Foliculitis pseudolinfomatosa de McNutt (localización nasal) / McNutt's pseudolymphomatous folliculitis (nasal located)

La foliculitis pseudolinfomatosa, descripta por McNutt en 1986, es una afección de etiología desconocida y poco frecuente, que simula un linfoma cutáneo tanto por su clínica como por su histología. Se presenta como una lesión nodular solitaria, eritematosa, de 0,5 hasta 3cm, de crecimiento rápido, sobre todo en la cara, en personas de 40 a 60 años, con una histopatología caracterizada por un infiltrado linfocitario B yT perifocular, y células dendríticas positivas en la inmunohistoquímica para S100yCD1a. Su curso es benigno, muchas veces autolimitado. Se expone el caso de una paciente con una particular forma clínica de pseudolinforma.

Pseudolymphomatous folliculitis, described by McNutt in 1986, is a non-frequent entity of unknown etiology that simulates a cutaneous lymphoma, both clinically and histologically. It shows as a solitary erythematous nodular lesion of 0.5 to 3 cm, with a rapid growth, mainly on the face, in people aged 40 to 60 years, and histopathology characterized by a perifollicular B and T lymphocytic infiltrate, and positive dendritic cells for immunohistochemistry S100 and CD1a. Its course is benign, often self-limited. The case of a patient with a particular clinical form of pseudolymphoma is presented.

Tratamento cirúrgico de hemangioma infantil nasal e labial na fase involuída: relato de caso / Surgical treatment of infantile nasal and labial hemangioma in the involuted phase: a case report

Hemangioma infantil (HI) é o tumor vascular mais comum e a neoplasia benigna mais frequente da infância, com maior incidência no sexo feminino e na população branca. Quase 60% dos casos ocorrem em cabeça e pescoço, sendo o tratamento ativo durante a fase proliferativa mais frequentemente indicado, em decorrência dos possíveis problemas funcionais e do potencial desfigurante. Relatamos um caso de paciente com hemangioma infantil involuído de ponta nasal e lábio superior, tratado de forma expectante durante a infância, submetida à correção da deformidade residual com técnicas de rinoplastia, associado à zetaplastia e lipoenxertia do lábio superior com bom resultado e satisfação do paciente.

Infantile hemangioma (IH) is the most common vascular tumor and the most frequent benign neoplasm in childhood, with the highest incidence in females and the white population. Almost 60% of cases occur in the head and neck, and active treatment during the proliferative phase is the most frequently indicated, due to possible functional problems and disfiguring potential. We report a case of a patient with involute infantile hemangioma of the nasal tip and upper lip, treated expectantly during childhood, submitted to residual deformity correction with rhinoplasty techniques, associated with zetaplasty and upper lip grafting with good results and patient satisfaction.

Pemphigus vegetans with isolated involvement of the nose and chest: rare variant of pemphigus vulgaris

Abstract: Pemphigus vulgaris is chronic bullous disease that manifests as bullae and erosions of skin and mucosas, with intraepidermal suprabasal cleft formation seen in the histological examination. It has a rare variant called pemphigus vegetans, where vesicles and bullae are replaced by pustular, verrucous and hyperpigmented lesions, mainly in skin folds. The treatment is similar to that for classic pemphigus vulgaris. The authors present an exuberant case of pemphigus vegetans, covering the nose and chest exclusively, without oral or flexural lesions.

Assessment of nasopharyngeal airway volume in pediatric patients with adenoid hypertrophy by cone-beam computerized tomography / Volumen de la vía aérea nasofaríngea en pacientes pediátricos con hipertrofia adenoidea: evaluación por tomografía computarizada de haz cónico

