Melanoma is a malignant tumor and is commonly found second least in the head and neck region, with approximately 10% - 25% of melanomas followed by ear (8% - 11%). We reported a case of sino-nasal malignant melanoma i...Melanoma is a malignant tumor and is commonly found second least in the head and neck region, with approximately 10% - 25% of melanomas followed by ear (8% - 11%). We reported a case of sino-nasal malignant melanoma in a 46-year-old Asian lady who presented with epistaxis and dysphagia. By nasoendoscopy and CT scan imaging, the diagnosis of sino-nasal malignant melanoma was later confirmed by histopathology examination along with immunohistochemistry by using Melan A and S100. Malignant melanoma in the head and neck is rare and has a poor prognosis. There has been an increase in the incidence of 5% per year and mortality at 2% per year. This dictates malignant melanoma has rapidly increased compared to any other cancer except lung cancer in women and has contributed to the third highest number of deaths among all cancers. The mortality rate has also increased, and that is attributed to the negligence of symptoms during the initial period. This usually leads to patients seeking consultation during the advanced stage of the disease. In conclusion, this paper is to report that malignant melanoma may be one of the differentials of sino-nasal masses, and it may mimic nasopharyngeal carcinoma in its presentation.展开更多
<strong>Background:</strong> Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high ...<strong>Background:</strong> Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high propensity to recur, local aggressive behavior and possibility of malignant transformation attract considerable interest. <strong>Objective:</strong> To assess the factors affecting Sino-nasal IP, malignant transformation rate, and post-operative recurrence rate. <strong>Methods:</strong> A retrospective study was carried out on all cases diagnosed as Sino-Nasal Papilloma between January 2010 and December 2020 at Salmaniya Medical Complex, Bahrain. Data gathered from medical records were analyzed using SPSS. A total of 49 Sino-Nasal Papilloma cases were recorded of which 37 were IP. Factors affecting Sino-Nasal IPs are presented. <strong>Results:</strong> Sino-Nasal IP was recorded in 37 cases, composed of 28 males and 9 females with first presentation average age of 45.86 years. These involved 20 cases in the left side, 14 in the right side and 3 were bilateral. Recurrence in males and females was found to be 35.7% and 33%, respectively, with an average of 12.6 months. The symptoms include nasal blockage (97.3%), epistaxis and postnasal drip (13.5% each), headache (8.1%) and hyposmia and rhinorrhea (5.4%, each). The main recurrence was at stage T2 (60.5%), while in smokers (26.7%) and non-smokers (50%). Malignant transformation occurred in one patient only (2.6%). <strong>Conclusion:</strong> IP is the most common type of SNP with male predominance. The recurrence rate is high with an average of a year and the malignant transformation occurred in 2.6 % of the cases.展开更多
Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexist...Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexists with adenoid enlargement especially in the young which was in sharp contrast to ethmoidal polyposis occurring in the presence of adenoid enlargement. Moreover, the hidden location of nasopharynx housing the adenoids, coupled with the masking effect of bilateral sinonasal polyps, leads to inadvertent misdiagnosis of this complex pathology with subsequent difficulty in providing effective management. Case Presentation: A 24 year-old lady presented with recurrent bilateral nasal obstruction that became persistent associated with nasal discharge and anosmia. She also had recurrent right otorrhoea with associated hearing loss. Diagnostic rigid nasal endoscopy revealed mucoid discharge with bilateral polypoid masses filling both nasal cavities. Otoendoscopic finding revealed a small (about 5%) central tympanic membrane perforation. A