Tumor glómico del septum nasal / Glomic tumor of the nasal septum

Presentamos el caso clínico de una mujer de 58 años que consulta por episodios de epis-taxis autolimitadas por fosa nasal derecha asociados a hipersensibilidad al manipular dicha fosa nasal. A la exploración se evidenció en el septum nasal una lesión mucosa nodular, de consistencia dura y aspecto violáceo. Se llevó a cabo exéresis de la misma por vía endonasal, con resultado histopatológico de tumor glómico (TG) del septum nasal. El TG es una neoplasia benigna perivascular, derivada de las células musculares lisas presentes en el cuerpo glómico; estructura con función termorreguladora, formada por un shunt entre arteriolas y vénulas, sin presencia de red capilar. Los cuerpos glómicos están presentes, mayoritariamente, en extremidades (lecho ungueal). Los tumores glómicos son, verdaderamente, excepcionales en el área ORL, existiendo sólo una treintena de casos publicados hasta la fecha a nivel nasosinusal. La mayoría de casos se presentan entre la 5ᵃ y 6ᵃ década de la vida y más, frecuentemente, en mujeres. Plantea diagnóstico diferencial, fundamentalmente, con dos entidades: el paraganglioma (con el que no debe ser confundido desde el punto de vista terminológico ni histológico), y con el tumor fibroso solitario (antiguo hemangiopericitoma). El comportamiento es benigno y el tratamiento es la cirugía

We present the clinical case of a 58-year-old woman who consulted for episodes of self-limited epistaxis in the right nostril associated with hypersensitivity to manipulation of this nostril. Examination revealed a nodular mucosal lesion in the nasal septum, with a hard consistency and purplish appearance. The lesion was excised endonasally, with histopatho-logical result of a glomus tumor (GT) of the nasal septum. The GT is a benign perivascular neoplasm, derived from smooth muscle cells present in the glomus body; structure with thermoregulatory function, formed by a shunt between arterioles and venules, without the presence of capillary network. Glomus bodies are mostly present in the extremities (nail bed). Glomus tumors are truly exceptional in the ENT area, with only about thirty cases published to date at the nasosinusal level. Most cases occur between the 5th and 6th decade of life and more frequently in women. It raises differential diagnosis fundamentally with two entities: paraganglioma (with which it should not be confused from the terminological or histological point of view) and with solitary fibrous tumor (former hemangiopericytoma). The behavior is benign and the treatment is surgery.

Variétés histologiques des tumeurs bénignes du septum nasal une série documentaire de 30 cas

Contexte et objectif. Les variétés histologiques de tumeurs du septum nasal sont peu documentées dans les pays d'Afrique. La présenté étude avait pour objectif de décrire les variétés histologiques de tumeurs septales bénignes. Méthodes. C'était une analyse rétrospective de dossiers des patients admis pour tumeurs septales bénignes, entre janvier 1998 et aout 2021 ; à l'hôpital Dr Dorban en Algérie. Les variables d'intérêt englobaient les données cliniques et histopathologiques. Résultats. En 23 ans, seulement trente dossiers de tumeurs bénignes du septum nasal ont été colligés. Leur âge moyen était de 36,2 ans avec les extrêmes entre 13 et 70 ans avec une prédominance du sexe féminin (63,3 %). Les tumeurs vasculaires étaient prépondérantes (83,3 %) en particulier les hémangiomes capillaires (92 %) suivies des variétés épithéliales (13,3%) et un seul adénome pléomorphe septal. L'évolution clinique était émaillée par 3 récidives pour les hémangiomes, et absence de récidive pour l'adénome pléomorphe après 120 mois de recul. Trois autres cas étaient perdus. Conclusion: Les tumeurs bénignes du septum nasal sont rares et diversifiées sur le plan histologique. A coté des formes classiques et communes (hémangiomes, papillomes, adénomes), il existe des variétés rares et qui nécessitent une étude spécifique et une expertise dédiée.

Schwannoma septal, una causa infrecuente de obstrucción nasal / Septal schwannoma, an uncommon cause of nasal obstruction

Resumen Los schwannomas son neoplasias derivadas de las células de Schwann de la cubierta de los nervios periféricos. Su desarrollo en la región nasosinusal es poco frecuente, especialmente a nivel septal. Su diagnóstico diferencial es variado y debe establecerse con otras causas más habituales de masa nasal unilateral. Su tratamiento es quirúrgico. Describimos el caso de un varón de 47 años con una masa nasal derecha intervenida mediante cirugía endoscópica nasosinusal y con diagnóstico anatomopatológico de schwannoma septal.