Objective: Adenoid hypertrophy is a disease whose most serious effect is the obstruction of the nasopharyngeal airway, leading to severe dentoskeletal deformities. The aim of this study was to determine the volume of the nasopharynx in patients with different grades of adenoid hypertrophy. Materials and methods: A retrospective study was conducted. One hundred and twenty-five cone beam computed tomographies of 8 to 12-year-old pediatric patients, obtained from the 2014-2017 database of the School of Dentistry of Universidad de San Martin de Porres, were selected. Romexis 3.6.0 software (PlanMeca®, Finland) was used. In order to make a diagnosis and determine the grade of hypertrophy (Grade 1= healthy, Grade 2= mild, Grade 3= moderate and Grade 4= severe) quantitative and qualitative methods were used; grades 2, 3 and 4 were considered pathological. The same software was used to determine the volume of the nasopharynx. Results: Grade 1 hypertrophy was 44%, mild 36,8%, moderate 13,6% and severe 5,6%, accounting for a pathological adenoid hypertrophy prevalence of 56%. The mean volume of the nasopharynx was 4.985, 3.375, 2.154 and 0.944cm3 for grades 1, 2, 3 and 4, respectively. Conclusions: There is a high prevalence of pathological adenoid hypertrophy (56%). The volume of the nasopharynx decreases according to the severity of the adenoid hypertrophy.

Objetivo: La hipertrofia adenoidea es una patología cuya repercusión más severa es la obstrucción de la vía aérea nasofaríngea, con graves consecuencias de malformaciones dento-esqueléticas. El objetivo del estudio fue determinar el volumen de la vía aérea nasofaríngea en pacientes con diferentes grados de hipertrofia adenoidea. Material y método: Se realizó un estudio retrospectivo, se seleccionaron 125 tomografías computarizadas de haz cónico de pacientes pediátricos de 8 a 12 años de edad obtenidas en la base de datos del 2014 al 2017 de la Facultad de Odontología de la Universidad de San Martín de Porres. Se utilizó el software Romexis 3.6.0 (PlanMeca®, Finlandia); para realizar el diagnóstico y determinar el grado de hipertrofia (Grado 1= sano, Grado 2=leve, Grado 3=moderado y Grado 4= severo) se utilizaron dos métodos, uno de evaluación cualitativa y otra cuantitativa; los grados 2, 3 y 4 fueron considerados como patológicos; para determinar el volumen de la vía aérea nasofaríngea se utilizaron las herramientas del mismo software. Resultados: La hipertrofia grado 1 estuvo constituida por el 44%, leve en el 36.8%, moderado en el 13.6% y severo en el 5.6%; constituyendo finalmente una prevalencia de hipertrofia adenoidea patológica del 56%. Las medias de los volúmenes de la vía aérea nasofaríngea fueron de 4.985, 3.375, 2.154 y 0.944 cm3 para los grados 1, 2, 3 y 4 respectivamente. Conclusión: Existe una alta prevalencia de hipertrofia adenoidea patológica (56%), el volumen de la vía aérea nasofaríngea tiende a disminuir conforme a la severidad de la hipertrofia adenoidea.

Reacción granulomatosa a cuerpo extraño en punta y dorso nasal por materiales de relleno: presentación de un caso clínico y revisión de la literatura / Granulomatous foreign body reaction in tip and nasal dorsum due to filling materials: presentation of a clinical case and review of the literature

RESUMEN Paciente de 29 años con antecedente de tres rinomodelaciones en la punta nasal con ácido hialurónico hace cinco años, evaluada por deseo de mejora estética nasal y obstrucción nasal. Al examen visual se observó una leve giba osteocartilaginosa, punta bulbosa, narinas simétricas, sin laterorrinea, no se palparon masas ni nodulaciones. Posterior al manejo de su rinitis y previo consentimiento informado, al realizar rinoseptoplastía abierta se encontró gran cantidad de tejido granulatorio tipo cuerpo extraño en la punta y dorso nasal lo que obligó a cambiar el plan quirúrgico. La biopsia diferida confirmó granuloma por cuerpo extraño por biopolímero derivado de la silicona. Evolucionó satisfactoriamente estética y funcionalmente. La rinomodelación ha aumentado en los últimos años, aunque no existen rellenos faciales aprobados por la FDA para uso nasal. La correcta utilización de los rellenos nasales continúa siendo un tema controvertido. Los granulomas nasales por cuerpo extraño son complicaciones tardías que se han incrementado con el uso de biopolímeros con dosis y técnicas inadecuadas. El uso de ecotomografía ha contribuido a mejorar la planificación quirúrgica, así como el estudio histológico diferido ha permitido identificar el material utilizado en la mayoría de los casos convirtiéndose en el estándar de oro.

