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1.
Artigo em Chinês | MEDLINE | ID: mdl-36347578

RESUMO

Objective:To review the clinical and radiological presentation and management of infected nasal dermal sinus cysts(NDSC) in children. Methods:Clinical data were collected from 59 NDSC children with secondary fronto-orbital area infection who presented to Beijing Children's Hospital from January 2007 to December 2021. All patients underwent preoperative imaging workup, including MRI and CT. All patients underwent endoscopic excision of a NDSC under general anesthesia. Results:A total of 59 patients were included in the study,while 58 presented with a sinus, 1 presented with a cyst.The main lesions of NDSC included nasal root in 20 cases (33.9%), nasal bridge in 34 cases (57.6%), nasal tip in 4 cases (6.8%), and nasal tip and nasal root in 1 case (1.7%). The depth of lesions included 6 cases (10.2%) of superficial type of nasal frontal bone, 33 cases (55.9%) of nasal frontal bone, 19 cases (32.2%) of intracranial epidural type, and 1 case (1.7%) of intracranial epidural type. The main sites of infection included inner canthus in 15 cases (25.4%), nasal dorsum in 22 cases (37.3%), nasal root in 16 cases (27.1%), and forehead in 6 cases (10.2%). Among 59 cases, 7 cases (11.9%) were complicated with other diseases, and 4 cases(6.8%) had external nasal deformities. Surgical approaches included transverse incision in 12 cases(20.3%), minimal midline vertical incision in 41 cases (69.5%), external rhinoplasty in 4 cases (6.8%) and bicoronal incision with vertical incision in 2 cases (3.4%). The range of lesions was completely consistent with MRI results.All cases were successfully operated without one-stage nasal dorsum reconstruction. All patients were followed up from 7 to 173 months(average 52.2 months). There were 6 cases of recurrence, all of which were in situ recurrence. The operation was performed again, and no recurrence has occurred since the follow-up, No nasal deformity was noted, and cosmetic outcome were favorable for all patients. Conclusion:NDSC infection in children with midfacial infection as the first symptom is rare in clinical practice, and its manifestations are diverse. Early diagnosis and rational treatment are very important to improve the cure rate.Preoperative high resolution MRI combined with CT scanning is of great significance in judging the course of NDSC, especially the intracranial extension. The treatment goal is to achieve minimally invasive and individualized treatment under the premise of complete excision of the lesion, and take into account the cosmetic needs.


Assuntos
Cisto Dermoide , Neoplasias Nasais , Doenças dos Seios Paranasais , Rinoplastia , Espinha Bífida Oculta , Criança , Humanos , Cisto Dermoide/diagnóstico , Cisto Dermoide/patologia , Cisto Dermoide/cirurgia , Neoplasias Nasais/cirurgia , Espinha Bífida Oculta/cirurgia , Doenças dos Seios Paranasais/cirurgia
2.
Rom J Morphol Embryol ; 63(2): 413-419, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36374146

RESUMO

Currently, allergic rhinitis (AR) is the most common allergic disease worldwide. AR is defined as immunoglobulin E (IgE)-mediated chronic inflammatory disease of the upper airways. It characterizes by symptoms like nasal obstruction, rhinorrhea, nasal itching, and sneezing. The immune system and genetic susceptibility in the interaction with the environment lead to the development of AR. Many cytokines, chemokines and cells maintain allergic inflammation. Studies show that 10% to 30% of the adult population are affected, and that prevalence rates are increasing world widely. AR, nasal polyps (NP), as well as chronic rhinosinusitis (CRS) are all associated with eosinophilic infiltration and large quantities of mast cells (MCs) within the mucosa. The diagnosis and management of chronic sinonasal diseases involves the analysis of eosinophilic infiltration, MCs, and their markers eosinophilic cationic protein (ECP) and tryptase. Regarding nasal cancer, nasal allergies were found to exhibit a dual function: immune surveillance may help in the defense against malignant cells, but an opposite effect is observed in tissues with chronic stimulation and inflammation. In the present paper, we studied a group of 70 patients diagnosed with AR and NP, rhinosinusitis or nasal cancer, admitted to the Ear, Nose & Throat (ENT) Clinic of the Emergency City Hospital, Timisoara, Romania, between January 2016 and December 2020, and we identified 37 (53%) patients diagnosed with AR and NP, 25 (36%) patients diagnosed with AR and rhinosinusitis, and eight (11%) patients diagnosed with AR and nasal cancer. The average age of the patients was 53 years old. Every patient included in the study was histopathologically and immunohistochemically diagnosed.