Abstract Schwannomas are tumors that proceed from Schwann cells in the cover of peripheral nerves. It is uncommon in the sinonasal area, especially in the nasal septum. The differential diagnosis is extensive and requires contemplating other more frequent causes of unilateral nasal mass. The current treatment of septal schwannoma is surgical. We report a 47-year-old male with a right nasal mass operated by endoscopic sinonasal surgery with an anatomopathological diagnosis of a nasal septal schwannoma.

Effects of the anti-sucking device «SuckStop Müller¼ on calf behavior.

INTRODUCTION: When cross-sucking persists beyond calf-hood, it represents an important problem in dairy heifers and cows. It can cause teat injuries and severe mastitis and lead to significant economic losses. The «SuckStop Müller,¼ a novel anti-sucking device, is designed to give the calf a negative feedback when cross-sucking on a conspecific. The aim of this study was to assess whether wearing a SuckStop would result in behavioral changes other than cross-sucking and thus, impair welfare in the short- and longer-term. Sixteen group-housed calves were observed in groups of four on five days, before and after fitting the SuckStop: day -2, day -1, day 0, day 1, and day 9. Maintenance behaviors (e.g., feeding, drinking, lying) were recorded using instantaneous scan sampling. In addition, the frequency of contact behaviors (e.g., exploring the feeding fence, touching own body) was recorded by means of continuous focal animal observations. Contact behaviors were classified as «impaired¼ or «normal¼ depending on whether or not the calf flinched in response to the contact. Finally, the number of visits to the milk and concentrate feeders was extracted from the computer-controlled feeding system. Fitting a SuckStop resulted in a higher proportion of observations spent lying and less exploration behavior on day 0 and day 1 than on day -2, day -1, and day 9. On day 0 and day 1, 6,3 % of exploration behaviors were classified as impaired, compared to 0,4 % (day -2, day -1) before and 0,2 % (day 9) after fitting the SuckStop. On day 9, all calves had superficial ulcerations on the nasal septum. In four calves, these ulcerations were moderately severe, whereas all other calves had slight ulcerations. In summary, the calves habituated quickly to this novel anti-sucking device. Follow-up studies are necessary to assess the long-term relevance of tissue alterations in the nasal septum for calf welfare as well as the effect of the SuckStop on cross-sucking behavior.

INTRODUCTION: Lorsque la succion croisée persiste au-delà de l'âge de veau, elle représente un problème important chez les génisses et les vaches laitières. Elle peut provoquer des blessures aux trayons et des mastites graves et entraîner ainsi des pertes économiques importantes. Le «SuckStop Müller¼, un nouveau dispositif anti-succion, est conçu pour donner au veau un feedback négatif lorsqu'il suce un congénère. L'objectif de cette étude était de déterminer si le port d'un SuckStop pouvait entraîner des changements de comportement autres que la succion croisée et, par conséquent, nuire au bien-être à court et à long terme. Seize veaux logés en groupe ont été observés par groupes de quatre pendant cinq jours, avant et après la pose du SuckStop: jour ­2, jour ­1, jour 0, jour 1 et jour 9. Les comportements d'entretien (par exemple se nourrir, boire, se coucher) ont été enregistrés à l'aide d'un échantillonnage par balayage instantané. En outre, la fréquence des comportements de contact (par exemple, explorer le râtelier, toucher son propre corps) a été enregistrée au moyen d'observations continues de chaque animal. Les comportements de contact ont été classés comme «altérés¼ ou «normaux¼ selon que le veau a tressailli ou non en réponse au contact. Enfin, le nombre de visites aux distributeurs de lait et de concentré a été extrait du système d'alimentation contrôlé par ordinateur. L'installation d'un SuckStop a entraîné une proportion plus élevée d'observations de comportements couchés et moins de comportements d'exploration le jour 0 et le jour 1 que le jour ­2, le jour ­1 et le jour 9. Le jour 0 et le jour 1, 6,3 % des comportements d'exploration ont été classés comme déficients, contre 0,4 % (jour ­2, jour ­1) avant et 0,2 % (jour 9) après la pose du SuckStop. Au jour 9, tous les veaux présentaient des ulcérations superficielles sur la cloison nasale. Chez quatre veaux, ces ulcérations étaient modérément graves, tandis que tous les autres veaux présentaient de légères ulcérations. En résumé, les veaux se sont rapidement habitués à ce nouveau dispositif anti-suceur. Des études de suivi sont nécessaires pour évaluer la pertinence à long terme des altérations tissulaires de la cloison nasale pour le bien-être des veaux ainsi que l'effet du SuckStop sur le comportement de succion croisée.

Cocaïne et lésions destructrices centro-faciales : à propos d'un cas.