ABSTRACT A 29-year-old patient with a history of three nasal fillings in the nasal tip with hyaluronic acid five years ago, reason for consultation improvement nasal aesthetics and nasal obstruction. Physical examination showed a slight osteocartilaginous hump, bulbous tip, symmetrical nostrils, no deviation nasal pyramid, no masses or nodules were palpated. After the management of his rhinitis and previous informed consent, when performing open rhinoseptoplasty, a large amount of foreign body type granulation tissue was found in the tip and nasal dorsum, which forced the surgical plan to change. The post-surgical biopsy showed foreign body granuloma by biopolymer derived from silicone. Evolved satisfactorily aesthetically and functionally. The use of nasal fillers has increased in recent years, although there are no facial fillers approved by the FDA for nasal use. The correct use of nasal fillers is a controversial issue. Nasal granulomas by foreign body are late complications that have increased with the use of biopolymers with inadequate doses and techniques. The use of ecotomography has contributed to improve the surgical planning; the deferred histological study has allowed to identify the material used in most cases becoming the gold standard

Tumores nasales congénitos de la linea media / Congenital nasal tumors of the midline in ENT

Las masas nasales congénitas de la línea media se presentan con una frecuencia muy baja ­1/20.000 a 1/40.000 nacidos vivos­. Se trata de hallazgos asintomáticos en el recién nacido y son resultado de anomalías congénitas del desarrollo embrionario, que suelen aparecer como masas en la línea media nasal en un punto cualquiera entre glabela y columela. Estas tumoraciones presentan un riesgo elevado de extensión al sistema nervioso central, lo que es especialmente importante tener en cuenta para prevenir consecuencias tales como la fístula de líquido cefalorraquídeo y/o la aparición de meningitis recidivante. Existen gran cantidad de tumores nasales de la línea media que aparecen en el recién nacido o en el lactante y que constituyen diagnósticos diferenciales de las lesiones congénitas antes descriptas. Describiremos brevemente los más frecuentes según nuestra experiencia. AU

Congenital nasal masses of the midline are very rare ­ 1/20,000 to 1/40,000 live births ­. Nasal tumors are asymptomatic findings in the neonate and are caused by congenital abnormalities during fetal development, usually appearing at the nasal midline between the glabella and columella. These tumors are associated with a high risk of extension to the central nervous system; therefore, it is especially important to prevent the development of a cerebrospinal fluid fistula and/or recurrent meningitis. There is a large number of nasal tumors of the midline in neonates or infants in the differential diagnosis of the above-described congenital lesion. Here we briefly describe the most common nasal tumors seen at our department. AU

Squamoid eccrine ductal carcinoma

Abstract Squamoid eccrine ductal carcinoma is an eccrine carcinoma subtype, and only twelve cases have been reported until now. It is a rare tumor and its histopathological diagnosis is difficult. Almost half of patients are misdiagnosed as squamous cell carcinoma by the incisional biopsy. We report the thirteenth case of squamoid eccrine ductal carcinoma. Female patient, 72 years old, in the last 6 months presenting erythematous, keratotic and ulcerated papules on the nose. The incisional biopsy diagnosed squamoid eccrine ductal carcinoma. After excision, histopathology revealed positive margins. A wideningmargins surgery and grafting were performed, which again resulted in positive margins. The patient was then referred for radiotherapy. After 25 sessions, the injury reappeared. After another surgery, although the intraoperative biopsy showed free surgical margins, the product of resection revealed persistent lesion. Distinction between squamoid eccrine ductal carcinoma and squamous cell carcinoma is important because of the more aggressive nature of the first, which requires wider margins surgery to avoid recurrence.

