1,721,065 research outputs found
Esthesioneuroblastoma and cervical lymph node metastases: clinical and therapeutic implications
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Granulomatous Diseases of the Nose and Paranasal Sinuses
No full textPROGRAM DESCRIPTION
The nose and paranasal sinuses may play host to a large range of systemic granulomatous diseases. The principal element of these diseases is granuloma formation consisting of a conglomerate of macrophages, epithelioid cells, and multinucleated giant cells. This configuration is present in a number of conditions, including infectious (spirochetes[syphilis, yaws], mycobacteria[tuberculosis, leprosy], bacteria[rhinoscleroma], and fungus[aspergillus]) and inflammatory (Wegener granulomatosis, sarcoidosis, Churg-Strauss syndrome, cocaine induced midline destructive lesions). Many of these lesions present with non-specific sinonasal symptoms and may progress rapidly to involve contiguous structures, such as the orbit and skull base, presenting significant clinical implications for timely diagnosis and management. Thorough diagnostic workup, including endoscopic, radiologic, histopathologic and serologic testing is imperative to arrive at the proper diagnosis and to initiate appropriate local and systemic treatment. Granulomatous diseases of the nose and sinuses represent an uncommon but clinically important and potentially lethal group of disorders encountered in otolaryngologic practice. A high index of suspicion, coupled with timely diagnosis and appropriate medical and surgical management, is required in this patient population. This miniseminar will introduce the participants to the current diagnostic and classification scheme of infectious, inflammatory, and neoplastic granulomatous conditions affecting the sinonasal tract. Pertinent endoscopic, radiologic and histologic findings will be highlighted in order to exemplify the typical clinical picture of these granulomatous diseases. Contemporary management strategies, including topical sinonasal and systemic therapies and the role of sinonasal surgery will be reviewed. The miniseminar faculty will be comprised of rhinologists with internationally recognized expertise in management of these disorders.
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EDUCATIONAL OBJECTIVES
1) Understand the classification for infectious, inflammatory, and neoplastic granulomatous diseases of nose and sinuses. 2) Recognize the salient endoscopic, radiographic, histologic, and serologic features in patients with granulomatous disease. 3) Appreciate the appropriate medical and surgical management strategies in the patient population
Peak nasal inspiratory flow; normal range in adult population
No full textAIMS: Measurement of Peak Nasal Inspiratory Flow (PNIF) seems to be a cheap,
simple, easily performed method to assess nasal patency. The purpose of this
study is to establish normative PNIF data for a healthy adult population and
provide charts relating PNIF normal values with age, height and sex in adults.
METHODS AND RESULTS: Repeated measurements of PNIF were performed in 170
volunteers. In total, 137 of these fulfilled the study criteria (66 females and
50 males) and all of them were non-smokers, non-asthmatic, without nose and
paranasal sinuses problems, with ages ranging from 16 to 84 years. Data were
statistically analysed and tables were produced relating PNIF to age, sex and
height. There was no interaction of sex with age or height. There was
considerable residual variability of PNIF between individuals not explained by
any of the variables studied.
CONCLUSIONS: We conclude that PNIF could be a useful method to study nasal
patency in both primary and secondary care to aid diagnosis of nasal disease. The
study provides normative data for a Caucasian population. Further variables need
to be explored to predict expected PNIF values more accurately
Optimum imaging for inverted papilloma
No full textInverted papilloma is the most common benign tumour of the nose and paranasal sinuses, and usually arises in the lateral wall of the nasal cavity and the middle meatus. The diagnosis is suggested on computed tomography (CT) when there is a mass continuous from the middle meatus into the adjacent maxillary antrum, through an expanded maxillary ostium. The mass may contain areas of high density or calcification, and there may be sclerosis of the wall of the affected sinus. The main advantage of magnetic resonance imaging (MRI) is in defining the extent of the tumour, and in differentiating it from adjacent inflammatory tissue, but there are no certain signal intensity or enhancement characteristics to help differentiate inverted papilloma from sinus malignancy. In the differential diagnosis, antro-choanal polyp, malignant sinus tumours and chronic rhinosinusitis and fungal disease need to be excluded. The combination of bone deformity and sclerosis with the typical antro-meatal mass suggests a slow-growing tumour such as inverted papilloma
Optimum imaging for mucoceles
