Table of Contents
1
UI - 11368658
AU - Driscoll BP; Baker SR; Drisco BP
TI -
Reconstruction of nasal alar defects.
SO - Arch Facial Plast Surg 2001 Apr-Jun;3(2):91-9
AD - Center for Facial Cosmetic Surgery, University of Michigan Health
Center, 199900 Haggerty Rd, Suite 103, Livonia, MI 48152, USA.
OBJECTIVE: To evaluate aesthetic and functional results of
reconstruction of the nasal alar subunit using free cartilage grafts
with an interpolated cheek or forehead flap and a vascularized mucosal
flap when required. SETTING: University-based facial plastic surgery
practice. PATIENTS: A case series of 50 patients with primary alar
defects undergoing nasal alar reconstruction. MAIN OUTCOME MEASURES:
Observer's and patient's rating of the final results, patient's rating
of breathing and level of self-consciousness, and medical record review
of complications. RESULTS: Most aesthetic outcomes were excellent to
good. Breathing from the reconstructed side can be returned to
preoperative status in most of these patients. CONCLUSION: Staged
reconstruction of the nasal ala using free cartilage grafts,
interpolated cheek or forehead and mucosal flaps when necessary, result
in a highly aesthetic and functional outcome in most patients.
2
UI - 11392584
AU - Xaubet A; Mullol J; Roca-Ferrer J; Pujols L; Fuentes M; Perez M; Fabra
TI -
JM; Picado C
Effect of budesonide and nedocromil sodium on IL-6 and IL-8 release from
human nasal mucosa and polyp epithelial cells.
SO - Respir Med 2001 May;95(5):408-14
AD - Servei de Pneumologia i Allergia Respiratoria, Institut Clinic de
Pneumologia i Cirurgia Toracica, and Institut d'Investigacions
Biomediques August Pi i Sunyer, Barcelona, Spain.
We investigated the effect of budesonide and nedocromil sodium on the
secretion of IL-6 and IL-8 by cultured epithelial cells from healthy
nasal mucosa and nasal polyps. Human epithelial cell conditioned media
was generated with fetal calf serum (FCS) in the presence or absence of
budesonide and/or nedocromil sodium. Budesonide inhibited FCS-induced
IL-6 and IL-8 release in a dose-dependent manner. The IC25 (25%
inhibitory concentration) of budesonide on IL-6 release was higher in
nasal polyp than in nasal mucosa epithelial cells (34 nM vs. 200 pM).
The IC25 of budesonide on IL-8 release was higher in nasal mucosa than
in nasal polyps (145 pM vs. 4 pM). Nedocromil sodium caused a
dose-related inhibitory effect on IL-8 release from nasal mucosa (IC25,
207 nM), while it only had a significant effect in nasal polyps at
10(-5) M. Nedocromil sodium had no effect on IL-6 release. The
inhibitory effect of budesonide was higher than that of nedocromil
sodium on both nasal polyps and nasal mucosa. Budesonide and nedocromil
sodium may exert their anti-inflammatory action in the respiratory
mucosa by modulating the secretion of IL-6 and IL-8. The different
effect of budesonide and nedocromil sodium on IL-6 and IL-8 release may
be explained by differences in the mechanisms which regulate the
upregulation of these cytokines in inflammatory responses.
3
UI - 11425208
AU - Lee SH; Park JH; Oh BH; Jung KY; Lee HM; Choi JO; Lim HH
TI -
Analysis of proteoglycan gene messages in human nasal mucosa and nasal
polyp using dot blot hybridization.
SO - Acta Otolaryngol 2001 Apr;121(3):398-402
AD - Department of Otorhinolaryngology-Head & Neck Surgery, College of
Medicine, Korea University, Seoul, South Korea.
