National Cancer Institute®
Last Modified: November 21, 2001
UI - 20409300
AU - Trotter WL; Kaw P; Meyer DR; Simon JW
TI - Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery.
SO - J AAPOS 2000 Aug;4(4):250-3
AD - Albany Medical College, New York.
During the past 2 decades, the introduction of functional endoscopic sinus surgery (FESS) has dramatically improved the treatment of sinus disorders. However, a variety of orbital complications have been reported, including optic nerve damage, hemorrhage, infection, compromise of the lacrimal drainage apparatus, and strabismus. At least 10 cases have reported damage to the medial rectus muscle. (1-8) Treatment options for such patients have been limited, especially because most are adults at risk for anterior segment ischemia after transposition of vertical rectus muscles. We describe 2 patients whose medial rectus myectomies were repaired by using nonabsorbable "hang-back" sutures in combination with a botulinum toxin (Botox) injection of the antagonist lateral rectus muscle. Good primary position alignment was achieved in both patients, and one patient was able to regain binocular function. We recommend this surgical approach, especially in patients at increased risk for anterior segment ischemia.
UI - 21324141
AU - Bonfils P; Jankowski R; Werner A
TI - [Smell dysfunction in nasal and paranasal sinus disease: a review of the literature (I)]
SO - Ann Otolaryngol Chir Cervicofac 2001 Jun;118(3):131-42
AD - Service d'ORL et de Chirurgie Cervico-Faciale I, Hopital Europeen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France. email@example.com
Substantial advances have been achieved during the last decade in our understanding of the biological bases of the sense of smell, as well as in the clinical identification, diagnosis, and management of dysosmia. Nasal obstruction can result from inflammatory, neoplastic, traumatic, and developmental alterations within the nasal cavity. All these processes, if they result in bilateral restriction of airflow to the olfactory neuroepithelium, presumably alter the ability to smell. Rhinitis, nasal polyposis, and rhinosinusitis are accompanied by decreased ability to smell. Benign and malignant neoplasms can obstruct the nasal chamber and thereby alter airflow to the olfactory receptors without damaging the olfactory neuroepithelium. The purpose of this synthesis is to provide an advanced review of the literature in order to describe the basis of smell alterations in nasal polyposis and chronic rhinosinusitis.
UI - 21324143
AU - Choussy O; Lerosey Y; Marie JP; Dhermain F; Seng SH; Francois A;
TI - Andrieu-Guitrancourt J; Dehesdin D [Adenocarcinoma of the ethmoid sinuses: results of a retrospective study in Rouen]
SO - Ann Otolaryngol Chir Cervicofac 2001 Jun;118(3):156-64
AD - Service ORL et chirurgie cervico-faciale, CHRU de Rouen, 76031 Rouen Cedex, France.
Ethmoid adenocarcinoma is a rare tumour of the ethmoidal sinuses. The authors report on the clinical features, treatment and follow-up results in 19 cases. Risk factors were those regularly encountered. Delay to diagnosis was long due to the nonspecific clinical features and course. Nasal endoscopy was essential for follow-up. Computed tomography and magnetic resonance imaging were also required to assess tumour spread. Our results suggest that radiotherapy following surgery should be preferred. Survival rate is generally low for this type of tumor.We had 77% survival at 5 years.
UI - 21353217
AU - Saengpanich S; Kerekhanjanarong V; Chochaipanichnon L; Supiyaphun P
TI - Nasolacrimal duct injury from microscopic sinus surgery: preliminary report.
SO - J Med Assoc Thai 2001 Apr;84(4):562-5
AD - King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok.
Nasolacrimal duct injury is a well established complication of functional endoscopic sinus surgery. In 1992, Bolger reported an incidence of nasolacrimal duct injuries in endoscopic sinus surgery of up to 15 per cent, but there is no documentation in microscopic sinus surgery. Fluorescein instillation into the lacrimal system via the punctum was done to determine the incidence of nasolacrimal duct injuries in 16 patients who underwent 32 microscopic sinus procedures. Only one patient exhibited nasolacrimal duct injury intraoperatively on the left side (0.3%). He had complete healing of the nasolacrimal duct at 2 months and no postoperative epiphora developed.
UI - 21388936
AU - Azizi L; Marsot-Dupuch K; Bigel P; Mzali S; Meyer B; Tubiana JM
TI - Merkel cell carcinoma: a rare cause of hypervascular nasal tumor.
SO - AJNR Am J Neuroradiol 2001 Aug;22(7):1389-93
AD - Department of Radiology, Hopital Saint Antoine, 18 Rue du Faubourg Saint Antoine, 75012 Paris, France.
