[Ulcero-necrotic and lymphoproliferative naso-paranasal lesions in cocaine abuse]. / Lesioni ulceronecrotiche e linfoproliferative naso-paranasali da abuso di cocaina.

In this work are reported two clinical cases of cocaine abusers with destructive lesions of nasal-paranasal cavities. The clinical presentation and the absence of a positive history of drug addiction led to a differential diagnosis between lymphoma, idiopathic median line granuloma and Wegener granulomatosis. Biochemical and serological examinations did not prove conclusive. The diagnosis was finally formulated on the basis of the documented presence of cocaine in the biological fluids. Emphasis is placed in the difficulty of obtaining a reliable case history in this type of patients. Moreover, the Authors point out that it is advisable to test for drugs in the biological fluids prior to undertaking time-consuming diagnostic procedures for pathologies which are extremely rare in the West countries.

Allergic and disergic children rhinopathy.

Authors studied 42 children affected with obstructive rhinopathy. They complained nose obstruction with mono or bilateral difficult nasal breathing, permanent (rarely seasonal) symptoms, hypertrophic adenoids, nasal hypersecretion, hearing loss and recurrent otitis media. Two groups of tests were performed: 1) to document the entity of nasal stenosis and the correlated otologic diseases: rhinomanometry by Mercury NR1 rhinomanometer; tympanogram, classified according to Jerger; tubotympanogram, according to Honjo, Morimitsu and Cocchini. 2) To formulate etiologic hypothesis: Prick skin tests; immunoenzymatic specific and total IgE assay; nasal smear; secretory IgA assay. In 8 children anamnesis showed an environmental allergy while familiar anamnesis was positive in 26 cases. Skin tests and/or IgE assay were positive in 14. Neutrophilia in nasal smear was noted in 30, lymphocytosis in 2 and eosinophilia in 5. Secretory IgA were decreased in 39. Children were divided into three classes: A: no documented atopic component; B: disergic children; C: allergic children.

The surgical treatment of small juvenile nasopharyngeal angiofibroma (JNA).

JNA is a rare disease of young males. It is a benign tumor and may be classified in three stages according to clinical and radiologic criteria. The treatments proposed for this tumor are different: by estrogens, by embolization, by radiotherapy or by surgery. The surgical techniques described in the literature are: paralateronasal; Rouge-Denker's transmaxillary; Bocca's transpharyngeal; transpalatine. Authors report their experience about nine stage I JNAs in young males treated and cured by surgical transpalatine technique. The follow-up is from 2 to 6 years. No relapse have been noted and no velo-palatine dysfunction has ever been complained of.