Clinical features of otogenic cerebral sinovenous thrombosis: Our experience and review of literature.

Otogenic cerebral sinovenous thrombosis is an intracranial complication secondary to otogenic disease; it is rare but could be a life-threatening condition. Its management is always challenging. This study aimed to focus on clinical features, on diagnosis of this pathology and to review the most controversial aspect of management of otogenic cerebral sinovenous thrombosis. We reviewed retrospectively 10 inpatients treated with cerebral sinus thrombosis secondary to otitis between 1995 and 2020. Ten inpatients (eight males and two females) with ages ranging from 11 to 77 years were diagnosed with ontogenesis sinus thrombosis. The most commonly reported symptoms were headaches and otalgia. Five patients had mastoiditis, and 7 of the 10 patients had other concurrent complications: cerebellar abscess (three patients) and extradural empyema in two patients, retropharyngeal abscess in one patient, and meningitis in one patient. All patients were treated with broad-spectrum antibiotherapy, anticoagulation was used to treat nine patients, and surgery was required in nine patients. Nine patients had satisfactory resolution of their symptoms, but one patient had sequel as permanent loss of visual acuity. Because of the inconspicuous clinical presentation, and the probability of a fatal evolution, suspicion is essential for a proper diagnosis and suitable treatment.

A rare case of primary sinonasal meningioma: A case report.

INTRODUCTION AND IMPORTANCE: Extra cranial primary meningioma of sinonasal tract is a rare entity. It is often misdiagnosed as nasal polyp. CASE PRESENTATION: Here we report a case of a primary ethmoid sinus meningioma with extension into the nasal cavity in a 41-year-old man. The tumor was completely excised via endoscopic endonasalapproach and the histologic diagnosis of meningioma was established. The patient was regularly follow up for 12 months without recurrence of the tumor. CLINICAL DISCUSSION: The final diagnosis of primary sinonasal meningioma is based on histopathology and immunohistochemistry analyses results. The importance of complete surgical resection is undoubted and also is a goodindicator prognosis. CONCLUSION: The otolaryngologists should be aware of the diagnosis of primary meningioma; despite of its rarity it is considered as a possible cause of nasal obstruction.

Management of Isolated sphenoidal aspergillosis: Case report and review of literature.

INTRODUCTION AND IMPORTANCE: Sphenoidal aspergillosis is an uncommon serious condition that could lead to a fatal outcome. There is dilemma in its management. Published data concerning this pathology are limited so we find interesting in adding our experience to the literature mass. In fact, this work focused on the description of the clinical features of this entity as well as its management by presenting a case report and reviewing literature. CASE PRESENTATION: We report a case of 53 years old male who presented to the outpatient department of our university teaching Hospital with isolated chronic headache complaint that evolving through two years. His physical examination revealed no abnormalities. CT scan of facial bone and MRI showed an aspect in favor of sphenoidal aspergillosis. He underwent an endoscopic sphenoidotomy. Microscopic examination was consistent with the diagnosis of sphenoidal aspergillosis. There were no needs to associate an antifungal treatment since we estimate the surgery excision was complete. The patient remained free of disease after surgery for a follow-up of 4 years. CLINICAL DISCUSSION: Aspergillosis is ubiquitous in nature, currently causing severe disease in both immunocompetent and immunocompromised patients. Its frequency has increased over the past few years due to the widespread use of antibiotics, corticosteroids, and improved diagnostic methods. Surgery is the primary form of treatment, however if signs of invasion are present, it should be supplemented with an anti-fungal treatment. CONCLUSION: Sphenoidal aspergillosis is a rare condition whose diagnosis is not always obvious. The clinician should always bear this diagnosis in mind in patients with chronic sinusitis avoiding invasive and fulminant forms which could be life-threatening.

Solitary Fibrous tumor of Nasal cavity: A case report and review of literature.

INTRODUCTION AND IMPORTANCE: Solitary fibrous tumors (SFTs) involving the nasal cavity are extremely rare with few cases reported in the literature. CASE PRESENTATION: We present a case of SFT in a 90 year-old male complaining of a slow-growing mass prolapsing through left nostril. Nasal endoscopy and imaging exams revealed a mass occupying the entire left nasal cavity, pushing the nasal septum to the opposite side and extending up to the nasopharynx. Biopsy specimen examination reported sarcoma. The patient underwent complete surgical resection of the mass through left para-latero-nasal approach. Immuno-histochemical analyses confirmed the diagnosis of SFT. The patient has remained free of tumor 2 years after surgery. CLINICAL DISCUSSION: Clinical and imaging features of SFTs of nasal cavity are not specific. A broad of differential diagnosis is associated with histopathologic features of SFTs. Therefore, immuno-histochemical analyses are crucial to confirm the diagnosis. Complete resection of the mass with clear margins is mandatory to minimize local recurrence. CONCLUSION: SFTs of nasal cavity are very rare neoplasms which continue to pose challenges to practitioner. Pathological examination and mainly immunohistochemical studies are important to establish the diagnosis. Complete resection of the tumor is the key for good outcome.