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Pleomorphic adenoma of the nasal septum: a case report
Polycarp Gana, Liam Masterson
Journal of Medical Case Reports , 2008, DOI: 10.1186/1752-1947-2-349
Abstract: We present the case of a 61-year-old man who presented with a 2-year history of left nasal obstruction, occasional epistaxis and facial pain. Radiological examination demonstrated well pneumatised paranasal sinuses and a soft tissue mass in the anterior aspect of the left nasal cavity. In this patient, an intranasal approach was used to achieve a wide local resection.Pleomorphic adenomas are rare tumours of the nasal cavity and have been shown to be misdiagnosed in over half of cases leading to more aggressive treatment than is necessary. If unilateral nasal obstruction is the main presenting complaint, we suggest consideration of this diagnosis. In view of the potential for tumour recurrence, long-term follow-up and careful examination of the nose with an endoscope are necessary.Salivary gland tumours constitute about 3% [1] of all neoplasms. The majority of these tumours are benign and about 70% are pleomorphic adenomas. A small minority (8%) are located in the oral cavity, neck and nasal cavity. We present a rare case of pleomorphic adenoma of the nasal septum.Several benign lesions of the septum such as leiomyoma, osteochondroma and transitional cell papilloma have been reported in literature. The other differential diagnoses may include malignant tumours such as melanoma, adenoid cystic carcinoma and squamous cell carcinoma. The majority of these tumours arise from the mucosa of the bony and cartilaginous septum.Nasoseptal swell body is a discrete area of erectile tissue in the submucosa over the anterior nasal septum. In some individuals, it can present as a suspicious lesion. It does not have a significant relevance when considering the differential diagnosis in this patient given the enormous size of the septal mass. However, in smaller septal swellings, it could be given consideration.A 61-year-old man presented with a 2-year history of left nasal obstruction, occasional epistaxis and facial pain. There was no history of visual defect, atopy or previous tra
Surgery of the nasal septum and turbinates
Matthias, Christoph
GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery , 2007,
Abstract: The following article presents nasal septum and turbinate surgery. First an overview with special consideration of the anatomical and physiological background is given followed by indications for surgical procedures. Key steps of the gold standard procedure first described by Cottle and common variations are presented. Furthermore, some techniques dealing with special problems of the septumplasty are discussed followed by an overview on complications and long term results. However, it should be mentioned that studies on surgical procedures of the nasal septum are still not sufficient as higher evidence levels are very rare. Within a separated chapter techniques for closure of septum perforations are presented and indications particularly in the background of the standard procedure of bridge flaps forwarded by Schultz-Coulon are discussed. The second part focusses on turbinate surgery. Accordingly, anatomical and physiological basics are presented followed by indications for surgical procedures and the surgical steps of different procedures as well as postsurgical treatment and long term results.
Absceso del septum nasal
Barril,María F; Ferolla,Fausto M; José,Pablo; Echave,Cecilia; Tomezzoli,Silvana; Fiorini,Sandra; López,Eduardo Luis;
Archivos argentinos de pediatr?-a , 2008,
Abstract: a nasal septal abscess (na) is defined as a collection of pus between the cartilage or bony septum and its normally applied mucoperichondrium or mucoperiostium. it is an uncommon disease wich should be suspected in a patient with acute onset of nasal obstruction and recent history of nasal trauma, periodontal infection or an inflammatory process of the rhinosinusal region. we report a case of an 8-year-old boy with bilateral na caused by community-acquired methicillin-resistant staphylococcus aureus(mr-co) in order to emphasize the importance of prompt diagnosis and adequate treatment to prevent the potentially dangerous spread of infection and the development of severe functional and cosmetic sequelae.
Nasal septum extramedullary plasmacytoma  [PDF]
Beli? Branislav,Mitrovi? Slobodanka,Arsenijevi? Sne?ana,Erdevi?ki Ljiljana
Vojnosanitetski Pregled , 2013, DOI: 10.2298/vsp1302221b
Abstract: Introduction. Plasmacytomas are malignant tumors characterized by abnormal monoclonal proliferation of plasma cells. They originate in either bone - solitary osseous plasmacytoma, or in soft tissue - extramedullary plasmacytoma (EMP). EMP represents less than 1% of all head and neck malignancies. Case report. We presented a case of EMP of the nasal septum in a 44-year-old male who had progressive difficulty in breathing through the nose and frequent heavy epistaxis on the right side. Nasal endoscopy showed dark red, soft, polypoid tumor in the last third of the right nasal cavity arising from the nasal septum. The biopsy showed that it was plasmacytoma. Bence Jones protein in the urine, serum electrophoresis, bone marrow biopsy, skeletal survey and other screening tests failed to detect multiple myeloma. This confirmed the diagnosis of EMP. The mass was completely removed via an endoscopic approach, and then, 4 week later, radiotherapy was conducted with a radiation dose of 50 Gray. No recurrence was noted in a 3-year follow- up period. Conclusion. EMP of the nasal cavity, being rare and having long natural history, represents a diagnostic and therapeutic challenge for any ear, nose and throat surgeon. Depending on the resectability of the lesion, a combined therapy is the accepted treatment.
