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Kulak Burun Bogaz Ihtisas Dergisi : KBB... 2014Sinonasal teratocarcinosarcoma is an extremely rare malignant neoplasm presenting with the characteristics of a malignant teratoma and carcinosarcoma. The most common...
Sinonasal teratocarcinosarcoma is an extremely rare malignant neoplasm presenting with the characteristics of a malignant teratoma and carcinosarcoma. The most common sites of origin of teratocarcinosarcomas are the nasal cavity and paranasal sinuses. The clinical presentation is usually with nasal obstruction and episodes of epistaxis. Teratocarcinosarcomas are aggressive and rapidly growing tumors with a poor prognosis. The incidence of sinonasal teratocarcinomas is higher in men than women. Treatment is primarily surgery, followed by radiotherapy. In this article, we report a 46-year-old male case of sinonasal teratocarcinosarcoma who was admitted with complaints of pain and swelling around the right eye and treated surgically followed by radiotherapy.
Topics: Carcinosarcoma; Combined Modality Therapy; Diagnosis, Differential; Humans; Male; Middle Aged; Nasal Obstruction; Nose Neoplasms; Paranasal Sinus Neoplasms; Radiotherapy, Adjuvant; Teratoma
PubMed: 25046074
DOI: 10.5606/kbbihtisas.2014.50490 -
Australian Dental Journal Sep 2014Rhinosinusitis is a very common condition which is normally readily recognizable. Given the intimate anatomic relationship between the antrum and the posterior maxillary... (Review)
Review
Rhinosinusitis is a very common condition which is normally readily recognizable. Given the intimate anatomic relationship between the antrum and the posterior maxillary teeth, maxillary sinusitis can present as odontalgia. Distinguishing between odontogenic orofacial pain and pain associated with maxillary sinusitis is important to prevent unnecessary dental intervention and to direct patients to medical colleagues. Conversely, odontogenic infection can spread to involve the antrum, termed odontogenic sinusitis, or maxillary sinusitis of dental origin. Odontogenic sinusitis accounts for about 10-40% of all cases of sinusitis, and usually requires combined dental and medical treatment. Maxillary sinusitis can also be a complication of exodontia, resulting from tuberosity fractures, displaced teeth or root fragments and the creation of oroantral communications and fistulae. Dental implants and endodontic materials can also impinge on the maxillary sinus, and are rare causes of sinusitis. Often it is stated that rhinosinusitis may contribute to a halitosis complaint, and widely used diagnostic protocols for rhinosinusitis sometimes list halitosis as a minor criterion. However, gold standards in halitotosis research such as organoleptic assessment or gas chromatography have not been used to validate a correlation between objective (genuine) halitosis and sinusitis. The pathophysiology of this mechanism is unclear, and the relative importance of this alongside other causes of extraoral halitosis is debated.
Topics: Dental Implants; Diagnosis, Differential; Female; Halitosis; Humans; Maxillary Sinus; Maxillary Sinusitis; Oral Medicine; Oroantral Fistula; Rhinitis; Tooth Extraction; Toothache
PubMed: 24861778
DOI: 10.1111/adj.12193 -
Clinical Cardiology Feb 1999Early repolarization (ER) is an enigma. The purpose of this review is to reemphasize the overall electrocardiographic (ECG) pattern of this normal ST variant which... (Comparative Study)
Comparative Study Review
Early repolarization (ER) is an enigma. The purpose of this review is to reemphasize the overall electrocardiographic (ECG) pattern of this normal ST variant which continues to challenge the clinician because of its similarity to the current of injury potential to myocardium or an acute pericarditis. The data were provided from the studies identified through computerized searches of Medline, Toxline, Oxford, Agricola, and Bios Afterdark, Cumulative index, and a review of bibliographies of relevant articles on the related subjects. Early repolarization has elevated, upward, concave ST segments, located commonly in precordial leads, with reciprocal depression in a VR, tall, peaked and slightly asymmetrical T waves with notch, and slur on the R wave. The other accompanying features in the ECG are vertical axis, shorter and depressed P-R interval, abrupt transition, counterclockwise rotation, presence of U waves, and sinus bradycardia. Males dominate and patients are often younger than 50 years of age. The incidence of 1 to 2% is found equally common in all races. Degree and incidence of ST elevation decrease as age advances. Exercise or isoproterenol administration may normalize the ST segment. Early repolarization is a benign condition. If the ECG conforms to a classical pattern of ER on serial ECGs, it would exclude the unnecessary hazards of present day revascularization therapy for myocardial infarction such as primary angioplasty or thrombolytic therapy, or aggressive management of acute pericarditis, and so forth. This review concludes with a discussion of comparative ECG features of ER, pericarditis, and myocardial infarction, and provides an algorithm for diagnostic management of patients suffering from these conditions.
