Treatment of Multiple Oral and Oropharyngeal Venous Malformations in Maffucci's Syndrome with a Combination of Percutaneous Sclerotherapy and Ligation. A Case Report.

Maffucci's Syndrome is an osteochondromatous syndrome with congenital vascular malformations. Major ailments involved are habitual fractures, length discrepancy of the extremities, impediment of the affected parts, extremity overgrowth and pain. The vascular lesions, aside from their mass effects, tend to ulcerate and bleed. Endotracheal intubation is also troublesome in these patients. Malignant tranformation of mesodermal tissue is the major lethal factor in this syndrome. This report describes severe respiratory impairment caused by venous malformations in a young girl. Multiple bunched venous malformations within the tongue, oral cavity and oropharynx were treated with percutaneous sclerotherapy and a simple ligation technique. Airway obstruction was cleared following repetitive treatment sessions.

The effects of natural ostium and nasoantral window on mucosal regeneration after maxillary sinus surgery in rabbits.

The aims of the study were to investigate the effects of natural ostium and the nasoantral window on the mucosal regeneration after maxillary sinus surgery and to detect the changes in the mucociliary clearance during regeneration process. Twenty-eight rabbits were studied. In the study group consisting of 21 rabbits, the mucosa of each right maxillary sinus was totally removed, natural ostium was occluded with bone-wax and a nasoantral window was created, while the left sinus mucosa was removed and the natural ostium was left open without creating a nasoantral window. Maxillary sinus mucosa taken during surgery was investigated by light and electron microscopy. The study group was divided into three subgroups. The first group was followed for 2, the second for 4, and the last group for 8 weeks. At the end of these periods, the mucociliary function was evaluated scintigraphically using 99mTc-Human serum albumin. Following this investigation mucosal biopsies were taken from the right and left sinuses and the rabbits were sacrificed. In the control group consisting of 7 rabbits a small hole was opened in the anterior wall of the maxillary sinus of each rabbit and the scintigraphic evaluation was performed for this group at the end of each follow up period as well. In the histopathologic investigation, no difference was found between the natural and the nasoantral window using light microscopy, but there was a difference between them in the electron microscopic findings (p < 0.05, Chi-square test). The scintigraphic, light and electron microscopic findings and gross appearances of the sinuses are discussed.

Giant polypoid tumor of the esophagus.

A patient with a giant polypoid tumor of the esophagus, measuring 22 cm in length is described in this report. The patient presented with cough attacks and respiratory distress. Diagnostic and therapeutic intervention required aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Benign esophageal tumors are rarely seen and originate from the upper third of esophagus, frequently close to the cricopharyngeus muscle. They may attain giant proportions. A variety of clinical presentations are described, the most serious being asphyxia secondary to laryngeal obstruction. We observed a giant esophageal tumor which was interpreted as angiofibromyolipoma that caused laryngeal obstruction. We present the clinical picture and histopathological findings of the tumor.

Huge osteoma of the frontoethmoidal sinus with secondary brain abscess.

Osteomas of paranasal sinuses are usually asymptomatic. When enlarged, they may cause serious complications. We report a case of huge frontoethmoidal osteoma associated with brain abscess. If an osteoma associated with an intracerebral pathology is detected, it should be remembered that this could have been a complication of the osteoma and a detailed radiological examination should be performed to show the extent of the osteoma and to confirm any defect at the posterior wall of the sinus which may lead intracerebral complications. Such an osteoma should be operated after the abscess was resolved and patient became stable neurologically.

Effects of otitis media with effusion on the vestibular system in children.

Middle ear effusion has been considered the most common cause of vestibular disturbance in children. However, there have been only a few studies on vestibular disturbance in children with otitis media with effusion. We studied the vestibular systems of 30 children with otitis media with effusion aged 8 to 13 years and compared the results with 15 age- and sex-matched controls. A questionnaire relating to vestibular disturbance was given to patients and their parents. Spontaneous nystagmus and positional nystagmus were recorded by electronystagmography as diagnostic tests of the vestibular system. Romberg's and past-pointing tests were performed on children with otitis media with effusion and controls. After vestibular tests were completed, myringotomy was performed, and a ventilation tube was inserted. The questionnaire and the vestibular tests were repeated after the operation and during the first month after surgery. Our study showed that there was a history of vestibular disturbance in 33% of children with otitis media with effusion. Electronystagmography and Romberg's test findings demonstrated that 33% of the children had vestibular dysfunction (p < 0.05). After myringotomy with ventilation tube insertion, vestibular test results returned to normal, and symptoms related to vestibular disturbance improved. These findings confirm the assumption that middle ear effusion may affect the vestibular system, which can be resolved after myringotomy with ventilation tube insertion.