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1.
J Craniofac Surg ; 32(8): e771-e773, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727452

RESUMO

ABSTRACT: Esthesioneuroblastoma is a rare neoplasm originating from the olfactory neuroepithelium at the cribriform plate. The superior nasal cavity is primarily affected. Morbidity and mortality are related to locally destructive growth as well as metastatic potential. Orbital involvement is associated with decreased survival. The authors describe a case of advanced esthesioneuroblastoma with bilateral orbital involvement, presenting with a rare constellation of orbital hypertelorism and Foster-Kennedy Syndrome.


Assuntos
Estesioneuroblastoma Olfatório , Hipertelorismo , Neoplasias Nasais , Doenças do Nervo Óptico , Estesioneuroblastoma Olfatório/cirurgia , Humanos , Cavidade Nasal/diagnóstico por imagem , Neoplasias Nasais/complicações , Neoplasias Nasais/cirurgia
2.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 56(11): 1174-1178, 2021 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-34749456

RESUMO

Objective: To evaluate the application of island flap and combined flap in one-stage reconstruction of nasal alae defects after external nasal tumor resection. Methods: Data of 11 patients with perforating or full-thickness defects of the alae after nasal tumor resection in XuanWu Hospital, Capital Medical University between June 2016 and February 2021 were analyzed retrospectively. There were 7 males and 4 females, and the ages ranged from 51 to 89 years. Island flap, island flap combined with nasolabial flap or V-Y advancement flap, and island flap combined with bilobed flap were applied according to the range of defects. Descriptive statistical method was applied to analyze the treatment effects. Results: All flaps of the 11 patients were successful survival and the incisions were primary healing. Being followed up for 5 to 59 months, the patients had satisfying appearance and ventilation function, and no tumor relapsed. Conclusion: For the patients with nasal alae defects after external nose tumor resection, selecting suitable island skin flap or combined skin flap can be used to reconstruct the ideal nasal appearance and function of the nose.


Assuntos
Neoplasias Nasais , Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Estudos Retrospectivos , Transplante de Pele , Retalhos Cirúrgicos
3.
Curr Opin Otolaryngol Head Neck Surg ; 29(6): 487-491, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34710067

RESUMO

PURPOSE OF REVIEW: The aim of this study was to present the evaluation and current management of congenital paediatric nasal dermoid. RECENT FINDINGS: There has been a trend towards less invasive surgical excision techniques, including purely endoscopic excision, endoscopic-assisted approaches and midline excision with nasal bone osteotomies and bone flap. These approaches allow adequate access for both total resection and nasal contour and skull base reconstruction. Following resection, if nasal bone osteotomies are insufficient for restoring nasal appearance, free temporoparietal fascial graft and/or conchal cartilage can be considered. For nasal tip deformities, interdomal sutures and free fat grafting are a suitable option. SUMMARY: Complete surgical excision remains the treatment of choice for nasal dermoid lesions. The surgical approach taken and reconstruction depends on the type of lesion (cyst versus sinus or fistula), location (intranasal versus extranasal), whether or not there is intracranial extension, and experience of the surgical team.


Assuntos
Cisto Dermoide , Neoplasias Nasais , Criança , Cisto Dermoide/diagnóstico , Cisto Dermoide/cirurgia , Endoscopia , Humanos , Nariz , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/cirurgia , Base do Crânio
4.
Hautarzt ; 72(10): 913-921, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34529088

RESUMO

The nose has an important function in the esthetic perception of the face. The esthetic coverage of defects on the nose is therefore of particular importance; however, the position is exposed to sunlight and poses a particular risk for the development of non-melanoma skin cancer (NMSC) and melanomas. After tumor excision, the size of the defect is decisive for defect closure. In addition, multilayer defects in which the cartilage or mucous membranes must be reconstructed by plastic surgery, represent a particular challenge for the surgeon. There are various options for reconstruction depending on the extent of the defects on the nose. This article gives an overview of the paramedian forehead flap, the indications and implementation.


