RESUMEN
This article presents the case of a 33-year-old woman who consulted the authors' ENT clinic in the 39th week of pregnancy with recurrent epistaxis. A livid endonasal mass was found on the left side, subtotally displacing the nose and leading to deformation of the external nose. External biopsy provided no indications of malignancy. Postpartum CT of the paranasal sinuses revealed a mass destroying the cartilaginous nasal septum. Endoscopic resection of the finding was performed with preservation of the clinically sound nasal septal cartilage. Histopathological examination revealed a capillary hemangioma, which was classified as granuloma gravidarum due to its occurrence during pregnancy.
Asunto(s)
Epistaxis , Hemangioma Capilar , Cartílagos Nasales , Deformidades Adquiridas Nasales , Complicaciones Hematológicas del Embarazo , Complicaciones Neoplásicas del Embarazo , Humanos , Femenino , Embarazo , Adulto , Epistaxis/diagnóstico por imagen , Epistaxis/patología , Recurrencia , Complicaciones Hematológicas del Embarazo/diagnóstico por imagen , Complicaciones Hematológicas del Embarazo/patología , Biopsia , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/patología , Cartílagos Nasales/diagnóstico por imagen , Cartílagos Nasales/patología , Hemangioma Capilar/diagnóstico por imagen , Hemangioma Capilar/patología , Complicaciones Neoplásicas del Embarazo/diagnóstico por imagen , Complicaciones Neoplásicas del Embarazo/patologíaRESUMEN
La nariz es estructuralmente compleja, y esta complejidad da como resultado variaciones de forma nasal. El estudio tuvo como objetivo determinar las desviaciones septales nasales que ocurren en relación con las deformidades nasales externas. Se realizó un estudio transversal en el departamento de oído, nariz y garganta, en nuestro hospital. Todos los individuos que tienen desviación septal con deformidad nasal externa de noviembre de 2017 a noviembre de 2018. Esos pacientes serán evaluados mediante un examen clínico integral de la oreja, la nariz y la garganta. Los síntomas del paciente se clasifican con el cuestionario de prueba china nasal -22. Las deformidades septales se clasificaron utilizando la clasificación Mladina modificada. Las deformidades nasales externas se clasificaron empleando la clasificación de Yong Jo Jang. Aproximadamente, el 43% eran hombres y el 57% eran mujeres. Alrededor del 90% de los pacientes de 21 años a 50 años. Alrededor del 58% de los pacientes eran sintomáticos, mientras que el resto del 42% no tenía síntomas. Al correlacionar los síntomas con el tipo de desviación, se encontró significativamente asociación (P = 0.05). La mayoría de las personas se encuentran en el grupo de mediana edad. Tipo II y IV son los tipos más comunes de NSD, mientras que el tipo I es un final común. El encuentro notable de nuestro estudio es que los pacientes no tenían deformidad
The nose is structurally complex, and this complexity results in nasal shape variations. The study aimed to determine the nasal septal deviations occurrence in relation to external nasal deformities. A crosssectional study was conducted in Department of Ear, Nose and Throat, in our hospital. All the individuals having septal deviation with external nasal deformity from November 2017 to November 2018. Those patients be evaluated by comprehensive clinical examination of ear, nose and throat. Patient's symptoms are rated with Sino-Nasal Test -22 questionnaire. Septal deformities were classified using Mladina classification modified. External nasal deformities were classified employing Yong Jo Jang's classification. Approximately, 43% were males and 57% were females. About 90% of patients aged from 21 years to 50 years. About 58% of patients were symptomatic while the rest 42% were without symptoms. On correlating the symptoms with the type of deviation it was found significantly association (P=0.05). Majority of individuals are in the middle age group. Type II and IV are the most common types of NSD whereas type I is a common END. Noteworthy finding of our study is patients had no deformity.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Deformidades Adquiridas Nasales/patología , Cartílagos Nasales/anomalías , Cavidad NasalRESUMEN
