Nasopharyngeal angiofibroma: Our experience and literature review

Introduction: Juvenile nasopharyngeal angiofibroma is a rare, highly vascular, and histologically benign tumor, generally observed in male adolescents. It shows very aggressive behavior due to local invasiveness and is associated with various symptoms. Juvenile nasopharyngeal angiofibroma originates in the sphenopalatine forame, causing epistaxes and nasal obstruction. Objective: To retrospectively describe our experience in the diagnosis and treatment of patients with juvenile nasopharyngeal angiofibroma. Scientific drawing: Retrospective, descriptive study conducted after approval from the Ethics Committee of the Federal University of Sergipe (protocol 0114.0.107.000 -11). Methods: We analyzed findings in 20 patients who underwent surgery between 2004 and 2011. Factors analyzed include patient age and gender, symptoms, stages, treatment, length of surgery, intraoperatory bleeding, postoperative need for nasal tampons, hospitalization time, complications, and tumor recurrence. Results: Patients were aged 10-29 years. All patients were treated surgically, including 17 who underwent endoscopic surgery. The mean operation time was 120 min, and the mean bleeding volume was 300 mL. Seventeen patients required clamping of the external carotids and tumor embolization. Conclusion: Endoscopic surgery alone or with other conventional techniques was safe for the treatment of angiofibromas of different stages...

Efeitos da pressão positiva contínua em vias aéreas sobre os sintomas nasofaríngeos em pacientes com a síndrome da apnéia obstrutiva do sono / Effects of continuos positive airway pressure on nasal and pharyngeal symptoms in patients with obstructive sleep apnea

INTRODUÇAO: Sintomas nasofaríngeos são comuns em pacientes com a síndrome da apnéia obstrutiva do sono (SAOS) em tratamento com pressão positiva contínua em vias aéreas (CPAP). No entanto, sintomas nasofaríngeos são também comuns em pacientes com SAOS antes do início do tratamento. OBJETIVO: Determinar o impacto do tratamento com CPAP nasal sobre os sintomas nasofaríngeos em pacientes com SAOS. MÉTODO: Foram avaliados 35 pacientes (28 homens), com idade de 54 ±10 anos portadores de SAOS moderada a grave diagnosticada através de polissonografia. Os sintomas nasofaríngeos (espirros, coriza, prurido, obstrução, sangramento e ressecamento nasal e de garganta) foram quantificados através de questionário aplicado antes e depois de pelo menos 3 meses de tratamento com CPAP nasal. RESULTADOS: O índice de apnéia + hipopnéia foi de 50±25 eventos por hora. Ao menos um sintoma nasofaríngeo estava presente em 26 pacientes (74 por cento) antes do tratamento. A obstrução nasal foi o sintoma mais comum, presente em 18 pacientes (51 por cento). Dentre os pacientes inicialmente assintomáticos (n = 9), 78 por cento apresentaram alguma reação nasofaríngea adversa com o tratamento. Em contraste, nos pacientes inicialmente sintomáticos, houve redução significativa da intensidade da obstrução, do ressecamento nasal e de garganta e do sangramento nasal após o tratamento. CONCLUSAO: Sintomas nasofaríngeos são freqüentes em pacientes com SAOS. O uso de CPAP pode tanto desencadear sintomas nasofaríngeos em pacientes assintomáticos, como reduzir sua intensidade nos pacientes com sintomas prévios.