INTRODUCTION: Cocaine use is associated with multiple complications, some of which can mimic systemic diseases, especially Antineutrophil Cytoplasmic Antibody (ANCA) associated vasculitis. We report a case of Cocaine Induced Midline Destructive Lesions (CIMDL) for which a diagnosis of granulomatosis with polyangiitis (GPA) was discussed. CASE REPORT: A 42-year-old male, cocaine consumer, was admitted in our department for a centrofacial destructive process. He had no extra ear, nose and throat (ENT) involvement. ANCA were positive with a perinuclear fluorescence pattern and an anti-Proteinase 3 specificity. Regarding this unusual immunologic pattern and in the absence of histological argument for a GPA, a diagnosis of CIMDL was made. CONCLUSION: CIMDL is a centrofacial destructive process due to intranasal cocaine use. It is frequently associated with the presence of p-ANCA with both anti-HNE and anti-PR3 specificity.

Septorrinoplastia y su influencia en el acondicionamiento nasal / Septorhinoplasty and its influence on the nasal conditioning

Introducción: La septorrinoplastia funcional y estética primaria es un procedimiento común en cirugía plástica facial. Objetivo: Analizar de forma subjetiva y objetiva el impacto de la cirugía en el acondicionamiento nasal en pacientes con deformidades nasales externas e internas. Diseño: Cuasi-experimental. Materiales y métodos: Se incluyeron 42 pacientes este estudio, se midieron la temperatura y humedad del ambiente y la intranasal del paciente, además del grado de obstrucción nasal antes y doce meses después de la cirugía; se utilizó una escala subjetiva de obstrucción nasal y un termohigrómetro con sensor externo para las mediciones intranasales. Resultados: Los valores de temperatura, humedad postoperatorias y la escala subjetiva de obstrucción nasal fueron de manera significativa estadísticamente mayores en comparación con las preoperatorias (p<0,05) Conclusiones: De acuerdo con los resultados de este estudio, los pacientes tienen un beneficio general gracias a una mejoría del acondicionamiento del aire nasal inspirado posterior a la realización de una septorrinoplastia funcional y estética primaria.

Introduction: The primary aesthetic and functional septorhinoplasty is a common procedure in facial plastic surgery. Objective: To analyze subjectively and objectively the impact of surgery on the nasal conditioning in patients with external and internal nasal deformities. Design: Quasi-experiment Materials and Methods: 42 patients were included in this study, the intranasal temperature and humidity were measured, as well as the degree of nasal obstruction before and twelve months after surgery; we used a subjective scale of nasal obstruction and an external sensor thermohygrometer for intranasal measures. Results: The values of temperature, humidity and postoperative subjective scale of nasal obstruction were in a significant way, statistically higher compared to preoperative measures (p<005). Conclusions: According to the results of this study, we found that there is an overall benefit for patients ought to an improvement in inspired nasal air conditioning after conducting a primary aesthetic and functional septorhinoplasty

Calcinosis tumoral en septum nasal en un paciente con insuficiencia renal crónica dializado. Presentación de un caso / Tumoral calcinosis in nasal septum in a patient with chronic renal failure in dialysis. Presentation of a case

Los trastornos metabólicos ocasionados por la insuficiencia renal y la diálisis para su tratamiento pueden conducir a la precipitación de sales de fosfato cálcico con la consecuente formación de tumores en diversas localizaciones. Estos pueden ser únicos o múltiples, pudiendo ocasionar obstrucción y compresión de distintas estructuras anatómicas con la consecuente alteración funcional. Si bien el manejo clínico de las alteraciones antes citadas es fundamental, la cirugía adquiere relevancia en estas situaciones. Se presenta un caso de Calcinosis Tumoral única ubicada en el tercio anterior del septum nasal, ocasionando obstrucción de la fosa nasal. La tomografía computada orientó el diagnóstico y la resección tumoral completa por vía nasal fue el tratamiento elegido. El informe de anatomía patológica confirma el diagnóstico de Calcinosis Tumoral. A los nueve meses de seguimiento en el postoperatorio no se evidencia recidiva.

Metabolic disorders caused by chronic renal failure and dialysis for its treatment can lead to the precipitation of calcium phosphate salts with the consequent formation of tumors in various locations. These can be single or multiple, and may cause obstruction and compression of different anatomical structures with consequent functional alteration. Although the clinical management of the above mentioned alterations is fundamental, the surgery acquires relevance in these situations. We present a case of unique tumoral calcinosis located in the anterior third of the nasal septum, causing obstruction of the nasal fossa. Computed tomography guided diagnosis and complete tumor resection by nasal route was the treatment chosen. The pathological anatomy report confirms the diagnosis of tumor calcinosis. At nine months post-operative follow-up there was no evidence of tumor recurrence.