Assuntos
Pólipos Nasais , Neoplasias Nasais , Rinite Alérgica , Sinusite , Humanos , Adulto , Pessoa de Meia-Idade , Pólipos Nasais/complicações , Pólipos Nasais/patologia , Neoplasias Nasais/patologia , Sinusite/complicações , Sinusite/patologia , Rinite Alérgica/complicações , Rinite Alérgica/metabolismo , Doença Crônica , Inflamação/patologia , Mucosa Nasal/patologia
4.
J Immunol Res ; 2022: 4406838, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36213327

RESUMO

Objectives: This study was intended to explore and analyze the factors which affect the survival and prognosis of patients with malignant tumors of nasal cavity and sinus. Methods: Retrospective analysis was performed on the clinical data of 39 cases of malignant tumors of nasal cavity and sinus that met the requirements of the study. A follow-up study was performed on the patients for more than 36 months. Survival analysis was conducted via the Kaplan-Meier method and log-rank test. Cox regression model was used for multivariate analysis. Results: Gender, pathological type, treatment plan, clinical stage, and survival time of patients were different. Clinical stage was substantially related to the survival of patients (P < 0.05), which was an independent factor affecting prognosis. Conclusions: Early detection and comprehensive treatment of sinonasal malignancies can improve the prognosis and prolong the survival time of patients.


Assuntos
Neoplasias Nasais , Neoplasias dos Seios Paranasais , Seguimentos , Humanos , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/terapia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/terapia , Prognóstico , Estudos Retrospectivos
5.
Dermatol Online J ; 28(4)2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-36259866

RESUMO

Mohs micrographic surgery (MMS) is a surgical technique used to remove skin tumors with a complete evaluation of the margins. The keystone flap technique is generally used to repair large surgical defects on limbs. We present a case where a modified keystone flap technique was used to close a large defect after Mohs micrographic surgery in a patient with a basal cell carcinoma on the nose. An excellent functional and aesthetic result was obtained with no complications during or after the procedure. We offer a novel indication for this technique for surgical defects in this area.


Assuntos
Carcinoma Basocelular , Neoplasias Nasais , Procedimentos Cirúrgicos Reconstrutivos , Humanos , Carcinoma Basocelular/cirurgia , Cirurgia de Mohs/efeitos adversos , Neoplasias Nasais/cirurgia , Retalhos Cirúrgicos/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos
6.
Anticancer Res ; 42(11): 5449-5455, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36288895

RESUMO

BACKGROUND/AIM: There is significant variation in post-treatment surveillance imaging for sinonasal malignancies. This study examined the utility of surveillance imaging in detecting recurrence in patients treated for sinonasal malignancies. PATIENTS AND METHODS: We performed a retrospective review on an IRB-approved dataset of patients with sinonasal malignancies treated at a single institution between 2005 to 2021. Patients were categorized into groups based on the frequency of annual imaging and total number of imaging studies. We compared time-to-recurrence between the groups using log-rank test. A two-sided p-value of <0.05 was considered as the threshold for significance. RESULTS: A total of 93 patients were eligible for this study with a median follow up of 42.3 months and 25.8% (n=24) of patients had documented recurrence. Sensitivity and specificity for recurrence based on computed tomography (CT) scans within one year of treatment completion were 50.0% and 19.5%; positron emission tomography/CT was 90.0% and 19.5%; and magnetic resonance imaging was 60.0% and 61.0%, respectively. Regardless of the type of imaging, symptomatic presentation after treatment had a specificity of 91.0% with a positive likelihood ratio of recurrence of 2.95 (95%CI=1.06-8.22). The frequency of scans was not associated with the risk of recurrence (HR=0.55; 95%CI=0.23-1.29, p=0.17). Similarly, no association was noted between the total number of scans and risk of recurrence (HR=0.64; 95%CI=0.27-1.51, p=0.31). CONCLUSION: The total number of frequency of scans within the first year after treatment had no association with time to recurrence of sinonasal malignancies. Symptomatic presentation was strongly associated with recurrence and should be investigated with appropriate imaging.