Cutaneous neuroendocrine carcinoma, first described in 1972, is an aggressive disease usually occurring in sun-exposed skin. Other sites have been described, however; such tumors occasionally occur within the nasal fossa. A high rate of metastasis (>30%) explains the poor prognosis. Descriptions of the imaging features of these tumors, mainly located in cutaneous region, are rare. We therefore present the imaging features of two cases of Merkel cell carcinoma involving the sinonasal region, suggestive of a hypervascular tumor.
UI - 21396154
AU - Chao KS; Kaplan C; Simpson JR; Haughey B; Spector GJ; Sessions DG;
TI - Arquette M Esthesioneuroblastoma: the impact of treatment modality.
SO - Head Neck 2001 Sep;23(9):749-57
AD - Radiation Oncology Center, Mallinckrodt Institute of Radiology, Washington University Medical Center, WU Box 8224, 4939 Children's Place, Suite 5500, St. Louis, MO 63110, USA. firstname.lastname@example.org
BACKGROUND: We evaluated the impact of treatment modality on esthesioneuroblastoma. METHODS: Between 1976 and 1996, 25 patients with esthesioneuroblastoma were treated at Mallinckrodt Institute of Radiology. There were 11 male and 14 female patients; their ages ranged from 16 to 73 years (median, 57 years). The tumors were Kadish stage A in 3, Stage B in 13, C in 8, and modified D in 1 (cervical nodal metastasis). Seventeen patients were treated with surgery and radiation therapy, six were treated with irradiation alone, and two were treated with surgery only. Eight patients received neoadjuvant chemotherapy. Median follow-up was 8 years (range, 2-24 years). RESULTS: The 5-year actuarial overall survival, disease-free survival, and local tumor control rates were 66.3%, 56.3%, and 73.0%, respectively. Kadish stage was not a significant prognosticator for local control or disease-free survival. Five-year local control rates were 87.4% for the combination of surgery and radiation therapy and 51.2% for irradiation alone. Two patients with Kadish stage A and B disease underwent surgical resection alone; both failed locally. In contrast, 33.3% of patients (three of nine) with Kadish stage A or B disease who received adjuvant radiation therapy had a local recurrence develop. With adjuvant radiation therapy, the surgical margin status did not influence local tumor control. Among the eight patients who received neoadjuvant chemotherapy, six patients showed no response, one had partial response, and one showed a complete response. CONCLUSIONS: Surgical resection plus adjuvant radiation therapy yielded the best treatment outcome. More effective chemotherapy agents with a reproducible effectiveness are needed for patients with locally advanced esthesioneuroblastoma. Copyright 2001 John Wiley & Sons, Inc.
UI - 21430295
AU - Letichevsky V; Talmon Y; Samet A; Cohen Y
TI - [Verrucous carcinoma of the nose and maxillary sinus]
SO - Harefuah 2001 Aug;140(8):706-8, 806
AD - Depts. of Otolaryngology and Pathology, Western Galilee Hospital-Naharia.
Verrucous carcinoma is a rare type of squamous cell carcinoma that is most commonly seen in the oral cavity, and seldom in the larynx. It should be distinguished from benign papilloma, verrucous hyperplasia and well-differentiated non verrucous squamous cell carcinoma. Verrucous carcinoma is a rare tumor of the sinonasal tract. Only 28 such cases have been described in the medical literature reviewed until this time. We describe the first case in Israel of a patient with such a tumor in the nasal cavity. We reviewed the existing literature dealing with Verrucous Carcinoma of paranasal sinuses.
UI - 21437443
AU - Kayal JD; Hampton RW; Sheehan DJ; Washington CV
TI - Malignant glomus tumor: a case report and review of the literature.
SO - Dermatol Surg 2001 Sep;27(9):837-40
AD - Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA.
Glomangiosarcoma, or malignant glomus tumor, is a very rare neoplasm that when seen typically arises from a benign glomus tumor. Despite having histologic features of malignancy, these tumors usually do not metastasize. However, when metastasis occurs this disease is often fatal. We report a case of a malignant glomus tumor arising de novo on the nose of an 89-year-old white woman, and we review the literature concerning glomangiosarcomas.
UI - 21445198
AU - Shoham T; Yaniv E; Koren R; Gal R; Parameswaran R; Kravitz A; Geron H;
TI - Markovitz D; Lantzki M; Zipori D Reduced expression of activin A in focal lymphoid agglomerates within nasal polyps.