Endoscopic septoplasty in primary cases using electromechanical instruments: surgical technique, efficacy and results.

INTRODUCTION AND OBJECTIVES: The microdebrider is a surgical tool which has been used successfully in many endoscopic surgical procedures in otolaryngology. In this study, we analysed our experience using this powered instrument in the resection of obstructive nasal septum deviations. SUBJECTS AND METHODS: This was a longitudinal, prospective, descriptive study conducted between January and June 2007 on 141 patients who consulted for chronic nasal obstruction caused by a septal deviation or deformity and underwent powered endoscopic septoplasty (PES). RESULTS: The mean age was 39.9 years (15-63 years); 60.28% were male (n=85) The change in nasal symptom severity decreased after surgery from 6.12 (preoperative) to 2.01 (postoperative). Patients undergoing PES had a significant reduction of nasal symptoms in the pre- and postoperative period, which was statistically significant (P<.05). There were no statistically significant differences between the results at the 2 nd week, 6th week and 5th year after surgery. The 100% of patients were satisfied with the results of surgery and no patient answered "No" to the question added to compare patient satisfaction after surgery. Minor complications in the postoperative period were present in 4.96% of the cases. CONCLUSIONS: Powered endoscopic septoplasty allows accurate, conservative repair of obstructive nasal septum deviations, with fewer complications and better functional results. In our experience, this technique offered significant perioperative advantages with high postoperative patient satisfaction in terms of reducing the severity of nasal symptoms.

Adenoma pleomorfo del septum nasal, dos casos clínicos y revisión del tema / Pleomorphic adenoma of the nasal septum: two clinical cases

El tumor benigno más frecuente de las glándulas salivales mayores es el adenoma pleomorfo. Además de las glándulas salivales mayores, también puede ocurrir en las glándulas salivales del paladar duro y blando. Raros casos se han reportado en la nasofaringe, orofaringe, hipofaringe y laringe. Adenomas pleomorfos intranasales son muy infrecuentes y pueden ser mal diagnosticados debido a que tienen mayor celularidad mioepitelial y poco estroma mixoide, en comparación con los que se localizan en otros lugares. Presentamos dos raros casos de adenomas pleomorfos del septum nasal y analizamos los hallazgos patológicos y el manejo clínico. Se revisa la literatura en relación al tema.

The most common benign tumor of major salivary glands is the pleomorphic adenoma. In addition to the major salivary glands may also occur in the salivary glands of hard and soft palate. Rare cases have been reported in the nasopharynx, oropharynx, hypopharynx and larynx. Intranasal pleomorphic adenomas are very rare and can be misdiagnosed because they have greater myoepithelial cellularity and little myxoid stroma, compared with those located elsewhere. We report two rare cases of pleomorphic adenomas of the nasal septum and analyze the pathological findings and clinical management. We review the literature on the subject.

Septal turbinates: An entity with physiological importance

Septal turbinate refers to a widened region of the septum located superior to the inferior turbinates and anterior to the middle turbinates. Although a common anatomical variant, its significance is not well reported. We report a 56-year-old Malay man who presented with a three year history of chronic nasal obstruction secondary to septal turbinate and type II deviated nasal septum. His nasal symptoms improved dramatically following commencement of intranasal steroids. He remained free of symptoms during seven years of follow up. The physiologic implication and management of septal turbinates is discussed.

Perfuração do septo nasal: tratamento e revisão da literatura / Septum nasal perforation: treatments and literature' review

Introdução: O presente trabalho consiste de uma revisão da bibliografia a respeito de artigos relacionados às diferentes manifestações e formas da perfuração nasal septal, com ênfase principal na descrição de suas técnicas de correções cirúrgicas. Quanto à etiologia, essa é fundamentalmente iatrogênica, por consequência de trauma cirúrgico. Outras causas incluem exposição a reagentes químicos industriais, uso de cocaína, terapêutica esteroídica intranasal, neoplasias e condições infecciosas. Há poucos dados com relação à prevalência de perfuração do septo na população em geral. As tomadas de decisão sobre correção cirúrgica ou tratamento médico dependem das características anatômicas e da patogênese da perfuração septal.

Introduction: The present study consists in a bibliographical' review concerning the articles related to the different manifestations and forms of the septum nasal perforation, with a main emphasis in the description of its techniques of surgical correction. As the etiology, that is fundamentally iatrogenic, accordingly surgical trauma. Other causes include exhibition to chemical industrial reagents, cocaine use, intranasal steroidal therapeutic, neoplasia and, infectious conditions. There is a few data concerning the prevalence of septum perforation in the general population. The decision making about surgical correction or medical treatment depend on the anatomic characteristics and of the pathogenesis of the septal perforation.