Reconstrução de dorso nasal: relato de caso / Reconstruction of the nasal dorsum: a case report

INTRODUÇÃO: O dorso nasal é um local comum para o desenvolvimento de neoplasias cutâneas, predominantemente o epitelioma basocelular. Em 1964, Barsky preconiza um retalho quadrangular do dorso nasal, com base na região glabelar, utilizando somente pele da região dorsal. Baseava-se em um procedimento simples recobrindo áreas cruentas até a ponta nasal, resultando em cicatrizes pouco perceptíveis. RELATO DE CASO: Paciente de 82 anos procurou o Serviço de Cirurgia Plástica do Hospital Universitário Maria Aparecida Pedrossian apresentando lesão em dorso nasal de aproximadamente 3 × 2 cm, ulcerada com base eritematosa e limites mal definidos. A técnica utilizada para correção da perda de substância foi o deslizamento de um retalho frontoglabelar com pedículo randomizado. A paciente evoluiu com viabilidade do retalho, apresentando restauração do dorso nasal e resultado estético satisfatório. CONCLUSÃO: Em decorrência da cor e textura adequadas da pele desta região, o retalho frontoglabelar é reconhecidamente uma excelente área doadora para cobertura do dorso do nariz.

INTRODUCTION: The nasal dorsum is a common location for the development of cutaneous tumors, predominantly basal cell epithelioma. In 1964, Barsky recommended a quadrangular flap for coverage of the nasal dorsum, taken from the glabellar region, to most closely match the skin of the dorsal region. This was based on a simple procedure for covering raw areas up to the nasal tip, resulting in less noticeable scars. CASE REPORT: An 82-year-old woman presented to the Plastic Surgery Service of the University Hospital Maria Aparecida Pedrossian with a lesion on the nasal dorsum of approximately 3 x 2 cm, ulcerated with an erythematous base, and ill-defined limits. A fronto-glabellar sliding flap was used to correct the loss of substance. The patient progressed with flap viability, restoration of the nasal dorsum, and satisfactory esthetic results. CONCLUSION: Owing to the color and texture of the skin from this region, the fronto-glabellar flap is an excellent donor area for coverage of the nasal dorsum.

Reconstrução parcial de nariz baseada em retalho nasogeniano após ressecção de carcinoma espinocelular envolvendo septo nasal, columela e lábio superior / Partial reconstruction of a nose based on a nasolabial flap after the resection of a squamous cell carcinoma involving the nasal septum, columella, and upper lip

INTRODUÇÃO: Reconstruções de defeitos complexos na face constituem um desafio para os cirurgiões. Após ressecção da lesão, o reparo nasal é difícil, já que possui uma variedade de tecidos e área local doadora reduzida para reconstrução. Já as lesões de lábio possuem como principal dificuldade a restauração da função, priorizando a integridade da estrutura esfincteriana, a continência oral, a abertura bucal e a sensibilidade. Entre as alternativas para reconstrução dessas áreas, podemos optar por retalhos locais, entre os quais o nasogeniano. OBJETIVO: Analisar desfechos de reconstrução nasal e de lábio superior em dois tempos cirúrgicos, utilizando retalho nasogeniano, após defeito complexo causado por ressecção de carcinoma espinocelular (CEC). RELATO DO CASO: Paciente do gênero feminino, 56 anos, apresentou CEC de progressão avançada em região nasal da columela, terço anterior do septo e parte do lábio superior. A paciente foi submetida à reconstrução com retalho nasogeniano e, em segundo momento cirúrgico, ao enxerto de cartilagem costal para reconstrução de columela. Apresenta evolução com boa integração e viabilidade dos enxertos e retalhos. O resultado estético foi satisfatório. CONCLUSÃO: A utilização de retalho nasogeniano como opção terapêutica para a reconstrução parcial de nariz e de lábio superior apresentou desfechos funcionais/estéticos favoráveis. Além disso, a segmentação do procedimento cirúrgico traz segurança na utilização dos retalhos locais, principalmente em indivíduos de difícil cicatrização.

INTRODUCTION: Reconstruction of complex facial defects is a challenge for surgeons. After the excision of a lesion, nasal reconstruction is challenging because of the variety of tissues involved and the reduced local donor area for reconstruction. On the other hand, a major difficulty in the reconstruction of lip lesions is restoration of function, with the priority being the maintenance of the integrity of the sphincter structure, oral continence, mouth opening, and sensitivity. Among the alternatives for the reconstruction of these areas are local flaps, including the nasolabial flap. AIM: To analyze the outcome of nasal and upper lip reconstruction performed in two surgical stages, by using a nasolabial flap for complex defects resulting from the resection of squamous cell carcinoma (SCC). CASE REPORT: A 56-year-old female patient presented with advanced SCC in the nasal region of the columella, anterior third of the septum, and part of the upper lip. She underwent reconstruction with a nasolabial flap and, in a second surgical procedure, with a costal cartilage graft for the reconstruction of the columella. The procedures resulted in good integration and viability of grafts and flaps. The aesthetic result was satisfactory. CONCLUSION: The use of a nasolabial flap as a therapeutic option for the partial reconstruction of the nose and upper lip produces favorable functional and aesthetic outcomes. In addition, the division of the surgical procedure into stages provides safety in the use of local flaps, particularly in patients with poor healing.