It has been suggested that the formation and growth of nasal polyp
require the remodeling of extracellular matrix. Proteoglycans (PGs) are
major components of the extracellular matrix that maintain the integrity
of structural tissue. The leucine-rich repeat PGs include lumican,
decorin and biglycan and have many important biologic activities in
various pathologic conditions, including the remodeling of the
extracellular matrix. Therefore, these small-PG families may be involved
in the formation and growth of nasal polyp. In the present study,
surgical specimens of nasal polyps and nasal mucosa were assessed for
expression of mRNA coding for lumican, decorin and biglycan using
reverse transcriptase-polymerase chain reaction followed by dot blot
hybridization. Lumican, decorin and biglycan mRNA were expressed in all
tissue samples examined. Semiquantitative dot blot hybridization
revealed that the levels of the lumican and biglycan messages are lower
in nasal polyp tissues than in nasal mucosa. The decorin messages in
nasal polyp were expressed at levels similar to those in nasal mucosa.
These results suggest that lumican, decorin and biglycan may be
important components of the extracellular matrix in nasal mucosa.
Considering the function of these PGs, normal levels of decorin
associated with low levels of biglycan and lumican may play a role in
the pathogenesis of nasal polyposis.
4
UI - 11424740
AU - Nonaka R; Nonaka M; Takanashi S; Jordana M; Dolovich J
TI -
Eosinophil activation in the tissue: synthetic steroid, budesonide,
effectively inhibits the survival of eosinophils isolated from
peripheral blood but not nasal polyp tissues.
SO - J Clin Lab Immunol 1999;51(1):39-53
AD - Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
We investigated the effect of a potent synthetic steroid, budesonide
(BUD), on the survival of nasal polyp (NP) derived eosinophils (EOS).
BUD, at the highest dose used, 10(-6) M, decreased this survival but
only by approximately one third. We speculated that the relatively small
inhibitory effect of budesonide on the survival of NP-EOS could be the
result of these EOS being exposed to substantial amounts of GM-CSF, IL-5
or IL-3. In this regard, we detected 148 pg of GM-CSF per 150 mg of
tissue, which approximately contained 106 of eosinophils, in the
supernatant of NP explants for 24 h without any stimulation. Contents of
both IL-5 and IL-3 were much less. We further studied survival of PB-EOS
exposed to rhGM-CSF and found that 10(-6) M of BUD could only inhibit by
less than one third the survival of PB-EOS exposed to an amount of
rhGM-CSF, similar to that detected in the supernatant of NP explants. In
addition, we exposed PB-EOS to 200 pg/ml of rhGM-CSF for a relatively
long period of time (4 days) in order to mimic chronic exposure in the
tissue and found that the survival of these cells was prolonged to the
extent similar to that observed in NP-EOS. Our data suggests that the
prolonged spontaneous survival of NP-EOS ex vivo is likely the result of
sustained in vivo exposure to GM-CSF and budesonide has a smaller
inhibitory effect in the survival of these eosinophils as compared to
those from peripheral blood.
5
UI - 11450908
AU - Cackett P; Weir C
TI -
Olfactory neuroblastoma--an unusual presentation.
SO - J Neuroophthalmol 2001 Jun;21(2):90-1
AD - Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow,
Scotland. pdcackett@hotmail.com
6
UI - 11453501
AU - Vento SI; Simola M; Ertama LO; Malmberg CH
TI -
Sense of smell in long-standing nasal polyposis.
SO - Am J Rhinol 2001 May-Jun;15(3):159-63
AD - Department of Otorhinolaryngology, Helsinki University Central Hospital,
Finland.
An impaired sense of smell is a common complaint in patients with nasal
polyposis, and hyposmia is usually attributed to obstruction of the
nasal airways. The duration of nasal polyposis and nasal surgery may
also affect olfaction. It has been shown that aging and chronic rhinitis
both impair olfaction. The aim of our study was to evaluate the sense of
smell in patients who had had nasal polyposisfor at least 20 years. The
olfactory threshold was assessed with a commercially available odor
detection threshold test. The threshold of 19 (46%) of 41 patients was
greater than the age-related upper 95% reference limit. In a forward
stepwise multiple regression analysis of all the polyposis patients, the
degree of opacity of ethmoidal sinuses seen in computed tomography (CT),
polyposis visible in anterior rhinoscopy, total nasal resistance, and
gender had a significant association with olfactory threshold.
