phenylephrine-hydrochloride and Nasopharyngeal-Neoplasms

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is an inflammatory disease with a treatment goal of controlling symptoms and limiting disease burden. While endoscopic sinus surgery is effective for removing polyps and aerating sinuses, proper medical management remains necessary for reducing inflammation and limiting polyp recurrence.. This article aims to summarize the literature regarding medical treatment of chronic rhinosinusitis with nasal polyposis, with a specific focus on developments in the past 5 years.. We conducted a literature review using PubMed to identify studies assessing medical treatment strategies for patients with CRSwNP. Articles focusing on chronic rhinosinusitis without nasal polyposis were excluded unless specifically stated. Surgical treatment and biologic therapies for CRSwNP will be covered in subsequent chapters and are therefore not included.. Intranasal saline irrigations and topical steroids are mainstays of CRSwNP treatment in the pre-surgical, post-surgical, and maintenance phases of the disease. Alternative steroid delivery methods and adjunctive treatments with antibiotics, anti-leukotrienes, and other topical therapies have been investigated and may benefit certain patient populations, but convincing evidence does not exist to warrant addition of these treatments to the standard of care for CRSwNP.. Topical steroid therapy is clearly effective for CRSwNP, and recent studies demonstrate the safety and efficacy of high-dose nasal steroid rinses. Alternate delivery methods for local steroids may be useful for patients who are not responding to or who are noncompliant with conventional intranasal corticosteroid sprays and rinses. Future studies are needed to clarify if oral or topical antibiotics, oral anti-leukotrienes, or other novel therapies are significantly effective in decreasing symptoms and improving the quality of life in patients with CRSwNP.

Topics: Anti-Bacterial Agents; Humans; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Quality of Life

Endoscopic skull base surgery has significantly revolutionized the management of skull base disease. Our review focuses on the recent literature relating to endoscopic skull base surgery emphasizing its limitations.. Current literature continues to expand the indications for endoscopic approaches to the skull base. Experience in endoscopic techniques continues to grow across the world. This is due in part to advances in instrumentation and technology, improvements in technique and, more importantly, an increase in the number of surgeons with training in endoscopic techniques. Long-term outcome data remain sparse.. The limitations in endoscopic skull base surgery have not been reached. Increasing experience and improvement in technology will likely expand current indications. Future studies should focus on outcome analysis.

Topics: Angiofibroma; Cerebral Angiography; Dura Mater; Embolization, Therapeutic; Endoscopy; Hemostasis; Humans; Magnetic Resonance Imaging; Nasopharyngeal Neoplasms; Nose; Preoperative Care; Skull Base Neoplasms

Topics: Brain Neoplasms; Humans; Mandible; Methods; Nasal Cavity; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Palate; Skull Neoplasms

Topics: Endoscopy; Facial Injuries; Humans; Maxillary Diseases; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Paranasal Sinus Neoplasms; Penicillins; Rhinoplasty; Sinusitis; Surgery, Plastic

Topics: Epiglottis; Glottis; Humans; Laryngeal Neoplasms; Laryngoscopy; Larynx; Nasopharyngeal Neoplasms; Neck; Nose; Paranasal Sinus Neoplasms; Paranasal Sinuses; Pharyngeal Neoplasms; Radiography; Radiotherapy Dosage; Tomography; Vocal Cords

To evaluate the therapeutic effect of clarithromycin combined with tanshinone in the treatment of rhinosinusal and laryngeal radiation injury induced by radiotherapy in patients with nasopharyngeal carcinoma (NPC).. A total of 255 NPC patients with rhinosinusal and laryngeal radiation injury following radiotherapy were randomized into 3 groups for treatment with clarithromycin (group A, n=69), tanshinone (group B, n=69), and clarithromycin + tanshinone (group C, n=69), and the clinical outcomes of the patients were evaluated.. In all the 3 groups the patients responded favorably to the treatments and showed obvious improvements (P<0.05). The therapeutic effects were similar between groups A and B (P>0.05), but the patients in group C showed the most obvious improvements (P<0.05).. Clarithromycin combined with tanshinone can be an effective regimen for treatment of rhinosinusal and laryngeal radiation injury induced by radiotherapy in NPC patients.

Topics: Abietanes; Adult; Aged; Carcinoma; Clarithromycin; Combined Modality Therapy; Female; Humans; Larynx; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Paranasal Sinuses; Pharynx; Radiation Injuries; Young Adult

Conservative therapy for chronic polyposis rhinosinusitis are well covered, and modern endoscopic rhinosurgery can effectively cope with this pathology. Clinical cases of large destructive anthrochoanal polyps are not uncommon, the pathology is well studied. However, cases with giant sinonasal polyposis, which lead to bone-destructive changes in the bones of the nose and the walls of the paranasal sinuses are very rare. We found only one case similar to the clinical observation presented in this article.. В настоящее время вопросы консервативной терапии полипозного риносинусита хорошо освещены в литературе, а современная эндоскопическая ринохирургия позволяет эффективно справляться с данной патологией. Клинические случаи выявления больших антрохоанальных полипов нередки, патология хорошо изучена. Особый интерес представляют случаи полипозного риносинусита с полипами большого размера, которые приводят к костно-деструктивным изменениям костей носа и стенок околоносовых пазух; в литературе описаны единичные случаи, подобные представленному в данной статье клиническому наблюдению.

Topics: Chronic Disease; Humans; Nasal Cavity; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Paranasal Sinuses; Sinusitis

Juvenile nasopharyngeal angiofibromas (JNAs) are rare hyper vascular, benign tumours typically demonstrating a locally aggressive growth pattern. The cardinal presenting symptoms are unilateral nasal obstruction and recurrent, spontaneous epistaxis. Cases outside the adolescent male population are exceedingly rare and present a diagnostic challenge. We present the case of a man in his 30s referred to our tertiary skull base centre, presenting with left nasal obstruction. Examination showed left nasopharyngeal fullness without a discrete mass. Cross-sectional imaging detailed a 2.5×2.1×1.3 cm mass localised to his left sphenoid sinus with bony erosion. Due to the suspicion of malignancy, multidisciplinary consensus was to perform a diagnostic excisional biopsy and this revealed a JNA. He remains clinically well and asymptomatic following surgery. This case highlights the potential for subtle symptomatology in the presentation of these tumours and the challenge in diagnosing a JNA outside the adolescent male population.

Topics: Adolescent; Angiofibroma; Epistaxis; Humans; Male; Nasal Obstruction; Nasopharyngeal Neoplasms; Nasopharynx; Nose

本文介绍了3例鼻内镜下等离子切除儿童鼻咽纤维血管瘤的诊疗经验。3例患儿临床表现为持续性鼻塞、打鼾伴间断性鼻出血，其中1例为10岁女童，初期曾误诊为鼻腔恶性肿瘤并给予活检。术前根据病史、体格检查、鼻内镜、CT及MRI诊断为鼻咽纤维血管瘤。术中行数字减影血管造影栓塞肿瘤供血动脉，栓塞成功后即刻鼻内镜下行鼻咽纤维血管瘤等离子全程切除术，术后病理证实为鼻咽纤维血管瘤。术后随访3~6个月，患儿均无鼻塞、鼻出血、脑脊液鼻漏、视力障碍等症状，检查未见肿物复发。.

