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Open access

Ranko Mladina, Neven Skitarelić, Cemal Cingi and Nuray Bayar Muluk

Abstract

OBJECTIVES. The purpose of this article is to highlight some terms which have been ingrained in the rhinosinusology literature.

MATERIAL AND METHODS. It regards the term “accessory ostium” and the term “septal deviation”. The well-known and deeply ingrained term “accessory ostium” has been widely used for decades, but essentially it is absolutely incorrect. “Septal deviation” is an inadequate term for the changes of the nasal septum form.

RESULTS. From the linguistic point of view, “accessory” means something (or someone) which (or who) helps someone or gives support (to something or someone) in some process. We recommend the use of the term “defect of the fontanel” instead of “accessory ostium”. The use of the term “septal deformity” (from Latin: de forma, meaning the change in the shape) is etymologically much more appropriate. Septal deformities appear in man in several, well defined shapes and, therefore, can be correctly classified. The classification contributes to the further scientific conversations regarding the clinical issues connected to the changes of the nasal septum form.

CONCLUSION. The usual term “accessory ostium” suggests almost a normal finding on the lateral nasal wall, but, on the contrary, it clearly signalizes that the respective maxillary sinus is chronically inflamed. The usual term “septal deviation” is not at all specific and only suggests that something is wrong with the position of the nasal septum. It does not at all imply any of the six well known types of septal deformities in man.

Open access

Nuray Bayar Muluk

Abstract

OBJECTIVES. We reviewed the relationship between olfactory functions and Behçet’s disease (BD).

MATERIAL AND METHODS. We searched Pubmed, Google, Google Scholar and Proquest Cebtral Database with the key words of “olfactory”, “functions”, “smell”, “nasal” and “Behçet’s disease”.

RESULTS. Behçet’s disease influences the nasal mucosa. Nasal mucosal inclusion causes mucosal ulcers, pain, burning, nasal obstruction, epistaxis, nasal itching and dysosmia. Nasal cartilage deformity is also reported. The higher rate of comorbid chronic rhinosinusitis (CRS) in BD patients may likewise be because of the complex mechanism of the disease inclining the host tissues to bacterial infections. Olfactory functions may decrease in BD. Odor identification may be lower in patients BD.

CONCLUSION. An olfactory dysfunction may be seen in patients with BD. BD patients should be evaluated for the involvement of the olfactory function and may require treatment because of a malfunction of the olfactory system that influences the quality of life. Neurological involvement associated with BD might play a more important role in causing olfactory dysfunction than mucosal involvement.

Open access

Daniela Vrinceanu, Mihai Dumitru, Maria Sajin, Carmen Maria Salavastru and Adrian Costache

Abstract

BACKGROUND. Lymph node tuberculosis is a pathology with an increasing incidence and prevalence in middle income countries.

MATERIAL AND METHODS. We present a series of 4 cases with cervical lymph node tuberculosis. We review current principles of diagnosis and treatment from the perspective of the ENT surgeon in a tertiary university clinic.

RESULTS. In each case we underline diagnosis difficulties and treatment options. These cases presented management difficulties due to associated morbidities. All cases underwent surgical excision of the afflicted lymph nodes with subsequent microscopic confirmation of tuberculosis. We illustrate key concepts leading to the microscopy diagnosis of lymph node tuberculosis.

CONCLUSION. There are various surgical incidents and accidents that the young surgeon must be aware of when approaching neck tuberculous lymph nodes. Further referral of the patient for long-term tuberculosis treatment is mandatory. All patients were supervised for a minimum of 1 year after the initial diagnosis and treatment with no sign of recurrence. A close cooperation between the ENT surgeon, the infectious disease specialist and the pathologist is the key to an optimum approach to lymph node tuberculosis at the head and neck level.

Open access

Andra Virlan, Nicoleta Schileru, Amalia Neagu and Claudiu Manea

Abstract

A 40-year-old female patient presented to our clinic for bilateral nasal obstruction, anteroposterior mucopurulent rhinorrhea, recurrent micro-epistaxis, anosmia, left otodynia, fever and sweating. The ENT findings and CT scan detected a septal tumor with predominant extension in the left nostril, with erosive character of the osteo-cartilaginous septal structure, without sinusal involvement and left lateralcervical adenopathy. Resection of the entire septal tumor formation was performed. The histopathological outcome revealed non-Hodgkin’s small-type NK/T extranodal nasal-type lymphoma – immunohistochemical tests confirmed histogenesis.