clinical assessment of chronic rhinosinusitis with nasal polyposis complicated by chronic suppurative otitis media (CSOM) was made. A non-contrast CT scan of the paranasal sinuses showed isodense lesions in the nasal cavities, all paranasal sinuses and the entire nasopharynx. She had endoscopic sinus surgery and a nasopharyngeal clearance biopsy. The nasal, paranasal and nasopharyngeal masses had histologic confirmation of inflammatory nasal polyps and lymphoid (adenoid) hyperplasia respectively. Her condition improved remarkably with subsequent medical treatment. She was followed up for 8 months and no recurrence was observed. Conclusion: Sinonasal polyposis can coexist with adenoid hypertrophy and middle ear disease as a single pathological condition. Hence, a high index of suspicion and thorough evaluation become necessary for making timely diagnoses and instituting effective management.展开更多
Squamous papillomas are squamous-derived growths commonly arising from the oral cavity and oropharynx. A 75-year-old woman presented with chronic persistent left nasal obstruction and gradual painless non-axial propto...Squamous papillomas are squamous-derived growths commonly arising from the oral cavity and oropharynx. A 75-year-old woman presented with chronic persistent left nasal obstruction and gradual painless non-axial proptosis with loss of vision in the left eye. Computed tomography scan showed an iso-dense lesion filling the frontal, left ethmoidal and sphenoidal sinuses, and the nasal cavity, with extension into the left orbit. She underwent surgical tumor resection with orbital exenteration and histology revealed features of an aggressive hyperkeratotic squamous papilloma arising from the sino-nasal region. Although squamous papillomas have been natively associated with the oral cavity and oropharynx, they present less frequently as sino-nasal tumors with orbital invasion.展开更多
目的本研究旨对鼻骨骨折患者的症状及生活质量(quality of life,QOL)进行纵向随访,寻找各阶段最具困扰的问题,并分析影响因素。方法采用方便抽样,通过医学结局研究简表36项健康调查(SF-36)、鼻腔鼻窦结局测量20条(SNOT-20)和视觉模拟量...目的本研究旨对鼻骨骨折患者的症状及生活质量(quality of life,QOL)进行纵向随访,寻找各阶段最具困扰的问题,并分析影响因素。方法采用方便抽样,通过医学结局研究简表36项健康调查(SF-36)、鼻腔鼻窦结局测量20条(SNOT-20)和视觉模拟量表(VAS)对240例鼻骨骨折患者术前、术后1个月和术后3个月的生活质量进行纵向随访与分析。结果鼻骨骨折患者术后1个月较术前,SF-36中生理机能维度得分、SNOT-20总分与VAS量表中鼻出血、鼻部肿胀和鼻塞得分均出现明显好转(P<0.05),而VAS量表中鼻部伤口疼痛得分以及SF-36中生理职能、躯体疼痛、社会功能和情感职能维度的得分不及术前(P<0.05);患者术后3个月QOL才明显改善,各项指标较术前、术后1个月差异有统计学意义,但SNOT-20显示患者忧虑的得分仍相对较高;性别、年龄、目前居住情况以及疾病诊断与SNOT-20得分之间的相关性较强(P<0.05)。结论鼻骨骨折手术能改善患者的临床症状,但术后早期各项指标恢复缓慢,关注相关因素对SNOT-20得分的影响,能更好的为患者提供个性化的护理措施,提高生活质量。展开更多
<strong>Background:</strong> Computed tomography (CT) Scan is the imaging of choice for the diagnosis of sino nasal (SN) pathologies in sub-Saharan African setting. However, it is often requested by non ex...<strong>Background:</strong> Computed tomography (CT) Scan is the imaging of choice for the diagnosis of sino nasal (SN) pathologies in sub-Saharan African setting. However, it is often requested by non experienced practitioners. We aimed to describe the utility and the appropriateness of CT Scan request forms and results in the diagnosis of SN pathologies. <strong>Method:</strong> We conducted a retrospective cross-sectional study in four health facilities in Yaoundé, Cameroun, from October 2018 to September 2019. All patients to whom SN CT Scan was performed were called for an appointment. After informed consent, data on the appropriateness and conformity of the request form were collected and compared to the guidelines of the French society of radiology. CT Scan results were also collected and the quality of the report was evaluated. <strong>Results:</strong> A total of 206 SN CT Scan request forms and reports were included, with a mean patient age of 37.7 ± 16.1 years. The request form was conformed to guidelines in 8.3% of cases and was found appropriate in 62.6% of cases. No CT Scan report had all the items required, and 159 (77.2%) reports were useful. The most common diagnosis in patients with abnormal results was chronic sinusitis (49.5%) and SN polyp or polyposis (19.4%). <strong>Conclusion:</strong> Most of SN CT Scan requested were appropriate and useful. However, the conformity of request forms and reports to the guidelines is low. Suggesting the need for capacity building for the diagnosis of SN pathologies especially for non specialists like general practitioners and nurses.展开更多