Topics: Acute Disease; Chest Pain; Diagnosis, Differential; Electrocardiography; Humans; Myocardial Infarction; Myocardial Revascularization; Pericarditis; Thrombolytic Therapy
PubMed: 10068841
DOI: 10.1002/clc.4960220203 -
Nigerian Journal of Clinical Practice Dec 2022Septoplasty, endoscopic sinus surgery, and tympanoplasty are the most commonly performed elective functional ear-nose-throat surgeries. Aim: This study investigated the...
BACKGROUND
Septoplasty, endoscopic sinus surgery, and tympanoplasty are the most commonly performed elective functional ear-nose-throat surgeries. Aim: This study investigated the relationship between preoperative anxiety, bruxism, and postoperative pain in inpatient groups undergoing three different functional otorhinolaryngologic surgeries. Patients and.
METHODS
This study was conducted in a single center of a tertiary referral hospital. The patients (n = 90) who had undergone septoplasty (group A), endoscopic sinus surgery (group B), and tympanoplasty (group C) were included. The State-Trait Anxiety Inventory (STAI) questionnaire and the Amsterdam Preoperative Anxiety Information Scale (APAIS) were administered. To evaluate bruxism, a self-questionnaire was administered, and for the evaluation of pain, the visual analogue scale (VAS) was administered.
RESULTS
In group C, preoperative STAI and APAIS and early and late pain values were higher than in the other groups. When patients were divided into two groups according to the presence of bruxism. A significant difference was found between the preoperative STAI and immediate and late VAS values (P < 0.001). A strong correlation was observed between APAIS and early and late VAS values in group C (P < 0.001).
CONCLUSION
Patients who will undergo tympanoplasty should be aware of the preoperative anxiety level and pain follow-up. Bruxism can be considered a vital follow-up parameter that manifests due to high preoperative anxiety. It may also be useful to examine preoperative bruxism and take appropriate measures due to its pain-increasing effect in patients.
Topics: Humans; Bruxism; Tympanoplasty; Anxiety; Endoscopy; Pain, Postoperative
PubMed: 36537455
DOI: 10.4103/njcp.njcp_400_22 -
Journal of Cystic Fibrosis : Official... Jan 2021The high incidence and prevalence of chronic pain in patients with cystic fibrosis (CF) is well documented. However, there is limited data on chronic pain management in...
BACKGROUND
The high incidence and prevalence of chronic pain in patients with cystic fibrosis (CF) is well documented. However, there is limited data on chronic pain management in this population.
METHODS
We designed a questionnaire examining care team members' views on the prevalence and characteristics of pain, pain management, and opioid use. The questionnaire was distributed to accredited programs throughout the US via a CF Foundation (CFF) email list-serve.
RESULTS
Responses came from 52 adult core or affiliated centers (Adult Responders - AR), 36 pediatric core or affiliated centers (Pediatric Responders - PR), and 9 were from combined programs. AR perceive more patients having chronic pain compared to PR. Furthermore, 40% of the AR said that > 50% of those with chronic pain also have comorbid depression or anxiety. 61% of PR ranked sinus/headache symptoms as the most common while AR ranked chest wall as the most frequent site (58%). While most centers (83%) report that pain management in patients with CF is a very important or important issue, 50% of AR feel uncomfortable or only slightly comfortable in prescribing opioids. 44% report that CF providers are currently responsible for this task.
CONCLUSIONS
Chronic pain is common in adult patients with CF and management presents a formidable challenge to providers. The development of guidelines and/or collaboration with pain specialists will likely benefit both patients and providers.
