phenylephrine-hydrochloride and Ulcer

Trigeminal trophic syndrome (TTS) is an exceedingly rare disease that causes facial ulceration, most commonly at the nasal ala. The overall incidence of TTS is not known, with less than 150 cases published in the literature.We searched the United States National Library of Medicine National Institutes of Health (PubMed) using the terms "Trigeminal Trophic Syndrome" and "TTS" as keywords. Publications in all languages were included if an English abstract was available. We reviewed 111 cases of TTS described in 75 publications from 1979 to 2021.Fourteen cases involved surgical reconstruction. Of these, the lesions completely healed in 7 cases (50%), recurred in 5 (36%), and were unspecified in 2 (14%). Reconstruction was completed in a 2 to 3-stage approach in 6 cases; of these, healing without recurrence was observed in 5 cases (83%). When donor tissue from the affected side was used as a basis for reconstruction, healing without recurrence was observed in 2 cases (50%). This is in comparison to the use of contralateral, sensate tissue in which there was healing without recurrence in all 3 cases (100%).The surgical management of TTS remains a topic of controversy. The rates of success remain comparable despite the use of various flap types. However, the use of contralateral, sensate flaps and a staged surgical approach appears to be effective based upon the best available evidence in the literature. Further prospective orretrospective controlled studies are necessary to make more reliable recommendations, though may be challenging given the rarity of TTS.

Topics: Face; Humans; Nose; Skin Ulcer; Syndrome; Ulcer

Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Female; Foreign Bodies; Humans; Iatrogenic Disease; Infant; Infant, Newborn; Lupus Erythematosus, Systemic; Male; Middle Aged; Nasal Septum; Nose; Nose Neoplasms; Occupational Diseases; Rhinitis, Atrophic; Sex Factors; Tuberculosis, Pulmonary; Ulcer; Wounds and Injuries

The objectives of this study were (1) to devise a nasal trauma score for preterm infants receiving non-invasive respiratory support, (2) to compare the incidence of nasal trauma in preterm infants <32 weeks gestation randomised to either nasal continuous positive airway pressure (NCPAP) or heated humidified high-Flow nasal cannulae (HHHFNC), in the first 7 days post-extubation and (3) to assess the effect of two different nasal dressings in those assigned to NCPAP. We randomly assigned preterm ventilated infants to receive Vapotherm® HHHFNC or NCPAP post-extubation. Infants receiving HHHFNC were treated with Sticky Whiskers® and infants receiving NCPAP received either Sticky Whiskers® or Cannualaide® nasal dressings. Bedside nursing staff scored six sites on each infant's nose for erythema, bleeding or ulceration. Scores were recorded three times daily for the first 7 days post-extubation. The sum of these 21 scores was used as the summary measure of nasal trauma. The mean nasal trauma score for infants assigned HHHFNC was 2.8 (SD 5.7) compared to 11.7 for NCPAP (SD 10.4), p < 0.001. There was no difference in mean trauma score between infants on NCPAP assigned Sticky Whiskers® 14.4 (SD 12.5) or Cannualaide® 9.5 (SD 7.3), p = 0.06.. HHHFNC resulted in significantly less nasal trauma in the first 7 days post-extubation than NCPAP and was most significant in infants <28 weeks of gestation. The use of protective dressings was not associated with decreased nasal trauma for infants on NCPAP.

Topics: Airway Extubation; Bandages; Catheters; Continuous Positive Airway Pressure; Epistaxis; Equipment Design; Erythema; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Male; Nose; Respiratory Insufficiency; Trauma Severity Indices; Ulcer

Topics: Humans; Nose; Ulcer

Topics: Humans; Nose; Skin Neoplasms; Ulcer

Trigeminal trophic syndrome (TTS) is a rare disorder that presents as ulceration of the nasal ala, and less often ipsilateral cheek, cutaneous lip, and forehead, following damage to the trigeminal nerve. TTS is often very difficult to treat due to anesthesia and paresthesia along the distribution of the trigeminal nerve, which often leads to a large behavioral component of this disease.. In this single case report, a thermoplastic mask was sutured in place overlying the chronic ulcerations of TTS in a 57-year-old man.. Significant re-epithelization of the chronic ulcerations of TTS was seen after only 6 weeks of thermoplastic mask attachment.. While TTS is a chronic and difficult to treat disease, the use of a thermoplastic mask in the treatment of this disease can significantly decrease the self-manipulation component and allow for re-epithelization and healing of the chronic ulcerations.