Tuberculosis of the middle ear and nasal passage: a case report

The following report highlights the case of a 55-year-old female with nasal and middle ear tuberculosis. The diagnosis was confirmed using imagery, histopathological biopsy reports, and Polymerase chain reaction [TB-PCR]. The patient was treated with rifampicin [10 mg/kg], isoniazid [5 mg/kg] and pyrazinamide [25 mg/kg] for 9 months. No recurrence was observed after one year of follow-up examination. Both nasal tuberculosis and tuberculous otitis media are currently considered rare diseases, yet if they are evaluated rapidly, there will be a good response to therapy without the need for surgery

Tumor cutâneo em parede nasal lateral e as opções de retalhos cutâneos para reconstrução após ressecção neoplásica / Nasal wall skin tumors and flap options for reconstruction after neoplasm resection

Introdução: As perdas de substâncias da parede nasal lateral são comuns, sendo causadas principalmente por ressecção de neoplasias de pele. Existem muitas alternativas para cobertura cutânea e os retalhos cutâneos representam as melhores opções tanto cosméticas como funcionais. Métodos: Foi realizada uma análise de 25 retalhos cutâneos nasais utilizados para reconstrução de perdas de substâncias da parede nasal lateral, secundárias à neoplasia, nos pacientes operados no Serviço de Cirurgia Plástica do Hospital São Lucas-PUCRS no período de dezembro de 2008 a dezembro de 2011. Resultados: A maioria dos pacientes foi do sexo masculino (60%) e a idade média foi de 66,55 anos. A maioria dos tumores cutâneos eram carcinoma basocelular (92%). O retalho mais utilizado foi o retalho de avanço em V-Y(72%), seguido do retalho bilobado (16%). Em 8% foi utilizado o retalho glabelar e em 4% o glabelar extendido. Conclusão: São múltiplas as opções cirúrgicas na reconstrução da parede nasal lateral após cirurgia oncológica, devendo-se escolher a mais adequada para cada caso, respeitando-se os contornos e a anatômia nasal de acordo aos princípios de Burget e Menick, além dos princípios oncológicos (AU)

Introduction: Losses of the lateral nasal wall are common and mainly caused by resection of skin neoplasms. There are many alternatives to cover skin, and skin flaps represent the best cosmetic and functional options. Methods: We performed an analysis of 25 skin flaps used for reconstruction of nasal losses of the lateral nasal wall, secondary to malignancy in patients operated at the Department of Plastic Surgery, Hospital São Lucas (PUCRS) from December 2008 to December 2011. Results: Most patients were male (60%) and the mean age was 66.55 years. Most cutaneous tumors were basal cell carcinoma (92%). The most often used flap was further advancement flap in VY (72%), followed by the bilobed flap (16%). Glabellar flap was used in 8% and extended glabellar in 4%. Conclusion: There are multiple surgical options for nasal wall reconstruction after cancer surgery, and one should choose the most suitable for each case, respecting the outlines and nasal anatomy according to the principles of Burget and Menick, in addition to oncological principles (AU)

Nasal encephalocele – a rare case report

Encephalocele is the herniation of the cranial contents through a bone defect in the skull. Nasal encephalocele is the herniation of cranial content in the nasal area. It is a congenital abnormality. It is one of the causes of craniospinal dysraphism, usually present at birth with symptom of obstruction or other complications. It presents as an external swelling on the nose. Clinically, there can be many differential diagnoses. An accurate diagnosis can reduce life threating intracranial complications and permit better management. For proper management, a multidiciplinary approach is needed. Approximately 80% of encephalocele exit the cranial cavity in the region of the occiput. Extraoccipital encephalocoele may protrude through defects in other portions of the cranial vault. We present a case of encephalocele in a 6-month-old girl who presented with a congenital swelling on the left lateral side of the nose with complaints of watering from the eye of same side

Tuberculosis of nose and palate with vanishing uvula.