OBJECTIVES/HYPOTHESIS: About 260,000 septoplasties are performed annually in the US to address nasal septal deviation (NSD). Yet, we do not consistently understand what aspects of NSD result in symptoms. STUDY DESIGN: Blinded cohort study. METHODS: Two fellowship-trained surgeons blindly reviewed computerized tomography (CTs) of 10 confirmed NSD patients mixed with 36 healthy controls. All patients were correctly identified, however, 24/36 controls were falsely identified by both surgeons as patients (33.3% specificity), which were grouped as asymptomatic NSD (aNSD), while the remaining controls as non-NSD (healthy). Acoustic rhinometry, rhinomanometry, individual CT-based computational fluid dynamics and nasal sensory testing were applied to address the puzzling questions of why these aNSD had no symptoms and, more fundamentally, what caused symptoms in sNSD patients. RESULTS: aNSD reported no nasal symptoms - Nasal Obstruction Symptom Evaluation score (sNSD: 60.50 ± 13.00; aNSD: 5.20 ± 5.41; non-NSD: 6.66 ± 7.17, P < .05); 22-item Sino-Nasal Outcome Test score (sNSD: 32.60 ± 14.13; aNSD: 10.04 ± 10.10; non-NSD: 9.08 ± 12.42, P < .001). No significant differences in measured nasal resistance, minimum cross-sectional area (MCA), degree of septal deviation, and nasal airflow distributions were found between sNSD and aNSD groups. Only three variables differentiate sNSD versus aNSD: anterior averaged heat flux on deviated side, inferior turbinate peak heat flux on non-deviated side, and nasal cool sensitivity measured by menthol lateralization threshold, with no significant differences among these variables found between the two healthy groups (aNSD vs. non-NSD). These variables by themselves or combined can differentiate sNSD from controls with higher specificity than the physicians (ROC area under the curve = 0.84 with 70% sensitivity and 91.6% specificity). CONCLUSIONS: This study sheds light on the potential mechanisms of NSD symptomatology: distorted nasal cooling due to NSD exacerbated by poorer nasal mucosal sensitivity. It further supports our previous hypothesis that nasal obstruction complaints do not result directly from obstruction, rather from the capacity of our nose to subjectively sense airflow cooling. LEVEL OF EVIDENCE: 3 Laryngoscope, 132:509-517, 2022.
Asunto(s)
Tabique Nasal/anomalías , Deformidades Adquiridas Nasales/complicaciones , Estudios de Casos y Controles , Humanos , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/fisiopatología , Deformidades Adquiridas Nasales/patología , Deformidades Adquiridas Nasales/fisiopatología , Trastornos del Olfato/etiología , Rinomanometría , Rinometría Acústica , Tomografía Computarizada por Rayos XAsunto(s)
Tabique Nasal/patología , Deformidades Adquiridas Nasales/cirugía , Rinoplastia/métodos , Colgajos Quirúrgicos/trasplante , Adolescente , Niño , Preescolar , Presión de las Vías Aéreas Positiva Contínua/efectos adversos , Presión de las Vías Aéreas Positiva Contínua/métodos , Femenino , Hemangioma/complicaciones , Hemangioma/patología , Hemangioma/cirugía , Humanos , Lactante , Masculino , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/patología , Neoplasias Nasales/complicaciones , Neoplasias Nasales/patología , Neoplasias Nasales/cirugíaAsunto(s)
Presión de las Vías Aéreas Positiva Contínua/efectos adversos , Deformidades Adquiridas Nasales/cirugía , Nariz/patología , Colgajos Quirúrgicos/trasplante , Humanos , Lactante , Recién Nacido , Necrosis/etiología , Necrosis/patología , Necrosis/cirugía , Nariz/cirugía , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/patología , Resultado del TratamientoRESUMEN
Crooked or deviated noses pose a specific challenge as many of the elements in a deviated nose are not symmetric and therefore not ideal for preservation techniques. Deviated noses are often where a hybridization between preservation and structural rhinoplasty is required. Careful preoperative evaluation of the soft tissue and bony anatomy of the patient is very important and congenital or post-traumatic asymmetry may involve more than the nasal pyramid. Full exposure of the nasal pyramid allows for visualization and appropriate osteotomy or rhinosculpture.
