Assuntos
Aspergilose/terapia , Doença Relacionada a Imunoglobulina G4/complicações , Seio Maxilar/microbiologia , Sinusite Maxilar/microbiologia , Doenças Nasofaríngeas/complicações , Aspergilose/diagnóstico , Endoscopia , Humanos , Doença Relacionada a Imunoglobulina G4/terapia , Seio Maxilar/cirurgia , Sinusite Maxilar/complicações , Sinusite Maxilar/diagnóstico , Sinusite Maxilar/terapia , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/terapia , Tomografia Computadorizada por Raios XRESUMO
RATIONALE: Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy. This disease almost always presents with cutaneous involvement. PATIENT CONCERNS: The 1st patient was a 16-year-old girl who presented with recurrent epistaxis. The 2nd patient was a 17-year-old female who presented with nasal obstruction and voice change for a month. DIAGNOSES: In the 1st patient, sinonasal computed tomography (CT) revealed a 2.9-cm sized, polypoid mass in the nasal cavity. In the 2nd patient, CT scans revealed a large enhancing nasopharyngeal mass involving adenoid and several small indeterminate lymph nodes at the neck. Cutaneous examination was unremarkable for either patient. Biopsy of these 2 masses and bone marrow biopsy were performed. Histologic diagnosis of the 2 cases was BPDCN. INTERVENTIONS: Both patients were treated with induction chemotherapy and received allogenic peripheral blood stem-cell transplant. OUTCOMES: No relapse was observed in the 2 patients for 14 and 11 months, respectively, after transplantation. Interestingly, they had no skin lesions at initial diagnosis or during the course of their illness. LESSONS: We 1st identified nasal cavity as an unusual site of BPDCN. BPDCN should be considered in differential diagnosis of blastic leukemia with an undifferentiated and ambiguous immunophenotype despite the absence of skin lesions.
Assuntos
Neoplasias Hematológicas/patologia , Doenças Nasofaríngeas/patologia , Adolescente , Células Dendríticas , Feminino , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/terapia , Humanos , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/terapia , Tomografia Computadorizada por Raios XRESUMO
Nasopharyngeal tuberculosis is a noteworthy disease and it should be differentiated from with nasopharyngeal carcinoma,especially in southern China,because of both having similar clinical presentations such as cervical lymph node enlargement and lesions in nasopharynx. Here we report 2 middle-aged patients of nasopharyngeal tuberculosis;between them,one was male, another was female. They came to hospital with the symptoms of pharyngeal pain and neck node, respectively. The former patient was accompanied by repeated fever. His chest radiographic displayed suspected active lesions; and nasopharyngeal examination inspected irregular mucosa with white patch covering the nasopharyngeal area; and magnetic resonance imaging (MRI) presented diffuse thickening of the mucosal wall of nasopharynx; moreover, the biopsy specimen pathological results showed ulceration with mucosal squamous papillary hyperplasia.Finally,acid-fast staining of nasopharyngeal secretions disclosed acid-fast bacilli was positive. However, the latter patient was completely different from the former in clinical presentations, while MRI finding was almost the same. In addition, the endoscopy depicted that characteristic of nasopharyngeal lesion was smooth, congested and swelling, and the pathological result revealed granulomatous inflammation with epithelioid histiocytes and multinucleated giant cells of Langerhans type.Combined their clinical manifestations with various laboratory and imaging examinations, both of the two patients were eventually diagnosed as nasopharyngeal tuberculosis.
Assuntos
Doenças Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/diagnóstico por imagem , Tuberculose/diagnóstico por imagem , China , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças Nasofaríngeas/terapia , Nasofaringe , Tuberculose/terapiaRESUMO
The paper presents the results of comprehensive survey and orthodontic treatment of 40 children with dentoalveolar anomalies and nasopharyngeal tonsil hypertrophy aged 7-9 years. The linear parameters obtained by cone beam CT and TWH in the lateral projection were analyzed. The study revealed changes, indicating that the presence of nasopharyngeal tonsil hypertrophy, leads to pathology of the dental system and estimated the efficiency of muscle training and combined use of functional devices and elastopositioner «Corrector¼ for the treatment of anomalies of dentition and the formation of physiological occlusion in the process of permanent teeth eruption.
