nasal

  • 文章类型: Journal Article
    多种疾病可影响鼻前庭。由于鼻前庭的解剖特征,诊断和治疗鼻前庭肿瘤可能具有挑战性。神经鞘瘤是来源于神经鞘的许旺细胞的肿瘤。不到4%的肿瘤侵入鼻腔和鼻窦。鼻前庭神经鞘瘤很少见,当发现一个质量时,它经常被忽略。其诊断主要依据临床症状,鼻内窥镜检查,和成像,治疗的主要方法是完全切除手术。病理检查提供最终诊断。我们介绍了一名鼻前庭神经鞘瘤患者,该患者接受了成功的内窥镜手术,没有美容畸形,并讨论临床表现,组织学特征,成像特征,鉴别诊断,治疗方案,然后回顾了这种罕见良性病变的相关文献。
    A variety of diseases can affect the nasal vestibule. It might be challenging to diagnose and treat a nasal vestibular tumor due to the anatomical characteristics of the nasal vestibule. Neurilemmoma is a tumor derived from Schwann cells of the nerve sheath. Less than 4% of these tumors invade the nasal cavity and sinuses. Nasal vestibule neurilemmoma is rare, it is often overlooked when a mass discovered. The diagnosis of it is mainly based on clinical symptoms, nasal endoscopy, and imaging, The mainstay of treatment is complete resection surgery. Pathological examination provides the final diagnosis. We present a patient with nasal vestibule neurilemmoma who underwent a successful endoscopic surgery without cosmetic deformity, and discuss the clinical manifestations, histological features, imaging features, differential diagnosis, treatment options, then reviewed relevant literature of this rare benign lesion.
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  • 文章类型: Case Reports
    鼻中隔脓肿(NSA)被认为是鼻急症。幸运的是,由于引入了抗生素和易于获得医疗护理,NSA的发病率显着降低。NSA通常是由鼻中隔和上覆的粘液膜和/或粘液膜骨膜之间的空间感染引起的。通常继发于鼻中隔血肿,但也可能是特发性的.及时的诊断和干预对于避免进一步的并发症至关重要。本文报道了一名46岁的男性,没有已知的NSA危险因素。他接受了广谱抗生素治疗,手术治疗包括切开引流,并在术后第5天在术中放置Penrose引流管和硅橡胶片。患者出院,无鼻中隔穿孔、鞍状鼻畸形等并发症。
    Nasal septal abscess (NSA) is considered a rhinologic emergency. Fortunately, the incidence of NSA has markedly reduced due to the introduction of antibiotics and easy access to medical care. NSA commonly results from infection in the space between the nasal septum and the overlying mucoperichondrium and/or mucoperiosteum, typically secondary to nasal septal hematoma, but it can also be idiopathic. Prompt diagnosis and intervention are critical to avoid further complications. This paper reports the case of a 46-year-old man with no known risk factors for NSA. He was treated with broad-spectrum antibiotics, and the surgical treatment involved incision and drainage with the intraoperative placement of a Penrose drain and a silastic sheet on postoperative day five. The patient was discharged without complications such as septal perforation or saddle nose deformity.
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  • 文章类型: Case Reports
    目的:描述临床表现,新颖的手术方法,和诊断为软骨骨呼吸道上皮腺瘤样错构瘤(COREAH)的狗的结果。
    方法:5岁阉割雄性约克郡梗。
    这只狗出现了慢性上呼吸道噪音,拥塞,面部肿胀,眼放电,还有鼻梁上的脓肿.间隔4个月进行两次CT扫描。CT扫描产生了类似的结果:囊肿样鼻腔肿块伴严重破坏性的双侧鼻炎,并伴有广泛的多发性骨溶解。进行鼻背切开术,鼻甲切除术和鼻腔清创术。发现一个定义不清但广泛的病变占据了整个左额窦和鼻腔。
    结果:组织病理学显示肿块与COREAH一致。这只狗从手术中恢复得很好,除了自限性皮下气肿,据报道,术后3周表现良好,有轻微的鼻腔分泌物.斯特雷多,鼻腔分泌物,术后报告打喷嚏发作;然而,这些都得到了改进。术后18个月,这只狗在另一家医院因疑似急性出血性腹泻综合征住院时,死于不受控制的癫痫发作。
    结论:COREAH应该被认为是狗的破坏性双侧鼻炎和骨溶解的潜在原因。鼻背切开术可以是可能的COREAH犬的手术治疗,结果可以接受。虽然临床症状可能无法完全缓解。这是COREAH在狗中的第一个临床描述。
    OBJECTIVE: To describe the clinical presentation, novel surgical approach, and outcome of a dog diagnosed with chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH).
