ABSTRACT
Respiratory distress in a newborn can be due to various causes and some need active intervention. Choanal atresia (CA) is a rare congenital anomaly with its incidence estimated to be 1 case/5,000–8,000 births. It is characterized by narrowing or blockage of the nasal passages. It is important to make an early clinical diagnosis with emphasis on timely management as it can be life-threatening. The pediatrician may be not able to pass a feeding tube through the neonate’s nostril even on repeated attempts. Detailed evaluation should be performed for the CHARGE association. High-resolution computed tomography can aid the diagnosis and transnasal endoscopic surgery is the preferred treatment modality. Here is a case report of a term neonate born with severe respiratory distress who was diagnosed to have bilateral CA on evaluation and managed with nasal endoscopic surgery.
ABSTRACT
BACKGROUND AND OBJECTIVES: The purpose of this study was to review the clinical characteristics and treatment outcomes of benign and malignant nasal septal tumors. SUBJECTS AND METHODS: A total of 34 patients who underwent the treatment for nasal septal tumor between 2004 and 2015 were included in this study. Demographic characteristics, sinonasal chief complaints, size and localization of nasal septal tumor, imaging findings, surgical method, histopathologic results, treatment outcomes, and postoperative complications were reviewed. RESULTS: Of the 34 patients with nasal septal tumor used in this study, 22 (64.7%) had benign tumors and 12 (35.3%) had malignant tumors. The most common sinonasal complaint of both benign and malignant nasal septal tumors was nasal obstruction. The most common benign tumor was inverted papilloma (n=7), whereas the most common malignant tumors were malignant melanoma (n=2), plasmacytoma (n=2), and metastatic carcinoma (n=2). All patients except two cases underwent endoscopic tumor removal. There were 4 recurrences in malignant nasal septal tumors. There was no recurrence in benign tumors. No major complications resulting from surgical intervention were found. CONCLUSION: Endoscopic surgery with complete excision is a safe and effective procedure for benign nasal septal tumors. Recurrence is more common in malignant nasal septal tumor. Therefore, long term follow-ups with regular radiologic and endoscopic examinations are necessary for patients with malignant nasal septal tumor.
Subject(s)
Humans , Follow-Up Studies , Melanoma , Methods , Nasal Obstruction , Nasal Septum , Papilloma, Inverted , Plasmacytoma , Postoperative Complications , Radiotherapy , RecurrenceABSTRACT
Actinomycosis is a rare anaerobic, gram-positive bacterial infection caused by Actinomyces, which is a normal flora in the gastrointestinal and female genitourinary tracts. The cervicofacial area is a common infection site for actinomycosis, while nasal cavity is rare. Generally, standard treatment of the disease is a long term antibiotics therapy. However, a treatment strategy for nasal actinomycosis has not been established due to its rarity. We present a case of nasal actinomycosis that was managed by surgical removal. A 49-year-old woman visited our clinic with epistaxis and foul odor and nasoendoscopy showed a mass in patient's right nasal cavity. The mass comprised of Actinomyces was easily removed by endoscopic surgery. Further histopathologic examination revealed that the surrounding tissues did not contain Actinomyces, so we stopped applying antibiotics to the patients. No recurrence has been observed for 26 months. We report this rare case of nasal actinomycosis with a literature review regarding treatment.