Assuntos
Neoplasias Nasais , Neoplasias dos Seios Paranasais , Humanos , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/terapia , Recidiva Local de Neoplasia/diagnóstico , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia Computadorizada por Raios X , Estudos Retrospectivos
7.
Indian J Pathol Microbiol ; 65(4): 750-754, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36308175

RESUMO

Aim: The aim of our study is to analyze the staining models for VEGF, p16, and p53, as well as to understand the biology of inverted papilloma caused by smoking. Materials and Methods: Thirty-one cases, diagnosed with sinonasal inverted papilloma between 2015 and 2019, were included. Demographic data such as age and gender, admission symptoms of the patients, and anatomical location, stage, surgical technique, and recurrence information were obtained from clinical follow-up files. Immunohistochemical staining for p16, VEGF, and p53 were performed on patient materials. Results: In our study, the female to male ratio was 9.33 with an average age of 53.137 ± 13.96 years. Of the patients, 17 were nonsmokers and 14 were smokers. No significant relationship was found between smoking status and relapse and dysplasia. In contrast, a significant relationship between the Krouse stage and dysplasia (P = 0.005) was observed. A similar significant relationship was observed between p16 immunohistochemical expression and dysplasia (P = 0.030). On the other hand, VEGF and p53 immunohistochemical expressions were not significantly related with dysplasia and recurrence. Conclusions: Inverted papillomas are benign tumors that clinically give symptoms similar to nasal polyps. However, recurrence and malignant transformation potential exist and the factors causing this risk are not clearly identified. In our study, no malignant transformation was observed in patients who were admitted to our hospital.


Assuntos
Neoplasias Nasais , Papiloma Invertido , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Papiloma Invertido/patologia , Proteína Supressora de Tumor p53 , Fator A de Crescimento do Endotélio Vascular , Prognóstico , Recidiva Local de Neoplasia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/patologia , Transformação Celular Neoplásica , Fumar/efeitos adversos , Estudos Retrospectivos
8.
Indian J Pathol Microbiol ; 65(4): 911-913, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36308205

RESUMO

A 3-month-old boy presented with an intranasal polypoidal mass protruding out of the nostril which was present since birth and growing slowly. The mass was non-pulsatile and soft to firm in consistency. It did not increase in size on coughing, crying, or compression of the jugular vein. Magnetic resonance imaging and contrast-enhanced computed tomography (CT) revealed a lobulated well-circumscribed soft tissue mass in the left nasal cavity with no intracranial communication. Complete surgical excision of the mass was carried out via an intranasal endoscopic approach. Histopathological examination confirmed the diagnosis of intranasal glioma.


Assuntos
Coristoma , Glioma , Pólipos Nasais , Neoplasias Nasais , Masculino , Recém-Nascido , Humanos , Lactente , Pólipos Nasais/patologia , Nariz/patologia , Coristoma/patologia , Glioma/diagnóstico , Glioma/cirurgia , Glioma/patologia , Cavidade Nasal/patologia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/cirurgia , Neoplasias Nasais/patologia
9.
Br J Radiol ; 95(1140): 20220367, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36240450

RESUMO

OBJECTIVES: To investigate the efficacy of pretreatment ADC and Ki-67 index in the prediction of the response to neoadjuvant chemotherapy (NACT) in advanced olfactory neuroblastoma (ONB) patients. METHODS: A total of 21 advanced ONB patients (mean 43.48 years ± 14.26; range 25-69 years; 13 men and 8 women) with diffusion-weighted imaging (DWI) before NACT between June 2015 and October 2021 were retrospectively analyzed. Patients were categorized into responders and non-responders according to RECIST 1.1 after two cycles of NACT. The clinical data, ADCmean value, and Ki-67 index were analyzed. RESULTS: Kadish stage, ADCmean value, and Ki-67 index showed statistical significance between responders and non-responders. Patients with Kadish C stage were more likely to respond to platinum-based NACT (p = 0.035). Patients with the lower ADCmean value showed response to NACT (p = 0.002) and the cutoff point was 1.04 × 10-3 mm2/s. Patients with the higher Ki-67 index showed response to NACT (p = 0.003) and the cutoff point was 17.5%. Predictive performance of Ki-67 index and ADCmean value showed no significance between responders and non-responders (p = 0.865). A significant negative correlation was found between ADCmean value and Ki-67 index (r = -0.539, p = 0.038). CONCLUSIONS: The pretreatment ADCmean value, Ki-67 index and Kadish stage have the potential to predict the response to NACT in advanced ONB patients. ADVANCES IN KNOWLEDGE: This is the first study that investigated the feasibility of DWI in predicting the response to NACT in ONB patients and showed that Kadish stage, pretreatment ADCmean and Ki-67 index may play an important role in the prediction.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Masculino , Humanos , Feminino , Terapia Neoadjuvante/métodos , Antígeno Ki-67 , Estudos Retrospectivos , Estesioneuroblastoma Olfatório/diagnóstico por imagem , Estesioneuroblastoma Olfatório/tratamento farmacológico , Imagem de Difusão por Ressonância Magnética/métodos , Cavidade Nasal
10.
Ann Ital Chir ; 112022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-36259423

