Angioleiomyoma of the Sinonasal Tract: A Systematic Review of an Uncommon Clinicopathological Entity.

Introduction Angioleiomyoma is a rare neoplasm that represents ∼ 0.2 % of all head and neck benign tumors and ∼ 2% of total cases of tumors of the sinonasal tract. It was once considered a possible subtype of leiomyoma, but, in the 2020 World Health Organization (WHO) classification of soft tissue tumors, it is accepted as a singular entity. Objective To systematically review the existing literature on angioleiomyoma in the light of the new classification of soft tissue tumors. Data Synthesis The present study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search in the PubMed, Cochrane, Scopus, and Google Scholar databases was performed in January 2022. The search items included the following keywords: nasal angioleiomyoma OR sinonasal angioleiomyoma OR nasal vascular leiomyoma OR sinonasal vascular leiomyoma . A total of 87 patients were evaluated. He age of the patients in the studies ranged from 15 to 88 years (mean age at diagnosis: 55.6 years). The most common site of involvement was the nasal septum (28.4 %), followed by the inferior turbinate (22.5%). The most common symptom was nasal obstruction (66.7%), followed by epistaxis (47.1%). Surgical excision represented the main treatment, and there was recurrence of pathology in only 1 case (0.9%). Conclusion To our knowledge, only 87 cases of sinonasal-tract angioleiomyoma have been previously described. The results of the present review seem to confirm the rarity and the benign nature of this neoplasm, and they seem to confirm the necessity to improve the available data about sinonasal-tract angioleiomyoma.

Angioleiomyoma of the Sinonasal Tract: A Systematic Review of an Uncommon Clinicopathological Entity

Abstract Introduction Angioleiomyoma is a rare neoplasm that represents ∼ 0.2 % of all head and neck benign tumors and ∼ 2% of total cases of tumors of the sinonasal tract. It was once considered a possible subtype of leiomyoma, but, in the 2020 World Health Organization (WHO) classification of soft tissue tumors, it is accepted as a singular entity. Objective To systematically review the existing literature on angioleiomyoma in the light of the new classification of soft tissue tumors. Data Synthesis The present study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive search in the PubMed, Cochrane, Scopus, and Google Scholar databases was performed in January 2022. The search items included the following keywords: nasal angioleiomyoma OR sinonasal angioleiomyoma OR nasal vascular leiomyoma OR sinonasal vascular leiomyoma. A total of 87 patients were evaluated. He age of the patients in the studies ranged from 15 to 88 years (mean age at diagnosis: 55.6 years). The most common site of involvement was the nasal septum (28.4 %), followed by the inferior turbinate (22.5%). The most common symptom was nasal obstruction (66.7%), followed by epistaxis (47.1%). Surgical excision represented the main treatment, and there was recurrence of pathology in only 1 case (0.9%). Conclusion To our knowledge, only 87 cases of sinonasal-tract angioleiomyoma have been previously described. The results of the present review seem to confirm the rarity and the benign nature of this neoplasm, and they seem to confirm the necessity to improve the available data about sinonasal-tract angioleiomyoma.

P6 acupressure effectiveness on acute vertiginous patients: a double blind randomized study.

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of P6 acupressure on vertigo and neurovegetative symptoms, its possible interference with vestibular-ocular reflex (VOR), and its clinical usefulness during acute vertigo. MATERIALS AND METHODS: Two hundred and four patients, either affected by acute vertigo (n=124) or undergoing labyrinth stimulation (n=80), were randomly divided in two homogeneous groups: an experimental group A and a placebo group B. Each patient rated severity of vertigo and neurovegetative symptoms on a visuo-analogue scale ranging from 0 to 10, before and after bilateral placement of a P6 device. The latter was placed on the P6 acupressure point (appropriate placement) in Group A patients or on the dorsal part of the carpus (inappropriate placement) in the Group B patients. Furthermore, qualitative and quantitative nystagmus parameters were collected via recorded video-oculoscopy and electronystagmography. RESULTS: Eighty-five percent of Group A patients reported improvement of symptoms, which was significant for neurovegetative symptoms, but not for vertigo. In contrast, only 11% of the Group B patients reported improvement. VOR analysis did not show any significant variation of qualitative and quantitative nystagmus variables. CONCLUSIONS: This study demonstrated that the P6 device is effective in improving neurovegetative symptoms in patients affected by spontaneous and provoked vertigo, without any interference with VOR. Given the low cost and lack of side-effects of the P6 device, its routine application is suggested for acute vertigo and during labyrinth stimulation.