Topics: Angiofibroma; Endoscopy; Humans; Nasopharyngeal Neoplasms; Nasopharynx; Nose

Juvenile nasopharyngeal angiofibromas (JNAs) are highly vascular and benign tumors that can expand into the skull base. Delay of treatment can result in intracranial invasion, requiring extensive open approaches such as a facial translocation, maxillary swing, or an orbitozygomatic craniotomy. We describe a single-stage, combined endoscopic and transoral approach on a 14-year-old male with extensive high-stage dumbbell-shaped JNA involving the infratemporal fossa, orbit, buccal space, and intracranial extension into Meckel's cave. Successful resection of the tumor and good postoperative outcome was achieved. A transoral approach allowed for greater access to the infratemporal fossa, where endonasal resection was not possible, allowing for improved visualization, greater traction, and dissection. In select highly staged JNAs with significant lateral extension and intracranial involvement, successful and complete resection may be accomplished with this combined approach. Utilization of this approach avoids the morbidity of more invasive open approaches.

Topics: Adolescent; Angiofibroma; Craniotomy; Endoscopy; Humans; Male; Nasopharyngeal Neoplasms; Nose

Treatment of tumors arising in the upper parapharyngeal space (PPS) or the floor of the middle cranial fossa is challenging. This study aims to present anatomical landmarks for a combined endoscopic transnasal and anterior transmaxillary approach to the upper PPS and the floor of the middle cranial fossa and to further evaluate their clinical application.. Dissection of the upper PPS using a combined endoscopic endonasal transpterygoid and anterior transmaxillary approach was performed in six cadaveric heads. Surgical landmarks associated with the approach were defined. The defined approach was applied in patients with tumors involving the upper PPS.. The medial pterygoid muscle, tensor veli palatini muscle and levator veli palatini muscle were key landmarks of the approach into the upper PPS. The lateral pterygoid plate, foramen ovale and mandibular nerve were important anatomical landmarks for exposing the parapharyngeal segment of the internal carotid artery through a combined endoscopic transnasal and anterior transmaxillary approach. The combined approach provided a better view of the upper PPS and middle skull base, allowing for effective bimanual techniques and bleeding control. Application of the anterior transmaxillary approach also provided a better view of the inferior limits of the upper PPS and facilitated control of the internal carotid artery.. Improving the knowledge of the endoscopic anatomy of the upper PPS allowed us to achieve an optimal approach to tumors arising in the upper PPS. The combined endoscopic transnasal and anterior transmaxillary approach is a minimally invasive alternative approach to the upper PPS.

Topics: Cadaver; Cranial Fossa, Middle; Dissection; Endoscopy; Female; Head; Humans; Infratemporal Fossa; Magnetic Resonance Imaging; Male; Maxillary Sinus; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Parapharyngeal Space; Skull Base; Transanal Endoscopic Surgery

Given the reliability of circRNAs in symbolizing cancer progression, this investigation was designed to expound the involvement of hsa_circ_0028007 in regulating chemosensitivity of nasopharyngeal carcinoma (NPC) cells.. Altogether, 241 pairs of NPC tissues and para-cancerous normal tissues were collected to identify NPC-symbolic circRNAs, which have been screened by circRNA microarray in advance. Expressions of the circRNAs were determined by means of real-time polymerase chain reaction (PCR). Besides, human NPC cell lines (ie, CNE2 and HONE1) were transfected by si-hsa_circ_0028007 and si-NC. Scratch assay, transwell assay, and MTT assay were performed to assess migration, invasion, and paclitaxel/cisplatin-resistance of NPC cell lines.. Hsa_circ_0028007 expression was abnormally heightened within NPC tissues in comparison with matched non-tumor tissues (P < .05). Over-expressed hsa_circ_0028007 was strongly associated with advanced (III-IV) tumor stage, aggressive infiltration, and metastatic lymph nodes of NPC patients (P < .05). Regarding in vitro experiments, hsa_circ_0028007 expression was elevated in CNE2 and HONE1 cell lines as compared with HENE cell line (P < .05). Silencing of hsa_circ_0028007 not merely sensitized CNE2 and HONE1 cells against paclitaxel and cisplatin (P < .05), but also significantly repressed migration and invasion of the cell lines (P < .05).. Hsa_circ_0028007 was involved in facilitating progression and chemo-resistance of NPC, which might offer an alternative for NPC treatment.

Topics: Antineoplastic Agents; Cell Line, Tumor; Cell Movement; Drug Resistance, Neoplasm; Female; Humans; Male; MicroRNAs; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Neoplasm Invasiveness; Nose; Paclitaxel

Epstein-Barr virus detection using nasopharyngeal swabs has been suggested as a potential screening test that could improve the specificity of current EBV-based serological assays. However, application requires insertion of the swab deep into the nasopharynx, a procedure not amenable to non-clinic screening. We reasoned that swabbing the more easily accessible nasal cavity might provide an appealing alternative for NPC detection. Patients > 18 years of age diagnosed with histologically confirmed NPC were recruited from the Otolaryngology Department at the National Taiwan University Hospital. ENT clinicians collected both nasal and nasopharyngeal swabs. EBV DNA and cellular beta-globulin DNA were quantified using quantitative PCR targeting a highly-conserved region of the BKRF1 gene. EBV DNA was detectable (non-zero) in all 34 nasopharyngeal swabs and above the positivity threshold of 1666 EBV copies in 30 (88.2%) patients. EBV DNA was detectable in 50% of 34 nasal swabs and above the positivity threshold in four (11.8%) patients. Average EBV DNA levels were >3-fold higher (P < 0.001) in nasopharyngeal compared to nasal swabs. Among the 17 NPC patients with detectable EBV DNA in both swab types, we observed correlation (P < 0.01) between EBV DNA measurements. Our data represent the first evaluation of EBV DNA collected from nasal swabs. Given current EBV DNA amplification techniques, nasopharyngeal swabs remain more sensitive than nasal swabs for NPC detection.

Topics: Adult; Aged; Antigens, Viral; Carcinoma; DNA, Viral; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Specimen Handling; Taiwan; Viral Load; Young Adult

We report a case of low-grade nasopharyngeal papillary adenocarcinoma in a 9 year-old male that was diagnosed incidentally after an adenoidectomy procedure and treated with endonasal endoscopic nasopharyngectomy without any adjuvant therapy. The patient has been followed up for 3 years with no evidence of recurrence. We point out the importance of preoperative fiberoptic nasopharyngoscopy in the absence of longstanding symptoms in school-aged children and histopathologic examination of adenoidectomy specimens in the presence of atypical findings. We also suggest endonasal endoscopic resection in case of papillary adenocarcinoma.

Topics: Adenocarcinoma, Papillary; Adenoidectomy; Carcinoma; Child; Endoscopy; Humans; Male; Nasal Surgical Procedures; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Pharyngectomy

Topics: Carcinoma; Endoscopy; Humans; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Pharyngectomy; Retrospective Studies; Survival Rate; Time Factors; Treatment Outcome

Nasopharyngeal mucoepidermoid carcinoma is a rare entity, for which surgical resection is the treatment of choice. The open technique is considered the standard approach, but this often results in significant morbidities such as trismus, dysphagia, and neurologic deficits. The advent of endoscopic endonasal techniques has made endoscopic resection a viable alternative to the open approach in terms of access, adequacy of resection, and lesser surgical morbidity. The authors describe a patient of recurrent nasopharyngeal mucoepidermoid carcinoma that was resected entirely endoscopically. The authors also present a literature review of this little-known disease and a comparison between the endoscopic and open approach.

