scholarly journals Newborn Nasal Obstruction due to Congenital Nasal Pyriform Aperture Stenosis

2016 ◽  
Vol 7 (1) ◽  
pp. ar.2016.7.0146 ◽  
Author(s):  
Thiago L. I. Serrano ◽  
Leopoldo Pfeilsticker ◽  
Vanessa Silva ◽  
Igor Hazboun ◽  
Jorge Paschoal ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Respiratory Distress ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Surgical Correction ◽  
Severe Respiratory Distress ◽  
First Case ◽  
Pyriform Aperture

Introduction Nasal obstruction is an important condition that can lead to severe respiratory distress in newborns. There are several differential diagnoses, and one of them is congenital nasal pyriform aperture stenosis (CNPAS). CNPAS is a rare case of respiratory distress caused by excessive growth of the nasal process of the maxilla and leads to narrowing of the anterior third of the nasal cavity. Diagnosis, associated anomalies, and treatment strategies are reviewed by the following presentation of two cases. Case Presentation We report two cases of infants diagnosed with CNPAS. The patients in the first case had no concomitant comorbidities, and the outcome was successful after surgical correction of stenosis. The patient in the second case had an associated holoprosencephaly, and although surgical correction and nasal cavity patency, the patient remains dependent on tracheostomy due to dysphagia and neurologic impairment. Discussion Airway obstruction affects 1 in 5000 children, and CNPAS is a diagnosis frequently forgotten and even unknown to neonatal and pediatric intensivists. Newborns are obligate nasal breathers, and, nasal obstruction, therefore, can lead to severe respiratory distress. CNPAS is not only rare but, many times, is not easily recognized. It is important to bear in mind the diagnostic criteria when evaluating infants with nasal obstruction. Conservative treatment should be prioritized, but surgical treatment is required in severe cases with failure to thrive and persistent respiratory distress. Respiratory distress and dysphagia may persist to some degree despite correction of the stenotic pyriform aperture due to associated narrowing of the entire nasal cavity and association with other anomalies. Final Comments CNPAS is a rare condition and may be lethal in newborns. Differential diagnosis of nasal obstruction must be remembered to recognize this anomaly, and the otolaryngologist must be familiarized with this condition and its diagnosis. Precise surgical treatment in severe cases have high rates of success in children without other comorbidities.

scholarly journals Pituitary macroadenoma presenting as a nasal tumor: case report

2014 ◽  
Vol 132 (6) ◽  
pp. 377-381 ◽  
Author(s):  
Nivaldo Adolfo Silva Junior ◽  
Fabiano Reis ◽  
Larissa Kaori Miura ◽  
Guilherme Henrique Vieira ◽  
Luciano Souza Queiroz ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Sphenoid Sinus ◽  
Sella Turcica ◽  
Rare Condition ◽  
Lower Surface ◽  
Large Mass ◽  
Histopathological Analysis ◽  
Tumor Extension

CONTEXT: Pituitary macroadenomas are rare intracranial tumors. In a few cases, they may present aggressive behavior and invade the sphenoid sinus and nasal cavity, causing unusual symptoms. In this paper, we report an atypical case of pituitary adenoma presenting as a nasal mass.CASE REPORT: The patient was a 44-year-old woman who had had amenorrhea and galactorrhea for ten months, with associated nasal obstruction, macroglossia and acromegaly. Both growth hormone and prolactin levels were increased. Magnetic resonance imaging showed a large mass originating from the lower surface of the pituitary gland, associated with sella turcica erosion and tumor extension through the sphenoid sinus and nasal cavity. Histopathological analysis demonstrated a chromophobe pituitary adenoma with densely packed rounded epithelial cells, with some atypias and rare mitotic figures. There was no evidence of metastases.CONCLUSION: Macroadenoma invading the nasal cavity is a rare condition and few similar cases have been reported in the literature. This study contributes towards showing that tumor extension to the sphenoid sinus and nasopharynx needs to be considered and investigated in order to make an early diagnosis when atypical symptoms like nasal obstruction are present.

scholarly journals Pedunculated Cavernous Hemangioma Originating in the Olfactory Cleft

2014 ◽  
Vol 93 (9) ◽  
pp. E29-E33 ◽  
Author(s):  
Kaiming Su ◽  
Weitian Zhang ◽  
Haibo Shi ◽  
Shankai Yin
Keyword(s):  
Nasal Cavity ◽  
Cavernous Hemangioma ◽  
English Language ◽  
Nasal Congestion ◽  
Rare Condition ◽  
Lateral Wall ◽  
Endoscopic Examination ◽  
Nasopharyngeal Angiofibroma ◽  
Olfactory Cleft ◽  
First Case

