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European Annals of Otorhinolaryngology,... Feb 2017Assessment of sinonasal symptoms on a self-reported questionnaire is thoroughly subjective, but indispensable for quantifying symptoms. The present study sought to... (Comparative Study)
Comparative Study
OBJECTIVE
Assessment of sinonasal symptoms on a self-reported questionnaire is thoroughly subjective, but indispensable for quantifying symptoms. The present study sought to compare responses on the DyNaChron questionnaire just before and just after consultation for chronic sinonasal dysfunction.
MATERIALS AND METHODS
78 patients (mean age, 43.1±16.9 years) consulting for chronic sinonasal dysfunction took part in a prospective study, responding to the computerized version of the DyNaChron self-reported questionnaire, in a dedicated room, just before and just after medical interview and physical examination.
RESULTS
Most patients tended to grade symptoms as less severe after consultation. Significant differences in mean score were found for nasal obstruction (difference of 0.94/10), anterior (0.40) and posterior rhinorrhea (0.26), olfactory disorder (0.65), and facial pain and headache (0.65), but not for chronic cough.
CONCLUSION
Self-reported scores for chronic sinonasal dysfunction differ slightly from before to after consultation. They are therefore to be interpreted with caution, taking account of possible factors of bias.
Topics: Adult; Facial Pain; Female; Headache; Humans; Male; Nasal Mucosa; Nasal Obstruction; Olfaction Disorders; Paranasal Sinuses; Prospective Studies; Referral and Consultation; Self Report; Surveys and Questionnaires; Symptom Assessment; Visual Analog Scale
PubMed: 27726976
DOI: 10.1016/j.anorl.2016.09.012 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Nov 2021To study the clinical manifestations and surgical treatment of temporal bone cerebrospinal fluid leakage. The clinical data of twenty seven cases with temporal bone...
To study the clinical manifestations and surgical treatment of temporal bone cerebrospinal fluid leakage. The clinical data of twenty seven cases with temporal bone cerebrospinal fluid leakage were analyzed retrospectively. Different surgical procedures were adopted according to the location of the leak and the hearing status of the affected ear.If the leakage location was clear before surgery, direct repair was performed via mastoid path or middle cranial fossa path with or without mastoid abdominal fat packing.For patients with unclear leak, large lesion or intractable CEREBROspinal fluid leakage of temporal bone, subtotal petrosal resection and abdominal fat packing were performed.Subtotal temporal bone resection and abdominal fat packing were performed for patients with cochlear involvement. In this study, cases of temporal bone CSF leakage including 13 cases of inner ear malformation; 5 cases secondary to head trauma or previous surgery,5 cases of idiopathic intracranial hypertension or meningocele, 2 cases of langerhans histiocytosis in the temporal bone and 2 cases of inner ear inflammation. High resolution CT (HRCT) of temporal bone showed bone defect of inner auditory canal with vestibular communication in 13 patients with inner ear malformation.The temporal bone HRCT of the remaining 14 patients showed bone defects in the middle cranial fossa or posterior cranial fossa, while MRI of the temporal bone showed meningeal continuity interruption with cerebrospinal fluid inflow into the temporal bone or meningoencephalocele in 12 patients. The 26 patients were followed up from 6 months to 6 years. 1 patient lost follow-up.Meningitis recurred in only 1 patient with inner ear malformation, and subtotal resection of rock bone plus abdominal fat packing was performed.Postoperative hearing was preserved or improved in 7 patients.None of the patients had serious complications, and only 1 patient developed HB Grade Ⅱ facial paralysis after vestibular obliteration, and the facial paralysis recovered within one week. Temporal bone cerebrospinal fluid leakage is relatively rare. Surgical intervention should be taken as early as possible when conservative treatment is failure. Preoperative HRCT and MRI examination are necessary for the localization of the leakage, and individualized surgical approaches can be adopted according to the location of the leakage and the features of the lesion.
Topics: Cerebrospinal Fluid Leak; Cerebrospinal Fluid Otorrhea; Humans; Retrospective Studies; Temporal Bone; Vestibule, Labyrinth
PubMed: 34886603
DOI: 10.13201/j.issn.2096-7993.2021.11.008 -
Medicine Nov 2018Seromucinous hamartoma is a rare benign glandular proliferation of the sinonasal tract and nasopharynx, and the majority of lesions occur on the posterior nasal septum.