Asunto(s)
Tabique Nasal/anomalías , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/cirugía , Rinoplastia/métodos , Humanos , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/patología , Osteotomía/métodosRESUMEN
INTRODUCTION: Concha bullosa (CB), which is pneumatization of the concha, is one of the most commonly seen anatomic variations of the lateral nasal wall. OBJECTIVE: To investigate the effects on olfactory function of lateral turbinectomy and crushing methods used in the surgical treatment of CB. METHODS: The study included a total of 47 patients operated on for a diagnosis of CB and nasal septum deviation. The patients comprised 22 females and 25 males, with bilateral CB in 18 cases and unilateral in 29 cases. Intervention was made to a total of 65 CB. The cases were separated as those applied with septoplasty and lateral turbinectomy in group 1 (n = 34) and those applied with the septoplasty and crushing method in group 2 (n = 31). The olfactory function of the patients was evaluated preoperatively and at 3 months postoperatively with the Brief Smell Identification Test. RESULTS: A statistically significant increase was determined in the postoperative smell test results compared with the preoperative values in both group 1 (P = .021) and group 2 (P = .001). When the change in the smell test results from preoperative to postoperative was compared between the groups, the increase in group 2 was determined to be statistically significantly greater (P = .002). CONCLUSION: The results of this study showed that the crushing method in surgical treatment of CB increased olfactory functions more than the lateral resection method, and as the improvement in olfactory functions was greater, this demonstrated that only increasing the nasal cavity is not sufficient and the nasal mucosa should be protected as far as possible.
Asunto(s)
Enfermedades Nasales/cirugía , Trastornos del Olfato/cirugía , Rinoplastia/métodos , Olfato , Cornetes Nasales/cirugía , Adulto , Femenino , Humanos , Masculino , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/complicaciones , Deformidades Adquiridas Nasales/patología , Deformidades Adquiridas Nasales/cirugía , Enfermedades Nasales/complicaciones , Enfermedades Nasales/patología , Trastornos del Olfato/etiología , Periodo Posoperatorio , Periodo Preoperatorio , Estudios Prospectivos , Resultado del Tratamiento , Cornetes Nasales/patologíaRESUMEN
The purpose of this study was to investigate the effects of craniofacial structure and nasal septal deviation on frontal sinus morphology 3-dimensionally. This study of anatomy, anthropology, morphology, and radiology included 74 dry skulls as study sample. The craniofacial measurements were made through conventional anthropometric methods by the use of calipers. The nasal septal deviation measurements were done by computerized software on photographs taken from frontal view. Frontal sinus volumes were estimated by the computerized tomography-based volumetry. The relationships between craniofacial structure, nasal septal deviation, and frontal sinus morphology were tested by linear regression and correlation analysis. The analysis of numerical variables and categorical variables within different groups was done by Mann-Whitney U/Kruskal-Wallis, and χ2 tests, respectively. There appeared a positive relationship between the dimensions of the frontal sinuses and the maximal cranial length and the nasal height especially on the left side (P < .05). However, after multivariate linear regression model for both factors was created, solely the nasal height kept being a positive factor for frontal sinus size as an independent variable. No statistical relevance was detected between the presence of metopic suture and frontal sinus morphology. Septal deviation itself affected frontal sinus morphometry, but the morphometry did not differ between the deviation side and the opposite side. In conclusion, the cranial structure does not affect the frontal sinus morphology but nasal structure affects. The true influences, among measured craniofacial elements, in relationship with the pneumatization of frontal sinus are appeared to be the nasal structure related.