SO - J Histochem Cytochem 2001 Oct;49(10):1245-52
AD - Department of Molecular Cell Biology, The Weizmann Institute of Science, Rehovot, Israel.
It has been previously reported that activin A, a homodimer of the betaA inhibin subunit, is secreted by stromal cells from mouse bone marrow and causes apoptotic death of mouse plasmacytoma tumor cells. Recent in vitro studies have also implicated this cytokine in the suppression of normal B-cell lymphopoiesis. In this study we examined the occurrence of activin A in nasal polyp tissues that present a combination of epithelium, mesenchyme, and vascular endothelium, with frequent massive hemopoietic infiltration. Anti-betaA-chain antibodies strongly stained epithelial mucous glands and some endothelial cells, and diffusely stained the polyp stroma. Normal adult conchae were similarly stained, whereas activin A was not detected prenatally by immunostaining of nasal tissues. Staining specificity was substantiated by ligand competition assays. Detailed examination of the inflammatory polyp infiltrate showed that activin A staining was reduced in sites of focal infiltration of B-lymphoid cells. It is therefore implied that local accumulation of a large number of B-cells is associated with relatively low activin A expression.
UI - 21453553
AU - Stennert E
TI - Rhino-frontal sinuseptotomy (RFS): a combined intra-extra nasal approach for the surgical treatment of severely diseased frontal sinuses.
SO - Laryngoscope 2001 Jul;111(7):1237-45
AD - Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, Cologne, Germany.
OBJECTIVES: Frontal sinus surgery is a challenge to those involved in the treatment of recurrent frontal sinusitis. The purpose of this report is to describe the technique and to present the results of a combined endoscopic and external approach to the frontal sinus (rhino-frontal sinuseptotomy [RFS]). MATERIAL: RFS was performed in 45 patients by the author; 41 of these patients had a follow-up over 12 months and were included in this series. Indications for RFS were severe chronic frontal sinusitis (n = 23), mucoceles (n = 12), in two cases each with osteoma, inverting papilloma, and malignant tumors of the frontal sinus, respectively. The surgical technique is started with an external approach according to Jansen-Ritter and includes the resection of the interfrontal septum, partial resection of the nasal septum, bilateral subtotal resection of the middle turbinates, bilateral endoscopic ethmoidectomy, and resection of the frontal sinus floor. The nasofrontal communication is epithelialized with free mucosal grafts and fixed with fibrin clue. RESULTS: After a mean follow-up of 62 months, 40 patients (98%) had a widely patent epithelialized nasofrontal communication. Ninety-one percent of the patients with chronic frontal sinusitis or mucoceles noted complete relief of their frontal discomfort within 1 week after RFS. No patient required revision surgery of the nasofrontal outflow tract after RFS. Only one severe complication was recognized (cerebrospinal fluid leakage). CONCLUSION: The results reported here with the RFS technique are superior to those reported on external procedures and endoscopic drill-out procedures. The key to successful management is the creation of a large nasofrontal communication, and direct epithelialization with free mucosal grafts obtained from the septum and turbinates.
UI - 21379597
AU - Sedlmaier B; Schleich A; Ohnesorge B; Jovanovic S
TI - [The NEN (Nicolet Electronic Naviation System) ENT navigation system. Initial clinical application]
SO - HNO 2001 Jul;49(7):523-9
AD - HNO-Klinik mit Polikliniken, Klinikum Benjamin Franklin, Freie Universitat, Hindenburgdamm 30, 12200 Berlin. email@example.com
BACKGROUND: Intraoperative computer navigation will soon play an important role in procedures performed on the anterior and lateral skull base. Electromagnetic systems compared to optical systems offer some advantages such as small hardware dimension and free unimpaired mobility of the surgeon. PATIENTS AND METHODS: The NEN navigational system (Nicolet Electromagnetic Navigation System) was used in 22 patients who underwent microscopic/endoscopic surgery for polypoid rhinosinusitis. It is the prototype of a new system, which localizes the surgical probe via the measurement of pulsed electromagnetic DC fields. This system was modified for the needs of head and neck surgery. Preoperative imaging data consisted of an axially oriented spiral computed tomography (CT) resulting in a slice thickness of 1 mm with a radiation dose slightly higher than a routine coronary CT scan of the paranasal sinuses. RESULTS: The data acquired during clinical application was used to optimize navigation accuracy. The number and positions of the markers were gradually modified and improved. Six markers including the volume of the paranasal sinus system (three non-coplanar frontal markers, one on each of the mastoid processes and one median marker on parietooccipital junction) offered the best navigation precision. Additionally, all surgical instruments measured as ferromagnetic, i.e., nasal specula, were replaced by titanium instruments. An adapter affixed to the maxilla-designed to hold a second sensor used to track the patient's head was developed. With these modifications, it was possible to improve navigation accuracy to 1.5 mm in the plane of the sphenoid bone while retaining free head movement of the patient. CONCLUSION: For routine procedures such as microscopic/endoscopic endonasal sinus surgery, the systems have to be cost effective and easy to operate.