RATIONALE
Seromucinous hamartoma is a rare benign glandular proliferation of the sinonasal tract and nasopharynx, and the majority of lesions occur on the posterior nasal septum.
PATIENT CONCERNS
The patient had complaints of rhinorrhea, sneezing, and itching for a number of years, and recurrent right nasal bleeding for which the patient underwent endoscopic removal of a right inferior turbinate tumor. The biopsy result was low-grade, non-intestinal type adenocarcinoma, and the patient was referred to our hospital.
DIAGNOSIS AND INTERVENTIONS
An endoscopic medial maxillectomy of the right nasal cavity was performed. The histopathological analysis of the nasal mass revealed a seromucinous (glandular) hamartoma.
OUTCOMES
The postoperative course was unremarkable. The patient has been followed up regularly for 1 year with no additional treatment and no recurrence.
LESSONS
Seromucinous hamartoma of the nasal cavity is extremely rare, especially in anterior portion of nasal cavity. It is important to distinguish seromucinous hamartoma from adenocarcinoma and to maintain regular long-term follow-up.
Topics: Adult; Female; Hamartoma; Humans; Neoplasms, Cystic, Mucinous, and Serous; Nose Diseases; Turbinates
PubMed: 30407294
DOI: 10.1097/MD.0000000000013022 -
Cancer Management and Research 2021Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is a rare nasopharyngeal tumor. This study aimed to analyze the clinical and histopathological features of the...
PURPOSE
Low-grade nasopharyngeal papillary adenocarcinoma (LGNPPA) is a rare nasopharyngeal tumor. This study aimed to analyze the clinical and histopathological features of the disease, and to share our experience of its treatment.
PATIENTS AND METHODS
We collected demographic data, clinical symptoms, tumor location, pathological features, immunohistochemical results, treatments, and outcomes of 28 patients with pathologically confirmed LGNPPA between 2009 and 2019.
RESULTS
The median age of the 28 patients was 41.5 years, with a female: male ratio of 1.5:1 (17 females, 11 males). The most common symptom was blood-stained rhinorrhea. The neoplasms were located on the roof of the nasopharynx (RON) in 13 patients, the posterior margin of the nasal septum (PMONP) in 12 patients, the lateral wall of the nasopharynx in one case, and both the RON and PMONP in two patients. Fourteen patients were diagnosed with thyroid-like LGNPPA. Immunohistochemically, the tumors were uniformly positive for cytokeratin 7, cytokeratin 8, vimentin, epithelial membrane antigen, and pan-cytokeratin, and negative for thyroglobulin. Twenty-three patients underwent pure endoscopic surgery, three patients underwent preoperative radiotherapy, and two patients underwent radiotherapy postoperatively. All patients were alive without evidence of lymphatic or distant metastases in the follow-up period (range: 7 to 121 months). Two patients (7%, 2/28) experienced disease recurrence.
CONCLUSION
LGNPPA is an indolent tumor with an excellent prognosis. Endonasal endoscopic excision was an effective treatment. It is important to distinguish thyroid-like LGNPPA from metastatic papillary thyroid carcinoma because these diseases have similar microscopic features but different prognoses.
PubMed: 33603472
DOI: 10.2147/CMAR.S288007 -
Cureus Jan 2021Rhinitis is classified as allergic or nonallergic. It presents with nasal congestion, nasal pruritus, posterior nasal drainage, rhinorrhea, and/or sneezing. During short...
Rhinitis is classified as allergic or nonallergic. It presents with nasal congestion, nasal pruritus, posterior nasal drainage, rhinorrhea, and/or sneezing. During short procedures, nasal cannula administration of supplemental oxygen may be utilized to prevent hypoxia. Postprocedural rhinitis after intravenous sedation with supplemental nasal oxygen (PRAISE SNOG) - a noninflammatory variant of nonallergic rhinitis - has been observed in colonoscopy patients. Symptoms (sneezing and/or rhinorrhea with or without tearing) typically begin during emergence from sedation and persist for hours to days before resolving. A 66-year-old woman developed bilateral PRAISE SNOG following cataract extraction; her bilateral symptoms of nasal pruritus, rhinorrhea, and sneezing began immediately after awakening from sedation and spontaneously resolved within 24 hours. Mucosal irritation by the nasal cannula prongs that deliver the oxygen is a postulated pathogenesis for postprocedural rhinitis. Modification of the nasal prong composition (by using a soft silicon-based material), placement (by insertion prior to the induction of sedation and by not impinging on the nasal mucosa), and length (by trimming from 10 to two millimeters) are possible actions that might be initiated in order to prevent PRAISE SNOG.
