of the complexity to differentiate them in a histopathological study. Their effective differentiation can have a clinical impact, that's why the advances in therapeutic intervention could prolong patient survival, improve quality of life and even find a cure. [ABSTRACT FROM AUTHOR]

Background: Nosocomial infections caused by strains of methicillin-resistant Staphylococcus aureus (MRSA) are a major health problem throughout the world. This microorganism produces a wide variety of infections including osteomyelitis, invasive endocarditis, septic arthritis, and septicemia. S. aureus is usually found in the skin and nasal cavity, it is easily spread through fomites, skin-skin contact or contact with nasal fluids. The students of the EMM are in continuous contact with patients of the Hospital Central Militar and can acquire or disseminate this type of microorganisms. Hence the importance of preventive medicine, in order to assess the frequency of this microorganism and use sanitary measures that can prevent its spread. Objective: To determine the frequency of resistant methicillin-resistant Staphylococcus aureus (MRSA) carriers in students of the Escuela Militar de Medicina. Methodology: Mucosa samples from the nasal cavity of students of the Escuela Militar de Medicina from the 2nd to 5th year, were cultured on blood agar and salt-mannitol agar, strains with corresponding colonial and microscopic morphology were selected S. aureus, tests were performed of catalase and coagulase, positive strains of S. aureus were subjected to antibiogram using oxacillin sensitives and the resistance was determined from the diameter in the inhibition zone. Student carriers received eradicating treatment with intranasal 5% mupirocin for 7 days and samples were taken again to determine the persistence of S. aureus in the nasal cavity. Results: Of the 110 students of the Escuela Militar de Medicina who were sampled 51 patients (46.36%) were positive carriers to S. aureus, the antibiogram with oxacillin discs showed a resistance to methicillin of 12 patients corresponding to 10.9%, while that with antibiotic eradication therapy with 5% intranasal mupirocin, the presence of resistant S. aureus Methicillin decreased to 0%. Conclusions: A 10.9% of students carriers of resistant S. aureus methicillin were obtained, which was eradicated in its entirety with 5% intranasal mupirocin [ABSTRACT FROM AUTHOR]

Nasal Cavity can be divided by the nasal septum into two cavities, extending from the nares above until choanae subsequently, continuing from there with the nasopharynx. Usually both cavities are different sizes. Each side can be divided into a nasal vestibule and nasal cavity itself. The aim of this paper is to describe the endonasal anatomy and correlate with tomographic images of cadaveric cuts. We used 15 (fifteen) bodies fixed with 10% formalin and preserved in phenoxetol 4% carbolic acid and 1%; to which underwent endonasal endoscopic dissection. Then five were sectioned in sections on the coronal and axial plane.**The nasal endoscopic examination should follow a systematic progression in three major steps: 1) Lobby nasal, septum, inferior meatus and nasopharynx. Sphenoethmoidal; 2) Recess and superior meatus; 3) middle meatus. Tomographic images of craniofacial used without contrast axilal and coronal slices. The different axial and coronal head compared with the tomographic slices of craniofacial, which allows the location of relevant anatomical elements when planning an endonasal approach. The endoscope is an instrument used to look inside a body cavity, duct or hollow organ. It consists of a flexible tube which has a light and a camera at the end of the probe. Introducing the instrument, it is used through a natural body orifice such as the mouth, nose nostril, rectum or urethra, or also through an incision. Endoscopic surgery of nose and paranasal sinuses is a surgical technique that has spread rapidly. Sinonasal pathology and anatomical variations make essential the use of diagnostic endoscopy and computed tomography. In times when tomographic findings do not match the endoscopic view, comes into play the role of anatomical knowledge to conserve important structures in the region. [ABSTRACT FROM AUTHOR]