No full textA mucocele is an epithelial lined mucus-containing sac completely filling a paranasal sinus and capable of expansion. They are relatively unusual, occurring most frequently in the fronto-ethmoidal region. The imaging features on plain X-ray, computerized tomography and magnetic resonance imaging are relatively characteristic allowing distinction of the lesion from other pathologies in this area although the mucoceles may occur in association with other pathologies such as nasal polyposis and neoplasia
Optimum imaging for sinonasal malignancy
No full textA combination of computed tomography (CT) and magnetic resonance imaging (MRI) is now established as the optimum assessment of sinonasal malignancy. CT and MRI are of particular value in assessing the skull base, orbit and pteryo-palatine and infratemporal fossae. Although MRI offers better differentiation of tumour from surrounding tissue and fluid, coronal CT is still required for the demonstration of bone erosion particularly in the region of the cribriform plate. Thus the extent of local tumour spread may be determined with a degree of accuracy in excess of 98 per cent. However, the final determinant of penetration of the dura and orbital periosteum requires per-operative frozen section assessment. A knowledge of the tissue characteristics and site of origin can be of value in distinguishing some of the commoner sinonasal malignancies such as squamous cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, olfactory neuroblastoma and chondrosarcoma. Imaging, particularly MRI also plays an important role in the post-therapeutic follow-up of patients, indicating areas of residual or recurrent disease, defining suspicious areas for biopsy. Post-operative surveillance is best achieved with three planar T1-weighted MRI, with, and without, gadolinium and axial T2-weighted sequences. The subtraction of the T1 pre- and post gadolinium T1 sequences can be of particular value in delineating recurrence
Does peak nasal inspiratory flow relate to peak expiratory flow?
No full textAIMS: Measurement of Peak Nasal Inspiratory Flow (PNIF) seems to be a cheap and
easily performed method to assess nasal patency. As demonstrated in a previous
work, PNIF is influenced by SEX, AGE and HEIGHT. However there is a large degree
of between-patient variability in PNIF levels. The purpose of this analysis is to
determine whether the measurement of the pulmonary ventilatory capacity, by mean
of Peak Expiratory Flow (PEF), enables more precise determination of PNIF.
METHODS AND RESULTS: Repeated measurements of PNIF and PEF were performed in 112
volunteers. 100 of these fulfilled the study criteria (55 females and 45 males)
and all of them were non-smokers, non-asthmatic, without nose and paranasal
sinuses problems, with ages ranging from 15 to 71 years. Statistical analysis was
undertaken to determine whether a relationship existed between PNIF and age, sex
and height, but which also considered PEF. The data from both experiments were
analysed together. In both groups there is a clear tendency for PNIF to increase
with PEF. As clearly demonstrated in this work the value of PEF is informative in
predicting PNIF and that the larger the value of PEF, the larger the value of
PNIF.
CONCLUSIONS: PNIF is a useful method to study nasal patency in both primary and
secondary care to aid diagnosis of nasal disease, but low values of PNIF have to
be confirmed by a study of the PEF as PNIF low values may be an expression of low
ventilatory activity rather than an expression of nasal obstruction
Is there any Association between Helicobacter Pylori Infection and Laryngeal Carcinoma
Full text linkObjective: To investigate the possible role of Helicobacter pylori as a cause of squamous cell carcinoma of larynx
in a case-control study in an otolaryngology ward at an academic university. Subjects and Methods: A total of
65 patients with laryngeal cancer and 65 matched cancer-free controls underwent esophagogastroduodenoscopy
and biopsy of antral and body regions of the stomach for evaluation of Helicobacter pylori infection. Results:The
proportion of subjects with a positive rapid urease test for gastric infection was similar between the two groups
(49.2 % in cases vs. 40% in controls). However, a positive rapid urease test for body was less frequently seen in
patients with laryngeal cancer whereas a positive rapid urease test for antrum was significantly higher (P=0.04).
Conclusion: Our study failed to show Helicobacter pylori as one of the etiologies of laryngeal cancer. However, it
supported the hypothesis that colonization of Helicobacter pylori only in the gastric body might have a protective
effect against laryngeal cancer with decreasing gastric acid while antral Helicobacter pylori, increasing gastric
acid due to G cell hyperplasia, may be a predisposing factor for laryngeal cancer, with acid reflux as a possible
underlying etiology.
Keywords: Helicobacter pylori - laryngeal cancer - rapid urease test - gastric acid - esophagogastroduodenoscop
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