Sinonasal cavernous hemangioma is a rare condition that usually affects the lateral wall of the nasal cavity. We report the case of a 77-year-old man who presented with severe epistaxis, nasal congestion, and olfactory dysfunction. Endoscopic examination of the nasal cavity revealed the presence of a red-blue tumor that had almost completely filled the nasopharynx. Preoperatively, it was difficult to distinguish this lesion from a juvenile nasopharyngeal angiofibroma. During endoscopic surgery, the tumor was found to originate in the left olfactory cleft, and it had a long peduncle that contained blood vessels. Postoperative histopathologic examination indicated that the mass was a cavernous hemangioma. To the best of our knowledge, this is the first case of an olfactory cleft cavernous hemangioma and the first case of olfactory cleft disease associated with a cavernous hemangioma to be reported in the English-language literature.

Congenital Bony Nasal Cavity Deformities

1998 ◽  
Vol 12 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Jacqueline E. Jones ◽  
Eytan Young ◽  
Linda Heier
Keyword(s):  
Soft Tissue ◽  
Respiratory Distress ◽  
Airway Obstruction ◽  
Nasal Cavity ◽  
Congenital Anomalies ◽  
Clinical Management ◽  
Choanal Atresia ◽  
Anatomical Features ◽  
Tissue Edema ◽  
Pyriform Aperture

Although the most common form of nasal obstruction in neonates is soft tissue edema, congenital bony nasal deformities are being recognized as an important cause of newborn airway obstruction. In addition to the well described choanal atresia, CT imaging of the newborn in respiratory distress reveals two other forms of bony nasal cavity deformities: nasal pyriform aperture stenosis and nasal cavity stenosis. All of the three types of bony nasal cavity deformities have characteristic anatomical features, are associated with distinctive congenital anomalies, and are postulated to have differing embryological causes. Five patients with congenital bony nasal cavity deformities are presented. These cases illustrate the clinical and radiological presentation of varied types of congenital nasal cavity obstruction as well as the criteria used to guide clinical management.

scholarly journals A Rare Presentation of Cavernous Hemangioma of Both Inferior Turbinates

2017 ◽  
Vol 25 (2) ◽  
pp. 111-114
Author(s):  
KN Salimath ◽  
N Ramakrishnan ◽  
JR Galagali
Keyword(s):  
Case Report ◽  
Nasal Cavity ◽  
Histological Examination ◽  
Nasal Obstruction ◽  
Cavernous Hemangioma ◽  
Inferior Turbinate ◽  
Mesenchymal Tumors ◽  
Rare Presentation ◽  
First Case ◽  
Inferior Aspect

The nasal cavity presents with various types of neoplasms, including epithelial and mesenchymal tumors. Cavernous hemangioma of nasal cavity is quite rare. It usually presents as a unilateral mass arising from mucosa of nasal cavity. Case Report                                       We describe here, a case of 25-year-old serving soldier, who was referred to our hospital with a mass in both nasal cavities with bilateral nasal obstruction. On examination, the mass originated from the inferior aspect of inferior turbinate of both sides. Subsequently on histological examination after complete endoscopic excision revealed that the mass was a cavernous hemangioma arising from both inferior turbinates. Discussion To our knowledge, this is the first case of cavernous hemangioma arising from both inferior turbinate reported in literature.

scholarly journals Left Pulmonary Agenesis: Report of a Case

2018 ◽  
Vol 7 (2) ◽  
pp. 27
Author(s):  
Sudhir Singh ◽  
Jiledar Rawat ◽  
Gurmeet Singh
Keyword(s):  
Respiratory Distress ◽  
Clinical Examination ◽  
Medical Management ◽  
Congenital Malformations ◽  
Poor Prognosis ◽  
Rare Condition ◽  
Delayed Presentation ◽  
Severe Respiratory Distress ◽  
Pulmonary Agenesis

Pulmonary agenesis is a very rare condition with poor prognosis. Although the condition is a congenital malformations, delayed presentation is also seen. A female neonate with left pulmonary agenesis presented to us with severe respiratory distress. She was initially misdiagnosed as a case diaphragmatic hernia at another hospital and referred to us for further management. Clinical examination and further investigations confirmed the diagnosis of left pulmonary agenesis. The child improved on medical management and is asymptomatic up to 6 months of follow-up.