Assuntos
Tonsila Faríngea/anormalidades , Doenças Nasofaríngeas/terapia , Ortodontia Corretiva/métodos , Anormalidades Dentárias/terapia , Tonsila Faríngea/diagnóstico por imagem , Tonsila Faríngea/patologia , Criança , Tomografia Computadorizada de Feixe Cônico , Oclusão Dentária , Dentição Permanente , Exercício Físico , Feminino , Humanos , Hipertrofia , Masculino , Doenças Nasofaríngeas/complicações , Doenças Nasofaríngeas/diagnóstico por imagem , Ortodontia Corretiva/instrumentação , Anormalidades Dentárias/diagnóstico por imagem , Anormalidades Dentárias/etiologia , Erupção Dentária , Resultado do TratamentoAssuntos
Epistaxe/etiologia , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Transtornos Linfoproliferativos/etiologia , Doenças Nasofaríngeas/etiologia , Adulto , Humanos , Imunossupressores/efeitos adversos , Transtornos Linfoproliferativos/diagnóstico , Transtornos Linfoproliferativos/terapia , Masculino , Imagem Multimodal , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/terapia , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
PRACTICAL RELEVANCE: Nasopharyngeal disease is a common presenting problem in feline medicine. CLINICAL CHALLENGES: The management of feline nasopharyngeal disease can be challenging at a number of levels. In many cases, a specific diagnosis may remain elusive. Some conditions may not be curable so owners need to understand the requirement for long-term management. In addition, treatment may be compromised by poor patient compliance. AUDIENCE: This review, which is directed at any clinicians involved in the management of cats with nasopharyngeal disease, discusses acute rhinitis (cat 'flu) and a variety of conditions causing chronic rhinosinusitis/chronic nasopharyngeal disease. The intention is to assist treatment decision making by reviewing the most appropriate therapies from the options available for these patients. EVIDENCE BASE: The information presented in this article is based on peer-reviewed publications and the clinical experience of the authors.
Assuntos
Doenças do Gato/terapia , Doenças Nasofaríngeas/veterinária , Rinite/veterinária , Animais , Antibacterianos/uso terapêutico , Doenças do Gato/diagnóstico , Gatos , Doença Crônica , Diagnóstico Diferencial , Endoscopia/veterinária , Doenças Nasofaríngeas/terapia , Doenças Nasais/veterinária , Palpação/veterinária , Pólipos/veterinária , Sons Respiratórios/veterinária , Rinite/diagnóstico , Rinite/tratamento farmacológicoAssuntos
Cateterismo/instrumentação , Doenças Nasofaríngeas/terapia , Idoso , Carcinoma , Terapia Combinada , Constrição Patológica/etiologia , Constrição Patológica/terapia , Endoscopia , Desenho de Equipamento , Seguimentos , Humanos , Masculino , Carcinoma Nasofaríngeo , Doenças Nasofaríngeas/etiologia , Neoplasias Nasofaríngeas/complicações , Neoplasias Nasofaríngeas/terapiaRESUMO
OBJECTIVES/HYPOTHESIS: Although acquired nasopharyngeal stenosis (NPS) is frequently attributed to infectious and granulomatous processes, it can also occur secondary to external beam radiation therapy for head and neck cancer. NPS can be treated with local flaps, laser excision, nasal stenting, and combinations thereof. Unfortunately, the postoperative course is frequently complicated by scarring and restenosis that often necessitates multiple revision surgeries. The objective of this study is to report a novel endoscopic approach, employing the use of a flexible CO(2) laser in combination with balloon dilation and mitomycin-C application, allowing for the successful treatment of acquired NPS with lasting results. STUDY DESIGN: Retrospective review of case series. METHODS: An endoscope with a working channel is passed transnasally to the location of nasopharyngeal stenosis. A flexible CO(2) laser fiber is then inserted via the working channel of the scope. Precise radial incisions are made on the stenosis using the laser under direct visualization. The laser is removed, and a controlled radial expansion balloon dilation device is inserted, advanced to span the segment of stenosis, and inflated to achieve adequate dilation. Mitomycin-C is then applied topically to the area of dilation. RESULTS: Three patients with severe NPS were treated using this novel technique. All patients had successful long-lasting dilation of NPS without complications over a follow-up period ranging from 12 to 18 months. CONCLUSIONS: Acquired NPS can be successfully treated with durable results with radial laser incisions and controlled radial expansion balloon dilation.
Assuntos
Cateterismo/métodos , Neoplasias de Cabeça e Pescoço/radioterapia , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Doenças Nasofaríngeas/terapia , Idoso , Obstrução das Vias Respiratórias/etiologia , Obstrução das Vias Respiratórias/terapia , Estudos de Coortes , Terapia Combinada , Constrição Patológica/etiologia , Constrição Patológica/terapia , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Nasofaríngeas/etiologia , Qualidade de Vida , Lesões por Radiação/complicações , Lesões por Radiação/diagnóstico , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
A case of nasopharyngeal stenosis with secondary hiatal hernia is described. An 8-year-old castrated male domestic shorthair cat was referred for a chronic upper respiratory problem and presumptive vomiting. Despite conservative management by the primary care veterinarian, the cat's condition progressed. The cat was presented to an emergency facility prior to referral to a specialty hospital. On presentation, inspiratory stridor was evident. Thoracic radiography revealed a hiatal hernia. Computed tomography indicated pharyngeal edema and probable nasopharyngeal stenosis. Endoscopy confirmed the presence of nasopharyngeal stenosis consistent with either stricture or choanal atresia. Balloon dilation of the choana was performed. The hiatal hernia regressed spontaneously post-resolution of the nasopharyngeal stenosis. The cat remained asymptomatic at recheck 3 months later.