Topics: Adult; Carcinoma, Mucoepidermoid; Female; Humans; Magnetic Resonance Imaging; Nasopharyngeal Neoplasms; Nasopharynx; Natural Orifice Endoscopic Surgery; Neoplasm Recurrence, Local; Nose

Epistaxis is the most common ENT emergency encountered in the Emergency Department. Most cases can be managed by simple anterior nasal packing. This is usually a safe and very effective option in an emergency situation, requiring minimal expertise and infrastructure. This paper describes a rare instance of a serious complication following anterior nasal packing in a case of nasopharyngeal angiofibroma.. A 27-year-old man diagnosed with nasopharyngeal angiofibroma presented to the Emergency Department with bilateral epistaxis. The patient was stabilised and anterior nasal packing was performed, which controlled the bleeding. Three hours later, the patient developed complete blindness in both eyes. Aggressive medical management was initiated immediately, but failed to restore the patient's vision.. Anterior nasal packing is a simple and minimally invasive procedure practised regularly in an Emergency Department setting. However, it can occasionally lead to serious complications such as blindness. Thus, obtaining informed consent is essential to avoid medico-legal consequences in high-risk cases.

Topics: Adult; Angiofibroma; Blindness; Epistaxis; Hemostatic Techniques; Humans; Male; Nasopharyngeal Neoplasms; Nose

Although endoscopic nasopharyngectomy and intensity-modulated radiotherapy (IMRT) have been reported to be useful in treating isolated local recurrent nasopharyngeal carcinoma (NPC), their efficacy needs to be revaluated with comparison to 2D conventional radiotherapy (RT).. Four hundred ten patients with recurrent NPC were retrospectively analyzed, among whom the patients underwent IMRT, endoscopic nasopharyngectomy, and 2D conventional RT.. The 5-year overall survival (OS) and distant metastasis-free survival were significantly higher in endoscopic nasopharyngectomy and IMRT groups than in 2D conventional RT group both in the entire series and in the subgroup of patients with recurrent T1 to 2 NPC (p < .05), except in the subgroup of recurrent T3 to 4 stratifications (IMRT vs 2D conventional RT; 28.8% vs 16.8%; p = .351). Furthermore, endoscopic nasopharyngectomy was associated with better OS than IMRT in the recurrent T1 to 2 subgroup (79.2% vs 62.1%; p = .007). Multivariate analysis indicated therapeutic modality was an independent predictor of OS and distant metastasis-free survival (p < .001).. Endoscopic nasopharyngectomy and IMRT are associated with an improved OS and distant metastasis-free survival of patients with recurrent NPC compared to 2D conventional RT in early recurrent disease.

Topics: Adult; Carcinoma; Chemotherapy, Adjuvant; China; Female; Humans; Male; Middle Aged; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Natural Orifice Endoscopic Surgery; Neoplasm Recurrence, Local; Nose; Radiotherapy, Conformal; Radiotherapy, Intensity-Modulated; Salvage Therapy; Survival Analysis; Treatment Outcome

Juvenile nasopharyngeal angiofibroma (JNA) is the most common benign neoplasm of the nasopharynx. Almost always unilateral on diagnosis, JNAs are locally invasive and may extend across the midline, giving a false bilateral appearance; as such, true bilateral JNA is exceedingly rare. We present a recent case of true bilateral JNA.. Single case report of a patient with bilateral JNA, including clinical presentation, diagnosis, and management.. The patient presented with unilateral nasal obstruction and recurrent epistaxis. Computed tomography and magnetic resonance imaging demonstrated bilateral, noncontiguous masses. Angiography revealed independent vascular supplies from each respective side with no bilateral supply noted. The patient underwent preoperative embolization followed by endoscopic surgical removal of the larger mass; no complications were noted. Follow-up at 2 years demonstrated no recurrence or growth.. The vast majority of JNAs are unilateral, though invasive growth to the contralateral side may appear "bilateral" in presentation. Proper identification of true bilateral JNA is helpful in guiding management, wherein excision of both tumors may not be necessary.

Topics: Adolescent; Angiofibroma; Early Detection of Cancer; Endoscopy; Epistaxis; Humans; Magnetic Resonance Imaging; Male; Nasal Obstruction; Nasopharyngeal Neoplasms; Nose; Pharynx; Tomography, X-Ray Computed; Treatment Outcome

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions. Although both the EEA and the TORS approach have been extensively described as viable surgical options in managing nasopharyngeal and centrally located head and neck pathology, both endonasal and transoral techniques have inherent limitations. Given these limitations, several institutions have published feasibility studies with the combined EEA and TORS approaches for a variety of skull base and nasopharyngeal pathologies. In this article, the authors present their clinical experience with the combined endonasal and transoral approach through a case series presentation, and discuss advantages and limitations of this approach for surgical management of the middle and posterior skull base and nasopharynx. In addition, a presentation is included of a unique, simultaneous endonasal and transoral dissection of the nasopharynx through an innovative intraoperative setup.

Topics: Adult; Aged, 80 and over; Carcinoma; Carcinoma, Papillary; Endoscopy; Female; Humans; Magnetic Resonance Imaging; Male; Minimally Invasive Surgical Procedures; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Nose Diseases; Retrospective Studies; Robotics; Skull Base; Thyroid Cancer, Papillary; Thyroid Neoplasms

To observe the effect of hypothermia plasma radiofrequency ablation to the adhesion of nasal cavity after radiotherapy of nasopharyngeal carcinoma.. The subjective score combined with nasal ventilation function test were used to reflect the degree of patients with nasal adhesion.. There is a significant improvement in subjective feeling after treatment. Nasal cavity volume began to increase and nasal expiratory resistance decrease obviously 3M later.. Hypothermia plasma radiofrequency ablation technology can improve the nasal cavity adhesion in patients with nasopharyngeal carcinoma after radiotherapy, and also the patients quality of life.

Topics: Carcinoma; Catheter Ablation; Female; Humans; Hypothermia, Induced; Male; Nasal Cavity; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Nose Diseases; Quality of Life; Tissue Adhesions

A global regulator of chromatin remodelling and gene expression, special AT-rich-binding protein 1 (SATB1) has been implicated in promotion of growth and metastasis of a number of cancers. Here, we demonstrate that the principal oncogene of Epstein-Barr virus (EBV), latent membrane protein 1 (LMP1) upregulates SATB1 RNA and protein expression in human nasopharyngeal cell lines. Silencing of endogenously expressed SATB1 with specific short hairpin RNA decreases cell proliferation and resistance to apoptosis induced by growth factor withdrawal. Additionally, we provide evidence that LMP1-mediated expression of Survivin, a multifunctional protein involved in promoting cell growth and survival, is mediated at least in part by SATB1 in human nasopharyngeal cells. Finally, we show that SATB1 protein levels are elevated in tissue samples from patients with nasopharyngeal carcinoma (NPC), and are directly correlated with the expression of LMP1. Taken together, our results suggest that SATB1 functions as a pro-metastatic effector of LMP1 signalling in EBV-positive NPC.