PubMed: 33552770
DOI: 10.7759/cureus.12452 -
Annals of Medicine and Surgery (2012) Mar 2021and importance: this case report aimed at an unusual case of extensive rhinoscleroma with a literature review, We report this case to bring attention to the patients...
and importance: this case report aimed at an unusual case of extensive rhinoscleroma with a literature review, We report this case to bring attention to the patients with immunodeficiency problem regardless of presenting symptoms. Case presentation: a 70 -year-old patient with diabetes and hypertension, consulted for chronic median and posterior headaches have not improved with symptomatic treatment. She reported cacosmia without rhinorrhea and right otalgia. The examination of the nasal cavity showed a bleeding lesion on the lateral wall of the nasopharynx. CT-scan of the facial showed tissue lesion on the posterior and lateral walls of the nasopharynx, with infiltration of the parapharyngeal space and bone lysis right edge of the clivus. The biopsy confirmed the diagnosis of rhinoscleroma. The patient started the ciprofloxacin for 3 months, and the evolvement has noticed with the disappearance of the lesion during the first month of treatment. The patient started the ciprofloxacin for 3 months, and the evolvement was noticed with the disappearance of the lesion during the first month of treatment. Cilinical discussion: rhinoscleroma is a chronic and progressive granulomatous disease of the nasal cavities. The diagnosis is confirmed by the search for bacteria and an anatomopathological assessment of MIKULICZ cells. The medical treatment of choice has a high concentration in macrophages such as rifampicin and fluoroquinolone. Conclusion: rhinoscleroma is a granulomatous disease caused by klebsiella rhinoscleromatis, you must think about in front a nasopharyngeal lesion imitating a malignant pathology.
PubMed: 33643651
DOI: 10.1016/j.amsu.2021.02.012 -
International Forum of Allergy &... Feb 2023Temperature-controlled radiofrequency (TCRF) neurolysis of the posterior nasal nerve (PNN) area for the treatment of chronic rhinitis was previously reported as superior... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Temperature-controlled radiofrequency (TCRF) neurolysis of the posterior nasal nerve (PNN) area for the treatment of chronic rhinitis was previously reported as superior to a sham-control procedure at 3 months postprocedure in a randomized controlled trial (RCT). The primary endpoint was a responder rate of ≥30% improvement (decrease) for 24-hour reflective total nasal symptom score (rTNSS) compared with baseline. Herein, 12-month outcomes after active treatment are reported.
METHODS
In this prospective, multicenter, patient-blinded RCT, patients in the index active treatment arm were unblinded at 3 months and followed through 12 months. At 3 months, eligible patients from the sham-control arm of the study were invited to crossover to active treatment. Eligibility criteria included rTNSS ≥6, with moderate-severe rhinorrhea and mild-severe congestion. The TCRF stylus was applied bilaterally to nonoverlapping areas in the region of the PNN.
RESULTS
Patients in the index active treatment arm (n = 77) had a mean baseline rTNSS of 8.3 (95% confidence interval [CI], 7.9-8.7). At 12 months, the responder rate was 80.6% (n = 67) (95% CI, 69.1%-89.2%). At 12 months, the mean change in rTNSS was -4.8 (95% CI, -5.5 to -4.1; p < 0.001), a 57.8% improvement. The available initial rTNSS-based outcomes in the crossover active treatment arm (n = 27) were following the same course as the index treatment arm. No serious adverse events and 8 adverse events related to the device/procedure were reported in the trial to date.
CONCLUSION
TCRF neurolysis of the PNN area is safe and the symptom burden improvement that was superior to a sham procedure at 3 months was sustained through 12 months.