    METHODS: 5-year-old castrated male Yorkshire Terrier.
    UNASSIGNED: The dog was presented with chronic upper respiratory noise, congestion, facial swelling, ocular discharge, and an abscess on the nasal bridge. Two CT scans were performed 4 months apart. The CT scans yielded similar results: cyst-like nasal masses with severely destructive bilateral rhinitis with extensive polyostotic bony lysis. A dorsal rhinotomy with a turbinectomy and debridement of the nasal cavity were performed. A poorly defined but extensive lesion was found occupying the entirety of the left frontal sinus as well as the nasal cavity.
    RESULTS: Histopathology revealed a mass consistent with COREAH. The dog recovered well from surgery, except for self-limiting subcutaneous emphysema, and 3 weeks postoperatively was reportedly doing well, with mild nasal discharge. Stridor, nasal discharge, and sneezing episodes were reported postoperatively; however, these were improved. At 18 months postoperatively, the dog died from uncontrolled seizures while hospitalized for suspected acute hemorrhagic diarrhea syndrome at a different hospital.
    CONCLUSIONS: COREAH should be considered a potential cause of destructive bilateral rhinitis and bony lysis in dogs. Dorsal rhinotomy can be a surgical treatment for dogs with possible COREAH with acceptable outcome, though complete remission of clinical signs may not be achieved. This is the first clinical description of COREAH in a dog.
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  • 文章类型: Case Reports
    异位甲状腺癌常发生在颈部,鼻腔和鼻窦的转移性癌极为罕见。
    方法:一名11岁的女性因没有明显原因的鼻痛和鼻子中的血液而入院一周。手术期间在右鼻中隔后端看到浅红色肿块,有花梗。免疫组织化学显示低度甲状腺乳头状癌。
    外科医生应警惕异位甲状腺组织和相关疾病的可能性,疑似恶性病变的患者应进行常规病理检查,即使是正常的甲状腺,也应该检查恶性变化,以避免负面结果。
    结论:尽管鼻内镜手术已经成熟,对于性质不明确的肿瘤,仍然有必要进行常规病理检查,以避免习惯性错误。
    UNASSIGNED: Ectopic thyroid carcinoma often occurs in the neck, and metastatic carcinoma of the nasal cavity and sinuses is extremely rare.
    METHODS: An 11-year-old female was admitted to the hospital for one week due to nasal pain without an obvious cause and blood in the nose. A pale red mass with a peduncle at the back end of the right nasal septum was seen during the operation. Immunohistochemistry showed low-grade papillary thyroid carcinoma.
    UNASSIGNED: Surgeons should be alert to the possibility of ectopic thyroid tissue and related diseases, Patients with suspected malignant lesions should undergo routine pathological examination, and even a normal thyroid should be checked for malignant changes to avoid negative outcomes.
    CONCLUSIONS: Although nasal endoscopic surgery is mature, for tumors with unclear properties, it is still necessary to undergo routine pathological examination to avoid habitual errors.
