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The nose is an uncommon site for head and neck paraganglioma. The diagnosis is seldom established pre-operatively; its rarity, infrequent functionality and often benign biologic outcome underlie this fact. We present one such case in a 60-year-old man who presented with right nasal obstruction and episodic epistaxis. Rhinoscopy revealed a fleshy polypoid mass arising from the anterior cartilaginous nasal septum. Imaging studies excluded extra-nasal extension. The tumor was highly vascular showing numerous variable sized, mostly thin walled branching blood vessels akin to stag-horn shape simulating a vascular neoplasm. There were large areas of hyalinization. The typical tumor morphology was discernible only in focal areas. Immuno-histochemistry confirmed the diagnosis. The tumor cells expressed neuron specific enolase; S-100 stain demonstrated a vague zell-ballen pattern. Paraganglioma is a rare histologic diagnosis in nasal polypectomy specimen. We discuss the approach to exclude its morphologic mimics including vascular tumors.
Hereditary hemorrhagic telangectasia (HHT) or Rendu-Osler-Weber syndrome, is a rare genetic disorder with autosomal dominance and variable penetrance. The typical findings of the disease are telangiectasias in skin and mucous membranes, and arteriovenous malformations presenting in the organs like lung, intestine, brain and liver. It is characterized by the classic triad of recurrent epistaxis, mucocutaneous telangiectasias and visceral hemorrhages, with familial occurrence.
This article describes a case of HHT of an adult patient, associated with multiple angiodysplasic injuries in the nasal mucosa, upper gastrointestinal tract, lungs and who presents continuous blood loss, resulting iron deficiency anemia. Based on clinical and diagnostic findings, we diagnosed this case as HHT, which has rarely been reported in our literature.
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.
ENT surgeons frequently encounter a variety of neoplastic, non-neoplastic and inflammatory masses involving the nasal cavity, the paranasal sinuses or the nasopharynx. Among these, the angiomatous polyp or angiectatic nasal polyps are rare and account for 4-5% of all inflammatory nasal polyps. They have variable growth patterns and clinical features. In angiomatous nasal polyps, there is a prominent component of dilated capillary-type blood vessels. We present a review of the literature regarding the most important features of this pathology and an unusual case of a large angiomatous polyp arising from the maxillary sinus.
-P. During the few months following his diagnosis of Type 3 VWD, he received seven exposures to Humate-P. Immediately after the seventh exposure, he developed an anaphylactic reaction requiring adrenalin and Benadryl (diphenhydramine). He made a full recovery from the reaction, which quickly subsided. Following this reaction, he continued to receive Humate-P on demand, but with Benadryl given first. After a total of 22 exposure days, the premedication was discontinued with no further reactions presented. In 2013, due to recurrent episodes of epistaxis and tonsillar
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.
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.