Assuntos
Acalasia Esofágica/veterinária , Hérnia Hiatal/veterinária , Doenças Nasofaríngeas/veterinária , Animais , Cateterismo/veterinária , Gatos , Constrição Patológica/complicações , Constrição Patológica/terapia , Constrição Patológica/veterinária , Acalasia Esofágica/complicações , Hérnia Hiatal/complicações , Masculino , Doenças Nasofaríngeas/complicações , Doenças Nasofaríngeas/terapia , Resultado do TratamentoAssuntos
Atresia das Cóanas/etiologia , Atresia das Cóanas/terapia , Doenças Nasofaríngeas/etiologia , Doenças Nasofaríngeas/terapia , Complicações Pós-Operatórias/terapia , Adulto , Constrição Patológica/etiologia , Humanos , Masculino , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Palato/cirurgia , Úvula/cirurgiaAssuntos
Tuba Auditiva , Doenças Nasofaríngeas/diagnóstico , Pescoço , Fístula do Sistema Respiratório/diagnóstico , Enfisema Subcutâneo/diagnóstico , Enfisema Subcutâneo/etiologia , Adulto , Feminino , Humanos , Doenças Nasofaríngeas/complicações , Doenças Nasofaríngeas/terapia , Fístula do Sistema Respiratório/complicações , Fístula do Sistema Respiratório/terapia , Enfisema Subcutâneo/terapiaRESUMO
OBJECTIVE: We report the first case of nasal and nasopharyngeal amyloidosis secondary to multiple myeloma; this case also represents the fourth report of systemic nasal or nasopharyngeal amyloidosis. METHOD: Case report and review of the world literature concerning nasal and nasopharyngeal amyloidosis epidemiology, presentation and management. RESULTS: Nasal and nasopharyngeal amyloidosis is rare. The presentation, clinical course and treatment are discussed for the presented patient. The amyloid tumour, which recurred in correlation with the progressive transformation of the multiple myeloma, was treated surgically. Subsequent localised radiotherapy decreased the size and growth rate of the tumour. CONCLUSION: Amyloid should be considered as a cause of resistant or recurrent epistaxis provided a mass lesion is seen on radiological imaging. Radiotherapy may be a treatment option in nasal and nasopharyngeal amyloidosis.
Assuntos
Amiloidose/complicações , Amiloidose/diagnóstico , Epistaxe/etiologia , Mieloma Múltiplo/complicações , Doenças Nasofaríngeas/complicações , Amiloidose/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/terapiaRESUMO
Clinical, laboratory and device methods were used in examinations of 175 children. Basing on the results of the above examinations, therapeutic and diagnostic criteria of choice of a method of treating adenoid vegetations in children were proposed.
Assuntos
Adenoidectomia/métodos , Tonsila Faríngea/patologia , Compostos de Benzalcônio/administração & dosagem , Infecções/complicações , Terapia com Luz de Baixa Intensidade/métodos , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/terapia , Tonsila Faríngea/microbiologia , Adolescente , Criança , Pré-Escolar , Doença Crônica , Diagnóstico Diferencial , Endoscopia/métodos , Feminino , Seguimentos , Humanos , Hipertrofia , Infecções/terapia , Masculino , Doenças Nasofaríngeas/complicações , Estudos Retrospectivos , Irrigação Terapêutica/métodos , Resultado do TratamentoRESUMO
Rhinosporidiosis in an Indian male with a tumorous skin lesion is reported. Histopathology from the skin lesion revealed gigantic foreign body giant cells bloated with multiple, engulfed sporangia of rhinosporidiosis, which has not been reported earlier. The term "dermosporidiosis", should be used to denote such predominant skin lesions of rhinosporidiosis.