scholarly journals Neonatal Respiratory Distress and Airway Emergency: Report of Two Cases

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 255
Author(s):  
Lorenzo Bresciani ◽  
Paola Grazioli ◽  
Roberta Bosio ◽  
Gaetano Chirico ◽  
Cesare Zambelloni ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Renal Dysplasia ◽  
Esophageal Intubation ◽  
Mask Ventilation ◽  
Anal Atresia ◽  
Severe Respiratory Distress ◽  
First Case ◽  
Emergency Tracheostomy ◽  
Vertebral Defects

We discuss two cases of congenital airway malformations seen in our neonatal intensive care unit (NICU). The aim is to report extremely rare events characterized by immediate respiratory distress after delivery and the impossibility to ventilate and intubate the airway. The first case is a male twin born at 34 weeks by emergency caesarean section. Immediately after delivery, the newborn was cyanotic and showed severe respiratory distress. Bag-valve-mask ventilation did not relieve the respiratory distress but allowed for temporary oxygenation during subsequent unsuccessful oral-tracheal intubation (OTI) attempts. Flexible laryngoscopy revealed complete subglottic obstruction. Postmortem analysis revealed a poly-malformative syndrome, unilateral multicystic renal dysplasia with a complete subglottic diaphragm, and a tracheo-esophageal fistula (TEF). The second case is a male patient that was vaginally born at 35 weeks. Antenatally, an ultrasound (US) arose suspicion for a VACTERL association (vertebral defects, anal atresia, TEF with esophageal atresia and radial or renal dysplasia, plus cardiovascular and limb defects) and a TEF, and thus, fetal magnetic resonance (MRI) was scheduled. Spontaneous labor started shortly thereafter, before imaging could be performed. Respiratory distress, cyanosis, and absence of an audible cry was observed immediately at delivery. Attempts at OTI were unsuccessful, whereas bag-valve-mask ventilation and esophageal intubation allowed for sufficient oxygenation. An emergency tracheostomy was attempted, although no trachea could be found on cervical exploration. Postmortem analysis revealed tracheal agenesis (TA), renal dysplasia, anal atresia, and a single umbilical artery. Clinicians need to be aware of congenital airway malformations and subsequent difficulties upon endotracheal intubation and must plan for multidisciplinary management of the airway at delivery, including emergency esophageal intubation and tracheostomy.

scholarly journals Congenital Dislocation of the Patella – Surgical Treatment Rationale and Literature Review

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Luisella Pedrotti ◽  
Barbara Bertani ◽  
Federica De Rosa ◽  
Federica Fossati ◽  
Margherita Ghilotti ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Joint Stiffness ◽  
Rare Condition ◽  
Quadriceps Muscle ◽  
Knee Extension ◽  
Clinical Findings ◽  
Surgical Correction ◽  
Trochlear Groove ◽  
Congenital Dislocation ◽  
Dislocation Of The Patella

Introduction: Congenital dislocation of the patella (CDP) is a rare condition and its treatment is not well defined. In CDP, patella is dislocated on the lateral aspect of the distal femur, laterally from the trochlear groove, it cannot be reduced manually and it is almost always associated with genu valgum, lateral torsion of the proximal tibia, and flexion contracture of the knee. This condition is present at birth, but the clinical findings can be subtle at birth due to the size and character of the structures being examined; early diagnosis is essential, but it may be delayed to late childhood or adulthood. If CDP is not promptly treated, the disability increases during growth, so surgical correction should be planned as soon as the diagnosis is confirmed. Case Report: We report a case of bilateral CDP associated with bilateral proximal radioulnar joint stiffness; the patient at the age of diagnosis was 11 years old and underwent a bilateral delayed surgical procedure; the 4-year follow-up results are satisfactory. Surgical treatment rationale and literature are reviewed. Conclusion: Surgical correction for CDP is generally recommended, but there is no agreement in literature on the ideal treatment and in some cases, with mild impairment of the knee function, observation alone has been suggested. The decision about a surgical treatment can be difficult and depends on the degree of disability of the patient. Keywords: Congenital dislocation of the patella, bilateral congenital dislocation, patella, Z-plasty quadriceps muscle, lateral retinaculum release, lack of active knee extension.