UI - 21390923
AU - Pan Z; Cao Z
TI - [Cerebrospinal aporrhinosis of nasal sinus operation]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Feb;33(1):47-8
AD - Department of Otolaryngology, First Affiliated Hospital, Chinese Medical University, Shenyang 110001.
OBJECTIVE: To study the treatment of cerebrospinal aporrhinosis after nasal sinus operation, especially frontal, ethmoid tumor resection. METHODS: Fourteen cases of cerebrospinal aporrhinosis after nasal sinus operations were reported. RESULTS: Seven cases of cerebrospinal apporrhinosis were found during the operation. Two cases were repaired with tensor facia latae, 3 with mucosoperichondrium of nasal septum and EC otocerebral glue and 1 with TJ bone cement. Seven cases cerebrospinal aporrhinosis were found after the operations when intranasal packing was removed. They were cured by cerebral decompression and antibiotics, none complicated with intracranial infection. CONCLUSION: Careful examination should be taken daring the operation. If aporrhinosis was found, it should be repaired immediately.
UI - 21409963
AU - Chmielik M; Wasiutnyski A; Maldyk J; Wachulski B; Bartoszek D
TI - Histological analysis of nasal polyps in children.
SO - Int J Pediatr Otorhinolaryngol 2001 Aug 20;60(2):131-3
AD - Children's ENT Department of Warsaw Medical University, 24 Marszakowska St., 00-576 Warsaw, Poland. firstname.lastname@example.org
During 1991-1999, in the Children's ENT Department of Warsaw Medical University, 39 polypectomies were performed. We analysed the histological structure of all polyps. The most common type of nasal polyp tissue in children was the inflammatory polyp (95% of cases).
UI - 21453626
AU - Dedo HH; Yu KC
TI - CO(2) laser treatment in 244 patients with respiratory papillomas.
SO - Laryngoscope 2001 Sep;111(9):1639-44
AD - Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California 94117, USA.
OBJECTIVE: Respiratory papillomas (RP) tend to recur and the difficulty in eradicating the disease makes their treatment frustrating. Meticulous CO(2) laser excisions every 2 months has been the most effective treatment to date. This article analyzes the results of this plan in 244 patients with RP in the nose, nasopharynx, pharynx, hypopharynx, larynx, trachea, lung parenchyma, and skin. METHODS: Two hundred forty-four patients with recurrent RP were treated by the senior author with CO(2) laser excisions and, in some cases, podophyllum and alpha interferon. Demographics, initial distribution of papillomas, number of operations performed on each patient, and current results were evaluated. RESULTS: Careful laser excisions of RPs every 2 months achieved "remission" of disease (no visible RP on indirect or often direct laryngoscopy 2 mo after last removal) in 37% of patients, "clearance" of the disease process (no RP clinically apparent for 3 y after last removal) in 6%, and "cure" (no clinical recurrence for 5 y after last removal) in 17%. Juvenile-onset RP tends to follow a more aggressive course than adult-onset RP. Four patients (1.6%) developed malignant transformation of their papillomas. Except for ones in lung parenchyma, RP in areas other than the true vocal cords tend to be cleared faster because aggressive removal does not cause hoarseness. Lung parenchyma RPs are eventually fatal because of pulmonary failure from abscesses and cysts resulting from a lack of effective treatment. CONCLUSION: Frequent and meticulously performed CO(2) laser excisions can achieve significant voice and airway improvement, and some clinical "cures." However, effective antiviral medicines and/or immunologic agents are needed to achieve true cures with elimination of all human papilloma virus 6 and 11 viruses.
UI - 21453156
AU - Claus F; De Gersem W; De Wagter C; Van Severen R; Vanhoutte I; Duthoy W;
TI - Remouchamps V; Van Duyse B; Vakaet L; Lemmerling M; Vermeersch H; De Neve W An implementation strategy for IMRT of ethmoid sinus cancer with bilateral sparing of the optic pathways.