Topics: Adult; Analgesics; Analgesics, Opioid; Attitude of Health Personnel; Child; Cystic Fibrosis; Health Care Surveys; Humans; Pain; Practice Patterns, Physicians'; United States
PubMed: 32798122
DOI: 10.1016/j.jcf.2020.07.021 -
Headache Apr 2022Although remarkable progress has been achieved in understanding cluster headache (CH) pathophysiology, there are still several gaps about the mechanisms through which... (Review)
Review
BACKGROUND
Although remarkable progress has been achieved in understanding cluster headache (CH) pathophysiology, there are still several gaps about the mechanisms through which independent subcortical and cortical brain structures interact with each other. These gaps could be partially elucidated by structural and functional advanced neuroimaging investigations.
OBJECTIVE
Although we are aware that substantial achievements have come from preclinical, neurophysiological, and biochemical experiments, the present narrative review aims to summarize the most significant findings from structural, microstructural, and functional neuroimaging investigations, as well as the consequent progresses in understanding CH pathophysiological mechanisms, to achieve a comprehensive and unifying model.
RESULTS
Advanced neuroimaging techniques have contributed to overcoming the peripheral hypothesis that CH is of cavernous sinus pathology, in transitioning from the pure vascular hypothesis to a more comprehensive trigeminovascular model, and, above all, in clarifying the role of the hypothalamus and its connections in the genesis of CH.
CONCLUSION
Altogether, neuroimaging findings strongly suggest that, beyond the theoretical model of the "pain matrix," the model of the "neurolimbic pain network" that is accepted in migraine research could also be extended to CH. Indeed, although the hypothalamus' role is undeniable, the genesis of CH attacks is complex and seems to not be just the result of a single "generator." Cortical-hypothalamic-brainstem functional interconnections that can switch between out-of-bout and in-bout periods, igniting the trigeminovascular system (probably by means of top-down mechanisms) and the consensual trigeminal autonomic reflexes, may represent the "neuronal background" of CH.
Topics: Cluster Headache; Functional Neuroimaging; Humans; Migraine Disorders; Neuroimaging; Pain
PubMed: 35315064
DOI: 10.1111/head.14279 -
Cureus Oct 2022The aim of this review article is to determine whether a deviated nasal septum (DNS) is a potential risk factor for the occurrence of chronic rhinosinusitis (CRS).... (Review)
Review
The aim of this review article is to determine whether a deviated nasal septum (DNS) is a potential risk factor for the occurrence of chronic rhinosinusitis (CRS). Nasal septal deformities include spur, deviated nasal septum, thickening, and dislocation. Deformities of the nose tip and columella are examples of external deformities, together with the deviated part of either cartilage or both the bony and cartilage part of the dorsum of the nose. Various symptoms of chronic rhinosinusitis include nasal obstruction, nasal or post-nasal drainage, facial pain and pressure, and smell disturbances. For a long time, the deviation of the nasal septum is related to the pathogenesis, progression, and severity of chronic rhinosinusitis. Mechanisms involving mechanical and aerodynamics theory may be used to explain this relationship. Etiology in the occurrence of CRS are allergy, asthma, tooth Infection, immunodeficiency, mucociliary disorders, anatomical irregularities like DNS, concha bullosa, septum spurring, or an expanded cystic middle turbinate or prominent agger nasi cells that compromise the osteomeatal complex. The computed tomography (CT) scan imaging of the nasal cavity and paranasal sinuses has dramatically improved especially since the use of coronary CT scans. These scans make it simple to find even minute changes and abnormalities in bony structures and mucosal pathologies. An increase in the angle of DNS is significantly linked to specific disease patterns in the osteomeatal complex. This review shows that not all subtypes of DNS always result in the development of CRS. Only extremely severe DNS appears to contribute to the etiology of CRS.