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  • 文章类型: Case Reports
    血友病性假瘤是一种罕见的,然而血友病的危险并发症。以前已经报道过在容易发生复发性创伤的部位,如长骨和骨盆。然而,在耳鼻咽喉科领域,报告的病例很少,因此没有既定的管理方案。我们特此报告一个2岁男孩的案例,已知的血友病A(VIII因子缺乏症),出现复发性鼻出血的患者对医疗管理没有反应。进行了成像,发现一个非均质的鼻腔肿块压迫了左眶壁,延伸到蝶窦,导致颅底侵蚀.通过内镜经鼻入路和手术前后替换因子VII,成功地对患者进行了清除和引流。据我们所知,这是第一例经鼻内镜引流和引流治疗的鼻腔血友性假瘤,这被认为是成功的。
    Hemophilic pseudotumor is a rare, yet dangerous complication of hemophilia. It has been reported previously at sites prone to recurrent trauma like long bones and pelvis. However, in the field of otorhinolaryngology, few cases are reported and therefore there is no established protocol for management. We hereby report a case of a 2-year-old boy, a known case of hemophilia A (factor VIII deficiency), who presented with recurrent epistaxis not responding to medical management. Imaging was done and revealed a heterogenous nasal mass compressing the left orbital wall, extending to the sphenoid sinus, and causing skull base erosion. The patient was successfully managed by evacuation and drainage of the pseudotumor via endoscopic endonasal approach and replacement of factor VII pre-and post-operatively. To our knowledge, this is the first case of nasal hemophilic pseudotumor managed by evacuation and drainage through an endoscopic endonasal approach, which was deemed successful.
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  • 文章类型: Journal Article
    背景:使用同种异体和同种异体鼻植入物在鼻整形中广泛流行。然而,这些材料的使用伴随着感染和挤压的风险。传统上,这些并发症的管理是以双阶段的方式进行的.首先,移除植入物并控制感染,然后执行延迟重建。然而,瘢痕和软组织挛缩使延迟重建具有挑战性,和最佳的审美结果是很难实现的。这项研究旨在评估移除受感染的鼻植入物后立即进行鼻重建的结果。
    方法:回顾性分析了所有感染鼻植入物并同时切除和立即用自体软骨重建鼻的患者(n=8)。收集的数据包括患者年龄,种族,术前演示,术中手术操作,以及术后结果和并发症。术后结果用于衡量单阶段方法的成功。
    结果:随访时间为12至156个月,研究中评估的8名患者平均为84.4个月,没有任何需要翻修或重建的重大术后并发症.所有患者的鼻腔形态和功能均有明显改善。八名患者中有六名(75%)报告了出色的美学结果;两名(25%)出于美学考虑要求进行修正手术。
    结论:在去除感染的鼻植入物后立即进行自体重建时,低并发症发生率和良好的美学效果是可能的。这是一种替代方法,可以避免传统延迟重建的固有问题。
    方法:本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述,请参阅目录或在线作者说明www。springer.com/00266..
    BACKGROUND: The use of alloplastic and allogenic nasal implants is widely popular in rhinoplasty. However, the use of these materials is accompanied by a risk of infection and extrusion. Traditionally, management of these complications is performed in a dual-staged fashion. First, the implant is removed and infection is controlled, then a delayed reconstruction is performed. However, scarring and soft tissue contracture make a delayed reconstruction challenging, and optimal aesthetic outcomes are difficult to achieve. This study was designed to evaluate the outcomes of immediate nasal reconstruction following removal of an infected nasal implant.
    METHODS: A retrospective chart review was performed of all patients who had infected nasal implants and underwent simultaneous removal and immediate nasal reconstruction with autologous cartilages (n = 8). Data collected included patient age, race, pre-operative presentation, intraoperative surgical maneuvers, and post-operative outcomes and complications. Post-operative results were used to measure success of the single-staged method.
    RESULTS: Follow-up ranged from 12 to 156 months with mean 84.4 months of the eight patients who were evaluated in the study, none had any major post-operative complications that required revision or reconstruction. All of the patients had marked improvement in nasal form and function. Six of the eight (75%) patients reported excellent aesthetic outcomes; two (25%) requested revisional surgeries for aesthetic concerns.
    CONCLUSIONS: Low complication rates and excellent aesthetic outcomes are possible in immediate autologous reconstruction following removal of an infected nasal implant. This is an alternative approach that obviates the inherent problems of a traditional delayed reconstruction.
    METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 ..