We present the case of a 36-year-old woman who developed during the fourth month of her first pregnancy a lesion of the right nose following an acute viral rhinitis. Due to constant manipulation and recurrent erosions the lesion evolved to a tumor that protruded the nostril and obstructed the airway. The lesion was removed two months after delivery and the pathological diagnosis revealed a nasal lobular capillary hemangioma. Due to the rare presentation of this entity, we performed a literature review. [ABSTRACT FROM AUTHOR]

INTRODUCTION: malignant tumors of the nose and paranasal sinuses represent 1% of malignant neoplasms of the body and 3% of those originating in the upper respiratory tract; the most common is epidermoid carcinoma. OBJECTIVE: determine the concordance between results of malignant neoplasms detected by pathology and those detected by computed tomography. MATERIAL AND METHODS: of histopathological results for malignant neoplasms of the nose and paranasal sinuses, obtained from 2012 to 2015, those with interpretation were included. We determined how many neoplasms were diagnosed as such in image studies and calculated the concordance with the Kappa coefficient. RESULTS: of 192 histopathological results of malignant neoplasms of the nose and paranasal sinuses, in the period studied, 42 had tomography and interpretation; the non-concordant proportion was 15 (35.7%) cases, the concordant proportion was 27 (64.3%) cases, and the observed proportion was 0.64; the expected proportion was estimated at 0.26, calculating a Kappa coefficient of 0.51 with "moderate" strength concordance. CONCLUSIONS: we can conclude that, to increase diagnostic concordance, it is essential to have a good clinical history and examination of the patient. In extension studies, it is important to have a suspected site of the primary tumor and conduct acquisition protocols and post-process protocols suitable for the head and neck region. [ABSTRACT FROM AUTHOR]

The reason for lip and cleft palate is due to a congenital malformation characterized by the interruption in the continuity of tissue. The primary surgery of the palate velum allows us to reconstruct the lost morphology in the velum palate, however this doesn't always consider the return of the uvula muscle anatomy, whereby the operated velum becomes an anomalous anatomy thus preventing an optimum closing between the nasal and oral cavity; this condition is known as pharyngeal velum insufficiency. The aim was to associate palate velum morphology with pharyngeal velum insufficiency on cleft palate operated patients. An analytical study was done, using the velum palate as sample; the sample was selected amongst patients who met the inclusion criteria. A photographic record and a clinical exam were done on those patients who were chosen in order to classify the anatomy of the velum palate. Subsequently a phonoaudiological evaluation was done in order to establish the degree of pharyngeal velum insufficiency. The data obtained were statistically tabulated and evaluated. The morphological classification of the palate velum determined that 52% of the vela were classified as concave; the flat and convex vela both had a 24% share each. According to the evaluation of the pharyngeal velum, 12% were shown to be insufficient, 52% as borderline insufficient, 24% as borderline sufficient, and only 8% proved to be sufficient. When relating the palate velum morphology with pharyngeal velum evaluation a p = 0.3 was obtained. There is a variability in both the palate velum morphology and in the evaluation of the pharyngeal velum insufficiency on operated cleft palate patients, with the latter shown as being unfavorable. No statistical relation was established between palate velum morphology and pharyngeal velum evaluation. [ABSTRACT FROM AUTHOR]

A case of nasal plasmacytoma with history of chronic unilateral epistaxis in a twenty-one month old, male, Akita dog, weighing 30 kg is described. Clinical examination and biopsy of the visible tumor in the left nasal cavity were performed. The location and extent of the tumor were determined by head and neck computer tomography. Histopathological and immune-histochemical (IHC) analyses of tumoral tissue were performed. Computer tomography showed a mass with soft tissue density of 10 cm long x 3.5 cm in diameter and low uptake of the contrast medium that entirely compromised the right nasal cavity and part of the rear portion of the left choana. The histopathological analysis revealed the presence of numerous pleomorphic round cells with little cytoplasm, surrounded by a scarce network of connective tissue, and a low mitotic index. The IHC analysis was negative for CD3 and CD20 antigens or T and B lymphocytes, respectively. Clinical and computer tomography findings, such as the results of the histopathology of the tumoral tissue were consistent with a low-grade malignancy extramedular plasmacytoma. [ABSTRACT FROM AUTHOR]