Asunto(s)
Antropometría/métodos , Tomografía Computarizada de Haz Cónico/métodos , Seno Frontal/diagnóstico por imagen , Imagenología Tridimensional/métodos , Deformidades Adquiridas Nasales/diagnóstico por imagen , Adulto , Distribución de Chi-Cuadrado , Huesos Faciales/diagnóstico por imagen , Huesos Faciales/patología , Femenino , Seno Frontal/patología , Humanos , Modelos Lineales , Masculino , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/patología , Deformidades Adquiridas Nasales/patología , Fotograbar , Cráneo/diagnóstico por imagen , Cráneo/patología , Estadísticas no ParamétricasRESUMEN
The pinched nasal tip deformity often results as sequelae of prior nasal surgery. Conventional tip surgery techniques that overemphasize tip narrowing often deform the lateral crura and weaken support for the alar margin. The pinched nasal tip is characterized by the demarcation between the nasal tip and the alar lobule, isolating the tip from the surrounding nasal subunits. Lateral crural strut grafts with or without repositioning offer the surgeon a powerful maneuver that can help correct this functional and aesthetic deformity and restore a natural appearance to the nasal tip.
Asunto(s)
Cartílago Hialino/trasplante , Deformidades Adquiridas Nasales/cirugía , Nariz/anomalías , Nariz/cirugía , Rinoplastia/métodos , Humanos , Deformidades Adquiridas Nasales/patología , Periodo Preoperatorio , Recolección de Tejidos y ÓrganosAsunto(s)
Aparato Lagrimal/trasplante , Deformidades Adquiridas Nasales/cirugía , Colgajo Perforante/trasplante , Procedimientos de Cirugía Plástica/métodos , Humanos , Deformidades Adquiridas Nasales/patología , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
Nasal reconstructive techniques have advanced significantly over the past 50 years. Modern techniques in nasal reconstruction are based on the nasal aesthetic subunits. In order to achieve ideal outcomes, reconstructive surgeons must consider differences in tissue qualities across the nasal aesthetic subunits and formulate reconstructive plans based on these differences. Local flaps, skin grafts, and several types of interpolated flaps comprise the most commonly used techniques for nasal reconstruction. Defects that involve structural or internal lining defects require reconstruction of significantly higher complexity.
Asunto(s)
Deformidades Adquiridas Nasales/cirugía , Neoplasias Nasales/cirugía , Rinoplastia/métodos , Trasplante de Piel , Colgajos Quirúrgicos , Humanos , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/patología , Neoplasias Nasales/patologíaRESUMEN
OBJECTIVES: In the present study, we investigated the relationship between olfactory fossa, cribriform plate, crista galli and nasal Septal Deviation (SD). Keros classification of olfactory fossa was also performed. METHODS: This study was performed retrospectively. Computerized Tomography (CT) images of 200 adult subjects were observed. Unilateral nasal Septal Deviation (SD) cases were included into the study. On coronal CT scans, SD side and location, SD angle, cribriform plate width, olfactory fossa depth (Keros classification) and width, area of the olfactory fossa, crista galli length, width and pneumatization were evaluated. RESULTS: Anterior and anteroposterior deviations were detected mainly. In females, 64.0% and in males, 45.3% of the SDs were located anteriorly. In males, anteroposterior SDs (40.0%) were detected more than females. In anteroposterior SDs, SD angle was higher than anterior SDs. With higher SD angle, crista galli width and height decreased. Cribriform plate width, olfactory fossa height, width and area values of contralateral side were significantly higher than those of the ipsilateral side. For Keros classification, in male group, type 1 (53.3%) and in females, type 2 (57.6%) was detected at ipsilateral side. For contralateral side, type 2 Keros was detected in both genders. Complete crista galli pneumatization was observed in 4.0% and partial pneumatization was detected in 12.0%. In 84% of the patients, there is no Crista galli pneumatization. With the presence of pneumatized crista galli, contralateral Keros values decreased. Crista galli height and contralateral olfactory fossa width showed positive correlation. In older patients, cribriform plate width decreased. CONCLUSION: In our study, there was no Keros type 3 olfactory fossa. In males' contralateral side of SD; and in females both ipsilateral and contralateral side of SD, Keros type 2 olfactory fossa were detected. Therefore, during sinus surgery, surgeons should work carefully not to made intracranial penetration.
