RESUMO
Lyme borreliosis is a prevalent disease with a wide variety of clinical manifestations. However, only a few pertinent references are found in the dental literature. Considering the diversity of differential diagnoses, borreliosis-associated orofacial pain may be a challenge for treatment providers and patients alike. The aim of this case report is to emphasize the importance of a sound, structured medical history and assessment to identify severe cases early and to start interdisciplinary therapy if indicated.
RESUMO
OBJECTIVES: Nasal and paranasal sinus malignancies are rare. The most common lesions are located in the nasal cavity and the maxillary sinus, although they also occur in the ethmoid, sphenoid and frontal sinuses. Treatment often combines surgery, radiotherapy and chemotherapy. Endoscopic surgical approaches are increasingly used in order to reduce the morbidity associated with standard open resection. The aim of our study was to analyse the long-term treatment results of sinonasal malignancies (SNM), with a special focus on surgical approaches. MATERIALS AND METHODS: A retrospective review of 123 patients treated in a tertiary referral centre from 1992 to 2008 was conducted, which included information on tumour stage, histology, treatment and follow-up. RESULTS: A variety of histological types were found with squamous cell carcinoma being the most frequent (n=38), followed by melanoma (n=24) and adenocarcinoma (n=21). Open surgery was performed in 55 patients, and endoscopic resection was performed in 28 patients. Nineteen patients were treated with primary radiation therapy (RTX), four underwent primary chemotherapy (CTX), and 15 had primary chemoradiation (RCTX). Two patients died prior to therapy onset. A comparison of survival rates did not show a significant difference between the treatment groups. Patients that underwent endoscopic resection had significantly fewer postoperative complications. CONCLUSION: In carefully selected patients, endoscopic surgery of SNM showed a similar outcome as open surgery, but with a significantly lower complication rate.