SO - Int J Radiat Oncol Biol Phys 2001 Oct 1;51(2):318-31
AD - Division of Radiotherapy, Ghent University Hospital, Ghent, Belgium
Purpose: To develop a protocol for the irradiation of ethmoid sinus cancer, with the aim of sparing binocular vision; of developing a strategy of intensity-modulated radiation therapy (IMRT) planning that produces dose distributions that (1) are consistent with the protocol prescriptions and (2) are deliverable by static segmental IMRT techniques within a 15-minute time slot; of fine tuning the implementation strategy to a class solution approach that is sufficiently automated and efficient, allowing routine clinical application; of reporting on the early clinical implementation involving Eleven consecutive T1-4N0M0 ethmoid sinus cancer patients were enrolled in the study. For Patients 1-8, a first protocol was implemented, defining a planning target volume prescription dose of 60 to 66 Gy in 30-33 fractions and a maximum dose (Dmax) of 50 Gy to optic pathway structures and spinal cord and limit of 60 Gy to brainstem. For Patients 9-11, an adapted (now considered mature) protocol was implemented, defining a (planning target volume) prescription dose of 70 Gy in 35 fractions and a Dmax to optic pathway structures and brainstem of 60 Gy and to spinal cord of 50 Gy. RESULTS: The class solution-directed strategy developed during this study reduced the protocol translation process from a few days to about 2 hours of planner time. The mature class solution involved the use of 7 beam incidences (20-37 segments), which could be delivered within a 15-minute time slot. Acute side effects were limited and mild. None of the patients developed dry eye syndrome or other visual disturbances. The follow-up period is too short for detection of retinopathy or optic nerve and chiasm toxicity. CONCLUSION: Conventional radiotherapy of ethmoid sinus tumors is associated with serious morbidity, including blindness. We hypothesize that IMRT has the potential to save binocular vision. The dose to the optic pathway structures can be reduced selectively by IMRT. Further enrollment of patients and longer follow-up will show whether the level of reduction tested by the clinical protocol is sufficient to save binocular vision. An adaptive strategy of IMRT planning was too inefficient for routine clinical practice. A class solution-directed strategy improved efficiency by eliminating human trial and error during the IMRT planning process.
UI - 21448782
AU - Kraft M; Simmen D; Casas R; Pfaltz M
TI - Significance of human papillomavirus in sinonasal papillomas.
SO - J Laryngol Otol 2001 Sep;115(9):709-14
AD - Department of Otorhinolaryngology, Kantonsspital Liestal, Rheinstrasse 41, CH-4420 Liestal, Switzerland.
Recent investigations have suggested human papillomavirus (HPV) to be involved in the development of sinonasal papillomas (SNP). Forty-three patients operated for SNP were studied to determine the prevalence of HPV-DNA sequences in these tumours and to evaluate their value as a prognostic parameter. The original sections of all cases were reviewed and reclassified according to the WHO. Paraffin blocks available from 37 patients were subjected to in situ hybridization (ISH) and polymerase chain reaction (PCR). Histology revealed 34 cases of inverted papilloma (IP) (79 per cent), five cases of exophytic papilloma (EP) (12 per cent) and four cases of columnar cell papilloma (CCP) (nine per cent). Recurrences developed in seven of 41 patients (17 per cent), and malignancy occurred in four of 43 patients (nine per cent). HPV was detected in four of 37 specimens (11 per cent) both by ISH and PCR. In particular, HPV-11 was found in three lesions (two EP, one IP) (eight per cent), and HPV-6b was detected in one lesion (one EP) (three per cent). Our findings suggest a possible role for HPV in the pathogenesis of exophytic papillomas. As no correlation was found to malignancy and recurrence of disease, screening for HPV seems not to be useful as a prognostic parameter.
UI - 21254034
AU - Birjawi GA; Haddad MC; Tawil AN; Khoury NJ
TI - Metastatic rhabdomyosarcoma to the breast.
SO - Eur Radiol 2001;11(4):555-8
AD - Department of Diagnostic Radiology, American University of Beirut Medical Center, P.O. Box 113-6044, Beirut, Lebanon.
Rhabdomyosarcoma is a common extramammary primary malignancy in childhood that rarely metastasises to the breast. We present a patient with primary sinonasal rhabdomyosarcoma who was in remission when she developed breast metastases. We describe particular imaging findings of this disease, using ultrasound and MR imaging. To our knowledge, MR findings have only been described in one previous case report in the literature.
UI - 21293670
AU - Menick FJ
TI - The use of skin grafts for nasal lining.