Assuntos
Neoplasias Nasais , Rinoplastia , Testa/cirurgia , Humanos , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Retalhos Cirúrgicos
5.
Medicine (Baltimore) ; 100(35): e27136, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477164

RESUMO

RATIONALE: Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses is a rare but aggressive neoplasm with a poor prognosis and a strong propensity for regional recurrence and distant metastasis. Diagnosis is challenging and relies on immunohistochemical study. Treatment includes surgical resection, radiation therapy, chemotherapy, or a combination of these modalities. However, the optimal therapeutic strategy is still controversial. Due to its rarity, the complexity of the histological diagnosis, and the variety of the treatment regimens, we presented a case of primary small cell neuroendocrine carcinoma in the nasal cavity with description of the clinical manifestation, pathology features, and our treatment regimen. PATIENT CONCERNS: An 82-year-old female patient with hypertension presented with right epistaxis on and off with nasal obstruction for several days. DIAGNOSIS: An exophytic mass over the posterior end of the right inferior turbinate was found on nasopharyngoscope. Biopsy was done and the pathology confirmed small cell carcinoma, strongly positive for cytokeratin (AE1/AE3) and insulinoma-associated protein 1 (INSM-1), scatteredly positive for chromogranin A, synaptophysin and CD56. The final diagnosis was small cell neuroendocrine carcinoma of right nasal cavity, pT1N0M0, stage I. INTERVENTIONS: The patient underwent wide excision of right intra-nasal tumor and post-operative radiotherapy with a dose of 6600 cGy in 33 fractions. OUTCOMES: No local recurrence or distant metastasis was noted during the 12 months of follow-up. LESSONS: Multimodality treatment remains the most common therapeutic strategy, although no proven algorithm has been established due to the rarity of this disease. Further investigation is needed for providing evidence to standardize the treatment protocol.


Assuntos
Carcinoma Neuroendócrino/patologia , Cavidade Nasal/patologia , Neoplasias Nasais/patologia , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/radioterapia , Carcinoma Neuroendócrino/cirurgia , Feminino , Humanos , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia
6.
Laryngorhinootologie ; 100(S 01): S1-S44, 2021 04.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-34352902

RESUMO

Due to their low incidence and thus resulting limited diagnostic criteria as well as therapeutic options, rare diseases of the nose, the paranasal sinuses, and the anterior skull base are a significant challenge. The value as of which a disease has to be considered as rare amounts to a maximum of 5 patients per 10 000 people. Within these diseases, however, there are extreme differences. Some rare or orphan diseases like for example the inverted papilloma belong to regularly diagnosed and treated diseases of larger departments of oto-rhino-laryngology whereas other rare diseases and malformations have only been described in less than 100 case reports worldwide. This fact emphasizes the necessity of bundling the available experience of diagnostics and therapy. The present article gives an overview about rare diseases of the nose, the paranasal sinuses, and the anterior skull base from the field of diseases/syndromes of the olfactory system, malformations of the nose and paranasal sinuses, ventilation and functional disorders as well as benign and malignant tumors. The classification and data on diagnostic and therapeutic options were established based on the current literature.


Assuntos
Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Seios Paranasais , Humanos , Nariz , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/epidemiologia , Neoplasias dos Seios Paranasais/terapia , Seios Paranasais/cirurgia , Doenças Raras/epidemiologia , Doenças Raras/terapia , Base do Crânio
7.
J Laryngol Otol ; 135(10): 937-939, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34446116

RESUMO

BACKGROUND: Total rhinectomy is an invasive procedure that significantly impairs the intranasal turbulence, humidification and heating of inspired air. The use of uvulopalatopharyngoplasty for the treatment of sleep-disordered breathing disorders such as primary snoring and obstructive sleep apnoea has diminished over the past years because of the emergence of less invasive procedures and alternative therapeutic options. This clinical record presents the treatment of a long-term side effect of total rhinectomy using uvulopalatopharyngoplasty. CASE REPORT: In 1997, a 62-year-old male underwent total rhinectomy for a nasal schwannoma, followed by rehabilitation with a nasal prosthesis. Twenty-one years later, he presented with severe complaints of nasal blockage and breathing difficulties during both daytime and night-time. Clinical examination revealed no major anomalies besides significant velopharyngeal narrowing. Thus, in 2019, uvulopalatopharyngoplasty was performed to re-establish velopharyngeal patency. Hereafter, the symptoms of nasal blockage disappeared, resulting in an improved quality of life. CONCLUSION: Uvulopalatopharyngoplasty may prove useful to treat selected patients with daytime breathing difficulties due to velopharyngeal narrowing.