During the past two decades, tuberculosis - both pulmonary and extrapulmonary - has re-emerged as a major health problem worldwide. Nasal tuberculosis - either primary or secondary to pulmonary tuberculosis or facial lupus - is rare, but it should be considered in the differential diagnosis of nasal granulomas. We describe a case of tuberculosis in an adult male who presented with palatal perforation with vanishing uvula and arch deformity of the palate. The diagnosis was based on histopathology and patient's successful response to antituberculous drug treatment.

Role of pre-operative assessment on the results of rhinoplasty in terms of patient satisfaction

The objectives of the study was to find out the importance of preoperative psychological assessment of patients in rhinoplasty and significance of excluding patients with psychiatric disorders, particularly Body dysmorphic disorder [BDD], on the overall results of surgery in terms of patient satisfaction. Randomized control trails [RCT]. This study was carried out at ENT out patients department [OPD], PNS Shifa and CMH Okara from January 2004 to Dec 2007. Patients complaining of nasal deformity with or without nasal obstruction were included in the study. A total of 85 [47 females and 38 males] patients were selected. After detailed history, examination and counseling 45 patients were selected by simple random method for psychological assessment and 40 patients not to have psychological assessment. The psychiatrist used DSM-IV TR criteria for psychological assessment and diagnosed 08 patients to be suffering from BDD and did not clear them for cosmetic surgery. Thirty seven patients being cleared for rhinoplasty [group A] and 40 patients [group B] not having psychological assessment, a total of 77 patients [42 females and 35 males] were offered cosmetic rhinoplasty. Patients were followed up for 01 year to check whether they were satisfied or not with postoperative results. The statistical data in the two groups was separately analyzed. Then by applying chi-square test the association in both the groups was calculated. Postoperatively 36/37 patients in group A were satisfied with their postoperative appearance and 32/40 patients in group B were satisfied. Chi-square test revealed the probability of <0.005, which is significant. Preoperative psychological assessment of patients has a significant role in patients undergoing cosmetic rhinoplasty as far as postoperative appearance is concerned

Nasal involvement in cutaneous leishmaniasis

To determine the frequency of nasal involvement in cutaneous Ieishmaniasis and to study demographic and clinical pattern of disease involving nose as well as nasal mucosa. Patients with cutaneous leishmaniasis presented to leishmaniasis clinic situated in the Basic Health Unit for Afghan refugees at Sarai Gambeela, District Lakki Marwat from January 1, 2009 to December 31, 2009 were registered. The patients were diagnosed clinically and confirmed by laboratory demonstration of parasite in a giemsa stained smear prepared from the lesion. Those having lesions primarily on nose, irrespective of age and gender were included in the study. All those cases with primary lesion elsewhere over face and secondarily involving nose [creeping lesion] were excluded. All important clinical details were recorded on a specially designed proforma and patients were given a registration card for the purpose of treatment and follow up visits. Sixty seven out of' 682 [9.82%] cases of nasal leishmanisis were encountered. Male to female ratio was 2:1. Forty nine [73.13%] had solitary lesions and among these fourty four [65.67%] had lesions limited to their nose. Wet type cutaneous leishmnaniasis was seen in 19 [28.36] cases. Seventy three percent of sufferers were less than 30 years of age. Cutaneous leishmaniasis is endemic in Distt. Lakki Marwat. Nose was a common site of involvement. In endemic areas, it should be included in the differential diagnosis of nasal lesions

Puesta al día en manejo de la obstrucción nasal por colapso valvular / Update in nasal obstrucción management caused by valvular collapse

La estenosis de la válvula nasal aparece como una complicación frecuente de rinoplastfa o traumatismo nasal. Existen diferentes técnicas para corregir el colapso de la válvula nasal; generalmente se utilizan injertos de tejido, que en algunas ocasiones son insuficientes para resolverla alteración y mejorar la función respiratoria. La válvula nasal funciona en base a la resistencia de la ley Starling, que consiste en un tubo semirrígido con un segmento flexible; cuando la presión inspirada excede un nivel crítico, éste se colapsa y provoca la alteración en su fisiología; por tanto, es necesario cierto grado de rigidez en el componente lateral nasal para evitar el colapso durante la inspiración. Cuando se ve afectado su funcionamiento causa frecuentemente obstrucción nasal.