Topics: Humans; Middle Aged; Nose; Paresthesia; Skin Ulcer; Syndrome; Ulcer

Intranasal administration of drugs is gaining popularity in medicine, and several animal models have been used to test the safety and efficacy of this delivery route. Nevertheless, the nasal anatomy of animals is different from humans, which can lead to pathological changes that stem from the delivery device and not the drug itself. Here, we report on nasal inflammation and ulceration in rabbits, secondary to the repeated trauma caused by the intranasal device. Similar changes were noted in the animals treated with the vehicle and with the tested drug, and therefore, these changes were not attributed to the drug itself. In some animals, superficial ulcer and stromal inflammation were noted in the eyes, secondary to nasal duct obstruction from the nasal inflammation. These observations emphasize the importance of proper interpretation of histopathological changes, attributed to trauma-induced pathological changes related to the handling of the animal and not to the tested product, which is the drug itself and the device that is optimized for clinical (human) use.

Topics: Administration, Intranasal; Animals; Humans; Inflammation; Nose; Pharmaceutical Preparations; Rabbits; Ulcer

Non-healing ulcers can be caused by a number of conditions, including vascular disease, diabetes, malignancy and some infections. Drug-related ulcers are rare, and a high index of clinical suspicion is required for diagnosis, in parallel with exclusion of more sinister underlying causes.. We present a patient with a complex medical background, who had a 10-week history of a non-healing ulcer on his nasal bridge. Inflammatory, autoimmune and malignant causes for the ulcer were excluded by histopathology.. Nicorandil was deemed to be the most likely cause for the patient's ulcer. Nicorandil is an anti-anginal medication known to cause oral ulceration and skin lesions in the perianal and peristomal regions and around surgical wounds. However, there are no previously reported cases of facial ulcers. The ulcer required surgical debridement and healed completely within six months, following discontinuation of nicorandil. This case highlights the importance of having a high index of clinical suspicion regarding non-healing ulcers, and of considering drugs as an aetiological factor, especially in patients with a complex medical background who are taking numerous medications.

Topics: Debridement; Gingiva; Humans; Male; Middle Aged; Mouth; Myocardial Ischemia; Nicorandil; Nose; Pemphigus; Treatment Outcome; Ulcer; Vasodilator Agents

The performance of a culture based assay, BacLite Rapid MRSA for the rapid detection (5 hours) of methicillin resistant Staphylococcus aureus (MRSA) from specimens (n = 377) obtained from nares, throat, wounds and perineum was investigated. Compared to culture based reference methods (chromogenic MRSA ID (bioMerieux)), selective enrichment broth, PBP2' latex agglutination (Oxoid) and VITEK 2 identification (bioMerieux), an overall sensitivity of 71% with a 82% specificity and a negative predictive value (NPV) of 95% was provided. The Baclite test is rapid and easy to use and has the advantage of a culture-based detection method for MRSA.

Topics: Ciprofloxacin; Humans; Methicillin-Resistant Staphylococcus aureus; Nose; Perineum; Pharynx; Ulcer

To evaluate the incidence and severity of nasal trauma secondary to nasal continuous positive airway pressure (nCPAP) in neonates.. Prospective observational study.. Neonatal intensive care unit (NICU) of the University Hospital of Lausanne, Switzerland.. All neonates admitted between January 2002 and December 2007 treated by nCPAP were eligible.. Patients' noses were monitored during nCPAP. Nasal trauma was reported into three stages: (I) persistent erythema; (II) superficial ulceration; and (III) necrosis.. 989 neonates were enrolled. Mean gestational age was 34 weeks (SD 4), mean birth weight 2142 g (SD 840). Nasal trauma was reported in 420 (42.5%) patients and it was of stage I, II and III in 371 (88.3%), 46 (11%) and 3 (0.7%) patients, respectively. Incidence and severity of trauma were inversely correlated with gestational age and birth weight. The risk of nasal trauma was greater in neonates <32 weeks of gestational age (OR 2.48, 95% CI 1.59 to 3.86), weighing <1500 g at birth (OR 2.28, 95% CI 1.43 to 3.64), treated >5 days by nCPAP (OR 5.36, 95% CI 3.82 to 7.52), or staying >14 days in the NICU (OR 1.67, 95% CI 1.22 to 2.28). Most cases of nasal trauma (90%) appeared during the first 6 days of nCPAP. Persistent visible scars were present in two cases.. Nasal trauma is a frequent complication of nCPAP, especially in preterm neonates, but long-term cosmetic sequelae are very rare. This study provides a description of nasal trauma and proposes a simple staging system. This could serve as a basis to develop strategies of prevention and treatment of this iatrogenic event.