Topics: Humans; Rhinitis; Temperature; Nose; Rhinorrhea; Treatment Outcome
PubMed: 35714267
DOI: 10.1002/alr.23047 -
Journal of Neurosurgery. Case Lessons Feb 2022Rhinorrhea due to lateral skull base cerebrospinal fluid (CSF) leaks can be a challenge to manage. Multiple strategies exist for treating CSF leaks in this region...
BACKGROUND
Rhinorrhea due to lateral skull base cerebrospinal fluid (CSF) leaks can be a challenge to manage. Multiple strategies exist for treating CSF leaks in this region including direct repair, posterior Eustachian tube packing, and CSF diversion. Endonasal closure of the Eustachian tube has been reported using cerclage and mucosal flaps.
OBSERVATIONS
We present the first reported case of endoscopic autologous fat packing of the Eustachian tube orifice to repair a CSF leak. In this case a 42-year-old woman who underwent middle fossa meningioma resection 20 years ago presented with refractory CSF rhinorrhea despite blind sac closure of the ear canal. This persisted after CSF diversion and only resolved after endoscopic endonasal Eustachian tube closure described herein.
LESSONS
This technique is simple to perform with minimal risk of morbidity. Eustachian tube orifice fat packing may be particularly useful for patients with refractory CSF rhinorrhea with low CSF pressure.
PubMed: 36130556
DOI: 10.3171/CASE21590 -
Journal of Yeungnam Medical Science Jan 2023The endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ) has recently been considered a safer alternative and less invasive approach than the...
The endoscopic endonasal approach (EEA) to the craniovertebral junction (CVJ) has recently been considered a safer alternative and less invasive approach than the traditional transoral approach because the complications associated with the latter are avoided or minimized. Here, we present two challenging cases of CVJ pathologies. The first case involved os odontoideum associated with anterior displacement of the occipitocervical junction where the EEA was used, followed by C0-C1-C2 fusion using a posterior approach to decompress the CVJ, and was complicated by rhinorrhea and Candida albicans meningitis. The second case involved basilar invagination with syringomyelia previously treated using a posterior approach, where aggravation of neuropathic symptoms required combined treatment with EEA and occipitocervical fusion of C0-C2-C3-C4, with the postoperative course challenged by operative site infection requiring drainage with debridement and antibiotic therapy. The EEA is an alternative approach for accessing the CVJ in well-selected patients. Knowledge of EEA complications is crucial for the optimal care of patients.
PubMed: 35855592
DOI: 10.12701/jyms.2022.00234 -
Acta Otorhinolaryngologica Italica :... Jun 2024Olfactory dysfunction (OD) represents a frequent complaint in general population and especially in patients with chronic sinonasal diseases. The aim of this study was...
OBJECTIVE
Olfactory dysfunction (OD) represents a frequent complaint in general population and especially in patients with chronic sinonasal diseases. The aim of this study was the cross-cultural adaptation and validation of the Self-reported Mini Olfactory Questionnaire (Self-MOQ) into Italian.
METHODS
One hundred fifty patients affected by chronic sinonasal diseases and reporting hyposmia were enrolled. Other 150 normosmic subjects without inflammatory or neoplastic sinonasal disorders were used as a control group. The Short-form 36 (SF-36) questionnaire was used for clinical validity.
RESULTS
Cronbach's alpha coefficient was 0.825. The test-retest reliability was excellent. The good correlation between the Self-MOQ and the Visual Analogue Scale scores (p < 0.05) demonstrated the construct validity of the questionnaire. The Self-MOQ was able to distinguish between subjects with or without OD (p < 0.05). Higher Self-MOQ score was found in case of nasal obstruction and posterior rhinorrhoea (p < 0.05). Self-MOQ showed significant correlation with SF-36 general health, SF-36 role functioning/physical, and SF-36 pain (p < 0.05).
CONCLUSIONS
The Italian version of the Self-MOQ showed good internal consistency, test-retest reliability, construct, and clinical validity.
Topics: Humans; Female; Male; Italy; Reproducibility of Results; Middle Aged; Self Report; Olfaction Disorders; Adult; Aged; Translations; Surveys and Questionnaires; Young Adult
PubMed: 38712517
DOI: 10.14639/0392-100X-N2386