Assuntos
Obstrução Nasal/cirurgia , Procedimentos Cirúrgicos Nasais/efeitos adversos , Neurilemoma/cirurgia , Palato Mole/cirurgia , Faringe/cirurgia , Úvula/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Neurilemoma/diagnóstico , Neurilemoma/reabilitação , Neoplasias Nasais/patologia , Palato Mole/patologia , Faringe/patologia , Próteses e Implantes/efeitos adversos , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/métodos , Aderências Teciduais/cirurgia , Resultado do Tratamento , Úvula/patologia
8.
Sci Rep ; 11(1): 17100, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429452

RESUMO

To better understand the pathogenesis of nasal polyps (NPs) and sinonasal inverted papillomas (SIPs), we aimed to establish cell lines from fresh tissues of NPs and SIPs and characterize them. Primary cell cultures were obtained from two NP tissues (NP2 and NP3) and one SIP tissue (IP4). All the cells were polygonal in shape, expressed cytokeratin 14, and had normal diploid chromosome status. HPV58 DNA was detected in NP3. To obtain immortal primary cells, NP2 and IP4 cells were transduced with a combination of mutant CDK4, cyclinD1 and TERT. These cells were thereafter named NP2/K4DT and IP4/K4DT, respectively. HPV58-positive NP3 cells were transduced with TERT alone, the resulting cells named NP3/T. Phenotypic and genotypic identity of original tissues and derived cells was investigated. All the cell cultures with transgenes were confirmed to be derived from their parental cells and primary tumor tissues by analysis of short tandem repeats (STR) and maintained in vitro growth, genetic profiles and gene expression characteristics of the primary cells. These virtually immortalized cells, as well as the primary cells, have potential as in vitro models for studying the pathogenesis of NPs and SIPs and for preclinical study to develop new therapeutic agents.


Assuntos
Técnicas de Cultura de Células/métodos , Pólipos Nasais/genética , Neoplasias Nasais/genética , Papiloma Invertido/genética , Adolescente , Idoso , Linhagem Celular Tumoral , Proliferação de Células , Células Cultivadas , Criança , Ciclina D1/genética , Ciclina D1/metabolismo , Quinase 4 Dependente de Ciclina/genética , Quinase 4 Dependente de Ciclina/metabolismo , Humanos , Masculino , Repetições de Microssatélites , Pólipos Nasais/patologia , Neoplasias Nasais/patologia , Papiloma Invertido/patologia , Telomerase/genética , Telomerase/metabolismo , Transdução Genética/métodos
9.
Ann Chir Plast Esthet ; 66(5): 395-405, 2021 Oct.
Artigo em Francês | MEDLINE | ID: mdl-34400003

RESUMO

Fortunately, traumatic total amputations of the nose are rare, especially in children. Their reconstructions generally require several operative steps, most often associating cartilaginous grafts (rib and/or concha), a free radial antebrachial flap for mucosal reconstruction and a frontal flap for the skin covering. These are therefore long and complex procedures requiring a trained surgical team and maximum patient adherence to their treatment plan. The clinical case described is that of an 11-year-old child presenting a sub-total amputation of the nose and having undergone reconstruction with skin expansion of the frontal flap due to a horizontal frontal scar of unknown origin and a particularly low hair implantation.


Assuntos
Amputação Traumática , Neoplasias Nasais , Rinoplastia , Amputação , Amputação Traumática/cirurgia , Criança , Testa/cirurgia , Humanos , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Retalhos Cirúrgicos
10.
Artigo em Chinês | MEDLINE | ID: mdl-34344098

RESUMO

Objective: To summarize the preliminary experience in the treatment of esthesioneuroblastoma (ENB) and to explore the effect of age, chemotherapy, modified Kadish stage and pathological grade on the prognosis of ENB. Methods: The clinical data of 87 ENB patients from the First Affiliated Hospital of Sun Yat-sen University and Sun Yat-sen University Cancer Center between June 2002 and November 2017 were retrospectively analyzed. The modified Kadish stage was used to evaluate the extent of the lesions, and the Hyams grading system was used for pathological grading. The patients were followed up regularly to evaluate the recurrence and metastasis of the tumor. Cox proportional hazard model was used for univariate and multivariate analyses. Prognostic factors with P<0.05 in univariate analysis were included in multivariate analysis. After controlling the confounding factors, the model coefficients were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: The median follow-up time of ENB patients was 29 months, and the 5-year overall survival rate was 39.3%. In univariate analysis, age, chemotherapy, modified Kadish stage and pathology grade were independent predictors of overall survival, while gender, radiotherapy and surgery were not prognostic factors. Multivariate analysis showed that modified Kadish stage and pathology grade were independent predictors of overall survival rate after excluding confounding factors. Conclusions: Age, chemotherapy, modified Kadish stage and pathological grade are taking important role in the overall survival rate of patients with ENB. Modified Kadish stage and pathological grade are independent predictors of overall survival rate.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Estesioneuroblastoma Olfatório/patologia , Estesioneuroblastoma Olfatório/terapia , Humanos , Cavidade Nasal/patologia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Nasais/patologia , Neoplasias Nasais/terapia , Prognóstico , Estudos Retrospectivos
12.
J S Afr Vet Assoc ; 92(0): e1-e6, 2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34212735