7
UI - 11476180
AU - Sharara N; Muller S; Olson J; Grist WJ; Grossniklaus HE
TI -
Sinonasal undifferentiated carcinoma with orbital invasion: report of
three cases.
SO - Ophthal Plast Reconstr Surg 2001 Jul;17(4):288-92
AD - Department of Ophthalmology, Emory University School of Medicine,
Atlanta, Georgia, USA.
PURPOSE: To report three patients with sinonasal undifferentiated
carcinoma (SNUC) that invaded the orbit. METHODS: Retrospective small
case series. The clinical, radiographic, and pathologic features of
three patients with SNUC were reviewed. RESULTS: Three patients with
SNUC that invaded the orbit were evaluated. A biopsy was performed on
the tumors, which were composed of small, hyperchromatic cells with
numerous mitoses and areas of necrosis. Immunohistochemical staining was
positive for cytokeratins AE1.3, epithelial membrane antigen, and
neuron-specific enolase in all three tumors. Electron microscopic
examination showed absence of neurosecretory granules and presence of
basement membrane production. Two patients were treated with surgical
resection and postoperative chemotherapy and/or radiation. One patient
was treated with preoperative radiation and chemotherapy. CONCLUSIONS:
Sinonasal undifferentiated carcinoma is a high-grade tumor that arises
in the nasal and paranasal sinuses and may invade the orbit. SNUC should
be distinguished from other small, round, blue cell tumors, in
particular, esthesioneuroblastoma.
8
UI - 11489373
AU - Galera-Ruiz H; Sanchez-Calzado JA; Rios-Martin JJ; DeMingo-Fernandez EJ;
TI -
Munoz Borge F
Sinonasal radiation-associated osteosarcoma after combined therapy for
rhabdomyosarcoma of the nose.
SO - Auris Nasus Larynx 2001 Aug;28(3):261-4
AD - Otolaryngology - Head and Neck Surgery Service, Virgen Macarena
University Hospital, Sevilla, Spain. hgalerar@seorl.org
Radiation-associated (RA) osteosarcomas (OS) are exceptional in
children, presenting more frequently in middle-aged and elderly
patients. This is a case report of RA-OS of the sinonasal cavities in a
13-yr-old girl after combined therapy for rhabdomyosarcoma (RMS) of the
nose diagnosed at the age of five. The treatment of choice is radical
surgery with wide margins and postoperative adjuvant chemotherapy and
radiotherapy. Despite an episode of recurrence, at the present time the
patient is alive and free of disease 5 yr after the initial treatment of
OS. The association between radiation, chemotherapy and sarcomas is
reviewed and discussed.
9
UI - 11527304
AU - Ferguson MJ; Dewar JA
TI -
Locally recurrent adenoid cystic carcinoma of the left antrum: response
to epirubicin, cisplatin and 5-fluorouracil.
SO - Clin Oncol (R Coll Radiol) 2001;13(3):236-7
10
UI - 11544889
AU - Sanchez-Hanke M; Ussmuller J; Kehrl W
TI -
[Extranasal glioma. On the differential diagnosis of frontonasal
abnormalities]
SO - HNO 2001 Aug;49(8):658-61
AD - HNO-Klinik, Universitatskrankenhaus Hamburg-Eppendorf.
A case of extranasal glioma without other heterotopias of brain tissue
is presented. The endonasal biopsy of this tumor presented histologic
evidence of ectopic glial tissue surrounded by connective and mucosa
tissue. Before any surgical procedure can be performed, radiographic
(computed tomography and magnetic resonance imaging) examination is
essential to rule out possible communication of the tumor with
intracranial space. Surgical excision is necessary to prevent
deformities of the nasal structure from occurring. Previously reported
cases of nasal glioma are reviewed and problems in diagnosis and
management are discussed.