RESUMO

AIM: To show a rare case of inverted papilloma with bilateral origin treated with endoscopic approach MATERIAL OF STUDY: The authors reported the unusual case of a 71-year-old male patient with a growing mass occupying both nasal cavities. The patient complained bilateral nasal obstruction associated with thick nasal secretions, anterior and posterior nasal drip, snoring and diffuse nasal pain. The biopsy revealed inverted papilloma. RESULTS: CT Scan and RMI of paranasal sinuses showed a bilateral origin of the tumor with a triple involvement on the left side: middle turbinate axilla, frontal recess posterior wall and ethmoidal sinus roof. Nasal endoscopic surgery approach was performed and the tumoral mass was removed completely. DISCUSSION: Inverted papilloma is an uncommon primary nasal tumor that presents three typical characteristics: a high rate of recurrence, local aggressive behaviour and association with malignancy. Although bilaterality is very rare, in this case the neoplasia occupied both nasal cavities with extension to left frontal, sphenoid and ethmoid sinuses. CONCLUSION: The authors, in line with the literature, showed that endoscopic approach represents once again a safe and efficient technique, even for larger tumors. KEY WORDS: Bilateral origin, Inverted papilloma, Paranasal sinuses.


Assuntos
Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Masculino , Humanos , Idoso , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/cirurgia , Neoplasias Nasais/diagnóstico por imagem , Neoplasias Nasais/cirurgia , Neoplasias Nasais/patologia , Endoscopia , Nariz
12.
Comput Biol Med ; 149: 105976, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36067631

RESUMO

BACKGROUND: Inverted papilloma (IP) is a common sinus neoplasm with a probability of malignant transformation. Nasal polyps (NP) are the most frequent masses in the sinus. The classification of IP and NP using computed tomography (CT) is highly significant for preoperative recognition, treatment, and clinical examination. Few visible differences exist between IP and NP in CT, making it a challenge for otolaryngologists to distinguish between them. This study intended to classify IP and NP using a neural network and analyze its ability to discriminate the differences. METHODS: IP and NP in CT were classified using a deep convolutional neural network (CNN) with an attention mechanism, which combines a densely connected convolutional network (DenseNet) and squeeze-and-excitation network (SENet). Using SENet's channel attention, the specific channel weights in the feature maps are improved, which can enhance feature discriminativeness. To discuss the interpretability of SE-DenseNet, we analyzed the heatmap of the final convolutional layer. RESULTS: We evaluated the classification performance of SE-DenseNet on a clinical dataset containing 3382 slices for 136 patients. The experimental results and a heatmap show that SE-DenseNet can effectively locate sinonasal lesions in patients and distinguish IP from NP with an average Acc of 88.4% and AUC of 0.87. CONCLUSION: Otolaryngologists can use the proposed model to diagnose IP and NP in CT because of its accuracy and efficiency. Moreover, the visualized heatmaps produced by the convolutional layers show that the method is reliable.


Assuntos
Pólipos Nasais , Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Humanos , Pólipos Nasais/diagnóstico por imagem , Redes Neurais de Computação , Neoplasias Nasais/patologia , Papiloma Invertido/diagnóstico por imagem , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/cirurgia
14.
Am J Otolaryngol ; 43(6): 103614, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36113312