Subject(s)
Female , Humans , Middle Aged , Actinomyces , Actinomycosis , Anti-Bacterial Agents , Epistaxis , Gram-Positive Bacterial Infections , Nasal Cavity , Odorants , Patient Rights , RecurrenceABSTRACT
Objective To study and observe the effect of transnasal endoscopic surgery in the treatment of patients with fungal paranasal sinusitis.Methods A total of 82 cases of patients with fungal paranasal sinusitis were collected and divided into the control group (40 cases) and the observation group (40 cases) according to the principles of random,single blind and parallel control design,the patients in the control group received conventional surgical treatment,and the patients in the observation group received transnasal endoscopic surgical treatment,the two groups were observed and compared in terms of treatment efficiency,sinus cavity scores in the lesion range,average operation time,postoperative complication rate and patients' satisfaction degree.Results The effective rate in treatment group was 94.6％,significantly higher than that of control group (80.0％);the lesions sinus cavity score was 0 points in observation group,significantly lower than the control group (13.1 ± 1.9),the average operation time was (45.4 ± 10.9) min in the observation group,significantly shorter in the control group (76.3 ± 10.5) min;the postoperative complication rate was 3.2％ in the observation group,which was significantly lower than that of 25.6％ in the control group (P＜0.05).Conclusion The transnasal endoscopic surgery in the treatment of patients with fungal paranasal sinusitis can effectively improve the treatment efficiency,remove the mold lesions in the sinuses of patients,shorten the operation time and reduce the postoperative complication rate,and is conducive to promoting the rehabilitation of patients and improving the quality of life of patients,thus it is worth popularization and application.
ABSTRACT
Analizamos los detalles de la técnica descripta por Ajler, Pablo y col. en el trabajo Cirugía trans nasal endoscópica para la resección de tumores de hipófisis (RANC 2012, 26: 105- 110). Los autores aquilataron una notable casuística en un corto tiempo. Opinamos que el uso de la posición semisentado, el punto esfeno selar, la conducta sistemática respecto del cornete medio, la escasa exposición del seno esfeno etmoidal, la apertura estrecha de la pared anterior del seno, la identificación poco precisa de las estructuras desde la cavidad del seno, la apertura escasa del piso selar y el no aprovechamiento del trabajo multidisciplinario, podrían conspirar contra una mejoría de los excelentes resultados que los autores seguramente poseen con el uso de la clásica técnica microquirúrgica.
We analyze the details of the technique described by Pablo Ajler et al. in the paper Endoscopic transnasal surgery forthe resection of pituitary tumors (RANC 2012, 26: 105-110). The authors present an impressive casuistic harvested ina brief time. Our opinion is that the adoption of the semi sitting position, the spheno-sellar point, the systematic policywith the medium turbinate, the scanty exposition of the spheno-ethmoidal sinus, the narrow opening of the anterior wallof the sphenoid sinus, the rather imprecise recognition of the of the structures displayed at the cavity of the sphenoidsinus, the narrow opening of the sellar floor and the non-multidisciplinary work could conspire against a significantimprovement vs. the excellent results the authors surely have by the use of the classic microsurgical technique.
Subject(s)
Humans , Endoscopy , General Surgery , Pituitary NeoplasmsABSTRACT
Craniopharyngiomas are rare benign tumors originated from epithelial remnants of Rathkes pouch. Its localization may cause endocrine and visual disturbances. We present a case of a 49 year old male patient referred to our Institution for management of a large supraselar Craniopharyngioma. Surgical management was performed by the Skull Base team of the San Ignacio University Hospital (Neurosurgery and Otolaryngology) using a totally Endoscopic four hands technique through a Trans Selar approach.
Los craneofaringiomas son tumores benignos poco frecuentes, originados de restos epiteliales de la bolsa de Rathke, que por su localización puede producir alteraciones visuales y endocrinas. Presentamos el caso de un paciente masculino de 49 años de edad que nos fue referido a nuestra institución para manejar un gran craneofaringioma supraselar. El manejo quirúrgico se llevó a cabo por el Grupo de Cirugía Endoscópica de Base de Cráneo del Hospital Universitario San Ignacio (Neurocirugía - Otorrinolaringología), utilizando una técnica totalmente endoscópica a cuatro manos, a través de un abordaje Trans Selar. Se presenta este caso clínico para demostrar la técnica endoscópica transnasal que actualmente utilizamos para el manejo de los tumores de hipófisis, haciendo énfasis en las ventajas que ofrece estatécnica.