11
UI - 11544925
AU - Adou A; Souaga K; Konan E; Assa A; Angoh Y
TI -
[Ameloblastoma of the maxillary sinus. Apropos of a case]
SO - Odontostomatol Trop 2001 Jun;24(94):42-4
AD - UFR d'Odontostomatologie Abidjan.
The ameloblastoma is benign odontogen tumour developed from epithelial
remains of MALASSEZ. Because of the inclination to invade in an
inexorable way all the surrounding tissues and of the faculty of
recurrence after removal, one attributes him the qualifier of
good-hearted tumour to local wickedness. The mandibulary localization is
the most frequent. Toward the maxillary, it is mostly observed in the
tuberosity region. The authors report in the work one case of
ameloblastoma developed from the pericoronal cyst of an intrasinusal
ectopic canine tooth.
12
UI - 11555784
AU - Paschen C; Guski H; Haake K
TI -
[Ossifying fibromyxoid tumor of soft parts]
SO - Laryngorhinootologie 2001 Sep;80(9):522-4
AD - Klinik fur Hals-Nasen-Ohrenheilkunde, Germany.
BACKGROUND: OMFT are nearly always benign, usually presented in soft
tissue, of uncertain origin and tend to relapse. They are regarded as
neoplasms of the adult, only three cases of children have been reported
so far. PATIENT: A case of a 12-year-old boy is presented, for the first
time, with an OMFT in the nasal cavity and the paranasal sinus. The
diameter measured 9 centimetres. Histologically the tumor consisted of a
myxoid matrix and showed areas of metaplastic bone. Most of the cells
showed a spindleform and sometimes polymorphic hyperchromatic nuclei.
The tumor expressed S-100 protein and vimentin. The cellularity was
moderately high, the mitotic rate was very low. CONCLUSIONS: OMFT are
rare neoplasms, the diagnosis should be verified histopathologically.
Complete excision should be performed. A clinical follow-up is
necessary.
13
UI - 11555788
AU - Westhofen M; Mautsch W; Blaum M
TI -
[How I do it - total maxillectomy via midfacial degloving]
SO - Laryngorhinootologie 2001 Sep;80(9):542-5
AD - Klinik fur Hals-, Nasen-, Ohrenheilkunde und Plastische Kopf- und
Halschirurgie des Universitatsklinikums der RWTH Aachen, Germany.
mwesthofen@post.klinikum.rwth-aachen.de
Midfacial degloving for total maxillectomy in the case of a 67 year old
male patient with a maxillary sinus adamantinoma of solid and
multicystic plexiform differentiation is presented. This is the first
report about surgical treatment of an adamantinoma via midfacial
degloving. The importance of preoperative staging by means of computed
tomography to exclude cheek infiltration and to plan the extension of
maxillary resection is pointed out. The prognosis of the adamantinoma
and its histopathological classification is discussed. The postoperative
obturation of the resection defect and nasal cavity towards the oral
cavity must be prepared preoperatively by the interdisciplinary care of
dentistry and ENT surgery. Complete functional restoration of speech,
swallowing and esthetic appearance can be achieved. Midfacial degloving
for complete maxillectomy is rarely cited. Nevertheless it can be
recommended for surgical treatment of maxillary tumours without spread
in the cheek muscles and upper lip, even those which need total
maxillectomy.
14
UI - 11557449
AU - Myssiorek D; Halaas Y; Silver C
TI -
Laryngeal and sinonasal paragangliomas.
SO - Otolaryngol Clin North Am 2001 Oct;34(5):971-82, vii
AD - Department of Otolaryngology and Communicative Disorders, Long Island
Jewish Medical Center, Albert Einstein College of Medicine, New Hyde
Park, New York 11040, USA.
Laryngeal paragangliomas are classified as supraglottic and
infraglottic. This article defines each type of paraganglioma, discusses
the clinical features and diagnoses, and covers the surgical management.
This article also addresses sinonasal paragangliomas, including their
clinical features, diagnosis, and treatment.
15
UI - 11570918
AU - Maitra A; Baskin LB; Lee EL
TI -
Malignancies arising in oncocytic schneiderian papillomas: a report of 2
cases and review of the literature.