RESUMO

PURPOSE: Although sinonasal inverted papilloma malignant transformation has not been entirely understood, some studies have suggested that human papillomavirus acts as a potential oncogenic agent in the progression of sinonasal inverted papilloma to squamous cell carcinoma. The purpose of this study was to assess the association between human papillomavirus infection and sinonasal inverted papilloma transformation, taking also into account human papillomavirus types and their distribution in different geographic areas. MATERIALS AND METHODS: The literature from the last 25 years was examined. The systematic review and meta-analysis were performed according to the PRISMA guidelines. RESULTS: A total of 163 malignant sinonasal inverted papilloma and 961 non-malignant sinonasal inverted papilloma were included in the overall analysis. From this sample it was possible to recognize a statistically significant increase in risk of malignancy of sinonasal inverted papilloma for human papillomavirus infection (OR = 2.43, 95 % CI: 1.45-4.08, I2 = 14.0 %). A positive association for patients with high-risk human papillomavirus types was noted (OR = 10.20, 95 % CI: 3.66-28.42, I2 = 15.9 %). In all the 3 geographical areas analyzed the presence of high-risk human papillomavirus significantly increased the probability of malignant transformation. CONCLUSIONS: High-risk human papillomavirus infection plays a key role in the malignant transformation of sinonasal inverted papilloma and its research during histological examination can be of paramount importance. More prospective studies are needed to help further tease out this association.


Assuntos
Neoplasias Nasais , Papiloma Invertido , Infecções por Papillomavirus , Neoplasias dos Seios Paranasais , Neoplasias do Sistema Respiratório , Humanos , Neoplasias dos Seios Paranasais/patologia , Neoplasias Nasais/patologia , Papillomaviridae , Transformação Celular Neoplásica
15.
J Neurol Sci ; 442: 120406, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36081302

RESUMO

PURPOSE: Esthesioneuroblastoma (ENB) is a rare malignant neoplasm of the olfactory epithelium with an estimated incidence of 0.4/million. It can directly extend along the cribriform plate in order to metastasize to the central nervous system. However, non-contiguous intracranial involvement without recurrence at the primary site is extremely uncommon. In this report, the authors review the literature and present a case of non-contiguous intracranial metastasis of ENB without recurrence at the primary site. To the best of our knowledge, this case presents the longest disease-free interval reported in the literature. METHODS: A systematic review of literature was conducted in accordance with the PRISMA guidelines. Additionally, the presentation, surgical management, and post-operative outcomes of an 82-year-old female with non-contiguous intracranial metastasis of ENB after 19 years of remission are described. RESULTS: A total of 137 deduplicated works were identified after the search. Of these, 6 papers satisfied our inclusion criteria for our systematic review. Average age at presentation was 50.8 years (range: 26-66) and 52.6% of patients were female. A majority of cases achieved gross-total resection and received adjuvant radiotherapy for initial treatment. The median interval to intracranial metastasis was 6 years from the time of primary tumor presentation. The median overall survival from ENB recurrence with non-contiguous intracranial metastasis was 11.5 months. CONCLUSIONS: ENB is a highly recurrent tumor and harbors the potential to involve the intracranial space even years after remission. Intracranial involvement entails poor overall survival. Lifetime radiographic follow-up should be considered in all patients with ENB.


Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Humanos , Feminino , Idoso de 80 Anos ou mais , Masculino , Estesioneuroblastoma Olfatório/patologia , Estesioneuroblastoma Olfatório/cirurgia , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Cavidade Nasal/patologia , Cavidade Nasal/cirurgia , Intervalo Livre de Doença
16.
Rev Col Bras Cir ; 49: e20223034, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36074390

RESUMO

INTRODUCTION: nose is the central point of the face and vulnerable to the occurence of non-melanoma skin cancer (NMSC), impacting on appearance. The paramedian forehead flap (PMFF) is considered the best option to treat extensive nasal defects. The objective of this study is to present the experience on PMFF for nasal reconstruction in the treatment of NMSC of a cancer referral center. METHODS: retrospective study was carried out through data from medical records of patients who underwent nasal reconstruction with PMFF due to NMSC at the Cancer Institute of the State of São Paulo (ICESP). RESULTS: 111 patients were identified, mostly ederly, with comorbidities and on initial tumors (T1 and T2). Basal cell carcinoma (BCC) was the predominant histological type. Dorsum and tip were the most affected subunitis. In addition to skin coverage, reconstruction of the lining and structural framework was also performed in half of the cases. Second intention healing was the technique of choice in closing the donor area. Pedicle division ocurred predominantly in the second operation and the median time to complete reconstruction was 6 months. There were low complication rates. CONCLUSIONS: the PMFF is safe and effective to treat nose NMSC, even in cases of high complexity. Since the treatment time can be prolonged and impact on quality of life, it is essential to emphasize and discuss this aspect with the patients before surgery.