RESUMO

Cutaneous squamous cell carcinoma (SCC) is a slow growing but locally invasive neoplasm, most commonly caused by prolonged exposure to ultraviolet (UV) radiation. Whilst SCC accounts for 15% of skin tumours in domesticated cats, cutaneous SCC in non-domesticated felids (apart from captive snow leopards) appears to be uncommon, with only three reports in the literature to date. In this report, a captive African lion (Panthera leo) presented with two ulcerative lesions on the nasal planum. Histopathology of the lesions revealed epidermal keratinocyte dysplasia and neoplastic basal- and supra-basal epithelial cells with dyskeratosis and evidence of basement membrane breaching and dermal invasion, consistent with a diagnosis of SCC. There was also evidence of laminar fibrosis and inflammation of the subjacent dermis suggesting that the SCC most likely resulted from UV-induced neoplastic transformation of the epidermal squamous epithelium following actinic keratosis. The lion was treated with hypofractionated radiation therapy and remained in remission until his death (euthanised 17 months later because of age-related chronic renal failure). This is the first report of cutaneous SCC in a lion with evidence of actinic damage and resolution after radiation therapy.


Assuntos
Carcinoma de Células Escamosas/veterinária , Leões , Neoplasias Nasais/veterinária , Hipofracionamento da Dose de Radiação , Neoplasias Cutâneas/veterinária , Animais , Carcinoma de Células Escamosas/radioterapia , Masculino , Neoplasias Nasais/radioterapia , Neoplasias Cutâneas/radioterapia
13.
Ophthalmic Plast Reconstr Surg ; 37(5): e179-e181, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34284422

RESUMO

Conjunctival papillomas are common tumors that exhibit an exophytic growth pattern, comprised of multiple filiform fronds of squamous epithelium that contain fibrovascular cores. The inverted (endophytic) variety of papilloma, often termed "Schneiderian," rarely occurs on the conjunctiva, with only 15 cases reported to date. Endophytic and exophytic papillomas are well described arising in the sinonasal Schneiderian epithelium where a low rate of malignant transformation may occur in the endophytic type; malignant transformation in exophytic sinonasal papillomas is exceedingly rare. The authors describe 2 cases of exophytic conjunctival papillomas with the morphology of a sinonasal or Schneiderian-type papilloma. Both were pink, sessile acquired growths in women in the sixth decade of life involving the inferior conjunctival fornix or nasal limbus. Nonkeratinizing squamous epithelium along with numerous goblet cells, intraepithelial mucinous cysts, and microabscesses were present. Immunohistochemistry showed reactivity for cytokeratin 7 and wild-type staining for p16 and p53, paralleling the findings in common conjunctival papillomas; both were also driven by low-risk human papillomavirus.


Assuntos
Neoplasias Nasais , Papiloma , Transformação Celular Neoplásica , Túnica Conjuntiva , Feminino , Humanos , Imuno-Histoquímica , Papiloma/cirurgia
14.
Rhinology ; 59(5): 433-440, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34254061

RESUMO

BACKGROUND: There is no consensus about the optimal management of the neck in clinically node negative esthesioneuroblastoma (ENB). The aim of this study is to assess the impact of elective neck irradiation (ENI) in terms of regional disease control and survival. METHODS: The study was performed according to the PRISMA guidelines searching on Scopus, PubMed/MEDLINE, and Google Scholar databases. The primary outcome was the regional recurrence rate (RRR), that was reported as odds ratio (OR) and 95% confidence interval (CI). Secondary outcomes were the overall survival (OS), and the distant-metastases free survival (DMFS), that were reported as logarithm of the hazard ratios (logHRs) and 95% confidence intervals (CIs). RESULTS: A total of 489 clinically node negative patients were included from 9 retrospective studies. ENI significantly reduced the risk of regional recurrence compared to no treatment. No difference was measured between ENI and observation, according to both OS and DMFS. No stratified analysis could be performed based on Kadish stage and Hyams grade. CONCLUSIONS: ENI should be recommended to improve the regional disease control. No advantage was measured in terms of survival or distant metastases with a low quality of evidence. Further prospective studies should be designed to understand if ENI could be avoided in early stage and low-grade tumors.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Estesioneuroblastoma Olfatório/radioterapia , Humanos , Cavidade Nasal , Recidiva Local de Neoplasia , Neoplasias Nasais/radioterapia , Estudos Prospectivos , Estudos Retrospectivos
16.
Clin Nucl Med ; 46(12): e587-e588, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34284480