Topics: Carcinoma; Cell Line; Cell Proliferation; Gene Expression Regulation; Herpesvirus 4, Human; Humans; Matrix Attachment Region Binding Proteins; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nose; Pharynx; RNA, Small Interfering; Signal Transduction; Viral Matrix Proteins

The authors report a case of nasal malignant melanoma involving the septum, nasal turbinates and nasopharynx which was approached by lateral rhinotomy combined with an anterior transantral approach with excision of the septum and the lateral wall of the nasal cavity for wide exposure of the tumour. Using this technique complete surgical resection of a large nasal malignant melanoma was achieved with minimal morbidity and good aesthetics.

Topics: Aged; Epistaxis; Esthetics; Humans; Male; Maxillary Sinus; Melanoma; Nasal Cavity; Nasal Mucosa; Nasal Obstruction; Nasal Polyps; Nasal Septum; Nasopharyngeal Neoplasms; Nose; Nose Neoplasms; Sphenoid Sinus; Turbinates

Our study was designed to compare two surgical approaches that are currently employed in the treatment of nasopharyngeal angiofibroma stages I and II.. Retrospective chart review to compare outcomes in 11 patients who underwent endoscopic resection with outcomes of transpalatal excision in 13 patients with juvenile nasopharyngeal angiofibroma (JNA) at our department between 1992 and 2008.. Academic otorhinolaryngologic referral centre.. Twenty-four patients were divided into two groups according to the surgical technique used. The transpalatal approach was followed for 13 patients, whereas the transnasal endoscopic approach was adhered to for 11. The outcome variables of intraoperative blood loss, length of hospital stay, complications, and rate of recurrence were analyzed.. Compared to the transpalatal surgery group, the transnasal endoscopic group had less intraoperative blood loss (375 ± 27 mL vs 635 ± 41 mL), the mean duration of surgery was significantly shorter (115.7 ± 7.6 minutes vs 141.5 ± 9.8 minutes), and there was a lower occurrence of complications (1 patient vs 6 patients) and a shorter length of hospital stay (4 ± 1.0 days vs 6 ± 1.5 days), but there was no significant difference in the rate of recurrence.. In JNA stages I and II, the transnasal endoscopic approach is clearly a good alternative to the transpalatal approach.

Topics: Adolescent; Adult; Angiofibroma; Child; Endoscopy; Follow-Up Studies; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Staging; Nose; Otorhinolaryngologic Surgical Procedures; Retrospective Studies; Treatment Outcome; Young Adult

Describe our technique for endoscopic transpterygoid nasopharyngectomy and support its feasibility with our early clinical outcomes.. Our endoscopic technique comprises an extended inferomedial maxillectomy, mobilization of the pterygopalatine fossa, removal of the pterygoid plates and Eustachian tube to access the posterolateral nasopharynx. Control of the parapharyngeal and petrous segments of the internal carotid artery is the keystone of the approach.. Various histopathologies were treated, including epidermoid carcinomas (n = 9), lymphoepithelioma (n = 1), adenoid cystic carcinoma (n = 5), adenocarcinoma (n = 2), mucoepidermoid carcinoma (n = 2), and sarcoma (n = 1). Negative microscopic margins were obtained in 95% (19/20) of patients. No perioperative mortality, cerebral spinal fluid (CSF) leak, meningitis, or cerebrovascular accident was encountered; however, one patient suffered an internal carotid artery (ICA) injury, without permanent sequelae. All but one patient received adjuvant therapy (external and/or stereotactic radiotherapy with or without chemotherapy). Follow-up ranged from 15 to 68 months (mean = 33). Overall survival was 45% (9/20) and local control was 65% (13/20).. Endoscopic transpterygoid nasopharyngectomy for primary and recurrent nasopharyngeal malignancies is feasible and safe in properly selected patients. Preliminary outcomes compare to that of conventional techniques. Endoscopic resections, however, are demanding; they require specialized equipment and a team versed in endoscopic oncologic surgery. Long-term follow-up and reproducibility remain undefined.

Topics: Adult; Cohort Studies; Endoscopy; Feasibility Studies; Female; Follow-Up Studies; Humans; Laryngoscopy; Magnetic Resonance Imaging; Male; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasm Invasiveness; Neoplasm Staging; Nose; Otorhinolaryngologic Surgical Procedures; Retrospective Studies; Risk Assessment; Time Factors; Treatment Outcome

Nasopharyngectomy is the primary treatment for locally recurrent nasopharyngeal carcinoma (rNPC). However, oncological nasopharyngectomy is difficult to achieve, even using extranasal surgical approaches, with potential risks of severe functional disabilities and serious complications. This report introduces an innovative, minimally invasive, oncological, endoscopic nasopharyngectomy.. Between October 2004 and January 2008, 37 rNPC patients received endoscopic nasopharyngectomy, with 17, 4, 14, and 2 cases of rT1N0M0, rT2aN0M0, rT2bN0M0, and rT3N0M0, respectively. Tumors in all patients were confined to the nasopharyngeal cavity, postnaris, nasal septum, superficial parapharyngeal space, or the base of the sphenoid sinus. Nasopharyngeal malignancies and adequate surgical margin (>0.5-1.0 cm) were required for continuous en bloc resection.. Among the 37 endoscopic nasopharyngectomies, 35 achieved en bloc tumor resection with negative surgical margins. In the remaining two cases, the tumors were dissected into small blocks, and one had positive surgical margins. No patient received postoperative radiotherapy and no severe complication was observed. During the 6-45 months of follow-up (median, 24 months), five patients experienced in situ residual or recurrence with 1 submaxillary lymphatic metastasis. One patient developed distant metastases and died, one died of intracranial infection, and one died of another cancer. The 2-year overall survival rate, local relapse-free survival rate, and progression-free survival rate were 84.2%, 86.3%, and 82.6%, respectively.. Appropriate endoscopic nasopharyngectomy is a minimally invasive, safe, and promising surgical modality for the en bloc excision of rNPCs with encouraging short-term outcome. Long-term patient follow-up is ongoing.

Topics: Adult; Aged; Endoscopy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; Neoplasm Staging; Nose; Pharyngectomy; Retrospective Studies; Survival Rate; Time Factors; Treatment Outcome

Angiography is an invasive, radiological investigation of vascular system. It plays an important role within variety of diagnostic tools in head and neck pathologies. In selected cases with well defined tumor supply vessels, angiography may be combined with intravascular obliteration. This possibility widen indications, which comprise diagnostic arteriographies - visualization of blood supply and extension of vascularization; therapeutic and diagnostic arteriographies - palliative or radical in character, dependent on pathology; and therapeutic angiographies as adjuvant therapy prior to surgical treatment. Authors present their experience with endovascular techniques application in head and neck pathologies. Material comprised 59 angiographies performed in patients treated at Otolaryngology Department at Poznań University of Medical Sciences between 2000-2007. In conclusion authors emphasize advantages and disadvantages, as well as, the role of the endovascular treatment in head and neck surgery.

