Browse

You are looking at 1 - 10 of 362 items for :

  • Surgery, other x
  • Clinical Medicine, other x
Clear All
Open access

Nuray Bayar Muluk

Abstract

OBJECTIVES. The aim of this paper is to review the united airway concept.

MATERIAL AND METHODS. We searched Pubmed, Google, Google Scholar and Proquest Central database of Kırıkkale University.

RESULTS. Upper and lower airways are thought as a morphological and functional unit. There is a link between rhinitis and asthma. Over 80% of asthmatics have rhinitis and 10-40% of rhinitis patients have asthma. Rhinosinusitis is related to asthma in 34-50% of the patients. The relationship between rhinosinusitis and asthma may include “nasobronchial reflex, pharyngobronchial reflex, inhalation of dry, cold air and environmental pollutants inhalation”.

CONCLUSION. The united airway concept suggests that upper and lower airways are thought as a morphological and functional unit. It has been commonly accepted in recent years. Allergic rhinitis (AR) is a risk factor for asthma; and Allergic Rhinitis and Asthma (ARIA) suggest bronchial involvement in AR patients.

Open access

Nadia Syafeera Naserrudin and Mohammed Azman Mohammad Raffiq

Abstract

BACKGROUND. The malignant sinonasal tumour is very rare. Sinonasal adenocarcinoma comprises only 10-20% of all primary malignant sinonasal tumours. The commonest type is the maxillary squamous cell carcinoma. It commonly presents with nasal blockage, nasal discharge and epistaxis during the early stage. Headache and blurry vision may occur at an advanced stage when it has invaded the brain, the eye or the optic nerve.

CASE REPORT. We present a 63-year-old patient with acute progressive worsening unilateral blurry vision and headache for 1 month. Epistaxis with anosmia developed only later. The patient had a neuroimaging by both Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI) scan which showed a skull base tumour, but early biopsy was inconclusive. He underwent combined transcranial and transsphenoidal tumor debulking in view of clinical impression of olfactory neuroblastoma. The histopathological examination showed adenocarcinoma. He was sent for postoperative radiotherapy.

CONCLUSION. We highlighted that a patient with sinonasal adenocarcinoma may present initially with the symptom of invasion to neighbouring structures prior to the local symptom.

Open access

Nadia Syafeera Naserrudin, Syafazaima Abd Wahab, Vijayaprakas Rao Ramanna and Abd Razak Ahmad

Abstract

BACKGROUND. Acinic cell carcinoma (ACC) is a rare malignant salivary gland tumour. It is of a low-grade type. The commonest site involved is the parotid gland. ACC is not common in minor salivary glands; this tumour type mainly arises in the oral cavity.

CASE REPORT. We present an 84-year-old Malay man with spontaneous, self-limiting, left-sided epistaxis for 2 days. He also had progressive left-sided nasal blockage. There was no hyposmia, blurry vision or headache. He had underlying hypertension. The clinical examination showed he was normotensive. There was no external nasal deformity. The anterior rhinoscopy demonstrated a fungating irregular mass filling up the left nasal vestibule. There was no neck node. The computed tomography showed a tumour localized in the nasal cavity. The biopsy showed features of acinic cell carcinoma. We proceeded with left lateral rhinotomy and wide excision. Intraoperatively, we discovered that the tumour aroused from the nasal septum and part of the septum had to be sacrificed for margin clearance. Currently, he is on routine surveillance and tumour-free.

CONCLUSION. We highlighted the importance of recognizing nasal acinic cell carcinoma and the fact that early biopsy is important as surgery provides a good prognosis even in the extreme age group.

Open access

Lucia Gariuc, Alexandru Sandul and Lupoi Daniel

Abstract

Invasive fungal rhinosinusitides are a group of disorders with three subtypes (acute invasive fungal rhinosinusitis, chronic invasive fungal rhinosinusitis and granulomatous invasive fungal rhinosinusitis), requiring urgent diagnosis and early treatment due to the reserved vital and functional prognosis. This disorder occurs in immunocompromised patients, but it can also occur in immunocompetent people. Aspergillus and Mucormicosis species are the most common microorganisms found in invasive fungal rhinosinusites. The otorhinolaryngologic clinical examination and imaging techniques provide important diagnostic information in patients with risk factors for invasive fungal rhinosinusitis, including intracranial or orbital extension identification. The treatment of invasive fungal rhinosinusites (acute or chronic) consists of reversing immunosuppression, appropriate systemic antifungal therapy and aggressive and prompt surgical debridement of the affected tissues.