RESUMO

ABSTRACT: We report the case of a 68-year-old woman who underwent 18F-FDG PET/CT for squamous cell carcinoma antigen (SCC Ag) elevation in the follow-up of a uterine cervical cancer. The examination showed an FDG-avid mass of the left nasal cavity with left maxillary sinusitis and no other site of abnormal FDG uptake. Surgical resection of the nasal polyp was performed, and pathological examination of the specimen revealed an inverted sinonasal papilloma. SCC Ag returned to normal after surgery. Inverted sinonasal papilloma is a rare cause of SCC Ag elevation, which can be depicted by 18F-FDG PET/CT.


Assuntos
Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Idoso , Antígenos de Neoplasias , Feminino , Humanos , Neoplasias Nasais/diagnóstico por imagem , Papiloma Invertido/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Serpinas
17.
Artigo em Chinês | MEDLINE | ID: mdl-34304493

RESUMO

Objective:To explore the risk factors of malignant transformation of sinonasal inverted papilloma (SNIP), and to improve the accuracy of preoperative diagnosis of tumor. Methods:The clinical data of 89 patients with sinonasal inverted papilloma (SNIP group, n=60) and malignant transformation of sinonasal inverted papilloma (IP-SCC, n=29) were analyzed retrospectively. Clinical symptoms, medical history, endoscopic examination, characteristic of sinonasal CT scan and MR imaging were collected and compared between two groups. Then the indicators with significant differences between the two groups were used for binary logistic regression analysis. The logistic regression model was established to predict the malignant transformation risk factors of inverted papilloma and the prediction ability of the regression model was estimated. Results:The significant differences between the two groups were: symptoms, including nasal obstruction, purulent mucus, blood in the nasal discharge; long-term smoking history; tumor attached with purulent mucus; CT scan showing bone destruction of the orbital wall and skull base; MR Imaging showing convoluted cerebriform pattern (CCP) sign, intraorbital involvement, and dural enhancement of the skull base. The results of logistic regression analysis showed that the risk factors of malignant transformation of SNIP were blood in the nasal discharge, long-term smoking history, tumor with purulent discharge, orbital wall destruction on CT scan, disappearance of CCP and orbital involvement on MRI. The accuracy rate of regression model for predicting malignant transformation of IP is 75.0%, and the accuracy rate for benign inverted papilloma is 96.7%, and the overall accuracy of the model is 89.8%. Conclusion:The risk factors for predicting malignant transformation of SNIP are blood in the nasal discharge, long-term smoking history, tumor with purulent discharge, orbital wall destruction on CT scan, and disappearance of CCP sign and orbital involvement on MRI. It's necessary to analyze all of clinical factors in order to improve the accuracy of preoperative diagnosis of sinonasal inverted papilloma.


Assuntos
Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Humanos , Neoplasias Nasais/diagnóstico por imagem , Papiloma Invertido/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Risco
18.
Can Vet J ; 62(7): 736-742, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34219783

RESUMO

This study describes the clinical, diagnostic, and pathological characteristics of canine nasal polyps and how they responded to medical, endoscopic, and surgical treatments. The database of a multi-center veterinary endoscopy group was searched from 2010 to 2018. All dogs with a histological diagnosis of nasal polyposis that were undergoing endoscopic investigation (N = 23), were included. Clinical signs at presentation were sneezing (91%), nasal discharge (83%), stertor (74%), and frontonasal deformation (17%). Skull radiography on 13 dogs had alterations in 77% of cases, including turbinate lysis (6/13), increased radiopacity of one (4/13) or both (6/13) nasal cavities, and lysis of the nasal vomer bone (3/13). Nasal polyposis had a characteristic endoscopic appearance. There were clinical and diagnostic similarities between this cohort of dogs and dogs with nasal neoplasia, although dogs with nasal polyps were often younger and polypoid tissue was external to the nose. Steroid therapy alone was not effective in treating polyposis in dogs; however, endoscopic debulking with a laser and forceps was more effective.