Schwannomas are benign neoplasms arising from Schwann cells of the peripheral,cranial and autonomic nerves.We report a case of schwannoma in the sino-nasal tract,a very rare site of tumour origin with unusual pseudoan...Schwannomas are benign neoplasms arising from Schwann cells of the peripheral,cranial and autonomic nerves.We report a case of schwannoma in the sino-nasal tract,a very rare site of tumour origin with unusual pseudoangiomatous histopathological changes,which we came across in a 22 years male with progressive nasal obstruction.展开更多
Background:Inflammatory bowel disease(IBD)is characterized by chronic inflammation of the gastrointestinal tract.Extra-intestinal manifestations such as pulmonary diseases have been reported.Chronic rhinosinusitis(CRS...Background:Inflammatory bowel disease(IBD)is characterized by chronic inflammation of the gastrointestinal tract.Extra-intestinal manifestations such as pulmonary diseases have been reported.Chronic rhinosinusitis(CRS),an inflammatory condition of the sinonasal mucosa,has been associated with several lung diseases.Given the relationship between lung and intestinal pathologies,and lung and sinus pathologies,we aimed to determine the prevalence of IBD among CRS patients.Methods:Pilot prevalence study.Ninety-two CRS patients were screened for IBD symptoms from October 2018 to January 2020.Patient-reported disease symptoms and overall quality of life were evaluated using the Sino-Nasal Outcome Test 22(SNOT-22),Short Inflammatory Bowel Disease Questionnaire(SIBDQ),and EuroQol 5 Dimension 5 Level(EQ-5D-5L)questionnaires.The Modified Lund-Kennedy(MLK)endoscopic and Lund-Mackay(LM)grading systems were used to confirm CRS diagnoses.Individuals who reported subjective symptoms of IBD were referred to a gastroenterologist clinic for further diagnostics.Results:Twenty of the 92(20.2%,95%CI:12.6%-29.8%)CRS patients reported symptoms of IBD and four individuals(4.26%,95%CI:1.17%-10.50%)were sub-sequently diagnosed with IBD.Compared to patients without IBD symptoms(n=72),those with symptoms(n=20)reported significantly worse SNOT-22(P=0.002),SIBDQ(P<0.05),and EQ-5D-3L(P=0.0063)scores.However,these patients did not exhibit significantly different MLK(P=0.81)or LM(P=0.04)scores.Conclusion:The prevalence of IBD may be elevated among individuals with CRS relative to the general Canadian population.This pilot study suggests that CRS with IBD is associated with lower quality of life.Further cross-sectional studies with larger sample sizes are required.展开更多
文摘Melanoma is a malignant tumor and is commonly found second least in the head and neck region, with approximately 10% - 25% of melanomas followed by ear (8% - 11%). We reported a case of sino-nasal malignant melanoma in a 46-year-old Asian lady who presented with epistaxis and dysphagia. By nasoendoscopy and CT scan imaging, the diagnosis of sino-nasal malignant melanoma was later confirmed by histopathology examination along with immunohistochemistry by using Melan A and S100. Malignant melanoma in the head and neck is rare and has a poor prognosis. There has been an increase in the incidence of 5% per year and mortality at 2% per year. This dictates malignant melanoma has rapidly increased compared to any other cancer except lung cancer in women and has contributed to the third highest number of deaths among all cancers. The mortality rate has also increased, and that is attributed to the negligence of symptoms during the initial period. This usually leads to patients seeking consultation during the advanced stage of the disease. In conclusion, this paper is to report that malignant melanoma may be one of the differentials of sino-nasal masses, and it may mimic nasopharyngeal carcinoma in its presentation.