SO - Arch Pathol Lab Med 2001 Oct;125(10):1365-7
AD - Department of Pathology, University of Texas Southwestern Medical
Center, Dallas, Texas, USA. aiims1742@hotmail.com
Oncocytic schneiderian papillomas (OSPs) are uncommon benign neoplasms
that arise from the sinonasal schneiderian epithelium. Malignancies
arising in OSPs are rare, and, to our knowledge, only 14 such instances
have been reported in the medical literature. We report 2 additional
cases--a small cell carcinoma and a sinonasal undifferentiated carcinoma
arising in OSPs and presenting synchronously with the benign neoplasm.
The potential for malignant transformation in OSPs is small, but
warrants that these papillomas be completely excised to exclude a
coexisting carcinoma.
16
UI - 11591188
AU - Ragab S; Parikh A; Darby YC; Scadding GK
TI -
An open audit of montelukast, a leukotriene receptor antagonist, in
nasal polyposis associated with asthma.
SO - Clin Exp Allergy 2001 Sep;31(9):1385-91
AD - Royal National Throat, Nose and Ear Hospital, London, UK.
BACKGROUND: Nasal polyposis occurs frequently in patients with intrinsic
asthma, especially in those who are aspirin sensitive. It can be
difficult to treat effectively, even with surgery and regular topical
intranasal corticosteroids many patients are still symptomatic.
OBJECTIVE: To investigate the response to montelukast, a leukotriene D4
receptor antagonist, as an add-on therapy to topical and inhaled
corticosteroids in patients, both aspirin sensitive (AS) and aspirin
tolerant (AT), with nasal polyposis and asthma. METHODS: Nasal polyposis
symptoms were assessed by visual analogue scales; nasal polyps were
assessed by nasendoscopy and via the measurement of nasal volumes by
acoustic rhinometry. The nasal airway was assessed by nasal inspiratory
peakflow (NIPF). Asthma was monitored using symptom scores and peak
expiratory flow measurements. Aspirin sensitivity was assessed by
history together with intranasal lysine aspirin challenge. Upper and
lower airway nitric oxide measurements were made before and during
treatment. RESULTS: Clinical subjective improvement in nasal polyposis
occurred in 64% AT (P < 0.01), patients and 50% AS patients (P > 0.05);
asthma improvement in 87% AT and 61% AS patients (P < 0.05 for both).
Objective changes in peak flow occurred only in AT patients (P < 0.05).
Acoustic rhinometry, nasal inspiratory peak flow and nitric oxide levels
did not change significantly in any group, however, correlations were
seen between nitric oxide levels and polyp scores and between nitric
oxide levels and acoustic rhinometry changes. Improvement on montelukast
therapy was not associated with any of the following variables: age,
sex, skin prick test positivity, disease duration or aspirin
sensitivity. (P > 0.05 for all). CONCLUSION: The findings are consistent
with a subgroup of nasal polyps/asthma patients in whom leukotriene
receptor antagonists are effective. This is not related to aspirin
sensitivity. Further placebo-controlled studies need to be undertaken.
17
UI - 11593541
AU - Kong H; Dong Z; Guo Y; Yang Z; Bu G
TI -
Intercellular adhesion molecule-1 and accumulation of eosinophils in
nasal polyp tissue.
SO - Chin Med J (Engl) 1999 Apr;112(4):366-8
AD - Department of Otorhinolaryngology & Head and Neck Surgery, The Third
Affiliated Hospital, Norman Bethune University of Medical Sciences,
Changchun 130031, China.
OBJECTIVE: To investigate the relationship between intercellular
adhesion molecule-1 (ICAM-1) and the accumulation of eosinophils in
nasal polyp tissue to better understand the mechanism of airway
eosinophilic inflammation. METHODS: The expression of ICAM-1 and its
natural ligand, lymphocyte function-associated antigen-1 (LFA-1), in
normal nasal mucosa from 6 controls and in nasal polyp tissue from 19
patients with nasal polyposis were determined with immunohistochemistry.