PubMed: 36381736
DOI: 10.7759/cureus.30261 -
The Journal of Manual & Manipulative... Sep 2019: Headaches can be associated with rhinosinusitis and may present a diagnostic challenge because of symptomatic overlap with other recurring headaches. Neck pain has... (Observational Study)
Observational Study
: Headaches can be associated with rhinosinusitis and may present a diagnostic challenge because of symptomatic overlap with other recurring headaches. Neck pain has received extensive attention in migraine, tension-type and cervicogenic headache but not as a comorbid feature of headache in those with rhinosinusitis. This study investigated the occurrence of neck pain and cervical musculoskeletal dysfunction in individuals with self-reported sinus headaches (SRSH). : Participants with and without SRSH attended a single data collection session. Participants completed the Headache Impact Test (HIT)-6 and the Sino-Nasal Outcome Test (SNOT)-22. Cervical range of motion (ROM), segmental examination, muscle endurance and pressure-pain threshold (PPT) were measured . : Participants included 31 with SRSH (77.4% female; age 43.7 (9.9) years) and 30 without headache. Average symptom duration was 89.7 (±85.6) months. Mean SNOT-22 and HIT-6 scores were 36.2 (15.3) and 56.7 (7.1), respectively. In the SRSH group, 83.9% ( = 26) reported neck pain. There was a significant difference between groups for cervical sagittal (14.3° [5.3°, 23.3°], = 0.002) and transverse plane ROM (21.5° [12.4°, 30.6°], < 0.001), but no difference in frontal plane motion ( = 0.017). There were significant between groups difference in neck flexor endurance (19.5 s [10.1 s, 28.9 s], <0.001), segmental dysfunction O-C4 ( < 0.001) but not in PPT ( = 0.04). : Neck pain and cervical musculoskeletal dysfunction are common among persons with SRSH and may be a comorbid feature or contributing factor to headaches attributed to rhinosinusitis. Further research is needed to understand these associations.
Topics: Adult; Case-Control Studies; Cervical Vertebrae; Comorbidity; Female; Headache; Humans; Male; Middle Aged; Muscle Strength; Neck Muscles; Neck Pain; Pain Threshold; Pressure; Range of Motion, Articular; Rhinitis; Self Report; Sino-Nasal Outcome Test; Sinusitis; Young Adult
PubMed: 30935330
DOI: 10.1080/10669817.2019.1572987 -
JNMA; Journal of the Nepal Medical... Jul 2021Tolosa-Hunt Syndrome is a rare disease characterized by painful ophthalmoplegia affecting third, fourth, and/or sixth cranial nerve caused by non-specific inflammation...
Tolosa-Hunt Syndrome is a rare disease characterized by painful ophthalmoplegia affecting third, fourth, and/or sixth cranial nerve caused by non-specific inflammation in the cavernous sinus or superior orbital fissure of unknown etiology. We presented a 67-year-old female with Tolosa-Hunt Syndrome. She had a right-sided headache and periorbital pain with double vision. Examination showed right-sided ptosis, right-sided trochlear and abducens nerve palsy, and partial right-sided oculomotor nerve palsy with hypoesthesia in the area of the ophthalmic division of the trigeminal nerve. Magnetic resonance imaging of head and orbit showed altered signal intensity changes in the optic nerve and lateral rectus muscle. After steroid therapy, pain and ptosis were significantly improved in 72 hours. Tolosa-Hunt Syndrome is a diagnosis of exclusion, with clinical presentation, normal investigations, magnetic resonance imaging findings, and response to steroid therapy crucial in making the diagnosis.
Topics: Aged; Blepharoptosis; Female; Humans; Magnetic Resonance Imaging; Pain; Tolosa-Hunt Syndrome
PubMed: 34508416
DOI: 10.31729/jnma.5700 -
Current Neurology and Neuroscience... Apr 2016Allergic rhinitis and migraine remain on the list of the most common diseases affecting adults. Migraines and headaches due to allergic rhinitis are easily confused... (Review)
Review
Allergic rhinitis and migraine remain on the list of the most common diseases affecting adults. Migraines and headaches due to allergic rhinitis are easily confused because the symptoms of both conditions often overlap. Both may occur with sinus headache, nasal congestion, and lacrimation and may worsen with weather changes and exposure to allergens. No precise clinical definition exists for what constitutes a sinus headache, which has always been a diagnostic dilemma. Contrary to popular belief, headache is not a typical symptom of rhinitis. Some studies have shown that up to 90 % of sinus headaches are actually migraines. Nevertheless, patients with self-diagnosed sinus headache self-treat or are treated by primary care physicians and/or otolaryngologists with medications for rhinosinusitis, ignoring the neurogenic causes of the symptoms when most of these patients fulfill diagnostic criteria for chronic migraine. Chronic migraine affects 2 % of the general population and has a significant socioeconomic impact on society, incurring health care costs and diminishing quality of life; therefore, the proper diagnosis and treatment of these headache patients should be a priority.
Topics: Animals; Chronic Pain; Headache; Humans; Migraine Disorders; Quality of Life; Rhinitis, Allergic; Sinusitis
PubMed: 26898685
DOI: 10.1007/s11910-016-0631-z