Asunto(s)
Cartílagos Nasales/anomalías , Cartílagos Nasales/diagnóstico por imagen , Cavidad Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Bulbo Olfatorio/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Deformidades Adquiridas Nasales/patología , Estudios Retrospectivos , Factores de Riesgo , Factores SexualesRESUMEN
BACKGROUND: Angiolymphoid hyperplasia with eosinophilia is a benign neoplasm that includes blood vessel proliferation and a dense eosinophilic inflammatory infiltrate. Mostly, it affects middle-aged adults manifesting as flesh/plum-colored pruritic nodules and papules, most commonly affecting the ear and the periauricular area. CASE PRESENTATION: In this case, we report a 13-year-old Caucasian girl with bilateral, huge, protruding, and yellowish nostril masses which were peculiar in location and of gross appearance. At first, the disease proved to be a diagnostic dilemma. After making a diagnosis of angiolymphoid hyperplasia with eosinophilia, the disease also proved to be a therapeutic dilemma. It did not respond to oral prednisolone or to oral indomethacin, and it proved to be resistant to topical steroids. Although surgery is the standard therapeutic approach, it recurred despite multiple surgical attempts. However, the only regimen that seemed to partially control the lesion was intralesional steroids combined with topical tacrolimus ointment. CONCLUSIONS: Angiolymphoid hyperplasia with eosinophilia proves a therapeutic dilemma, because there is a large variety of proposed treatments, yet there is not enough data on most of them. Although the disease is not deadly by itself, it usually presents with disfiguring lesions that grimly affect the patient's quality of life. This warrants further research and efforts to find an effective cure and a unified therapeutic approach.
Asunto(s)
Hiperplasia Angiolinfoide con Eosinofilia/diagnóstico , Deformidades Adquiridas Nasales/patología , Enfermedades Nasales/diagnóstico , Administración Tópica , Adolescente , Hiperplasia Angiolinfoide con Eosinofilia/economía , Hiperplasia Angiolinfoide con Eosinofilia/psicología , Hiperplasia Angiolinfoide con Eosinofilia/terapia , Costo de Enfermedad , Femenino , Humanos , Inmunosupresores/administración & dosificación , Inyecciones Intralesiones , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/psicología , Enfermedades Nasales/economía , Enfermedades Nasales/psicología , Enfermedades Nasales/terapia , Pomadas , Prednisolona/administración & dosificación , Calidad de Vida , Tacrolimus/administración & dosificación , Resultado del TratamientoRESUMEN
The curvature of the nasal septum (NS) is one of the most widespread deformations of the facial skeleton. The objective of the present study was to substantiate the principles of and develop the rationale for the surgical correction and conservative treatment of this condition based on the morphological features of various types of deflection of the nasal septum. We have undertaken the morphological analysis of the osseous and cartilaginous structures determining the type and the shape of the curvature of the nasal septum together with the clinical analysis of different morphological variants of the deflection of the nasal septum making use of the R. Mladina classification. Type I-IV vertical deflections are regarded as the acquired deformities whereas type II deviations can just as well be congenital malformations. Types V and VI deflections can be a consequence of the birth injury resulting in the displacement of the nasal structures and leading to the curvature of the nasal septum. The authors describe the defects in the anatomical structures adjoining the nasal cavity associated with various types of the deflection of the nasal septum that the surgeons should take into account when planning and performing septoplasty.
Asunto(s)
Tabique Nasal , Deformidades Adquiridas Nasales , Rinoplastia/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tabique Nasal/anomalías , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/clasificación , Deformidades Adquiridas Nasales/patología , Deformidades Adquiridas Nasales/fisiopatología , Deformidades Adquiridas Nasales/cirugía , Planificación de Atención al Paciente , Selección de Paciente , Federación de RusiaRESUMEN
The authors present a clinical report of deforming mucocutaneous leishmaniasis of the nose in a native American woman, left untreated for 25 years. The nose was reconstructed using the local tissue displaced as flaps, and using cartilage grafts taken from the nasal septum and the ear shell. To the best of the authors' knowledge, the literature offers just 1 report on a similar patient.