With dual immunohistochemistry and May-Griunwald Giemsa stain (MGG), the
expression of LFA-1 and infiltrating eosinophils in nasal polyp tissue
was observed. RESULTS: The expression of ICAM-1 and LFA-1 was stronger
in the nasal polyp tissue than in normal nasal mucosa. There was a
positive relationship between the infiltration of eosinophils and the
expression of LFA-1 on eosinophils. CONCLUSION: Accumulation of
eosinophils in nasal polyp tissue is associated with the counter-effect
between adhesion molecules and its ligand on eosinophils.
18
UI - 11603788
AU - Klimek T; Atai E; Schubert M; Glanz H
TI -
Inverted papilloma of the nasal cavity and paranasal sinuses: clinical
data, surgical strategy and recurrence rates.
SO - Acta Otolaryngol 2000 Mar;120(2):267-72
AD - University ENT Clinic Giessen, Germany.
BACKGROUND: In the last decade inverted papillomas of the nasal cavity
and paranasal sinuses have been observed in increasing numbers, and
treatment modalities have ranged from extensive open radical procedures
to microinvasive endonasal surgical excision. OBJECTIVE: To establish
criteria for selecting patients for open osteoplastic or endonasal
surgery according to clearly defined pathological and clinical data.
MATERIAL AND METHOD: In a retrospective study, clinical data of 55
patients treated surgically in the University ENT Clinic Giessen from
1991 to 1998 were analysed. In 33 patients (60%) endonasal excision of
the papillomas was carried out and in 22 (40%) osteoplastic lateral
rhinotomy or maxillotomy were performed. All histological specimens were
revised. Patients were followed up and endoscopically examined until 31
sinus, maxillary sinus, parts of the frontal skull base and anterior
ethmoid, and the orbit were operated on using open osteoplastic
procedures, with 4 (18%) recurrences observed. Tumours excised
endonasally showed the same recurrence rate: 6 out of 33 (18%). These
tumours were smaller in size and localized in the nasal cavity, the
middle and posterior parts of the ethmoid involving the sphenoid, and
the medio-posterior wall of the maxillary sinus. The functional outcome
was excellent for all patients; two patients developed a mucocele.
Cancerization was observed in three cases. CONCLUSIONS: In select cases
the endonasal microsurgical approach to inverted papillomas has the same
good results concerning function and tumour control as osteoplastic open
rhinotomy. This method should still be preferred in tumours localized in
the frontal sinus, anterior ethmoid. anterior. caudal and lateral parts
of the maxillary sinus and beyond the sinuses.
19
UI - 11603789
AU - Sanchez Fernandez JM; Anta Escuredo JA; Sanchez Del Rey A; Santaolalla
TI -
Montoya F
Morphometric study of the paranasal sinuses in normal and pathological
conditions.
SO - Acta Otolaryngol 2000 Mar;120(2):273-8
AD - Department of Otolaryngology, Basurto Hospital, School of Medicine,
University of the Basque Country, Bilbao, Spain.
Prospective and retrospective morphometric CT (axial and coronal)
research was performed with 100 healthy persons and 163 patients (145
males, 118 females, mean age 50 years, range 1-88 years). The patients
were classified into the following groups: chronic sinusitis (n = 85),
polyposis (n = 25), mucoceles (n = 13), benign tumors (n = 20) and
malignant tumors (n = 20). After initial calibration with the scale (in
cm) displayed on the CT image, each paranasal sinus was outlined
following its bone inner surface. The data were processed with a
high-resolution analysis system, and volumes were calculated using an
integration areas rule. The ethmoid, maxillary and sphenoid sinuses
exhibited an increase in volume for a period of up to 15 years,
afterwards maintaining similar values. The frontal sinus grows in a
monomodal pattern (peak at 30 years). The volumetric results (mean and
standard deviation) in the normal adult group were as follows: maxillary
sinus 13.07 cm3 (6.8), ethmoid 5.5 cm3 (2.0), sphenoid 3.5 cm3 (2.6) and
frontal 3.7 cm3 (3.6). Primary frontal and maxillary sinus hypoplasia
appeared in 3.9% and 1.3% of cases, respectively. The anatomic
variations were as follows: concha bullosa 8.3%, Haller cells 3.2% and
Onodi cells 8.3%. The sinusitis values (adults) were greater than those
in the normal group: 14.4 cm3 (7.3), 6.8 cm3 (2.9), 2.9 cm3 (1.9) and
4.2 cm3 (5.2), with the exception of the sphenoid, but the difference
was not statistically significant. Finally, we propose a new
classification for paranasal sinus tumors (benign and malignant),
volumetric T (vT), taking into account the morphometric tumoral volume
and the mean volumetric value of normal sinuses.