SO - Clin Plast Surg 2001 Apr;28(2):311-21, viii
The satisfactory replacement of missing nasal lining often determines the aesthetic and functional result of a nasal reconstruction. Although full-thickness skin grafts have been employed for lining in the prefabricated forehead flap technique, the results are unpredictable because they remain largely unsupported and subject to contraction. Advances in the understanding of the vasculature of the forehead flap, the use of primary and delayed cartilage grafts, and the appropriate use of operative staging permit full-thickness skin grafts to be combined with a forehead flap at the time of transfer, with little risk of loss. The technique is especially useful in the elderly or debilitated patient when a shortened operative time and less intranasal manipulation is appropriate, or when previous injury or rhinoplasty has interfered with septal blood supply, making the use of intranasal lining flaps unreliable.
UI - 21301904
AU - Lund VJ
TI - Distant metastases from sinonasal cancer.
SO - ORL J Otorhinolaryngol Relat Spec 2001 Jul-Aug;63(4):212-3
AD - Institute of Laryngology and Otology, Royal National Throat Nose and Ear Hospital, London, UK. email@example.com
Distant metastases from sinonasal malignancy are generally a rare event except in the terminal stages of the diseases and many patients die from recurrence before the secondaries become clinically manifest. Sinonasal neoplasia covers a diverse range of pathologies, some of which have a greater tendency to spread than others, in particular adenoid cystic carcinoma, malignant melanoma and some of the sarcomas. Notwithstanding this, the frequency with which systemic metastases occurs is such that screening at presentation could not be regarded as cost-effective and is consequently only instituted in the presence of specific symptoms. Copyright 2001 S. Karger AG, Basel
UI - 21453582
AU - Han JK; Smith TL; Loehrl T; Toohill RJ; Smith MM
TI - An evolution in the management of sinonasal inverting papilloma.
SO - Laryngoscope 2001 Aug;111(8):1395-400
AD - Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, U.S.A.
OBJECTIVE: We reviewed the 15-year experience of our institution (Medical College of Wisconsin, Milwaukee, WI) in managing sinonasal inverting papilloma, examining trends in diagnosis and treatment. STUDY DESIGN: Retrospective. METHODS: Thirty-seven patients with inverting papilloma were treated from 1986 to 1999. Demographic data, clinical presentations, pathological findings, surgical approaches and procedures, and recurrence rates were collected retrospectively. Each lesion was categorized into one of four groups based on computed tomography scans and endoscopic findings. This categorization was developed to compare various surgical approaches for tumors in each group. RESULTS: Thirty-one patients had complete information for inclusion in our study. Nineteen patients were treated endoscopically with an average follow-up of 50 months. Eight patients were in group I, five were in group II, six were in group III, and no patients were in group IV. The recurrence rate for the endoscopic group was 10%. Twelve patients underwent lateral rhinotomy or sublabial degloving approach with an average follow-up of 58 months. Five patients were in group I, three patients were in group II, 1 patient was in group III, and three patients were in group IV. The recurrence rate for the external group was 8%. Difference in recurrence rates (P =.85) was not observed between the endoscopic and external approach groups. Regardless of approach, patients who had primary resection had a recurrence of 0%, whereas those with secondary resection had a recurrence of 17% (P =.10). CONCLUSIONS: Technological advancements have led to a trend of detecting sinonasal inverting papilloma before extension beyond the sinonasal region. Difference in recurrence rates was not observed between the endoscopic and the external approach groups. Recurrence rates are lower for primary resection versus secondary resection, regardless of surgical approach.
UI - 21453583
AU - Thorp MA; Oyarzabal-Amigo MF; du Plessis JH; Sellars SL
TI - Inverted papilloma: a review of 53 cases.
SO - Laryngoscope 2001 Aug;111(8):1401-5
AD - Department of Otolaryngology, University of Cape Town, Groote Schuur Hospital, Observatory, South Africa.
OBJECTIVE: To assess the surgical management of patients with inverted nasal papilloma over a 14-year period. STUDY DESIGN: Retrospective study. SETTING: Tertiary health care center. RESULTS: Fifty-three patients (38 males, 15 females) with an average age of 49.8 years were treated. Overall recurrence rate was 28% and a malignant association of 9% was shown. Recurrence rates varied from 27% in patients with more extensive disease involvement treated by lateral rhinotomy and medial maxillectomy, to 30% in patients with less extensive disease treated conservatively. Of the 5 patients with associated malignancy, 3 (6% of all patients) are likely to have undergone malignant transformation. CONCLUSION: Aggressive initial management remains the therapeutic aim in this condition.