Topics: Angiofibroma; Embolization, Therapeutic; Face; Head; Humans; Nasopharyngeal Neoplasms; Neck; Nose; Radiography; Vascular Malformations

To discuss the indication, efficacy and safety of endoscopic minimally invasive surgery technique in the management of nasal skull-base neoplasms.. Thirty-six patients with nasal skull base neoplasms were treated from January 2000 to Jun 2004 under nasal endoscopy, including 16 nasopharyngeal fibroangioma, 8 sinus osteofibroma, 8 pituitary adenoma, 4 olfactory neuroblastoma. Pathology lab procedures were performed pre or post-operatively. The feeding artery of nasopharyngeal fibroangioma was selectively embolized with gelatin sponge before operation. All olfactory neuroblastoma and 2 pituitary adenoma received radiotherapy after operation.. Total or most of nasopharyngeal fibroangioma, sinus osteofibroma, olfactory neuroblastoma and pituitary adenoma were excised. Three cases presented complications of cerebrospinal fluid leakage, 2 cases were successfully mended with middle turbinate and muscle tissue respectively, another one gained self-healing after reducing the intracranial pressure and anti-inflammation. Followed up 4 to 8 years without recurrence for all patients. Seldom serious complications accrued.. When the indications are selected appropriately, nasal skull-base neoplasms, including benign and malignant, can be well treated with nasal endoscopic minimally invasive surgery.

Topics: Adolescent; Adult; Aged; Child; Endoscopy; Female; Fibroma, Ossifying; Humans; Male; Middle Aged; Minimally Invasive Surgical Procedures; Nasopharyngeal Neoplasms; Neuroblastoma; Nose; Olfactory Nerve; Pituitary Neoplasms; Skull Base Neoplasms; Young Adult

To explore whether the margin status at surgical salvage nasopharyngectomy for local residual or recurrent nasopharyngeal carcinoma affects patient survival.. Retrospective case series review.. Academic tertiary referral center.. Seventy-nine consecutive patients with operable local residual or recurrent nasopharyngeal carcinoma after failure of primary treatment with radiotherapy with or without chemotherapy underwent surgical salvage nasopharyngectomy with curative intent between November 28, 1987, and November 17, 2003. Sixty-one patients were men and 18 were women. Their mean age was 48 years (age range, 26-70 years).. Surgical salvage nasopharyngectomy.. The status of the closest margin at surgery was assessed as clear, close, or positive. Survival time was measured from the date of surgery to the date of the last follow-up, to the date of an event occurrence, or to the date of death. The Kaplan-Meier method was used to estimate the probability of local progression-free survival and overall survival at 5 years. Differences in survival rates between surgical margin statuses were assessed using the log-rank test.. Five-year overall survival for patients with clear margins was 77%, for patients with close margins was 46% (P = .05), and for patients with positive margins was 23% (P < .001).. Clear surgical margins at the time of surgical salvage nasopharyngectomy for residual or recurrent nasopharyngeal carcinoma positively affect patient survival.

Topics: Adult; Aged; Disease-Free Survival; Female; Follow-Up Studies; Hong Kong; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Nose; Pharyngectomy; Retrospective Studies; Survival Analysis; Survival Rate; Treatment Outcome

Juvenile nasopharyngeal angiofibromas are highly vascular, non-encapsulated tumours affecting predominantly young males. These lesions are benign histologically but they may become life-threatening with excessive bleeding or intracranial extension.. The surgical approaches to 22 male patients with nasopharyngeal angiofibromas are reviewed. A modification of midfacial degloving performed without rhinoplasty incisions and lateral osteotomies is described.. The patients' ages ranged between 9 and 26 years (mean 14.9). Three stage I tumours, 8 stage II tumours, 6 stage III tumours and 5 stage IV tumours were included into this study. All stage I lesions and one stage II lesion were treated via transnasal endoscopic approach. A modified midfacial degloving approach was used for the removal of seven other stage II lesions, all six stage III lesions, and three stage IV lesions. A combined midfacial degloving-infratemporal fossa Fisch C-transcranial approach was the route chosen for the remaining two stage IV lesions. The complications encountered in the postoperative course include temporary facial palsy in one patient (following a Fisch C infratemporal resection), mild crusting in the nasal cavity in 8 patients, and facial paraesthesia in 6 patients whose tumours were resected via midfacial degloving, and rupture of the subpetrous part of the internal carotid artery in one patient.. The suggested treatment of juvenile nasopharyngeal angiofibroma consists of an endoscopic transnasal approach for early stage lesions, and a modified midfacial degloving for almost all of the advanced lesions. The latter approach is very useful considering surgical exposure, duration of surgery, cosmetic outcome, and morbidity. It can be combined with an infratemporal approach or craniotomy if necessary.

Topics: Adolescent; Adult; Angiofibroma; Carotid Artery Injuries; Carotid Artery, Internal; Child; Craniotomy; Endoscopy; Facial Paralysis; Frontal Bone; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Staging; Nose; Nose Diseases; Oral Surgical Procedures; Paresthesia; Postoperative Complications; Retrospective Studies; Rupture; Temporal Bone; Treatment Outcome

This study presents a comparative analysis of current surgical approaches for the treatment of nasopharyngeal angiofibroma, including extension of tumors, postoperative morbidity, complications, and recurrence rate. Twenty-four patients who underwent surgery with the diagnosis of juvenile nasopharyngeal angiofibroma at our department between 1993 and 2003 were retrospectively reviewed according to their clinical presentation, surgical approaches, and prognosis. Radkowski staging scale was used for staging tumors. The transpalatal approach was used in 10 patients before 1999 with tumor stages between Ia and IIa. Transpalatal fistula was encountered in one. Nine patients underwent transnasal endoscopic surgery after 1999 with tumor stages between Ia and IIIa. Lateral rhinotomy in four patients and a degloving approach in one patient were used with tumor stages between IIa and IIIa; postoperative nasal crusting was the most annoying problem in these groups. Recurrent tumor was seen in only one patient who had undergone the transpalatal approach in the 12- to 56-month follow-up period. In this regard, the transnasal endoscopic approach can be used successfully in place of the transpalatal approach due to the former's lesser surgical morbidity and wide lateral exposure of the field in patients with nasopharyngeal angiofibroma. Also, many patients who underwent lateral rhinotomy for the removal of stage IIa, IIb, and IIIa tumors can successfully be treated using the transnasal endoscopic approach. In tumors that extend, infratemporal fossa lateral rhinotomy and degloving approaches provide the optimal exposure but have higher potential for morbidity than does transnasal endoscopic surgery.

Topics: Adolescent; Adult; Angiofibroma; Endoscopy; Follow-Up Studies; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Nose; Nose Diseases; Oral Fistula; Palate; Postoperative Complications; Prognosis; Retrospective Studies

To investigate the efficacy and the surgical techniques of transnasal endoscopic procedure for juvenile nasopharyngeal angiofibroma (JNA).. Twenty-one nasopharyngeal angiofibroma patients were treated using transnasal endoscopic approach. They were divided into group A (without intracranial extension) and group B (minimal intracranial extension) according to the staging of Sessions. The patients were treated mostly with endoscopic surgery. In two midfacial operations cases, endoscopy was also used. The staging, average blood loss during surgery, tumor residual, and (or) recurrent tumor were evaluated.. Group A (19 cases) had an average blood loss of 1000 ml. Nineteen patients had no residual or recurrent tumor over a follow-up of 8-24 months. Group B (2 cases) had an average blood loss of 1500 ml. One of the patients had minimal residual tumor around the cavernous sinus, but showed no progression over a follow-up of 2 years. Another patient had no residual or recurrent tumor over a follow-up of 8 months.. The data suggests that transnasal endoscopic surgical techniques can be used to treat JNA which either limited to nasal and nasopharyngeal cavities or and the tumor with sphenoid and ethmoid invasions and even minimal intracranial extension.