Nasal valve stenosis commonly presents as a postoperative complication of rhinoplasty or facial trauma. Various techniques have been reported to correct nasal valve stenosis through the use of methods that support the nasal valve with cartilage, rib graft, although these tissues are not useful in some cases to improve the nasal breathing. The nasal valve functions as the law Starling resistor, which is a semirigid tube with a flexible segment, when the inspired partial pressure exceeds a critical level, it collapses and causes nasal obstruction, and therefore need some degree of rigidity in nasal lateral component to avoid collapse during inspiration. When the nasal valve is affected frequently causes nasal obstruction.

Non-invasive 3D facial analysis and surface electromyography during functional pre-orthodontic therapy: a preliminary report

OBJECTIVES: Functional orthodontic devices can modify oral function thus permitting more adequate growth processes. The assessment of their effects should include both facial morphology and muscle function. This preliminary study investigated whether a preformed functional orthodontic device could induce variations in facial morphology and function along with correction of oral dysfunction in a group of orthodontic patients in the mixed and early permanent dentitions. MATERIAL AND METHODS: The three-dimensional coordinates of 50 facial landmarks (forehead, eyes, nose, cheeks, mouth, jaw and ears) were collected in 10 orthodontic male patients aged 8-13 years, and in 89 healthy reference boys of the same age. Soft tissue facial angles, distances, and ratios were computed. Surface electromyography of the masseter and temporalis muscles was performed, and standardized symmetry, muscular torque and activity were calculated. Soft-tissue facial modifications were analyzed non-invasively before and after a 6-month treatment with a functional device. Comparisons were made with z-scores and paired Student's t-tests. RESULTS: The 6-month treatment stimulated mandibular growth in the anterior and inferior directions, with significant variations in three-dimensional facial divergence and facial convexity. The modifications were larger in the patients than in reference children. In several occasions, the discrepancies relative to the norm became not significant after treatment. No significant variations in standardized muscular activity were found. CONCLUSIONS: Preliminary results showed that the continuous and correct use of the functional device induced measurable intraoral (dental arches) and extraoral (face) morphological modifications. The device did not modify the functional equilibrium of the masticatory muscles.

Linfoma CutáneoT/NK tipo nasal símil hidroa vacciniforme / Hydroa-like cutaneous T/NK-cell lymphoma, nasal type

El linfoma T/NK cutáneo símil hidroa vacciniforme (HV) es un linfoma poco común que afecta principalmente a niños asiáticos e indoamericanos. Se inicia con edema, vesículas, costras y cicatrices de tipo vacciniforme. De evolución prolongada, tiende a agravarse con los años, desfigurando y comprometiendo física y psíquicamente al paciente. Debido a la detección tardía del linfoma, en general el pronóstico de vida de estos pacientes es malo. Se presenta una paciente de 20 años con linfoma NK de tipo nasal, que comenzó a los 13 años con un cuadro de HV de mala evolución. Los autores proponen que en pacientes con HV atípica un tratamiento en etapas tempranas de la enfermedad podría mejorar su pronóstico.

The hydroa-like cutaneous T-cell lymphoma is not a very common lymphoma,children from Asia and indoamericans are mainly aff ected. Theybegin with edema, vesicles, crusts and vacciniform scars with a prolongedevolution increasing through to the years. This illness aff ects the patientsphysically and psychologically because of its disfi guring eff ects.Due to the late detection of the lymphoma, generally the prognosis ofthese patients is poor. A patient of 20 years old, who suff ered of NK-celllymphoma nasal type, is presented. She began with hydroa vacciniformeat the age 13 years old, she developed a T/NK lymphoma and died. Theauthors propose that on patients with atypical hydroa vacciniformes, atreatment in earlier stages could off er a better prognosis (Dermatol Argent2009;15(5):350-353).