文摘<strong>Background:</strong> Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high propensity to recur, local aggressive behavior and possibility of malignant transformation attract considerable interest. <strong>Objective:</strong> To assess the factors affecting Sino-nasal IP, malignant transformation rate, and post-operative recurrence rate. <strong>Methods:</strong> A retrospective study was carried out on all cases diagnosed as Sino-Nasal Papilloma between January 2010 and December 2020 at Salmaniya Medical Complex, Bahrain. Data gathered from medical records were analyzed using SPSS. A total of 49 Sino-Nasal Papilloma cases were recorded of which 37 were IP. Factors affecting Sino-Nasal IPs are presented. <strong>Results:</strong> Sino-Nasal IP was recorded in 37 cases, composed of 28 males and 9 females with first presentation average age of 45.86 years. These involved 20 cases in the left side, 14 in the right side and 3 were bilateral. Recurrence in males and females was found to be 35.7% and 33%, respectively, with an average of 12.6 months. The symptoms include nasal blockage (97.3%), epistaxis and postnasal drip (13.5% each), headache (8.1%) and hyposmia and rhinorrhea (5.4%, each). The main recurrence was at stage T2 (60.5%), while in smokers (26.7%) and non-smokers (50%). Malignant transformation occurred in one patient only (2.6%). <strong>Conclusion:</strong> IP is the most common type of SNP with male predominance. The recurrence rate is high with an average of a year and the malignant transformation occurred in 2.6 % of the cases.
文摘Background: Ethmoidal polyposis coexisting with adenoid enlargement and tympanic membrane perforation is a rare condition in otolaryngological practice. Evidences have shown that antrochoanal polyp often times coexists with adenoid enlargement especially in the young which was in sharp contrast to ethmoidal polyposis occurring in the presence of adenoid enlargement. Moreover, the hidden location of nasopharynx housing the adenoids, coupled with the masking effect of bilateral sinonasal polyps, leads to inadvertent misdiagnosis of this complex pathology with subsequent difficulty in providing effective management. Case Presentation: A 24 year-old lady presented with recurrent bilateral nasal obstruction that became persistent associated with nasal discharge and anosmia. She also had recurrent right otorrhoea with associated hearing loss. Diagnostic rigid nasal endoscopy revealed mucoid discharge with bilateral polypoid masses filling both nasal cavities. Otoendoscopic finding revealed a small (about 5%) central tympanic membrane perforation. A clinical assessment of chronic rhinosinusitis with nasal polyposis complicated by chronic suppurative otitis media (CSOM) was made. A non-contrast CT scan of the paranasal sinuses showed isodense lesions in the nasal cavities, all paranasal sinuses and the entire nasopharynx. She had endoscopic sinus surgery and a nasopharyngeal clearance biopsy. The nasal, paranasal and nasopharyngeal masses had histologic confirmation of inflammatory nasal polyps and lymphoid (adenoid) hyperplasia respectively. Her condition improved remarkably with subsequent medical treatment. She was followed up for 8 months and no recurrence was observed. Conclusion: Sinonasal polyposis can coexist with adenoid hypertrophy and middle ear disease as a single pathological condition. Hence, a high index of suspicion and thorough evaluation become necessary for making timely diagnoses and instituting effective management.
文摘Squamous papillomas are squamous-derived growths commonly arising from the oral cavity and oropharynx. A 75-year-old woman presented with chronic persistent left nasal obstruction and gradual painless non-axial proptosis with loss of vision in the left eye. Computed tomography scan showed an iso-dense lesion filling the frontal, left ethmoidal and sphenoidal sinuses, and the nasal cavity, with extension into the left orbit. She underwent surgical tumor resection with orbital exenteration and histology revealed features of an aggressive hyperkeratotic squamous papilloma arising from the sino-nasal region. Although squamous papillomas have been natively associated with the oral cavity and oropharynx, they present less frequently as sino-nasal tumors with orbital invasion.