Assuntos
Doenças do Cão , Pólipos Nasais , Neoplasias Nasais , Animais , Desbridamento/veterinária , Doenças do Cão/tratamento farmacológico , Doenças do Cão/cirurgia , Cães , Endoscopia/veterinária , Cavidade Nasal , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/cirurgia , Pólipos Nasais/veterinária , Neoplasias Nasais/veterinária
19.
Int J Pediatr Otorhinolaryngol ; 149: 110842, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34329830

RESUMO

OBJECTIVE: The study aimed to present the accuracy of radiological diagnostics in pediatric patients with nasal dermoids and to discuss the potential factors influencing the radiological pitfalls on imaging in these cases. MATERIAL AND METHODS: The patient's cohort included 25 surgically treated pediatric cases with nasal dermoid. The results of preoperative imaging studies were analyzed regarding intraoperative findings. A review of the literature concerning a series of cases with nasal dermoid was performed in order to evaluate the possible radiological pitfalls and the accuracy of radiological imaging. The following statistical parameters for the particular radiological tools was determined: sensitivity, specificity, predictive positive values and predictive negative values. RESULTS: Total number of 18 CT and 14 MRI were performed. 6 out of 32 radiological examinations occurred to be inconsistent with operative findings. Potential pitfalls were identified and discussed. All the patients with false radiological results were below the age of 5 and 83% were below the age of 3 y.o. The overall sensitivity (S), specificity (SP), predictive positive value (PPV) and predictive negative value (PNV) for CT vs. MRI were 68% vs. 79%, 90% vs. 95%, 65% vs. 86% and 90% vs. 92%, respectively. CONCLUSIONS: MRI technique characterizes with higher predictive values in terms of identifying intracranial extension of nasal dermoid on imaging. Further analysis of radiological methods' accuracy should be conducted based on the detailed data concerning age distribution. The combination of CT and MRI should become a gold standard in diagnostics of nasal dermoids in children under the age of 5.


Assuntos
Cisto Dermoide , Neoplasias Nasais , Criança , Cisto Dermoide/diagnóstico por imagem , Cisto Dermoide/cirurgia , Humanos , Imageamento por Ressonância Magnética , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/cirurgia , Radiografia , Tomografia Computadorizada por Raios X
20.
J Surg Oncol ; 124(5): 731-739, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34236707

RESUMO

OBJECTIVES: Sinonasal and skull base tumors are rare, making it difficult to identify trends in surgical outcome. This study examines complications in a large cohort of patients undergoing surgery for sinonasal malignancy. METHODS: Following IRB approval, an institutional database was reviewed to identify patients who underwent surgery for sinonasal or skull base malignancies from 1973 to 2016 at our institution. Charlson comorbidity index score and Clavien-Dindo grade were calculated. The main study endpoint was subgroup analysis of Clavien-Dindo Grade 0, Grades 1-2, and Grades 3-5 complications. An ordinal logistic regression model was constructed to assess the association between comorbidities, demographics, tumor characteristics, and surgical complications. RESULTS: In total, 448 patients met inclusion criteria. Perioperative mortality rate at 30 days was 1.6% (n = 7). The rate of severe complications (Clavien-Dindo 3 or higher) was 13.6% (n = 61). Multivariate analysis using an ordinal logistic regression model showed no association between Charlson comorbidity index score and Clavien-Dindo grade of postoperative complication. Advanced T-stage was significantly associated with complications (p = 0.0014; odds ratio: 3.442 [95% confidence interval: 1.615, 7.338]). CONCLUSION: Surgery for sinonasal and skull base tumors is safe with a low mortality rate. Advanced T-stage is associated with postoperative complications. These findings have implications for preoperative risk stratification. Key Points Surgery for sinonasal malignancy is safe with a 30 mortality of 1.6% and rate of severe complications of 12.8%. There is no association between patient comorbidity and post operative complication. On multivariate analysis, only advanced T stage was associated with increased rate of surgical complication.


Assuntos
Neoplasias Nasais/cirurgia , Neoplasias dos Seios Paranasais/cirurgia , Complicações Pós-Operatórias/patologia , Neoplasias da Base do Crânio/cirurgia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/patologia , Neoplasias dos Seios Paranasais/patologia , Complicações Pós-Operatórias/etiologia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias da Base do Crânio/patologia , Taxa de Sobrevida , Adulto Jovem
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