Topics: Adolescent; Adult; Angiofibroma; Child; Endoscopy; Humans; Male; Nasopharyngeal Neoplasms; Nose; Retrospective Studies; Young Adult

Rhinosurgery in children and adolescents meets special requirements: Limited cooperation and reduced limits for the organ dose for ionizing radiological examinations aggravate diagnostics. On the other side, bone sutures and bone growth areas have to be respected intraoperatively, and regions of bones not yet calcified have to be distinguished from possible tumor infiltration. Computer assisted surgery (CAS) can help to identify these areas safely.. 5 patients, from the first to the 20 (th) year of life, suffering from tumors, malformation syndromes or therapy resistant nasal polyposis were treated with CAS in rhinosurgery.. In addition to radiological diagnostics, we performed 3D computed tomography of the skull for CAS. CAS enabled us to intraoperatively respect possible areas of bone growth, to identify regions with thin, not bonily developed cranial vault and to safely distinguish bone sutures from ethmoidal cells. CAS helped the surgeon to navigate in the not yet developed paranasal sinus system.. CAS is a useful complementary method in rhinosurgery of the developing skull of the child. In spite of the additional 3D computed tomography, the calculated organ dose of the ocular lense amounted to 5 millisievert, so a recommended maximal organ dose for the ocular lense of 15 millisievert was not exceeded.

Topics: Adolescent; Adult; Age Factors; Child; Child, Preschool; Choanal Atresia; Craniofacial Dysostosis; Down Syndrome; Female; Fibroma; Humans; Imaging, Three-Dimensional; Infant; Male; Nasal Polyps; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Nose Diseases; Sinusitis; Skull; Surgery, Computer-Assisted; Tomography, X-Ray Computed

Topics: Adolescent; Angiofibroma; Endoscopy; Humans; Male; Nasopharyngeal Neoplasms; Nose; Otorhinolaryngologic Surgical Procedures

To assess the feasibility of passive marker computer-aided surgery in a single institution, we performed 22 procedures in 21 patients with disorders including sinonasal tumors (n = 9), fungal sinusitis (n = 4), recurrent polyps (n = 3), chronic sinusitis (n = 3), and cerebrospinal fluid rhinorrhea (n = 2). Passive marker computer-aided surgery was successful in 19 of the 21 patients. The accuracy was on the order of 1.35 mm. Probe conversion, rotation, and cordlessness were helpful in all 19 cases. The system helped with landmarks (n = 14), margins (n = 7), skull base (n = 6), orbit (n = 5), and approach (n = 4). Computer-aided surgery accurately confirmed the location of an instrument and demonstrated tumor-normal tissue interfaces. It aided the surgeon in procedures on the sinonasal area and cranial base. The potential advantages of a passive marker system as compared with other available technologies center around the ability to convert and/or rotate virtually any instrument to a cordless imaging probe on demand during the operation.

Topics: Angiofibroma; Cerebrospinal Fluid Otorrhea; Cerebrospinal Fluid Rhinorrhea; Craniopharyngioma; Endoscopy; Humans; Magnetic Resonance Imaging; Meningeal Neoplasms; Meningioma; Nasopharyngeal Neoplasms; Nose; Otorhinolaryngologic Surgical Procedures; Paranasal Sinuses; Pituitary Neoplasms; Safety; Sinusitis; Skull Base; Surgery, Computer-Assisted; Tomography, X-Ray Computed

To evaluate the result of sublabial transnasomaxillary approach (STA) as a route for removal of juvenile nasopharyngeal angiofibroma (JNA). Eleven young male patients with angiofibroma underwent removal via the sublabial transnasomaxillary approach. This technique is described in detail. There was neither major operative nor postoperative complication. One patient developed dacryocystitis. Long term follow-up longer than 18 months in 5 patients, showed no recurrence. This technique is useful for removal of angiofibroma because it enables the surgeon to gain extensive exposure of maxillary, ethmoid and sphenoid sinuses and to control sphenopalatine and internal maxillary arteries, without risk of palatal dysfunction or of oronasal fistula. Other advantages comprise the lack of a facial scar, nasal septal scar and bilateral premaxillar numbness, and good postoperative assessment.

Topics: Adolescent; Adult; Angiofibroma; Child; Female; Humans; Male; Maxilla; Nasopharyngeal Neoplasms; Nose; Otorhinolaryngologic Surgical Procedures; Retrospective Studies; Sensitivity and Specificity; Treatment Outcome

A transfacial approach to the deep cranio-maxillo-facial areas by the naso-maxillo-cheek flap technique (NMCF) is indicated for the treatment of some bulky tumors of the naso-pharynx. The procedure requires precise preoperative imaging. This study presents the morphologic bases of this surgical access and the reasonable limits of the excision preoperatively determined by magnetic resonance imaging (MRI). 18 facial and skull specimens were submitted to surgical facial dismantling by the NMCF technique according to Curioni's method. The clinical application in a 66-year-old patient suffering from a neuroblastoma of the olfactory nerve extended into the naso-pharynx is presented. Pre- and postoperative MRI correlations were made in transverse, sagittal and frontal acquisitions. Several structures were preserved in the procedure: facial reliefs, inferior orbital rim and orbital floor, posterior wall of the maxillary sinus covering the pterygopalatine fossa, lateral and medial pterygoid plates and pterygopalatine ganglion with its branches, lateral facial neurovascular pedicle, teeth and soft palate. Other structures were sacrificed: arteries and nerves located at the sites of skin and mucosal incision, and at the sites of osteotomies, ie the infraorbital nerve, the distal part of the greater palatine nerve, the nerves supplying the naso-pharynx, the nasal septum and the nasal conchae, nasolacrimal groove and lacrimal canal. The NMCF technique gives wide access to the deep nasal and nasopharyngeal areas. It is essential to preserve the lateral facial neurovascular pedicle to prevent necrosis of the midface structures. Preservation of the bony architecture surrounding the osteotomy sites is of great importance to allow precise final bone reassembly. Preoperative MRI appears of paramount importance to determine the borders of the lesion and the possibility of block resection.

Topics: Aged; Cadaver; Cheek; Cranial Nerve Neoplasms; Female; Humans; Lacrimal Apparatus; Magnetic Resonance Imaging; Male; Maxilla; Maxillary Sinus; Middle Aged; Nasal Septum; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasm Invasiveness; Neuroblastoma; Nose; Nose Neoplasms; Olfactory Nerve; Orbit; Osteotomy; Palate; Palate, Soft; Replantation; Sphenoid Bone; Surgical Flaps; Tooth

We present a surgical procedure that provides exposure to the medial part of the orbit, the interorbital space, and the nasopharynx. A midline incision of the nose is followed by a pedicled osteotomy of the lateral nasal wall and the medial wall of the orbit in one piece. This transnasal approach provides good exposure to the medial parts of the craniofacial junction to remove foreign bodies or benign tumors.