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  • 文章类型: Case Reports
    我们正在报告一例COVID-19相关的坏死性鼻溃疡。经过一轮完整的调查后,所有其他常见病因均被排除在外。尽管已知COVID-19通过不同的机制引起皮肤溃疡,这是目前文献中首次报道的鼻溃疡。
    We are reporting a case of a COVID-19-related necrotic nasal ulcer. All other common etiologies were excluded after a full round of investigations. Even though COVID-19 has been known to cause skin ulcers via different mechanisms, this is the first nasal ulcer to be reported in the current literature.
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  • 文章类型: Case Reports
    背景:小叶毛细血管瘤是快速生长的良性血管病变,具有独特的组织病理学特征。头颈部是小叶毛细血管瘤的常见部位。然而,这种病变在鼻腔中的存在是罕见的。尽管文献中已经确定了几个促成因素,确切的病理生理学尚未得到很好的理解。诱发因素包括鼻外伤,怀孕,以及避孕药的使用。因此,这种疾病在女性中更为普遍,在儿科患者中具有可变的峰值发生率。单侧鼻塞和复发性鼻出血是鼻小叶毛细血管瘤最常见的症状。大型病变通常需要使用对比增强计算机断层扫描和磁共振成像进行放射学评估。
    方法:我们介绍了一名30岁的女性,她在耳鼻喉科就诊,主诉为左侧鼻塞和鼻出血两个月,并伴有左侧面部疼痛和头痛。她没有诱发风险因素。CT和MRI成像显示左鼻腔有大量血管肿块。先进行手术切除,然后进行术前栓塞。
    结论:鼻内镜切除是治疗的标准方法。虽然一些作者认为不需要术前栓塞,其他人主张使用它。根据文献,复发率是可变的。
    结论:我们认为术前栓塞治疗大型鼻小叶毛细血管瘤会影响围手术期的发病率。
    BACKGROUND: Lobular capillary hemangiomas are fast-growing benign vascular lesions with distinctive histopathological characteristics. The head and neck region is a common location for lobular capillary hemangiomas. However, the presence of such lesions in the nasal cavity is rare. Although several contributing factors have been identified in literature, the exact pathophysiology is not yet well understood. Predisposing factors include nasal trauma, pregnancy, and the use of contraceptive pills. Thus, the disease is more prevalent in females, with variable peak incidence in pediatric patients. Unilateral nasal obstruction and recurrent epistaxis are the most common symptoms of nasal lobular capillary hemangiomas. Radiological evaluation using contrast-enhanced computed tomography and magnetic resonance imaging is often required for large lesions.
    METHODS: We present a 30-year old female who presented to ENT clinics with two month complaint of left-sided nasal obstruction and epistaxis with left facial pain and headache. She had no predisposing risk factors. Imaging with CT and MRI revealed a large hypervascular mass in left nasal cavity. Surgical excision preceded by pre-operative embolization was done.
    CONCLUSIONS: Endoscopic endonasal excision is the standard of treatment. While some authors believe that pre-operative embolization is not required, others advocate its use. Based on literature, recurrence rate is variable.
    CONCLUSIONS: We believe that use of pre-operative embolization for large nasal lobular capillary hemangioma would have an impact on perioperative morbidity.