Topics: Birth Weight; Continuous Positive Airway Pressure; Erythema; Female; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Intensive Care, Neonatal; Male; Necrosis; Nose; Nose Diseases; Prospective Studies; Trauma Severity Indices; Ulcer

Topics: Aged, 80 and over; Alcohols; Female; Humans; Nose; Plastic Surgery Procedures; Recurrence; Surgical Flaps; Trigeminal Ganglion; Trigeminal Neuralgia; Ulcer

Topics: Brain Stem Infarctions; Humans; Male; Middle Aged; Nose; Nose Diseases; Plastic Surgery Procedures; Pruritus; Stroke; Trigeminal Nerve Diseases; Ulcer

We present a case of 23-year-old man with acute meningoencephalitis, accompanied by inflammation of a nasal ulcer. He had been healthy until six months prior to admission to the hospital when he had a motorcycle accident. A star-shaped wound at his nose was incurred after falling into a swamp. A computed tomogram of the brain showed two nonenhancing hypodense lesions at the left caudate nucleus and the right parietal lobe, ependymitis and leptomeningeal enhancement. A skin biopsy showed chronic noncaseous granulomatous inflammation without demonstrated microorganisms. The patient did not respond to the empirical treatment with cloxacillin, ceftriaxone, and amphotericin B, and eventually died on the thirteenth day of hospitalization. At autopsy, hematoxylin and eosin-stained brain sections showed a chronic necrotizing inflammation with numerous amebic trophozoites and rare cysts. Definitive identification of Balamuthia mandrillaris was made by fluorescent immunohistochemical analysis. There were 10 Naegleria fowleri primary amebic meningoencephalitis, eight Acanthamoeba granulomatous amebic encephalitis, and three Acanthamoeba meningitis in Thailand. To our knowledge, this case is the first reported case of B. mandrillaris in Southeast Asia.

Topics: Adult; Amebiasis; Animals; Asia, Southeastern; Brain; Central Nervous System Protozoal Infections; Humans; Lobosea; Male; Meningoencephalitis; Nose; Tomography, X-Ray Computed; Ulcer

Malignancies in scars are generally known as Marjolin's ulcer. The majority of these arise from burn injuries. Although Marjolin's ulcer consists of all kinds of skin cancer, squamous cell carcinoma is the main cancer type reported in the literature. The pathogenesis of this tumor is due to chronic irritation of the effected area and mostly involves the extremities and scalp area. This report presents an unusually located and rare type of Marjolin's ulcer: on the nose and baso-squamotic in type. A 54-year-old man, 33 years after burn, presented with an unhealed ulcer on his nose which had been present for 2 years. The case was managed by tumor excision and a naso-labial transposition flap. To our knowledge, this is the first report of Marjolin's ulcer developing on post-burned skin of the nose.

Topics: Burns; Carcinoma, Basosquamous; Humans; Male; Middle Aged; Neoplasms, Post-Traumatic; Nose; Nose Neoplasms; Skin Neoplasms; Ulcer

The effect of dose fractionation on the radiation response of mouse tongue epithelium was quantified in fractionation protocols involving 1, 3, 4, 5 and 10 fractions, separated by at least 4 h. Fractionated irradiation was given either to the whole snout by 300 kV X-rays or locally to the tongue using 25 kV X-rays. Each protocol was terminated by a final local top-up dose (25 kV X-rays) of 5 Gy. The frequency of complete local denudation within the test area was used as the quantal end point. The kinetics of repair of sublethal damage was studied by snout irradiation with four equally spaced fractions, delivered at intervals of 35, 60, 90, 480 or 540 min, again followed by a local top-up dose of 5 Gy. The linear-quadratic model gave a satisfactory fit to the data with the exception of the four fraction/30-h data, suggesting cell cycle effects in this schedule. Analysis of the results with different two-step methods and with direct analysis yielded similar results. The alpha/beta ratio was determined to be approximately 11 GY (direct analysis: 11.6 Gy with 95% confidence limits of 8.1 and 16.4 Gy) and T1/2 was found to be 46 min (35-69 min). Both these values are in the range described for other acutely responding rodent tissues.