Open access

Paskaramoorthy Sasitharan, Nor Idayu Mohd Yusof and Kugan Varatha Raju

Abstract

Extramedullary plasmacytoma is a rare neoplasm characterized by monoclonal proliferation of plasma cells. It is most often located in the head and neck region. Extramedullary Plasmacytomas are more predominant in males who are in the 5th – 6th decade. In this report, this patient, who is a young female, presented to our clinic with history of intermittent nasal obstruction for the past year. She was diagnosed with extramedullary plasmacytoma and was subjected to radiotherapy. The clinical and histopathologic findings of plasmacytoma are discussed. In order to exclude systemic involvement, a systematic approach using clinical, laboratory and radiologic investigations was performed. Extramedullary plasmacytoma of the nasal cavity is rare and should be considered in the differential diagnosis of nasal cavity masses, especially in the young age group.

Open access

Gabriela Musat, Alina Anghel, Lucia Radu and Roxana Decusara

Abstract

BACKGROUND. Vestibular disorders are a group of widely spread diseases that have as a common denominator the disturbance of the equilibrium system. The assessment of vestibular disorders consists in a complex examination of the patient including a thorough anamnesis, a rigorous clinical examination and multiple functional explorations.

OBJECTIVE. To asses weather there is a correlation between the data obtained in posturography and those obtained in the videonystagmography in patients with peripheral vestibular disorders.

MATERIAL AND METHODS. Collecting data from the observation sheets of patients diagnosed with peripheral vestibular syndrome and examined in the Department of Otorhinolaryngology of the “Sfanta Maria” Hospital in Bucharest over a period of 18 months.

RESULTS. We analyzed a number of 97 cases of patients diagnosed with peripheral vestibular disorder. A large number of patients (49) had correlated changes in the caloric tests and also in the posturography. A second group of patients (43) had changes in caloric tests but with no changes in posturography. The third group of 5, paradoxically, had a vestibular deficiency in posturography associated with normal caloric reactivity.

CONCLUSION. The results obtained with the videonystagmography are correlated with those of the caloric and rotational videonystagmographic tests in the case of acute vestibular diseases. In chronic vestibular diseases, it is possible to find caloric vestibular paresis in the presence of a normal posturography. The “vestibular omission” is a phenomenon in which the patient does not use the vestibular input of a normal labyrinth with caloric and rotary tests within normal limits. As no vestibular examination can be considered as selfstaging diagnosis, we always have to establish the final diagnosis correlating the results of all the tests available.

Open access

Elena Patrascu and Claudiu Manea

Abstract

Obstructive sleep apnea is a chronic disease characterized by the appearance of apnea or hypopnea episodes during sleep. This condition is associated with several risk factors. Among them, the most important is obesity and it is the only potentially curable. The treatment is polimodal and it involves several therapeutic directions. The purpose of this paper is to establish the role of obesity in the etiology of sleep apnea, as well as the role of the weight loss in its management, both through intensive lifestyle interventions and surgical therapy.

Open access

Krishnamoorthy Madhusudhan, Nor Eyzawiah binti Hassan, Norasnieda binti Md Shukri, Shahrul bin Hitam and Ikmal Hisyam bin Bakrin

Abstract

Small cell neuroendocrine carcinoma (SCNEC) of the nasopharynx and nasal cavity is a rare condition. It is an aggressive malignancy with a high recurrence rate. Despite its rarity in the sinonasal region, it may occur as a second primary malignancy. Patients with cancer of the head and neck region are more prone to develop a second primary tumor due to the field cancerization phenomenon, and a higher incidence is seen in those who have previously received radiation therapy. A detailed clinical and histopathological examination is pivotal to diagnose SCNEC as a second primary malignancy. We wish to highlight such a peculiar case from our center.

Open access

Georgi Petrov Kukushev and Dilyana Vicheva

Abstract

BACKGROUND. The rigid endoscope developed by Karl Storz in 1961 led to a great advance in diagnosis and surgery and nowadays it is the gold standard in routine ENT practice. In addition, the development of video cameras has enhanced the surgical abilities as well as teaching opportunities in endoscopic sinus surgery.

OBJECTIVE. We developed a new prototype endoscope using the “chip-on-the-tip” technology. The aim of our non-clinical study was to observe and discuss the experimental data collected from laboratory tests on plastic models.

MATERIAL AND METHODS. The prototype rigid chip-on-the-tip endoscope has two parts - inner and outer. The inner part includes the chip-on-the-tip camera, light source and the cable. The outer part is a metal tube ending with a 0-degree lens. We performed laboratory tests of the rigid chip-on-the-tip endoscope for rhinosurgery and diagnosis.

RESULTS. We have observed technical parameters of the rigid chip-on-the-tip in order to compare them to conventional endoscopes connected with camera head units that are standard equipment for rhinosurgery and diagnosis.

CONCLUSION. Its advantages compared to the conventional Hopkins endoscope, connected to a standard camera head, are the smaller size, weight and the necessity of only one cable instead of two, allowing easy handling.