Assuntos
Neoplasias Nasais , Neoplasias Cutâneas , Brasil , Estudos Transversais , Testa/patologia , Testa/cirurgia , Humanos , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Qualidade de Vida , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia
17.
J Drugs Dermatol ; 21(9): 983-988, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36074508

RESUMO

Defects involving the glabella and nasal root require an optimal cosmetic outcome due to its critical position in the mid-face. Glabellar defects often involve multiple cosmetic subunits, hair variations, and various skin thicknesses (forehead superiorly, eyebrows / eyelids laterally, nasal root and dorsum inferiorly), further complicating the reconstruction. The eyebrows and natural concavity of this area must be preserved if possible. Repair options in this location vary by personal preference and experience rather than literature-based outcomes. Key considerations include the location of the defect (glabella vs nasal root +/- brow +/- medial canthus), the position of the defect (midline or off-center) and the texture/thickness of the skin (thick glabellar skin or thin skin of medial canthus). The rich blood supply in this area has made local flaps the preferred option for moderate to large defects. However, two pitfalls for local flaps are pincushioning resulting in a “bull nose” and the possibility of causing synophrys. Often, a combination of flaps, grafts, and/or primary closures are necessary to adequately close large glabellar/nasal root defects. There is a paucity of literature for reconstructive options of the glabella and nasal root, and in the authors’ experience, even experienced surgeons struggle to decide on these. We present a series of reconstructive approaches for the majority of moderate to large cutaneous glabellar and nasal root defects with excellent functional and aesthetic results. J Drugs Dermatol. 2022;21(9):983-988. doi:10.36849/JDD.6132.


Assuntos
Neoplasias Nasais , Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Animais , Bovinos , Estética , Testa , Humanos , Masculino , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Rinoplastia/métodos , Retalhos Cirúrgicos/transplante
18.
Am J Rhinol Allergy ; 36(6): 827-834, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35915990

RESUMO

OBJECTIVES: To examine the epidemiology, subtypes, trends over time, and predictive factors for recurrence and malignant transformation of sinonasal papillomas. METHODS: A retrospective chart review of 118 patients with sinonasal papillomas from 2009 to 2019 was conducted at the University of California, Los Angeles. This study is a follow-up to a previously published study from 2000 to 2009 at the same academic center. RESULTS: The mean age was at presentation was 58.5 years, with a 2:1 male to female ratio, and average follow-up of 30.1 months. The rate of recurrence after complete resection was 19% with an average of 32.6 months to recurrence. The time to recurrence followed a bimodal distribution with 57% of cases recurring within 24 months (mean = 10) and 43% from 40 to 103 months (mean = 61). The proportion of the inverted papillomas rose from 38% in 2000-2004 to 89.6% in 2015-2019. Patients presenting at a younger age had a higher chance of recurrence (mean age 52 with recurrence vs. 61 without recurrence). Age did not correlate with histopathologic transformation in surgical pathology. Furthermore, histopathological transformation did not raise the chance of recurrence. Smoking, alcohol use, chronic rhinosinusitis, and allergic rhinitis were not associated with any of the outcome measures in this study. The most significant factor predicting recurrence, beside age at presentation, was the history of two or more prior sinus surgeries for papillomas or other reasons (OR = 3.52 and 5.81). CONCLUSION: This study explored the features of sinonasal papillomas as well as the risk factors for recurrence and transformation. Younger age at presentation and two or more prior surgeries for papillomas were associated with recurrence. Time to recurrence followed a bimodal distribution, with late recurrences happenning from 40 to 103 months after surgery, emphasizing the importance of long-term follow-up for timely resection of tumors and prevention of malignancy.


Assuntos
Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Transformação Celular Neoplásica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/epidemiologia , Neoplasias Nasais/epidemiologia , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Papiloma Invertido/epidemiologia , Papiloma Invertido/patologia , Papiloma Invertido/cirurgia , Neoplasias dos Seios Paranasais/epidemiologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias dos Seios Paranasais/cirurgia , Estudos Retrospectivos
19.
Artigo em Chinês | MEDLINE | ID: mdl-35959585

