Nasal septum angiofibroma: a rare condition with an unusual onset

The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an “inhomogeneous solid lesion in the nasal fossa”. With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.

Nasal septum angiofibroma: a rare condition with an unusual onset

The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an “inhomogeneous solid lesion in the nasal fossa”. With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.

Internal laryngocele: unusual onset in a 91-year-old female patient

While internal laryngoceles rarely cause major clinical complaints, they may lead to airway obstruction and require emergency intervention on rare occasions. We report a 91-year-old patient who was referred to the Ear, Nose and Throat Clinic of the Policlinico Santa Maria alle Scotte, Siena, Italy, in 2017 due to recurrent episodes of severe dyspnoea. A flexible nasopharyngolaryngoscopic examination revealed an internal laryngocele of approximately 1.5 cm in diameter that moved up and down the glottic plane, occasionally invading the subglottic space during inspiration and impeding airflow. This caused cyanosis and dyspnoea so severe that an emergency tracheotomy was considered. Luckily, after considerable effort, the patient was able to cough, causing the mass to move above the vocal plane and allowing normal breathing. The laryngocele was subsequently removed via laryngomicrosurgery. Although the incidence of internal laryngoceles is quite rare, physicians should consider this potentially life-threatening condition among patients with dyspnoea

Atomized Nasal Douche: Our Experience

BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.

Atomized Nasal Douche: Our Experience

BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.