Voice disorders and posturography: variables to define the success of rehabilitative treatment.

Previous studies have investigated the relationship between muscular tension, body posture, and voice quality. The aim of this paper is to study the postural pattern during voice production in healthy subjects compared with patients affected by voice disorders and in the same patients before and after vocal treatment by means of static posturography. Classic posturographic variables and spectral frequency analysis of body sway have been measured. Posturographic values in patients before vocal treatment and controls were within normal ranges but not homogeneous. Body sway significantly decreased during voice production in patients after voice training. Spectral frequency analysis of body sway showed a significantly decreased body sway at middle frequencies on the anteroposterior (y) plane during voice production after voice training. Our results would suggest that in patients affected by voice disorders rehabilitative treatment may cause an improvement of the body proprioceptive scheme and this improvement might be useful to evaluate the proper (ongoing) treatment.

Dual-energy X-ray absorptiometry analysis of body composition in patients affected by OSAS.

Obstructive sleep apnoea syndrome (OSAS) is a disorder characterized by recurrent episodes of apnoea. This study evaluates the body composition in OSAS patients compared to normal weight, pre-obese and obese subjects. Body composition has been measured by dual-energy X-ray absorptiometry in the whole body and in three different body regions. Abdominal region revealed no significant differences in fat mass percentage between patients and controls and no correlation between fat mass percentage and severity of OSAS. At the level of oral region, OSAS patients showed a significant decrease of fat free mass compared to control groups. At the level of neck region, OSAS patients showed a significant increase of fat mass compared to control groups and a significant correlation between the neck fat mass percentage and severity of OSAS. Regional fat distribution constitutes a risk factor for OSAS and a prognostic factor for severity of OSAS.

Paroxysmal positional vertigo in skeet shooters and hunters.

Paroxysmal positional vertigo (PPV) is a high prevalence vestibular end organ disorder due to the detachment of the utricular otoconia floating in the posterior or lateral semicircular canal. In the majority of cases the etiology of PPV is unknown and it may follow viral infections, vascular disorders and head trauma. This report presents six cases (out of 520 diagnoses of PPV) of PPV following repeated training sessions of skeet shooting or gun shooting during animal hunting. The transmission of impulsive and vibratory energy from the shoulder to the cervical spine and the subsequent minimal whiplash injury ipsilateral to the side where the gun is placed on the shoulder may be considered to be responsible of the otoconia detachment.

Epithelioid haemangioendothelioma arising in the nasal cavity.

We report here the case of an epithelioid haemangioendothelioma (EHE) arising in the nasal cavity which is, to the best of our knowledge, the first ever described example in the world literature in that particular site. The patient is a 23-year-old male who presented with repeated episodes of epistaxis from the nasal cavity and with a 1.5 cm reddish, polypoid, smooth, spontaneously bleeding nodule in the right middle meatus. This lesion was histologically diagnosed as epithelioid haemangioendothelioma. Immunohistochemically the neoplasm displayed striking positivity for CD31, CD34 and vimentin. A surgical approach was performed by 'facial degloving', removing the right inferior turbinate, the anterior two-thirds of the middle turbinate and the medial wall of the ethmoid bone. After 12 months follow-up the patient is disease-free, without any local or distant recurrence.