Age anatomy of human nasal septum  [PDF]
Yemelianenko N.R.
Морфолог?я , 2009,
Abstract: A bibliographical analysis of recent scientific publication deals with a topical problem of modern otorhinolaryngolology – age anatomy of human nasal septum. In its anatomic structure the nasal cavity is one of the most difficult structures of human organism. An important structure, which control the aerodynamics of the air-stream, provides the heating, wetting and clean-ing of air, regulates in a definite way the hormonal balance of the whole organism, is the nasal septum. Plenty of scientific publications on this issue testify to the personal interest of the whole world scientists in these question. At the same time a general idea absents in relation to an anatomic structure, becoming, development, functioning, sexual-age-old changes of nasal septum, etiology and pathogenic of its most widespread diseases and choice of optimal methods of their correction. During the human development the nasal septum undergoes substantial changes. So in new-born the medial wall of nose is formed by a cartilaginous plate and bony vomer, which shows by itself two bony plates which engulf the lower edge of cartilaginous plate of nasal partition. On this stage of ontogenesis the processes of ossification of structures of nasal partition last yet. To it testifies circumstance that clear anatomic borders between the perpendicular plate of ethmoid bone and cartilage of nasal partition in new-born are impossible to set. Consequently, the analysis of scientific literature certifies that present information, in relation to the age anatomic features of nasal partition and character of its blood supply is fragmental and incomplete. It specifies on the necessity of lead through of their more complete research and systematization of findings.
Perforation of the Nasal Septum and Nasal Ulcers  [PDF]
Maria Pilar Martín-Fortea, Isabel Sanjoaquín-Conde, Santiago Letona-Carbajo, Maria José Crusells-Canales, Julián Cuesta-Mu?oz, Juan Antonio Amiguet-García
World Journal of AIDS (WJA) , 2011, DOI: 10.4236/wja.2011.12005
Abstract: A case about a HIV woman with nasal ulcers is described in this paper. In every inmunodepressed patient who has mu-cosal or cutaneous ulcers, infection by leishmanial parasites needs to be ruled out, especially when ulcers have not re-gression with usual treatments. The Leishmanial nasal disease usually shows swelling and mucosal ulcers, that may progress to necrosis. Delaying in appropriate therapy might cause irreversible damage.
Eosinophilic Angiocentric Fibrosis of the Nasal Septum  [PDF]
Yunchuan Li,Honggang Liu,Demin Han,Hongrui Zang,Tong Wang,Bin Hu
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/267285
Abstract: Background. Eosinophilic angiocentric fibrosis (EAF) is a rare benign condition of unknown aetiology that causes stenosis of the upper respiratory tract. It is most commonly found at the nasal septum and sinus mucosa causing mucosal thickening and nasal obstructive symptoms. The diagnosis is mainly based on characteristic histologic findings. Case Report. A 27-year-old young woman presented with a slow growing mass at her anterior nasal septum for over eight years. She complained of persistent nasal obstruction, epistaxis, sometimes diffused facial pain, and chronic headache. 3 years ago, the tumor was partially resected for ventilation and a nasal septum perforation was left. Imaging findings indicated soft-tissue thickening of the anterior part of septum and adjacent lateral nasal walls. Pathological examination showed numerous inflammatory cells infiltrates containing eosinophils, fibroinflammatory lesion with a whorled appearance fibrosis which typically surrounded vessels. A diagnosis of eosinophilic angiocentric fibrosis was made. All laboratory tests were unremarkable. Skin prick test was positive. The tumor-like lesion was totally resected. Conclusions. EAF is a rare benign and progressive disorder causing destruction. Combined with radiological imaging of EAF historical findings contribute to the diagnosis. It is important to prevent tumor from recurrence by total resection of the lesion. 1. Introduction Eosinophilic angiocentric fibrosis (EAF) is a rare, benign condition of unknown aetiology which may cause local tissue progressive destruction [1]. It mainly involves the sinonasal tract and is especially common at the nasal septum. EAF typically presents in young to middle-aged females. Most of the patients complain of progressive sinonasal obstructive with a tumor-like lesion. The etiology of EAF is unknown, and the diagnosis is mainly based on histologic findings. The histologic features include perivascular inflammatory cell infiltration (mainly eosinophils). The eosinophils infiltration is gradually replaced by the progressive fibrosis lesion with “onion-skin” pattern around small blood vessels [1–6]. It was first described by Holmes and Panje in 1983 who reported a case of so-called ‘‘intranasal granuloma faciale” [7]. After two years, Roberts and McCann reported two female patients with an unusual stenosing lesion involving the upper respiratory. They gave a descriptive diagnosis according to the histologic findings: eosinophilic angiocentric fibrosis [8]. Until now, 51 patients diagnosed with EAF have been reported in the English
Perforation of nasal septum: etiology and diagnosis  [cached]
Fornazieri, Marco Aurélio,Moreira, Jemima Herrero,Pilan, Renata,Voegels, Richard Louis
International Archives of Otorhinolaryngology , 2010,
Abstract: Introduction: The nasal septum perforation is an occasional finding of rhinoscopy and most patients are asymptomatic. However, there are several possible etiologies of this condition, making necessary a thorough investigation. Objective: To review the literature the main causes of septal perforation and describe the diagnostic tests currently used. Method: A systematic literature review of journals indexed identifiable until December 2008. Final Comments: The main causes are the traumatic / iatrogenic nasal drug use, exposure to toxic gases, inflammatory and infectious diseases and neoplasms. The diagnosis is based on detailed medical history, focusing on occupation and origin of the patient, observation of the characteristics of mucosal injury on biopsy and collection of additional tests such as ANCA, guided by the main suspect.