文摘目的本研究旨对鼻骨骨折患者的症状及生活质量(quality of life,QOL)进行纵向随访,寻找各阶段最具困扰的问题,并分析影响因素。方法采用方便抽样,通过医学结局研究简表36项健康调查(SF-36)、鼻腔鼻窦结局测量20条(SNOT-20)和视觉模拟量表(VAS)对240例鼻骨骨折患者术前、术后1个月和术后3个月的生活质量进行纵向随访与分析。结果鼻骨骨折患者术后1个月较术前,SF-36中生理机能维度得分、SNOT-20总分与VAS量表中鼻出血、鼻部肿胀和鼻塞得分均出现明显好转(P<0.05),而VAS量表中鼻部伤口疼痛得分以及SF-36中生理职能、躯体疼痛、社会功能和情感职能维度的得分不及术前(P<0.05);患者术后3个月QOL才明显改善,各项指标较术前、术后1个月差异有统计学意义,但SNOT-20显示患者忧虑的得分仍相对较高;性别、年龄、目前居住情况以及疾病诊断与SNOT-20得分之间的相关性较强(P<0.05)。结论鼻骨骨折手术能改善患者的临床症状,但术后早期各项指标恢复缓慢,关注相关因素对SNOT-20得分的影响,能更好的为患者提供个性化的护理措施,提高生活质量。
文摘<strong>Background:</strong> Computed tomography (CT) Scan is the imaging of choice for the diagnosis of sino nasal (SN) pathologies in sub-Saharan African setting. However, it is often requested by non experienced practitioners. We aimed to describe the utility and the appropriateness of CT Scan request forms and results in the diagnosis of SN pathologies. <strong>Method:</strong> We conducted a retrospective cross-sectional study in four health facilities in Yaoundé, Cameroun, from October 2018 to September 2019. All patients to whom SN CT Scan was performed were called for an appointment. After informed consent, data on the appropriateness and conformity of the request form were collected and compared to the guidelines of the French society of radiology. CT Scan results were also collected and the quality of the report was evaluated. <strong>Results:</strong> A total of 206 SN CT Scan request forms and reports were included, with a mean patient age of 37.7 ± 16.1 years. The request form was conformed to guidelines in 8.3% of cases and was found appropriate in 62.6% of cases. No CT Scan report had all the items required, and 159 (77.2%) reports were useful. The most common diagnosis in patients with abnormal results was chronic sinusitis (49.5%) and SN polyp or polyposis (19.4%). <strong>Conclusion:</strong> Most of SN CT Scan requested were appropriate and useful. However, the conformity of request forms and reports to the guidelines is low. Suggesting the need for capacity building for the diagnosis of SN pathologies especially for non specialists like general practitioners and nurses.
文摘Schwannomas are benign neoplasms arising from Schwann cells of the peripheral,cranial and autonomic nerves.We report a case of schwannoma in the sino-nasal tract,a very rare site of tumour origin with unusual pseudoangiomatous histopathological changes,which we came across in a 22 years male with progressive nasal obstruction.
文摘Background:Inflammatory bowel disease(IBD)is characterized by chronic inflammation of the gastrointestinal tract.Extra-intestinal manifestations such as pulmonary diseases have been reported.Chronic rhinosinusitis(CRS),an inflammatory condition of the sinonasal mucosa,has been associated with several lung diseases.Given the relationship between lung and intestinal pathologies,and lung and sinus pathologies,we aimed to determine the prevalence of IBD among CRS patients.Methods:Pilot prevalence study.Ninety-two CRS patients were screened for IBD symptoms from October 2018 to January 2020.Patient-reported disease symptoms and overall quality of life were evaluated using the Sino-Nasal Outcome Test 22(SNOT-22),Short Inflammatory Bowel Disease Questionnaire(SIBDQ),and EuroQol 5 Dimension 5 Level(EQ-5D-5L)questionnaires.The Modified Lund-Kennedy(MLK)endoscopic and Lund-Mackay(LM)grading systems were used to confirm CRS diagnoses.Individuals who reported subjective symptoms of IBD were referred to a gastroenterologist clinic for further diagnostics.Results:Twenty of the 92(20.2%,95%CI:12.6%-29.8%)CRS patients reported symptoms of IBD and four individuals(4.26%,95%CI:1.17%-10.50%)were sub-sequently diagnosed with IBD.Compared to patients without IBD symptoms(n=72),those with symptoms(n=20)reported significantly worse SNOT-22(P=0.002),SIBDQ(P<0.05),and EQ-5D-3L(P=0.0063)scores.However,these patients did not exhibit significantly different MLK(P=0.81)or LM(P=0.04)scores.Conclusion:The prevalence of IBD may be elevated among individuals with CRS relative to the general Canadian population.This pilot study suggests that CRS with IBD is associated with lower quality of life.Further cross-sectional studies with larger sample sizes are required.
