RESUMO
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.
Assuntos
Epistaxe , Hemangioma Capilar , Cartilagens Nasais , Deformidades Adquiridas Nasais , Complicações Hematológicas na Gravidez , Complicações Neoplásicas na Gravidez , Humanos , Feminino , Gravidez , Adulto , Epistaxe/diagnóstico por imagem , Epistaxe/patologia , Recidiva , Complicações Hematológicas na Gravidez/diagnóstico por imagem , Complicações Hematológicas na Gravidez/patologia , Biópsia , Deformidades Adquiridas Nasais/diagnóstico por imagem , Deformidades Adquiridas Nasais/patologia , Cartilagens Nasais/diagnóstico por imagem , Cartilagens Nasais/patologia , Hemangioma Capilar/diagnóstico por imagem , Hemangioma Capilar/patologia , Complicações Neoplásicas na Gravidez/diagnóstico por imagem , Complicações Neoplásicas na Gravidez/patologiaRESUMO
BACKGROUND: Chronic rhinosinusitis (CRS) is one of the most frequent chronic diseases. Among these patients the prevalence of immune defects is higher than in the healthy general population. METHODS: A selective review of the literature was carried out in PubMed and Medline covering the period between 2008 and 2019. Additionally, recent German publications in journals not listed in the abovementioned databases were analyzed. RESULTS: The diagnostic workflow with respect to the immunodeficiency consists of a detailed anamnesis and physical examination, laboratory tests and the antibody reaction to polysaccharide vaccines and antigens. Beside antibiotic treatment, vaccinations and immunoglobulin replacement are available. Notwithstanding the above, functional endoscopic surgery of the paranasal sinuses should be performed according to guideline recommendations. CONCLUSION: Patients with CRS who do not sufficiently respond to conservative and surgical treatment should be checked for underlying immunodeficiencies.