Nasal Septum Perforation due to Methamphetamine abuse
Mehdi Bakhshaee,Ehsan Khadivi,Masoud Naseri Sadr,Fereshteh Esmatinia
Iranian Journal of Otorhinolaryngology , 2012,
Abstract: Introduction: Spontaneous Perforation of the nasal septum is an uncommon condition. Nasal inhalation of substances such as cocaine has long been linked to this Perforation. Case Report: This report describes the case of a 46-year-old woman who was addicted to methamphetamine and who presented with perforation of the nasal septum.This is the first reported case of nasal septal necrosis linked to nasal inhalation of methamphetamine. Conclusions: Patient history and assurance regardingillegal drug consumption and abuse is a key point for fast and accurate diagnosis. The pathophysiology of drug-induced sinunasal disease and a review of the literature are also presented.
Inflammatory Myofibroblastic Tumor of the Nasal Septum  [PDF]
Yuri Okumura,Kazuhiro Nomura,Takeshi Oshima,Atsuko Kasajima,Takahiro Suzuki,Eichi Ishida,Toshimitsu Kobayashi
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/670105
Abstract: We report an extremely rare case of inflammatory myofibroblastic tumor of the posterior edge of the nasal septum. An 11-year-old boy presented with frequent epistaxis and nasal obstruction persisting for one year. Based on the clinical presentation and imaging studies, juvenile angiofibroma was suspected, but angiography suggested the possibility of another type of tumor. Transnasal endoscopic surgery found that the tumor protruded into the nasopharynx from the posterior end of the nasal septum. Histological examination identified spindle cells with immunoreaction for vimentin, smooth muscle actin, and anaplastic lymphoma kinase (ALK), but not for desmin and cytokeratin. This is a report of inflammatory myofibroblastic tumor mimicking juvenile angiofibroma. This case suggests that angiography is helpful in the differential diagnosis of epipharyngeal tumor in adolescence. 1. Introduction Inflammatory myofibroblastic tumor (IMT) was first observed in the lung in 1990 [1], but extrapulmonary IMTs have also since been reported. IMT is classified as myofibroblastic neoplasm with intermediate grade, which rarely metastasizes. The clinical presentation is a neoplastic process with recurrence and metastasis in some cases [2, 3]. IMT may occur throughout the body and is most commonly found in the lung, abdominal cavity, retroperitoneum, and extremities but is uncommon in the head and neck region [1, 4]. We present a case of IMT located in the nasopharynx, which mimicked juvenile angiofibroma. 2. Case Presentation An 11-year-old boy had visited a provincial hospital because of frequent epistaxis and nasal obstruction persisting for one year. A tumorous mass was found in the nasopharynx, so computed tomography (CT) and magnetic resonance (MR) imaging studies were performed. Juvenile angiofibroma was suspected, so he was referred to our hospital for further examination and treatment. Physical examination found a smooth reddish mass in the nasopharynx. The imaging studies performed at the previous hospital were reexamined. CT scans showed a homogeneously enhanced soft tissue mass in the nasopharynx without bone destruction (Figure 1). The T1-weighted MR image with contrast medium demonstrated an isointense mass with homogeneous enhancement (Figure 2). These findings elucidated the diagnostic impression of juvenile angiofibroma, as suggested by the previous physicians. Angiography detected faint tumor staining, but no obvious feeding artery (Figure 3). This result suggested the possibility of tumors other than juvenile angiofibroma because of the unexpectedly poor
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