Topics: Angiofibroma; Eye Foreign Bodies; Humans; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Orbit; Surgery, Plastic; Wounds, Gunshot

A retrospective analysis was undertaken of the late complications observed in 4527 patients with nasopharyngeal carcinoma treated by megavoltage radiotherapy during the years 1976-1985. Unconventional fractionation schedules were used because of serious resource limitations. The median equivalent doses were 65 Gy to the nasopharyngeal region and 53 Gy to the cervical region. 707 patients had reirradiation for local recurrences and 250 for regional relapses. The 10-year actuarial cancer-specific survival was 47%, and the corresponding all-complication-free and neurological-complication-free rates were 40% and 72%, respectively. Altogether, 1395 (31%) patients developed one or more late irradiation sequelae. The majority were mild soft-tissue damages, but 322 (7%) had significant functional disturbances, from which 62 (1%) died. Neurological damage that occurred in 450 (10%) patients constituted the major morbidity and accounted for all but three of the treatment mortalities. The cumulative incidence of the various complications is summarized, and the data recorded in the literature reviewed in order to give a proper perspective of the problem. Patients treated during 1981-1985 had a significantly higher actuarial encephalomyelopathy-free rate than those treated during 1976-1980, but the incidence-free rates for the other neurological complications remained unimproved, suggesting that the improvement could be mainly attributed to additional shielding for the brainstem rather than the reduction of dose from 3.8-4.2 Gy to 2.5 Gy per fraction.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Brain; Child; Ear; Female; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Neck; Nose; Radiation Injuries; Radiotherapy Dosage; Radiotherapy, High-Energy; Retrospective Studies; Temporomandibular Joint; Time Factors

Midfacial degloving is an extended sublabial rhinotomy, which permits good bilateral access to the nasal and paranasal cavities, the base of the skull, and the clivus. The incisions leave no visible scars. The access is suitable for large benign tumours (such as nasopharyngeal fibromas or inverted papillomas), but can also be used for malignant tumours. It can be enlarged by supplementary incisions to meet the demands of tumour surgery.

Topics: Adolescent; Histiocytoma, Benign Fibrous; Humans; Maxillary Sinus Neoplasms; Methods; Nasopharyngeal Neoplasms; Nose; Nose Neoplasms; Papilloma; Paranasal Sinus Neoplasms

A potential for recurrence of juvenile angiofibroma exists after all treatment modalities, both surgical and medical but the methods of defining recurrence and failure to cure varies considerably from series to series. To evaluate factors which might influence successful treatment, a series of 33 patients have been reviewed retrospectively. All patients were treated by simple or extended lateral rhinotomy as a primary or secondary procedure. The final long-term disease control rate was 97% but during the treatment period the overall symptomatic recurrence rate was 50%. However, amongst those treated primarily the recurrence rate was 34%. Of the factors examined, the strongest predictor of recurrence was preoperative embolisation. This group exhibited both early and multiple recurrence when compared with the non-embolised group and the possible reasons for this are examined.

Topics: Adolescent; Embolization, Therapeutic; Histiocytoma, Benign Fibrous; Humans; Male; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; Nose; Retrospective Studies; Risk Factors; Time Factors

Topics: Histiocytoma, Benign Fibrous; Humans; Masticatory Muscles; Nasopharyngeal Neoplasms; Nasopharynx; Neurilemmoma; Nose; Paranasal Sinuses; Parotid Neoplasms; Pterygoid Muscles; Sinusitis; Tomography, X-Ray Computed

My experience with 250 intranasal laser surgical procedures performed with the carbon dioxide laser and the surgical microscope are described. Procedures include excision and vaporization of polyps, turbinates, tumors, telangiectasias, synechiae, nasal stenoses, intranasal cysts, papillomas, and septal spurs. Avoidance of technical problems is emphasized in this article since intranasal laser surgery is, in some respects, difficult to perform. Included are practical suggestions about patient positioning, use of protective devices, and patient selection.

Topics: Granuloma; Hemangioma; Hemorrhage; Humans; Laser Therapy; Lasers; Methods; Microscopy; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Nose Diseases; Papilloma; Postoperative Complications; Turbinates; Volatilization

Eight patients underwent reconstruction of the nasal supratip using nasalis myocutaneous flaps. This flap's blood supply is an axial blood supply from the nasalis muscle. The muscle originates from the piriform aperature and stretches out into an aponeurosis that attaches into the dermis in the nasal supratip and tip areas. Tumor defects 1 to 2 cm in diameter have been reconstructed using this versatile flap. I have been very impressed with natural alar contour, skin texture, and color matching using these flaps. The nasalis myocutaneous flap can be advanced up to 1.5 cm and can be used for lateral nasal wall and central nasal tip defects.

Topics: Carcinoma, Basal Cell; Humans; Nasopharyngeal Neoplasms; Nose; Rhinoplasty; Skin; Surgical Flaps

This article discusses the diagnosis and management of acute and chronic diseases of the nasal cavity and sinuses. Also discussed are the anatomy of the upper respiratory tract, guidelines for obtaining a thorough history and performing a complete physical examination, and various diagnostic procedures, such as rhinoscopy, culture, and serology.

Topics: Animals; Cat Diseases; Cats; Cryptococcosis; Dog Diseases; Dogs; Foreign Bodies; Mycoses; Nasopharyngeal Neoplasms; Nose; Nose Diseases; Nose Neoplasms; Paranasal Sinus Diseases; Paranasal Sinus Neoplasms; Polyps; Rhinitis; Sinusitis

Topics: Child; Dermoid Cyst; Encephalocele; Foreign Bodies; Glioma; Histiocytoma, Benign Fibrous; Humans; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Nose Neoplasms

The antrochoanal polyp, a benign solitary polypoid lesion, usually arises in a maxillary sinus, opacifying and enlarging the sinus cavity without bone destruction. It passes through the ostium of the sinus into the choana, and from there into the posterior nasopharynx. The soft tissue mass does not erode or destroy contiguous soft tissue or bony structures. In this sequence of events, its radiologic findings are characteristic. Five case reports are presented, and the differential diagnosis is discussed.

Topics: Child; Diagnosis, Differential; Female; Histiocytoma, Benign Fibrous; Humans; Male; Maxillary Sinus; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Radiography; Sinusitis

In a study of non-epithelial tumors involving the nasal cavity, paranasal sinuses and nasopharynx, 256 lesions, 156 benign and 100 malignant, were identified. Of these, six were classified as myxoma. Myxomas of facial bones, neoplasms of uncertain histogenesis, infiltrate adjacent tissues and if not completely excised will recur locally. In this series, three patients at one time were treated with limited local excisions. Tumor persisted or recurred in all three. Five patients were treated with en bloc resection (following recurrences in two patients). None of these patients subsequently developed recurrent tumor. We believe that myxomas should be widely resected to prevent recurrence. The extent of the surgical resection should depend on the size, extent and location of the lesion.