20
UI - 11603795
AU - Baudoin T; Kalogjera L; Hat J
TI -
Capsaicin significantly reduces sinonasal polyps.
SO - Acta Otolaryngol 2000 Mar;120(2):307-11
AD - Department of Otorhinolaryngology/Head & Neck Surgery, University
Hospital "Sestre milosrdnice", Zagreb, Croatia.
Some reports indicate that topical nasal treatment with capsaicin, which
is usually effective in reducing symptoms of vasomotor rhinitis, may
also reduce symptoms in patients with nasal polyps. The aim of this
study was to investigate the effect of topical capsaicin treatment in
severe sinonasal polyposis. Nine non-allergic, non-asthmatic patients
with diffuse eosinophilic nasal polyposis were subjected to topical
capsaicin treatment: for 3 consecutive days 0.5 ml 30 micromol/l
capsaicin solution and on days 4 and 5 100 micromol/l capsaicin solution
was sprayed into each nostril. Coronary computed tomography (CT) images
were made shortly before treatment. Baseline nasal lavages and a
questionnaire containing subjective symptoms and nasal endosocpy were
taken just prior to the first application. Nasal lavages were performed
prior to and after the last treatment and over 4 weeks, endoscopy and
subjective scores at each weekly visit, and correspondent CT scans 4
weeks after the treatment. CT images were analysed by computer,
calculating the nose sinuses air volume (NSAV) from the surface of
aerated parts of nasal and sinus cavities for each slice per patient
prior to and after treatment. Statistical analysis was performed
comparing NSAV, subjective scores, endoscopy scores and eosinophil
cationic protein (ECP) levels in nasal lavages prior to and after
treatment. Topical treatment with capsaicin significantly increased NSAV
and very significantly improved subjective and endoscopy scores, but did
not significantly alter ECP levels in nasal lavages.
21
UI - 11605570
AU - Vargas H; Jennings TA; Galati LT
TI -
Unusual paranasal sinus tumors in two patients with common nasal
complaints.
SO - Ear Nose Throat J 2001 Oct;80(10):724-6, 728-9
AD - Division of Otolaryngology-Head and Neck Surgery, Department of Surgery,
Albany Medical College, 47 New Scotland Ave., MC41, Albany, NY 12208,
USA.
Common nasal complaints are managed by both the otolaryngologist and the
primary care physician. We describe the cases of two patients with nasal
obstruction who were referred to us for evaluation--one with severe
headache and the other with profuse epistaxis. Their histories prior to
referral included long-term, common rhinologic complaints of low-grade
headache and mild epistaxis. Neither patient had been referred to us
until their symptoms had become severe. Our examination revealed that
both patients had rare paranasal sinus pathology. One patient had a
fibroxanthoma of the frontal sinus, and the other had extramedullary
hematopoiesis of the maxillary sinus. Fibroxanthoma of the frontal sinus
is rare, and extramedullary hematopoiesis of the maxillary sinus has not
been previously reported. These two unique cases serve as a reminder
that long-term common rhinologic complaints can occasionally be a sign
of life-threatening pathology and require a full evaluation by an
otolaryngologist.
22
UI - 11597796
AU - Adams EJ; Nutting CM; Convery DJ; Cosgrove VP; Henk JM; Dearnaley DP;
TI -
Webb S
Potential role of intensity-modulated radiotherapy in the treatment of
tumors of the maxillary sinus.
