RESUMO
Videolaryngostroboscopy (VLS) is considered gold standard method for assessing voice disorders. But patients with irregular waveform of vocal folds cannot benefit from the VLS. Videokymography [VKG] is a single line real time, high speed imaging technique. It detects voice disorders based on vocal fold vibration characteristics whether the vibrations are regular or irregular. There is no standard clinical protocol or evidence on the clinical relevance of VKG for functional assessment of voice disorders. Since mechanism of voice production depends on vibration characteristics, VKG imaging leads to new possibilities for diagnosis, objective documentation and monitoring of vocal fold behavior in clinical practice in case of voice disorders. This study aims to evaluate clinical value of VKG in addition to VLS as a complementary tool for the assessment of voice disorder.
RESUMO
Malignant Peripheral Nerve Sheath Tumour (MPNST) is a neoplastic lesion rarely reported in literature. In approximately 5% of cases it is associated with Neurofibromatosis type 1 syndrome. Pathognomic features of MPNST include slow growth rate, aggressive nature, nearly circumscribed, unencapsulated arising from non myelinated Schwann cells. In this case report we elaborate probable molecular pathogenesis, clinical features, histopathology (HPE) and radiological findings in a unique case of MPNST. A 52 year old female patient presented with Right cheek swelling, Loss of sensations over right maxillary region, U/L nasal obstruction and watery nasal discharge, palatal buldge and intermittent pain over right maxillary region and generalised headache. Following Magnetic resonance imaging studies (MRI scan) of paranasal sinuses, Biopsy was taken from maxillary mass and palatal swelling. HPE report was suggestive of Spindle cell proliferation against myxoid stroma. Positron Emmision Tomography (PET-Scan) was done and Biopsy specimen was subjected for Immunohistochemistry staining (IHC). After confirmation of MPNST on IHC, patient was referred to skull base surgeon for complete excision of the tumour and reconstruction.
RESUMO
Angiomatous nasal polyps are rare, benign and non-neoplastic lesions rarely reported in literature. Clinically and radiologically it mimics sinonasal neoplasm. In 5% of inflammatory or allergic sinonasal polyps, extensive vascularisation and ectasia with pseudoamyloid deposition is noted. Pathognomic features of ANP are angiogenesis, accumulation of amorphous eosinophilic substance and atypical stromal cells. In this case report we elaborate probable etiology, clinical features, histopathology (HPE) and radiological findings in a unique case of ANP which mimicked sinonasal mass. Patient presented with U/L nasal obstruction and recurrent episodes of epistaxis. He was operated for similar complaints 8 years ago, details of which were not available with the patient. Patient was recently diagnosed with Hypertension (HTN) and Diabetes Mellitus (DM). On Diagnostic Nasal endoscopy and Radiological imaging, the nasal mass appeared to be a sinonasal vascular lesion. Revision Functional endoscopic sinus surgery was done and on HPE, ANP was reported. Thus, we conclude that ANPs are rare pathological entity and can cause a significant diagnostic dilemma. Thorough knowledge about the clinical presentation and histopathological features is important in establishing an early definitive diagnosis. Also we have made an attempt to establish the possible role of DM and HTN in pathophysiology of ANP.