Topics: Adolescent; Adult; Child; Diagnosis, Differential; Female; Humans; In Vitro Techniques; Liposarcoma; Maxillary Neoplasms; Maxillary Sinus; Middle Aged; Myxoma; Nasal Cavity; Nasopharyngeal Neoplasms; Neoplasm Recurrence, Local; Neurilemmoma; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Rhabdomyosarcoma

An unusual presentation and treatment of an intranasal Schwannoma are discussed. The clinical and pathological features are also reviewed.

Topics: Humans; Middle Aged; Nasal Polyps; Nasopharyngeal Neoplasms; Neurilemmoma; Nose; Palate; Turbinates

Topics: Carcinoma, Squamous Cell; Cystadenoma; Epithelial Cells; Epithelium; Humans; Melanocytes; Melanoma; Nasopharyngeal Neoplasms; Neuroectodermal Tumors, Primitive, Peripheral; Nose; Nose Neoplasms; Papilloma

Topics: Adolescent; Adult; Child; Child, Preschool; Ethmoid Sinus; Female; Fibroma; Frontal Sinus; Giant Cell Tumors; Humans; Male; Maxillary Sinus; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasm Recurrence, Local; Neoplasms, Connective Tissue; Nose; Nose Neoplasms; Ossification, Heterotopic; Osteoma; Osteoma, Osteoid; Osteosarcoma; Paranasal Sinus Neoplasms; Paranasal Sinuses; Sphenoid Sinus

Topics: Cerebrospinal Fluid Rhinorrhea; Cryosurgery; Epistaxis; Fractures, Bone; Histiocytoma, Benign Fibrous; Humans; Mucous Membrane; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Nose Diseases; Nose Neoplasms; Rhinitis; Rhinoplasty; Rosacea; Skin Neoplasms

Topics: Adolescent; Adult; Aged; Angiomatosis; Child; Ethmoid Sinus; Female; Glomus Tumor; Hemangioma; Hemangioma, Cavernous; Hemangiopericytoma; Histiocytoma, Benign Fibrous; Humans; Male; Maxillary Sinus; Middle Aged; Nasal Septum; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasms, Vascular Tissue; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Paranasal Sinuses; Turbinates

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Adenocarcinoma, Papillary; Adenoma, Pleomorphic; Adolescent; Adult; Aged; Carcinoma, Adenoid Cystic; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Papillary; Carcinoma, Small Cell; Carcinoma, Squamous Cell; Child; Female; Follow-Up Studies; Humans; Larynx; Lymphatic Metastasis; Male; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Palatal Neoplasms; Palate; Salivary Gland Neoplasms

Topics: Adolescent; Adult; Aged; Bronchi; Bronchial Neoplasms; Child; Demography; Female; Humans; Laryngeal Neoplasms; Lung; Lung Neoplasms; Male; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Respiratory Tract Neoplasms; Uganda

Topics: Age Factors; Aged; Ear; Ear Canal; Ear, External; Ear, Middle; Face; Humans; Larynx; Lymph Node Excision; Nasopharyngeal Neoplasms; Nasopharynx; Neck Dissection; Nose; Otitis Externa; Otorhinolaryngologic Diseases; Paranasal Sinus Neoplasms; Paranasal Sinuses; Parotid Gland; Pharynx; Rehabilitation; Submandibular Gland; Thyroid Gland; Tonsillectomy; Tracheotomy; Trigeminal Neuralgia; Tuberculosis, Lymph Node; Zygoma

Topics: Adult; Aged; Carcinoma, Papillary; Carcinoma, Transitional Cell; Follow-Up Studies; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Nose; Nose Neoplasms; Papilloma; Paranasal Sinus Neoplasms; Paranasal Sinuses

Topics: Brain; Cheek; Cobalt Isotopes; Ear; Eye; Humans; Larynx; Lymphatic Metastasis; Methods; Nasopharyngeal Neoplasms; Nose; Pharyngeal Neoplasms; Pharynx; Radiation Protection; Radioisotope Teletherapy; Radiotherapy; Radiotherapy Dosage; Salivary Gland Neoplasms; Smell; Spinal Cord; Taste

Topics: Bone Transplantation; Child; Cleft Lip; Cleft Palate; Histiocytoma, Benign Fibrous; Humans; Male; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Rhinoplasty; Skin Transplantation; Transplantation, Autologous

Topics: Adult; Diathermy; Epistaxis; Humans; Male; Nasopharyngeal Neoplasms; Nose

Topics: Adenoma; Congenital Abnormalities; Hemangioma; Histiocytoma, Benign Fibrous; Humans; Mouth Neoplasms; Nasal Cavity; Nasopharyngeal Neoplasms; Nose; Plasmacytoma; Surgical Procedures, Operative

Topics: Antineoplastic Agents; Humans; Nasopharyngeal Neoplasms; Neck; Neoplasms; Nose; Pharynx; Staining and Labeling; Triaziquone

Topics: Humans; Nasal Bone; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Paranasal Sinus Neoplasms; Paranasal Sinuses; Polyps

Topics: Abscess; Adenoids; Foreign Bodies; Hematoma; Humans; Nasal Obstruction; Nasal Polyps; Nasal Septum; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Rhinitis; Rhinitis, Allergic, Seasonal; Rhinitis, Atrophic

Topics: Humans; Maxillary Sinus; Nasopharyngeal Neoplasms; Neoplasms; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Paranasal Sinuses

Topics: Humans; Nasopharyngeal Neoplasms; Neoplasms; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Paranasal Sinuses

Topics: Humans; Nasopharyngeal Neoplasms; Neck; Neoplasms; Nose; Pharynx

Topics: Humans; Nasopharyngeal Neoplasms; Neck; Neoplasms; Nose; Pharynx; Radiology

Topics: Humans; Nasopharyngeal Neoplasms; Nose; Pharyngeal Neoplasms

Topics: Humans; Medical Records; Melanoma; Nasal Cavity; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasms; Nose; Paranasal Sinus Neoplasms

Topics: Fibroma; Humans; Nasopharyngeal Neoplasms; Nose; Pharynx

Topics: Humans; Nasopharyngeal Neoplasms; Neoplasms; Nose; Pharynx

Topics: Humans; Nasopharyngeal Neoplasms; Neoplasms; Nose; Pharynx

Topics: Colorectal Neoplasms; Humans; Nasal Polyps; Nasopharyngeal Neoplasms; Nose

Topics: Fibroma; Humans; Hypotension; Hypotension, Controlled; Nasopharyngeal Neoplasms; Nose; Pharynx

Topics: Fibroma; Humans; Nasopharyngeal Neoplasms; Nose; Pharynx

Topics: Aged; Humans; Nasopharyngeal Neoplasms; Neuroblastoma; Nose; Pharynx

Topics: Exophthalmos; Humans; Nasal Polyps; Nasopharyngeal Neoplasms; Nose

Topics: Humans; Hypopharynx; Nasal Cavity; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasms; Nose; Palatine Tonsil; Paranasal Sinus Neoplasms; Paranasal Sinuses; Tonsillar Neoplasms

Topics: Humans; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasms; Nose; Pharynx

Topics: Humans; Nasopharyngeal Neoplasms; Nasopharynx; Neoplasms; Nose; Nose Neoplasms; Pharynx; Plasmacytoma