UI - 21409147
AU - Gabris K; Orosz M; Suba Z
TI - The effects on teeth of radiotherapy for nasal endodermal sinus tumor (yolk sac tumor) in childhood.
SO - Int J Oral Maxillofac Surg 2001 Aug;30(4):356-8
AD - Department of Pediatric Dentistry and Orthodontics, Semmelweis University of Medicine, Budapest, Hungary.
A rare case of a 10-year-old girl with an endodermal sinus tumor that occurred in the nasal cavity is presented. She received chemotherapy and radiotherapy at the age of 4. The subsequent abnormal development of the maxillary teeth is described and discussed in the light of the known effects of radiotherapy.
UI - 21281016
AU - Nishizawa S; Yokota N; Yokoyama T; Mukodaka H; Watanabe T; Hoshino T;
TI - Ueda Y Prevention of postoperative complications in skull base surgery for nasal or paranasal sinus carcinoma invading the skull base.
SO - J Clin Neurosci 2001 May;8 Suppl 1():67-70
AD - Department of Neurosurgery, Hamamatsu University School of Medicine, Shizuoka, Japan.
With recent technical advances in skull base surgery, radical resection of a nasal or paranasal sinus carcinoma invading the skull base can now be achieved. To assure a satisfactory surgical result, it is essential to prevent postoperative infection. In our series of 14 cases, serious postoperative infections occurred in the earliest 10 cases, and only 2 of these patients are still alive. The vascularised abdominal muscle flap for skull base reconstruction was fixed with fibrin glue, but was not adequate to fill the dead space, resulting in cerebrospinal fluid leakage and subsequent meningitis. Once the infection occurred, a free bone flap became the focus of infection. Based on these earlier experiences, we used a ROC fastener system to completely fill the dead space with an abdominal muscle flap, and bone flap was primarily craniectomised in the four most recent cases. With this technique, there were no postoperative infections. Copyright 2001 Harcourt Publishers Ltd.
UI - 21452259
AU - Rodriguez-Camps S
TI - Nasal reconstruction after epithelioma.
SO - Aesthetic Plast Surg 2001 Jul-Aug;25(4):273-7
AD - Unidad de Cirugia Plastica y Estetica, Hospital Casa de Salud, Valencia, Spain.
In this paper we present our procedure for the treatment, histopathological diagnosis, and resection of skin cancer in the nasal pyramid and its subsequent reconstruction. Because we are dealing with the most important anatomical feature of the face our goal is an aesthetic reconstruction [2,4] according to the anatomical subunits criterion of Burget . First, a histopathological diagnosis is made to determine the nature of the tumor. Then, we proceed with the resection according to the Mohs Micrographic Surgery [1,5,7]. Then we begin with the first step of the nasal reconstruction.
UI - 21002845
AU - Diamantopoulos II; Jones NS; Lowe J
TI - All nasal polyps need histological examination: an audit-based appraisal of clinical practice.
SO - J Laryngol Otol 2000 Oct;114(10):755-9
AD - Department of Otorhinolaryngology, University Hospital, Nottingham, UK.
Case details were reviewed from 2021 patients treated surgically for nasal polyposis between 1991 and 1999, seen by six surgeons serving a catchment population of 805,000. The aim of this study was to determine the incidence of discrepancies between clinical and histological diagnosis. Twenty-two patients (1.1 per cent) were identified as having a lesion that differed histologically from the clinical diagnosis made at the time of surgery and which altered their further management. Amongst them were 11 cases of inverted papilloma, two of Wegener's granulomatosis; and two of sarcoid. The rest of the cases comprised three of squamous cell carcinoma, one of adenocarcinoma, one of myeloma, one of angiofibroma and one of microcystic papillary adenoma. In this series, the occurrence of malignancy, inverted papilloma, or other clinically significant pathology among the group of patients with otherwise clinically unsuspected histology justifies sending nasal polyps for routine pathologic examination. A cost-benefit analysis showed that, on the basis of 250 cases per year, the cost of laboratory and pathological services would be 12,000 Pounds, in comparison with the estimated average medicolegal cost of 51,000 Pounds per year incurred as a result of a delay in diagnosis together with the pain and suffering which would result given the case mix in this series.
UI - 20333774
AU - Leenhouts HP; Brugmans MJ
TI - An analysis of bone and head sinus cancers in radium dial painters using a two-mutation carcinogenesis model.