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  • 文章类型: Case Reports
    创伤性神经瘤发生在周围神经的损伤部位;然而,虽然很少,这种神经瘤的变体可能涉及未经历穿透性创伤的神经。下肢截肢残端是创伤性神经瘤最常见的位置。外伤性神经瘤可能是有症状的;肿瘤相关疼痛可能是严重的,并显著影响患者的生活质量。关于神经瘤相关疼痛的发病机理,已经提出了几个假设。包括α-平滑肌肌动蛋白,神经纤维结构变化,神经生长因子,和/或受累神经的致敏。除了预防,非手术治疗(如化学干预,冷冻疗法,神经调节,药物,和物理治疗)和手术干预(例如在神经瘤近端神经损伤或结扎时进行直接神经修复,以及各种潜在的方法,以最大程度地减少对近端神经远端自由端的后续刺激)已用于管理与神经瘤相关的疼痛。鼻子的创伤性神经瘤是罕见的。的确,仅在三个人中进行了描述:两名妇女(包括本报告中的白人妇女和一名土耳其妇女)和一名男子。良性肿瘤在两名妇女中都非常痛苦;然而,该男子的病变没有触痛。鼻腔部位的先前创伤包括裂伤或择期手术;然而,据报道,这名妇女的鼻子没有任何穿透性损伤。诊断是在切除后确定的(对于该男子),切口(对于土耳其妇女),或打孔(对白人妇女)活检。对其中两名患者进行了随访。这个人的神经瘤被完全切除了,他从未出现过肿瘤相关的压痛.然而,对于未完全切除神经瘤的报告女性,活检愈合后疼痛持续.报告的患者与病变相关的压痛具有爆炸性和明显的严重特征,促使我们提出了这种罕见但非常痛苦的神经瘤变体的首字母缩写:鼻外伤性(TNT)神经瘤。
    A traumatic neuroma occurs at the injury site of a peripheral nerve; however, albeit rarely, this variant of a neuroma can involve a nerve that has not experienced penetrating trauma. A lower extremity amputation stump is the most common location of a traumatic neuroma. Traumatic neuromas may be symptomatic; tumor-associated pain can be severe and significantly affect the patient\'s quality of life. Several hypotheses have been postulated for the pathogenesis of neuroma-related pain, including alpha-smooth muscle actin, neural fiber structural changes, nerve growth factor, and/or sensitization of the affected nerve. In addition to prevention, non-surgical treatment (such as chemical interventions, cryotherapy, neuromodulation, pharmacologic agents, and physiotherapy) and surgical interventions (such as direct nerve repair at the time of injury or ligation of the nerve proximal to the neuroma and various potential methods to minimize subsequent irritation of the distal free end of the proximal nerve) have been used to manage neuroma-associated pain. A traumatic neuroma of the nose is rare. Indeed, it has only been described in three individuals: two women (including the Caucasian woman in this report and a Turkish woman) and one man. The benign tumor was extremely painful in both women; however, the man\'s lesion was non-tender. Prior trauma to the nasal site included either a laceration or elective surgery; however, the reported woman did not experience any penetrating trauma to her nose. The diagnosis was established following an excisional (for the man), incisional (for the Turkish woman), or punch (for the Caucasian woman) biopsy. Follow-up was provided for two of the patients. The man\'s neuroma had been completely excised, and he never developed tumor-associated tenderness. However, the pain persisted after the biopsy healed for the reported woman whose neuroma was not entirely removed. The explosive and markedly severe character of the reported patient\'s lesion-related tenderness prompted us to propose an acronym for this uncommon yet exquisitely painful variant of a neuroma: tender nasal traumatic (TNT) neuroma.
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  • 文章类型: Journal Article
    提供的病例报告是一名22岁的女性,其右鼻腔内有未诊断的鼻异物(NFB)18年。其他医疗保健专家先前的体格检查和前鼻镜检查未能检测到NFB。她被许多耳鼻喉科专家保守治疗为鼻窦炎,使用抗生素治疗和抗过敏药物治疗多年,但没有改善。由于持续的鼻窦症状未通过保守治疗缓解,因此完成了鼻旁窦计算机断层扫描(CT)扫描的进一步调查,从而确定了NFB。在全身麻醉下,借助鼻内镜手术成功切除NFB。NFB被诊断为一块钙化的外部棉花植被。该病例强调了对持续性症状进行全面调查的重要性,包括使用非对比螺旋CT成像。除了扩大体格检查,临床和病理实验室检查。
    The case report presented is a 22-year-old female with an undiagnosed nasal foreign body (NFB) in her right nasal cavity for 18 years. Previous physical examination and anterior rhinoscopy by other health care specialists failed to detect the NFB. She was treated conservatively by many ENT specialists as sinusitis with antibiotics therapy and anti-allergy drugs for many years with no improvement. Due to persistent sinus symptoms unrelieved by conservative treatment further investigation with a paranasal sinus computed tomography (CT) scan was completed that identified the NFB. The NFB was successfully removed surgically with the aid of nasal endoscopy under general anesthesia. The NFB was diagnosed as a piece of calcified externally cotton vegetation. This case highlighted the importance of complete investigation of persistent symptoms including imaging with a non-contrast spiral CT, in addition to a dilated physical examination, clinical and pathologic lab exam.
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