scholarly journals Rhinolithiasis: A Rare Clinical Case

2021 ◽  
pp. 23-26
Author(s):  
Sylvain Diembi ◽  
Harol Boris Otouana ◽  
Gerard Chidrel Gouoni ◽  
A Tsieri Tsoba ◽  
Brice Diabassana ◽  
...  
Keyword(s):  
Foreign Body ◽  
Ct Scan ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Endoscopic Surgery ◽  
Clinical Case ◽  
Current Practice ◽  
Rare Condition ◽  
Therapeutic Management ◽  
Positive Diagnosis

Rhinolithiasis is a rare condition in our current practice. We report the case of a 19 year old woman, presenting with a double symptom marked by rhinorrhea and chronic unilateral nasal obstruction evolving since the age of 7 years, without any known foreign body. Rhinoscopy and nasal endoscopy coupled with CT scan were decisive examinations for the positive diagnosis. The therapeutic management consisted in the extraction of the rhinolithiasis resulting in the vacuity of the nasal cavity. The evolution was favorable with simple postoperative courses. Keywords: Rhinolithiasis; Woman; Rhinoscopy; Endoscopic Surgery

The correlation of the results of the survey SNOT-20 of objective studies of nasal obstruction and the geometry of the nasal cavities

2017 ◽  
Vol 71 (2) ◽  
pp. 1-7 ◽  
Author(s):  
Monika Prus-Ostaszewska ◽  
Jarosław Wysocki ◽  
Kazimierz Niemczyk ◽  
Jarosław Balcerzak
Keyword(s):  
Surgical Treatment ◽  
Nasal Cavity ◽  
Nasal Obstruction ◽  
Statistical Significance ◽  
Postoperative Control ◽  
Objective Parameter ◽  
Before And After ◽  
Objective Tests ◽  
Medical University ◽  
Question Survey

Introduction: In this paper were verified the correlation between the results of the survey SNOT-20 and the results of the objective tests of nasal obstruction which are rhinomanometry and acoustic rhinometry before and after surgical treatment, such as septoplasty, septoconchoplasty, ethmoidectomy and septoethmoidectomy. Material and methods: The material used in this study was 233 patients diagnosed routinely in the Rhinomanometry Laboratory of the Department of Otolaryngology at the Medical University of Warsaw, reporting rhinological problems. Data were obtained from 70 women (31,4%) ranging in ages from 18 to 81 years of age and 153 men (68,6%) ranging in ages from 16 to 81 years of age. The researches presented in the study were made using the device RhinoMetrics SRE 2100 which combines the Rhinomanometer (RhinoStream) and Acoustic Rhinometer (RhinoScan) Interacoustics AS (Denmark). Survey SNOT-20 (Sino-Nasal Outcome Test-20) in Polish was completed by patients before surgery and during the postoperative control visits. Results: The calculated correlations between the objective parameter, which was the resistance to the flow of air through the nasal cavity , and the subjective feelings of respondents expressed in the survey SNOT-20 were generally weak, and statistical significance was achieved with respect to the first question survey (the severity of the nose obstruction) for all components of resistance flow. Discussion: The feeling of nasal obstruction is the most reproducible and reliable complaint reported by the patient with rhinological problems.

Clinical Outcomes for the Surgical Treatment of Sinonasal Headache

2003 ◽  
Vol 129 (3) ◽  
pp. 217-221 ◽  
Author(s):  
David H. Harley ◽  
Eric S. Powitzky ◽  
James Duncavage
Keyword(s):  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Clinical Significance ◽  
Nasal Obstruction ◽  
Study Design ◽  
Patient Population ◽  
Surgical Correction ◽  
Contact Points ◽  
Outcomes Measures

OBJECTIVE: This study was designed to explore the changes in patient-relevant clinical outcomes in a selected group undergoing surgery for nasal septal and turbinate abnormalities. STUDY DESIGN: Seventy-nine consecutive patients with headache and correctable anatomic nasal obstruction were seen at the study institution from March 1998 to May 2000. These patients were evaluated for changes in patient-relevant clinical outcomes measures after surgical correction of their anatomic abnormalities. RESULTS: Seventy-one patients underwent surgical correction of nasal obstruction. More than half of these patients had contact points preoperatively. Statistically significant improvements were observed in the patient population with respect to 8 of the 10 clinical outcomes measures. Importantly, a decrease in the severity and frequency of headaches was noted after surgery, especially after the correction of contact points. CONCLUSION: The surgical correction of the septum and turbinates resulted in predictable improvement in headache and a majority of other important outcomes measures. CLINICAL SIGNIFICANCE: Pain may improve after surgical correction of septal and turbinate abnormalities in a properly selected group.

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