RESUMO

In this article we reported 13 cases of the substantial nasal mass in children. Among 13 these patients, 3 cases were septal hemangioma, 2 cases were maxillary hemangioma, 1 case was nasal infantile fibromatosis, 1 case was osteoblastoma of the nasal cavity and sinuses, 2 cases were lymphoma of nasopharynx, 1 case was maxillary lymphoma, 1 case was rhabdomyosarcoma of nasopharynx, 1 case was maxillary squamous-cell carcinoma, 1 case was squamous-cell carcinoma of nasopharynx.All 13 cases were treated with surgery, 1 case with nasal infantile fibromatosis, 2 cases with lymphoma of nasopharynx, 1 case with rhabdomyosarcoma of nasopharynx, 1 case with nasopharyngeal carcinoma and 1 case with maxillary carcinoma were taken postoperative radiotherapy and chemotherapy. The most common substantial nasal mass in children was hemangioma. This study included 2 cases with nasal invasive benign tumors, 1 case with nasal infantile fibromatosis and 1 case with osteoblastoma of the nasal cavity and sinuses. The functional nasal endoscopic surgery of mass resection was the main method for the treatment of mass in this area and had achieved satisfied effect. Lymphoma and rhabdomyosarcoma were the most common nasal malignant tumor in children. Nasopharyngeal carcinoma and maxillary carcinoma were not uncommon.


Assuntos
Neoplasias Ósseas , Carcinoma de Células Escamosas , Fibroma , Hemangioma , Linfoma , Neoplasias Nasofaríngeas , Neoplasias Nasais , Osteoblastoma , Rabdomiossarcoma , Carcinoma de Células Escamosas/patologia , Criança , Fibroma/patologia , Humanos , Cavidade Nasal/patologia , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas/patologia , Neoplasias Nasais/patologia , Neoplasias Nasais/terapia , Osteoblastoma/patologia
20.
Am J Surg Pathol ; 46(11): 1507-1513, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-35993580

RESUMO

Sinonasal papillomas are a diverse group of benign epithelial neoplasms of the sinonasal tract. Inverted papilloma, in particular, must be distinguished from other lesions with no malignant potential. The aim of this study was to distinguish sinonasal papillomas from morphologically similar lesions using CD163 immunostaining. Cases from a 19-year period were identified. These included 49 inverted, 10 exophytic, and 12 oncocytic papillomas, 21 chronic sinusitides with squamous metaplasia, 27 inflammatory polyps, 5 verrucae vulgares, 5 respiratory epithelial adenomatoid hamartomas, and 6 DEK::AFF2 carcinomas of the sinonasal tract. A subset of biopsy cases (8 inverted papillomas, 5 inflammatory polyps) was separately analyzed. CD163 immunohistochemistry (IHC) was performed. A unique "circle" staining pattern was identified in the surface epithelium. After locating a hotspot, circles were quantified in 10 consecutive high-power fields. Circles were present in 66/71 (93%) cases of sinonasal papilloma, with a mean of 35 circles/10 HPF (range: 0 to 160/10 HPF) and a median of 19 circles/10 HPF. Circles were present in 20/58 (34%) non-neoplastic cases, with a mean of 2 circles/10 HPF (range: 0 to 27/10 HPF) and a median of 0. Considering all resection and biopsy cases, performance for distinguishing papillomas from non-neoplastic lesions was best at a cutoff of 10 circles/10 HPF (2-tailed P <0.0001) with sensitivity, specificity, positive predictive value, and negative predictive value of 66.2%, 93.1%, 92.1%, and 69.2%, respectively. The results were similar in the biopsy subset. One other neoplastic entity, the DEK::AFF2 carcinomas, also showed prominent CD163 circle staining. In summary, sinonasal papillomas demonstrate extensive CD163 "circle" staining in the epithelium compared with the non-neoplastic lesions studied. As such, the "circle sign" on CD163 IHC may be helpful in distinguishing between diagnoses, particularly on small biopsies or equivocal specimens.


Assuntos
Carcinoma , Neoplasias Nasofaríngeas , Neoplasias Nasais , Papiloma Invertido , Neoplasias dos Seios Paranasais , Antígenos CD , Antígenos de Diferenciação Mielomonocítica , Proteínas Cromossômicas não Histona , Humanos , Neoplasias Nasais/patologia , Proteínas Oncogênicas , Papiloma Invertido/diagnóstico , Papiloma Invertido/patologia , Neoplasias dos Seios Paranasais/diagnóstico , Neoplasias dos Seios Paranasais/patologia , Proteínas de Ligação a Poli-ADP-Ribose , Receptores de Superfície Celular , Coloração e Rotulagem
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