Open access

Aru Chhabra Handa, Anup Singh and Jai Prakash Sharma

Abstract

Wegener’s granulomatosis (Granulomatosis with Polyangiitis) is an autoimmune granulomatous disorder of unknown etiology. The basic pathology is necrotizing granulomatous inflammation with necrotizing vasculitis involving medium-sized blood vessels. The typical triad of involvement of the upper and lower respiratory tracts and the kidneys is observed in varying proportions in individual patients. The sinonasal involvement is observed in the majority of patients and it can be involved in isolation in up to a quarter of affected individuals. The sinonasal changes involve both the soft tissue and bony architecture, with refractory chronic sinusitis associated with erosion of the cartilaginous and bony skeleton and may lead to saddle nose and other facial deformities in advanced cases. The radiology has a contributory role as diagnostic and diseases monitoring aid.

The various radiological findings associated with the disease (bone erosion with osteoneogenesis) have been mentioned in the literature. We present the progression of a radiological abnormality in a patient with a localized form of Wegener’s Granulomatosis and highlight some peculiar appearances observed on radiology in the patient.

Open access

Codrut Sarafoleanu, Violeta Melinte and Gabriela Musat

Abstract

Adenotonsillectomy is one of the most performed surgical procedures in otorhinolaryngology. When it comes to hospitalization duration, there are no general available truths. Every patient is unique and only the physician should decide for how long he/she has to remain in the hospital after adenotonsillectomy, taking into consideration the used technique, the intraoperatory evolution and also the associated risk factors.

The authors present some general aspects of this theme and their own point of view in what adenotonsillectomy is concerned in terms of ethics and moral responsibility of the surgeon, hospital and government for the hospitalization after the surgical intervention.

Open access

Aleksandre Kobakhidze, Elena Merkulova, Natalia Gvozdeva and Dilyana Vicheva

Abstract

BACKGROUND. There are not many works devoted to the structures of a nasal cavity in odontogenic maxillary sinusitis and to a condition of an alveolar ridge of the maxilla with a rhinogenous genesis of the disease.

MATERIAL AND METHODS. 100 patients (N) with chronic sinusitis hospitalized at the ENT (N=50) and Oral and Maxillofacial Surgery (N=50) Departments were examined. The character of anatomic options of a nasal septum in chronic maxillary sinusitis is estimated according to a cone-beam computed tomography (CBCT) with use of our own developed scheme of coordinates in the form of “triangles” which allows establishing versions of the block of the ostiomeatal complex and nasal septum deviation.

RESULTS. In cases of rhinogenous and odontogenic causes of maxillary sinusitis, the triangle deviation is detected more often, including a perpendicular plate of the ethmoid bone, the vomer and the quadrangular cartilage, contributing to the block of the ostiomeatal complex. This scheme has allowed us to establish a group of patients with the mixed genesis of maxillary sinusitis in the Otorhinolaryngology and MFS Departments (36% and 42% respectively) and that, in its turn, requires a cross-disciplinary approach when choosing a strategy of treatment.

CONCLUSION. In case of rhinogenous genesis of the disease, the bilateral nature of the process with involvement of other paranasal sinuses in the inflammatory process is detected more often. The category of patients with mixed genesis (rhinogenous plus odontogenic) of sinusitis demands a cross-disciplinary approach to diagnosis and making a decision about treatment strategies.

Open access

Anca Chiriac, Piotr Brzezinski, Meda Bradeanu, Adrian Năznean, Cristian Podoleanu and Simona Stolnicu

Abstract

Newborns are more likely to develop bruises due to mechanical trauma during birth. Establishing the correct diagnosis in newborns presenting with different skin lesions is not an easy task, and besides the well-known pathology, one must not forget simple posttraumatic injuries. We present three cases that raised questions before establishing that the lesions had been induced by simple mechanical trauma during birth. Trauma-induced skin lesions in newborns may represent an overlooked problem. The three cases presented here are meant to draw attention to the possibility of trauma-induced lesions in newborns, which require only close follow-up and surveillance instead of exhaustive clinical and laboratory investigations, which are inevitably accompanied by anxiety.

Open access

Balázs Oltean-Péter, István Kovács, Monica Chițu and Imre Benedek

Abstract

Atherosclerosis is a systemic disease that most often affects the carotid arteries. Being usually asymptomatic in its early stages, it is diagnosed only in advanced stages, when treatment is more difficult and prognosis is poor. Carotid ultrasound (US) is the most commonly used method for diagnosing carotid artery disease and represents a proper method for screening in patients with cardiovascular (CV) risk factors. This paper shows the methodology and necessity of carotid imaging methods in patients at high risk of developing atherosclerotic lesions. We also review the findings that underline the need of carotid screening in patients with ischemic heart disease or with ischemic arteriopathy, showing that the carotid arteries are like ‘mirrors’ of the arterial system, which need to be assessed in every patient with CV risk factors, regardless of the presence or absence of symptoms.