The lace is the main symbol of identity which defines us as individuals as well as in the process of interpersonal contacts. Metric characteristics contributed by craniometry allow us to characterize crania and faces by means of indexes. A craniometric study was carried out in 32 crania of adult subjects of both sexes. Facial diameters were measured using indexes according to Bidegain & Carvalho de Mello. Facial height average (n-pr) was 66.20 mm (SD±5.26) with maximum boundary of 76.68 mm and minimum of 51.22 mm. Facial maximum width on average (zy -zy) was 127.05 mm. (SD±6.85), with maximum boundary of 139.08 mm and minimum of 112.7 mm. Average Nasal width was 23.99 mm (SD ± 2.81), with maximum boundary of 35.13 mm and minimum of 18.97mm. Nasal height average (n-ns) was 50.97 mm (SD±3.58) with maximum boundary of 55.96 mm and minimum of 39.58 mm. Facial Superior Index on average was of 52.20 (SD±4.54) with maximum boundary of 62.29 mm and minimum of 43.92 determining the mesorrhine tendency in male and female crania. Nasal average index was 47.30 (SD±6.28) with maximum boundary of 67.14 and minimum of 36.23 thereby determining leptorrhine characteristics in male as well as female crania. The information obtained will afford health care professionals access to new data for anthropometric and anthropological studies. [ABSTRACT FROM AUTHOR]

Lymphoma accounts for 3 to 5% of all the malignant tumors. Most of sinonasal B-cell lymphoma are non-Hodgkin's lymphoma. In this article, we report a case of B-cell non-Hodgkin lymphoma of the nasal cavity, with a fast and aggressive evolution, pronouncing with important eyelid edema and erythema, limitation of eye movements, blurred vision and severe nasal obstruction. The CT scan of nose and sinonasal tract shows density of soft tissues that occupies in its totality the nasal cavity, respecting only the orbits. By means of a biopsy and immunophenotipic study, diagnose is confirmed, beginning treatment with rituximab with suitable evolution. [ABSTRACT FROM AUTHOR]

Schwannoma is a benign neurogenic tumor of slow growing. Fourty-five percent of cases occur in head and neck region; its origin on nasal cavity and paranasal sinuses is not common, about 4%. We report the case of a nasal septum schwannoma in a male 68 year-old patient, with a tumor of eight years of evolution with clinical signs of nasal obstruction and rhinorrhea. Extirpation by lateral rhynotomy was done successfully. After three years of follow-up patient does not have recurrence. [ABSTRACT FROM AUTHOR]

The tumoral processes that ore presented in the maxillary and jaw, in an excessive growth, they con deform the patient's face considerably. When being eliminated the lesions or tumors are presented dysfunctions in functions as the deglution, mastication and phonation like: to present speaks hipernasal, filtration of liquid to the nasal cavity or inclusive to the cavity it would orbit depending on the size of the tumor and the cavity remainder for what is necessary and indispensable the placement from a surgical choke to this type of patient. The quality of the patients' life with maxillofacial protesis altered, they are damaged psychologically, social and emotionally when having lost part of its face and finally its expectations are very high to feel normal and socially accepted of the people again. [ABSTRACT FROM AUTHOR]

Nasal tumors containing glial tissue are rare and since they are not really neoplasic growth, the term used today which best describes them is nasoglial heterotopia. An 8 day old female patient was brought in for consultation due to a nasal obstruction. Upon physical exploration, a mass was observed which completely occupied the left nostril. Magnetic resonance imaging revealed that a mass had not connected to the central nervous system. A biopsy with a diagnosis of nasoglial heterotopia was made. A total surgical resection was performed without complications. This case is remarkable because of the approximately 100 reported cases of intra-nasal nasoglial heterotopia, only four of those have been during the neonatal period. [ABSTRACT FROM AUTHOR]