Relación de las afecciones rinofaríngeas obstructivas altas con los trastornos del sueño / Relationship of the upper obstructive rhinonasopharyngeal affections with sleep disorders

Con el objetivo de comprobar el efecto que sobre el sueño y el estado de salud tiene la cirugía en pacientes con trastornos del sueño, causados por obstrucciones respiratorias altas, se estudiaron y trataron quirúrgicamente 60 pacientes remitidos de la consulta de trastornos del sueño del Hospital Militar Central "Doctor Carlos J. Finlay", en el período comprendido de enero de 1999 a diciembre de 2001, de los cuales 50 (90 por ciento) eran del sexo masculino y el 10 (por ciento) era femenino. Fue la desviación del septum nasal la afección de otorrinolaringología más frecuente, 36 (60 por ciento), seguida por la desviación del septum nasal, asociada a otra afección de otorrinolaringología, 10 (16,6 por ciento). Presentaron trastornos del sueño asociados con otras afecciones clínicas (cefalea, hipertensión arterial, vértigo, disfunción sexual) 40 (66,7 por ciento) y solo con trastornos del sueño 20 ( 33,3 por ciento). Se realizó tratamiento quirúrgico a los 60 enfermos y se obtuvo que curaron o mejoraron el trastorno del sueño 58 pacientes (96,7 por ciento), las afecciones constructivas curaron o mejoraron en 57 enfermos (95 por ciento), y las afecciones clínicas asociadas curaron o mejoraron en 37 pacientes (92,5 por ciento)(AU)

In order to prove the effect of surgery on sleep and health status in patients with sleep disorders caused by upper respiratory obstructions, 60 patients referred from the sleep disorders consulting room of "Carlos J. Finlay" Military Central Hospital were studied and surgically treated from January, 1991, to December, 2001. Of them, 50 (90 percent) were males and 10 percent were females. The deviation of the nasal septum was the most frequent otorrhinolaryngology affection, 36 (60 percent), followed by the deviation of the nasal septum associated with other otorrhinolaryngology affection, 10 (16.6 percent). 40 patients (66.7 percent) had sleep disorders associated with other clinical affections (headache, arterial hypertension, vertigo, sexual dysfunction), and only 20 (33.3 percent) had sleep disorders. In 58 (96.7 percent) of the 60 patients that underwent surgical treatment, sleep disorders were cured or improved, the constructive affections were cured or improved in 57 patients (95 percent) and the associated clinical affections were cured or improved in 37 patients (92.5 percent)(AU)

role of nasopharyngeal continuos positive airway pressure [NP-PAP] in the successful early weaning following extubation in low birth weight infants [LBW] on mechanical ventilation

Using two methods for early extubation, 52 babies, suffering from respiratory distress syndrome, were randomly selected to post- extubation headbox or postextubation nasopharyngeal continuous positive airway pressure [NP-CPAP]. All infants were suffering from respiratory distress and weight less than 2000 g, had a gestational age of less than 36 weeks, and had been weaning from mechanical ventilation within 7 days of life. The criteria for extubation included stable condition, fraction of inspired oxygen [FIO2] of <35%, peak inspiratory pressure [PIP] of <15 cm H2O and ventilator rate of 6/minute. The individual successful extubation rate of post- extubation in the NP-CPAP group and the post-extubation headbox group were 85% [22/27] and 48% [12/25], respectively. There were no significant differences in clinical characteristics between the two groups. Results suggested that application of NP-CPAP to a preset protocol for extubation can achieve a better success rate of early extubation in low birth weight [LBW] infants weaning from mechanical ventilation

Quiste nasofaríngeo / Nasopharyngeal cyst

Los quistes nasofaríngeos se clasifican en congénitos o adquiridos, y aquellos se localizan en la línea media o laterales. Los quistes congénitos de la línea media pueden surgir tanto en la bursa faríngea, a los que se les denomina quistes de Thornwaldt, como de la bolsa de Rathke. Los quistes adquiridos son de retención y se atribuyen a la coalescencia del receso medial de la amígdala laríngea. En general, los quistes de la nasofaringe, cuando son pequeños, no dan sintomatología, mientras que, al crecer, dependiendo de su localización, dan obstrucción nasal, rinorrea posterior, hipoacusia y cefaleas.

Nasopharyngeal tuberculosis: a case report

A case of Nasopharyngeal tuberculosis is presented along with a short discussion on tuberculosis in the pharynx in general, and in the nasopharynx, in particular