Assuntos
Doenças Nasofaríngeas/patologia , Rinosporidiose/patologia , Rhinosporidium/isolamento & purificação , Dermatopatias Parasitárias/patologia , Adulto , Animais , Biópsia por Agulha , Terapia Combinada , Seguimentos , Humanos , Imuno-Histoquímica , Masculino , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/terapia , Rinosporidiose/diagnóstico , Rinosporidiose/terapia , Medição de Risco , Índice de Gravidade de Doença , Dermatopatias Parasitárias/diagnóstico , Dermatopatias Parasitárias/terapia , Resultado do TratamentoAssuntos
Eosinofilia/patologia , Doenças Nasofaríngeas/patologia , Nasofaringe/patologia , Vasculite/patologia , Corticosteroides/uso terapêutico , Idoso de 80 Anos ou mais , Biópsia por Agulha , Terapia Combinada , Eosinofilia/diagnóstico , Eosinofilia/terapia , Fibrose/diagnóstico , Fibrose/terapia , Seguimentos , Humanos , Imuno-Histoquímica , Laringoscopia/métodos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/terapia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Doenças Raras , Estudos de Amostragem , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Vasculite/diagnóstico , Vasculite/terapiaRESUMO
OBJECTIVE: To report an extremely rare case of nasopharyngeal tuberculosis. CASE REPORT: A 35-year-old male patient presented with nasal obstruction and snoring. Nasal endoscopic examination with a rigid endoscope revealed a large mass on the posterior wall and roof of the nasopharynx. A computed tomography scan of the nasopharynx revealed a polypoid mass in the posterior nasopharyngeal wall. Histopathological examination of a biopsy taken from the posterior nasopharyngeal wall revealed granulomatous lesions with caseation necrosis. Treatment was decided after histopathological examination and intradermal positive reaction to tuberculin test, and started a week later. The patient was treated with antituberculosis drugs including isoniazid, rifampicin, pyrazinamide, and ethambutol. After six months, the nasopharyngeal examination was absolutely normal, and the patient was also symptom free. CONCLUSION: This case highlights that nasopharyngeal tuberculosis should be considered in the differential diagnosis of a nasopharyngeal mass, especially in patients from regions of the world where tuberculosis is endemic.
Assuntos
Obstrução Nasal/microbiologia , Doenças Nasofaríngeas/diagnóstico , Doenças Nasofaríngeas/microbiologia , Ronco/microbiologia , Tuberculose/diagnóstico por imagem , Tuberculose/patologia , Adulto , Humanos , Masculino , Doenças Nasofaríngeas/terapia , Radiografia , Tuberculose/terapiaRESUMO
Many patients with the obstructive sleep apnea syndrome (OSAS) look for alternative conservative or surgical therapies to avoid to be treated with continuous positive airway pressure. In view of the high prevalence and the relevant impairment of the patients lots of methods are offered which promise definitive cure or relevant improvement of OSAS. The working group "Apnea" in the German Society of Sleep Medicine and Research established a task force to evaluate the scientific literature on non-CPAP therapies in the treatment of OSAS according to the standards of evidence-based medicine. This paper summarizes the results of the task force. The data were unsatisfactorily for most of the methods. Sufficient data were available for intraoral appliances (IOA) and the maxillomandibular osteotomy (MMO). IOA's can reduce mild to moderate respiratory disturbances, MMO are efficient in the short and long term but are performed only in special situations such as craniofacial dysmorphias. Weight reduction and body positioning cannot be recommended as a single treatment of OSAS. Most surgical procedures still lack sufficient data according to the criteria of evidence based medicine. Resections of muscular tissue within the soft palate have to be strictly avoided. But even success following gentle soft palate procedures is difficult to predict and often decreases after years. Results in other anatomical regions seem to be more stable over time. Today combined surgeries in the sense of multi-level surgery concepts are of increasing interest in the secondary treatment after failure of nasal ventilation therapy although more data from prospective controlled studies are needed. There is no evidence for any other treatment options.
Assuntos
Pressão Positiva Contínua nas Vias Aéreas , Apneia Obstrutiva do Sono/terapia , Alemanha , Humanos , Doenças Nasofaríngeas/terapia , Reprodutibilidade dos Testes , Apneia Obstrutiva do Sono/tratamento farmacológico , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/cirurgia , Sociedades Médicas , TonsilectomiaRESUMO
Rhinosporidiosis is a chronic granulomatous disease of the mucocutaneous tissue, which clinically presents as polypoidal growths. Cutaneous lesions are infrequent and are generally associated with mucosal lesions. We present a case of cutaneous rhinosporidiosis in association with recurrent nasopharyngeal rhinosporidiosis in a 65-year-old male patient. He presented with dysphagia for solid foods and skin growth on the left side of jaw of 2 years duration. Histopathology of cutaneous and nasopharyngeal lesions revealed numerous thick walled sporangia in a vascular connective tissue along with a granulomatous inflammation confirming the diagnosis of cutaneous and nasopharyngeal rhinosporidiosis. Endoscopic removal of nasopharyngeal polyp was done and he was started on dapsone therapy.