Asunto(s)
Leishmaniasis Mucocutánea/complicaciones , Leishmaniasis Mucocutánea/patología , Deformidades Adquiridas Nasales/parasitología , Deformidades Adquiridas Nasales/cirugía , Rinoplastia/métodos , Anciano de 80 o más Años , Femenino , Humanos , Deformidades Adquiridas Nasales/patologíaRESUMEN
OBJECTIVES: The objective was to assess the reliability of a new standardised scale for evaluating nasal anomalies in order to compare the surgeon's assessment and patient satisfaction. DESIGN: Monocentric prospective cohort study. SETTINGS: First, we validated the reliability of the MiRa scale; then, we compared the surgeon's assessment and patient satisfaction. PARTICIPANTS: Fifty-two patients underwent septorhinoplasty surgery and gave their written consent before inclusion. MAIN OUTCOME MEASUREMENTS: Primary outcome measurement was to validate the reliability of the MiRa scale: two observers analysed all records twice. Intra-observer reproducibility and interobserver reproducibility were evaluated using the intraclass correlation coefficient (ICC). Secondary outcome measurement was to compare the surgeon's assessment and patient satisfaction: MiRa and ROE (Rhinoplasty Outcome Evaluation) scores were established for each patient prior to and 6 months after surgery. RESULTS: Using the MiRa scale, ICC for intra- and interobserver reproducibility was, respectively, 95.4% and 96%, showing no statistical difference (P=.70, P=.45). Good correlation scores were, respectively, 93% and 92%. Mean ROE scores were 7.1/24 (SD=11.3) before and 19.3/24 (SD=17.3) after surgery (P<.05). We found an increase in MiRa and ROE scores of +19.75% and +51.25% (P<.05), respectively. The average postoperative ROE score in the primary septorhinoplasty group was 20.4 (SD=14.4) and 17.2 (SD=23.1) in the secondary septorhinoplasty group (P<.05). CONCLUSION: MiRa scale is a reliable, standardised tool to evaluate surgical outcome in septorhinoplasty surgery. It provides an objective and reproducible score. The surgeon's assessment was more critical than patient satisfaction. Patient satisfaction is more difficult to achieve in cases involving a secondary septorhinoplasty.
Asunto(s)
Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/patología , Deformidades Adquiridas Nasales/cirugía , Satisfacción del Paciente , Rinoplastia , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Deformidades Adquiridas Nasales/psicología , Evaluación del Resultado de la Atención al Paciente , Estudios Prospectivos , Reproducibilidad de los Resultados , Resultado del Tratamiento , Adulto JovenRESUMEN
Both deviation and excessive width of the nasal dorsum result in conspicuous facial disharmony and are often attended by nasal airway dysfunction. Whether the result of developmental growth disturbances, nasal trauma, failed nasal surgery, or combinations therein, deviation and splaying of the nasal dorsum can be exceedingly difficult to treat. Individualized treatment is paramount because contour variations are seemingly endless, and a careful preoperative assessment of the anatomic, physiologic, cosmetic, and psychosocial factors that characterize the deformity is necessary to devise an effective patient-specific treatment plan. Ensuring the linearity, strength, alignment, and aesthetically pleasing profile dimensions of the nasal L-strut is the requisite first step in successful treatment. Releasing all deformed components in a controlled and precise manner using powered instrumentation (whenever possible) to facilitate minimally traumatic and effective repositioning, followed by structural reconstitution of the skeletal framework using autologous graft materials, and then consolidation of the newly created construct with suture fixation completes the transformation to normalcy. Paying equal attention to both cosmetic and functional wellness, while simultaneously seeking to maximize structural stability, serves to optimize the final outcome.