Topics: Animals; Dose-Response Relationship, Radiation; Epithelium; Female; Kinetics; Mice; Mice, Inbred C3H; Nose; Radiation Dosage; Radiation Injuries, Experimental; Salivation; Specific Pathogen-Free Organisms; Time Factors; Tongue; Tongue Diseases; Ulcer; Weight Loss; Wound Healing

Foreign bodies in the nose are commonly encountered in ORL practice. Miniature button battery impaction in the nose has rarely been reported. Seven such cases have been encountered, each suffering complications directly attributable to the button battery. The complications included septal burns in five patients leading to septal perforation in one child, one case of severe nasal bleeding and one case of necrosis of the lateral nasal wall. The site of maximal damage corresponded with the negative pole of the battery in every case. The possible explanation for this and mechanisms of cellular injury are proposed. This paper underlines the potential hazards of button batteries as foreign bodies in the nose and emphasizes the need for rapid removal and long-term follow-up of these patients.

Topics: Child, Preschool; Electric Power Supplies; Female; Foreign Bodies; Humans; Male; Nasal Septum; Nose; Nose Diseases; Turbinates; Ulcer

Three Japanese patients with trigeminal trophic syndrome, a rare dermatosis in Japan, were reported. Cutaneous lesions were a long-standing ulcer and destruction of the right ala nasi in case 1, a persistent deep ulceration on the forehead after a small trauma in case 2, and development of small, discrete ulcers on the right forehead during the treatment of a postherpetic neuralgia in case 3. A protective device was very effective in one patient.

Topics: Aged; Diabetes Complications; Facial Dermatoses; Female; Herpes Zoster; Humans; Male; Middle Aged; Nose; Syndrome; Trigeminal Neuralgia; Ulcer

Topics: Child; Female; Humans; Nose; Tongue; Tuberculosis, Miliary; Ulcer

Topics: Adult; Female; Humans; Nose; Tuberculosis, Cutaneous; Ulcer

Topics: Aerosols; Animals; Bronchopneumonia; Cat Diseases; Cats; Conjunctiva; Conjunctivitis; Fluorescent Antibody Technique; Histological Techniques; Lung; Nose; Pharynx; Picornaviridae; Rectum; Rhinitis; Spleen; Ulcer; Virus Diseases

Topics: Aged; Calculi; Female; Foreign Bodies; Humans; Intellectual Disability; Nose; Palate; Ulcer

Topics: Blood Protein Electrophoresis; Foot Dermatoses; Humans; Male; Middle Aged; Nose; Oral Manifestations; Skin Diseases; Tongue Diseases; Ulcer; Xanthomatosis

Topics: Granulomatosis with Polyangiitis; Hemoptysis; Humans; Larynx; Nose; Pneumonia; Respiratory Tract Diseases; Trachea; Ulcer

Topics: Humans; Neurosurgery; Neurosurgical Procedures; Nose; Postoperative Complications; Skin Ulcer; Trigeminal Nerve; Ulcer

Topics: Humans; Nose; Peripheral Nervous System Diseases; Skin Diseases; Trigeminal Neuralgia; Ulcer

Topics: Atrophy; Blood; Humans; Iron; Nose; Nose Diseases; Rhinitis; Rhinitis, Atrophic; Skin Diseases; Ulcer

Topics: Chloramphenicol; Humans; Nose; Nose Diseases; Serositis; Ulcer

Topics: Face; Granuloma; Humans; Nose; Ulcer

Topics: Chromium; Humans; Nasal Septum; Nose; Patch Tests; Skin; Transdermal Patch; Ulcer

Topics: Diabetes Mellitus; Humans; Nose; Ulcer

Topics: Humans; Nasal Septum; Nose; Ulcer

Topics: Humans; Nose; Peripheral Nervous System Diseases; Trigeminal Ganglion; Trigeminal Nerve Injuries; Ulcer

Topics: Humans; Nose; Peripheral Nervous System Diseases; Trigeminal Ganglion; Trigeminal Nerve Injuries; Ulcer

Topics: Humans; Irritants; Nasal Septum; Nose; Ulcer