RESUMEN
BACKGROUND: Proteus Syndrome (PS) is a rare hamartoneoplastic disorder consisting of a disproportionate and asymmetric overgrowth of body parts, leading to severe body and face disfigurement. Individuals with PS frequently need to undergo a number of surgical procedures including Otolaryngology interventions. Their peculiar anatomy turns even the most straightforward intervention to a challenging one. CASE DESCRIPTION: A 31-year-old adult male with PS presented with recurrent epistaxis and nasal obstruction. A nasal mass was found during the physical examination, which was surgically removed under general anesthesia. Histology revealed juvenile angiofibroma. CONCLUSION: This is the first reported case of a patient with PS presenting with juvenile nasopharyngeal angiofibroma. Although vascular malformations may appear in these patients, juvenile nasopharyngeal angiofibroma should be taken under consideration when PS patients present with recurrent epistaxis. HIPPOKRATIA 2017, 21(3): 147-149.
RESUMEN
The present report refers to two patients presenting with grinding of the teeth (bruxism). A brief review is made of the literature concerning the aetiology of the disease, the clinical manifestations and diagnosis, as well as the therapeutic approach.
Asunto(s)
Bruxismo/complicaciones , Adulto , Femenino , Humanos , Hipertrofia/etiología , Hipertrofia/patología , Hipertrofia/cirugía , Masculino , Músculo Masetero/patología , Músculo Temporal/patologíaRESUMEN
OBJECTIVES: To present a rare occurrence in ear, nose and throat practice of upper airway allergic edema from use of juice extracted from the fruit of Ecballium elaterium. INTRODUCTION: Ecballium elaterium is a plant indigenous to the Mediterranean region that bears the common name squirting cucumber. Many people in this region for the treatment of sinusitis use the juice of its fruit. However, allergy-prone patients after using it may sometimes present with edema at various sites of the upper respiratory tract. Otolaryngologists are frequently asked to diagnose and treat such an emergency situation. STUDY DESIGN: Retrospective review of the records of 42 patients with this condition during the last 4 years. METHODS: Patient records were retrospectively reviewed for age, sex, presenting symptoms, physical examination, and medical treatment. Seasonal distribution and data from the history of the patients were also considered. Skin prick and prick-to-prick testing to various allergens was performed in 12 patients. RESULTS: Most of the patients presented with localized swelling of the uvula and the nasal mucosa, whereas in the remainder of the patients various sites of swelling of the upper respiratory tract were observed. Skin tests elicited positive reactions to pollen weeds and to various fruits of the Cucurbitaceae family. Treatment of the patients with corticosteroids and antihistamines resulted in an uneventful recovery, and we did not need to resort to therapeutic modalities, such as intubation or tracheotomy. CONCLUSIONS: We think a further study of the pharmaceutical properties of the plant's fruit juice is needed, especially regarding its curative properties of rhinitis and sinusitis. However, adverse reactions in some patients with a positive history of allergy should always be considered.
Asunto(s)
Obstrucción de las Vías Aéreas/etiología , Cucurbitaceae , Edema/etiología , Medicina Tradicional , Extractos Vegetales/efectos adversos , Enfermedades Respiratorias/etiología , Adulto , Anciano , Obstrucción de las Vías Aéreas/diagnóstico , Obstrucción de las Vías Aéreas/terapia , Antiinflamatorios/uso terapéutico , Edema/diagnóstico , Edema/terapia , Tratamiento de Urgencia/métodos , Femenino , Grecia , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Hipersensibilidad/complicaciones , Masculino , Persona de Mediana Edad , Otolaringología/métodos , Fitoterapia , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/terapia , Estudios Retrospectivos , Estaciones del Año , Sinusitis/terapia , Pruebas Cutáneas , Esteroides , Resultado del TratamientoRESUMEN
Fibro-osseous dysplasia is a developmental non familial, benign anomaly of bone development occurring in single or multiple bones, characterised by the replacement of normal bone by fibro-osseous tissue. We describe the case of a fourteen year old boy, which illustrates many of the difficulties confronting surgeons dealing with this uncommon condition. Complete surgical excision was required, before a definitive histological diagnosis could be established. We report the clinical, radiological and pathological features of this unusual case. We review the pathology of the condition and discuss the approaches to surgical management.
Asunto(s)
Huesos Faciales/patología , Enfermedades Nasales/patología , Cráneo/patología , Adolescente , Enfermedades Óseas/diagnóstico , Enfermedades Óseas/patología , Enfermedades Óseas/cirugía , Diagnóstico Diferencial , Displasia Fibrosa Ósea/diagnóstico , Displasia Fibrosa Ósea/patología , Displasia Fibrosa Ósea/cirugía , Humanos , Masculino , Obstrucción Nasal/diagnóstico , Enfermedades Nasales/diagnóstico , Enfermedades Nasales/cirugíaRESUMEN
The effectiveness of some modifications of the Caldwell-Luc standard procedure in the prevention of post-operative mid-facial sensitivity disorders was investigated in a prospective comparative study at the ENT Department, Faculty of Medicine, University of Athens, Greece, from 1986-1992. Sixty-nine maxillary sinuses were operated on in 61 patients suffering from benign pathological conditions. The modifications concerned the type of mucoperiosteal incision and the site and size of the created anterior antrostomy. Only 8.7 per cent of the sinuses operated on by the modified technique presented with post-operative disorders whereas among those operated on by the classical technique, the ratio climbed to 33 per cent. In view of the findings of this study, the modifications applied can be valuable in treating non-extensive maxillary sinus disease with minimal post-operative sensitivity disorders.
Asunto(s)
Seno Maxilar/cirugía , Sinusitis Maxilar/cirugía , Otolaringología/métodos , Complicaciones Posoperatorias/prevención & control , Trastornos de la Sensación/prevención & control , Adulto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
An unusual case of cervicofacial actinomycosis presenting as acute upper airway obstruction and demanding urgent tracheostomy is reported. Diagnosis was established by microscopic examination of the pus and culture of Actinomyces israelii. Repeated surgical drainage of the purulent foci and prolonged treatment with penicillin obtained resolution of the disease. Clinicians dealing with acute head and neck swellings should always consider actinomycosis as a possible diagnosis.
Asunto(s)
Actinomicosis Cervicofacial/complicaciones , Obstrucción de las Vías Aéreas/microbiología , Actinomyces/aislamiento & purificación , Actinomicosis Cervicofacial/cirugía , Anciano , Obstrucción de las Vías Aéreas/cirugía , Femenino , Humanos , TraqueostomíaRESUMEN
A case of oncocytoma of the larynx is presented. These lesions are rarely found in the larynx, and have been more commonly described in the salivary and thyroid glands. The histopathological diagnosis is often difficult and the light microscopy can be unreliable for oncocytic lesions. For a more accurate definition of these tumours, the use of histochemical stains together with electron microscopy are advocated. With adequate surgery, the prognosis is excellent, and tumours are unlikely to recur. This paper discusses the management of a patient with a benign oncocytoma of the true vocal cord, and presents a review of the world literature.