SO - J Radiol Prot 2000 Jun;20(2):169-88
AD - National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands. Henk.Leenhouts@rivm.nl
Bone and head sinus cancer incidence after ingestion of 226Ra and 228Ra by radium dial painters is analysed using a two-mutation clonal expansion model for radiation carcinogenesis, taking into account the retention and radiation patterns of these nuclides in the body. The best fit is obtained for compact bone retention and efficient diffusion of 222Rn to the bone cavities and radiation action on both mutation rates of the cancer model, as found in a similar analysis of bone sarcomas after 226Ra injection in beagles. The model parameters of the best fit are consistent with cellular radiobiological data and a previous analysis of lung cancer in uranium miners. Due to the low background incidence of bone and head sinus cancer, the resulting dose-effect relationships for these cancers are linear-quadratic with radium ingestion and alpha radiation dose. These results do not support a threshold dose concept, but the risks at low doses calculated by the model come out to about a factor 10 lower than using a linear extrapolation of the data to low doses, a procedure currently applied by ICRP and EPA. Furthermore, the model results indicate radiation risks at low doses to be related with background cancer incidence between relative and absolute radiation risk projections. The results, which are dependent on the model assumptions, might be more generally applicable for bone seekers and will therefore need further study to arrive at better radiation risk estimations.
UI - 21293867
AU - Ahman M; Holmstrom M; Kolmodin-Hedman B; Thelin A
TI - Nasal symptoms and pathophysiology in farmers.
SO - Int Arch Occup Environ Health 2001 May;74(4):279-84
AD - Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden. firstname.lastname@example.org
OBJECTIVES: Increased morbidity and mortality in lower airway diseases have been reported among farmers. The aim of this study was to assess upper airway problems in farmers. SUBJECTS AND METHODS: Twenty-five dairy farmers, 20 pig farmers, 21 grain farmers and 19 control subjects were studied, by use of questionnaire, skin-prick test, dynamic spirometry, nasal inspection, acoustic rhinometry (before and after a decongestant) as well as by determinations of the olfactory threshold and nasal lavage (NAL) concentrations of eosinophil cationic protein (ECP), myeloperoxidase (MPO) and albumin. RESULTS: Compared with the control group, farmers had more complaints of work-related symptoms from the lower airways, and symptoms of smell impairment, and more often had nasal polyps and hyperaemia of the nasal mucosa. They also had higher levels of MPO in NAL (especially dairy farmers and pig farmers), and a tendency to more swollen nasal mucosa and lower olfactory threshold (especially grain farmers). CONCLUSIONS: The farmers had more pathological findings in their nasal mucosa, possibly indicating effects of allergens and irritants in their work environment. More studies are needed to evaluate work environment factors causing these pathological findings in farmers.
UI - 21403284
AU - Fedok FG; Burnett MC; Billingsley EM
TI - Small nasal defects.
SO - Otolaryngol Clin North Am 2001 Aug;34(4):671-94, v
AD - Division of Otolaryngology-Head and Neck Surgery, Pennsylvania State University, Hershey, Pennsylvania 17033, USA.
The nose occupies an important feature of a person's central face. The size, shape, and proportions of the various characteristics of the face provide a visual basis suggesting the character of the person. Scars, asymmetries, and any abnormalities of the central face are easily recognizable and noted by even a casual observer. Over the centuries, therefore, much attention has been paid to reconstruction of facial and nasal abnormalities of both acquired and congenital etiologies. The purpose of this article is to address the reconstruction of smaller defects of the nose, encompassing surface areas of 1.5 to 2 centimeters.
UI - 21433711
AU - Hofer A; Kaddu S; Seidl H; Kerl H; Wolf P
TI - Collision of squamous-cell carcinoma with melanoma in situ in a child with xeroderma pigmentosum.
SO - Dermatology 2001;203(1):66-9
AD - Department of Dermatology, Karl Franzens University, Graz, Austria. email@example.com
Coexistence (collision) of two different neoplasms in the same lesion has previously been documented by several authors. In this report, we describe a 13-year-old boy with xeroderma pigmentosum presenting with squamous-cell carcinoma and melanoma arising at the same site on the nose. Histopathologically, the melanoma component of the lesion was located mainly eccentrically to the squamous-cell carcinoma component. Immunohistochemical stains confirmed the histopathologic findings. Mutations for p53 assessed using single-strand conformation polymorphism, and sequencing analysis revealed a CC-to-TT transition at codon 159 of the p53 gene in the squamous-cell component but not in the melanoma component. This finding suggests a possible role for UV in the pathogenesis of at least the squamous-cell component of the tumor. To the best of our knowledge, this is the first report of a collision tumor comprising squamous-cell carcinoma and melanoma arising in childhood. Copyright 2001 S. Karger AG, Basel
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