Asunto(s)
Estética , Deformidades Adquiridas Nasales/cirugía , Nariz/anomalías , Nariz/cirugía , Rinoplastia/métodos , Humanos , Hueso Nasal/cirugía , Cartílagos Nasales/cirugía , Nariz/fisiología , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/patología , Osteotomía , Planificación de Atención al Paciente , Cuidados PreoperatoriosRESUMEN
We describe a rhinofacial entomophthoramycosis case in a sexagenarian (65 years old) housewife. She was immunocompetent and resident of Burkina Faso. She consulted both the service of dermatology and the service of stomatology of the Teaching Hospital of Bobo-Dioulasso in February 2016 for a diffuse facial tumefaction evolving over six months. This tumefaction was associated with headaches and a left nasal obstruction. Histological examination of the lesion showed an important and polymorphic inflammatory reaction. Also, a filamentous fungus with wide non-septated hyphae and right-angled fungal branching, consistent with mucormycosis was isolated. Mycological diagnosis based on fungal culture with Sabouraud medium without any antibiotic and cyclohexemide after incubation at 27°C and at 30°C was negative. Furthermore, it was not possible to amplify the DNA extracted from biopsy. Antifungal therapy based on the administration of fluconazole per os at 800mg/day was started allowing clinical improvement. This is the first case of a rhinofacial entomophtharomycosis documented in Bobo-Dioulasso. Rhinofacial entomophthoromycosis is largely unknown, even in tropical regions such as Burkina Faso. This lack of knowledge results in a delay in the diagnosis, and subsequently a bad prognosis. It is therefore urgent to improve knowledge on this disease to guide diagnostic steps, prognosis of outcome, and antifungal therapy.
Asunto(s)
Conidiobolus , Dermatosis Facial/patología , Deformidades Adquiridas Nasales/patología , Cigomicosis/patología , Anciano , Burkina Faso , Conidiobolus/aislamiento & purificación , Conidiobolus/fisiología , Dermatosis Facial/tratamiento farmacológico , Dermatosis Facial/microbiología , Femenino , Fluconazol/uso terapéutico , Humanos , Mucormicosis/tratamiento farmacológico , Mucormicosis/microbiología , Mucormicosis/patología , Deformidades Adquiridas Nasales/tratamiento farmacológico , Deformidades Adquiridas Nasales/microbiología , Enfermedades Nasales/tratamiento farmacológico , Enfermedades Nasales/microbiología , Enfermedades Nasales/patología , Clima Tropical , Cigomicosis/tratamiento farmacológico , Cigomicosis/microbiologíaRESUMEN
Introdução: Rinofima é uma inflamação crônica dos tecidos do nariz, caracterizada por hipertrofia e hiperplasia progressivas das glândulas sebáceas e do tecido conjuntivo. Determina um aspecto de elefantíase nasal, secundária à congestão dos vasos da derme. Sua etiologia está associada, na maioria dos casos, ao uso abusivo de álcool. É considerada por alguns autores como sendo um estágio avançado de acne rosácea. O artigo tem como objetivo relatar um caso de rinofima, tratado cirurgicamente no Serviço de Cirurgia Plástica do Hospital Universitário da Universidade Federal de Santa Catarina com decorticação e eletrocoagulação. Método: Foi realizado revisão de prontuário e registro fotográfico de um caso de rinofima. Resultados: Paciente foi submetido a tratamento cirúrgico com evolução favorável. Conclusão: Existem diversos tratamentos para rinofima, sendo que a decorticação e a eletrocoagulação constituem uma excelente opção terapêutica.
Introduction: Rhinophyma is a condition involving chronic inflammation of the nose and is characterized by progressive hypertrophy and hyperplasia of sebaceous glands and connective tissue. Rhinophyma leads to an appearance of nasal elephantiasis, which is caused by the congestion of dermis vessels. Its etiology is mostly associated with alcohol abuse. Rhinophyma is considered by some researchers to be an advanced stage of acne rosacea. Here, we report a case of rhinophyma that was surgically treated with decortication and electrocoagulation at the Plastic Surgery Service of the University Hospital of the Federal University of Santa Catarina. Methods: A review of medical and photographic records of a case of rhinophyma was conducted. Results: The patient was underwent surgical treatment with favorable outcomes. Conclusion: There are several treatments for rhinophyma, with decortication and electrocoagulation being an excellent therapeutic option.