SO - Int J Radiat Oncol Biol Phys 2001 Nov 1;51(3):579-88
AD - Joint Department of Physics, Institute of Cancer Research and the Royal
Marsden NHS Trust, Sutton, Surrey, UK. eliza@icr.ac.uk
PURPOSE: To assess 3-dimensional conformal radiotherapy (3D-CRT) and
intensity-modulated radiotherapy (IMRT) techniques to see whether doses
to critical structures could be reduced while maintaining planning
target volume (PTV) coverage in patients receiving conventional
radiotherapy (RT) for carcinoma of the maxillary sinus because of the
risk of radiation-induced complications, particularly visual loss.
METHODS AND MATERIALS: Six patients who had recently received
conventional RT for carcinoma of the maxillary sinus were studied.
Conventional RT, 3D-CRT, and step-and-shoot IMRT plans were prepared
using the same 2-field arrangement. The effect of reducing the number of
segments in the IMRT beams was investigated. RESULTS: 3D-CRT and IMRT
reduced the brain and ipsilateral parotid gland doses compared with the
conventional plans. IMRT reduced doses to both optic nerves; for the
contralateral optic nerve, 15-segment IMRT plans delivered an average
maximal dose of 56.4 Gy (range 53.9-59.3) compared with 65.7 Gy (range
65.3-65.9) and 64.2 Gy (range 61.4-65.6) for conventional RT and 3D-CRT,
respectively. IMRT also gave improved PTV homogeneity and improved
coverage, with an average of 8.5% (range 7.0-11.7%) of the volume
receiving <95% of the prescription dose (64 Gy) compared with 14.7%
(range 14.1-15.9%) and 15.1% (range 14.4-16.1%) with conventional RT and
3D-CRT, respectively. Little difference was found between the 15 and
7-segment plans, but 5 segments resulted in a reduced minimal PTV dose.
CONCLUSIONS: IMRT offers significant advantages over conventional RT and
3D-CRT techniques for treatment of maxillary sinus tumors. Good results
can be obtained from 7 segments per beam without compromising the PTV
coverage. This number of segments is practical for implementation in a
busy RT department.
23
UI - 11602930
AU - Grundmann T; Topfner M
TI -
[Treatment of ASS-Associated Polyposis (ASSAP) with a cysteinyl
leukotriene receptor antagonist - a prospective drug study on its
antiinflammatory effects]
SO - Laryngorhinootologie 2001 Oct;80(10):576-82
AD - Universitats-Hals-Nasen-Ohrenklinik Hamburg-Eppendorf.
grundman@uke.uni-hamburg.de
BACKGROUND: In a high rate of cases with recurrent polyposis an
association with ASS-intolerance is detectable despite missing pulmonary
symptoms. New examinations of a disturbed arachidonic acid metabolism
lead to the development of new therapeutical options. Treatment with
leukotriene-receptor antogonists (LTA) showed primarily good results in
therapy of ASS-associated asthma. METHODS: 18 patients with
ASS-intolerance trias - diagnosed by oral provocation - were treated
with the LTA Montelukast, after undergoing sinus surgery. Patients
underwent a diagnostic pathway of provocation including four groups:
recurrent chronic sinusitis, excessive polyposis, polyposis associated
with asthma and anaphylactic symptoms after oral ASS-intake. Clinically
we examined the following parameters periodically after sinus surgery:
nasal and pulmonal symptoms by scoring levels, recurrency of polypoid
hyperplasia by endoscopic follow-ups and serum ECP-levels. To evaluate
antiinflammatory tissue effects of LTA EG1/EG2 labelled cells and
cytokine levels of Interleukin 5 in mucosa samples of the lower
turbinate were analysed under LTA-therapy. RESULTS: Under therapy with
LTA we saw a beneficial effect on nasal and pulmonary symptoms and a
significant reduction of recurrent polyposis in endoscopic examinations
in relation to the untreated group. Results were proven by a permanent
reduction of serum ECP-level. A reduction of the rate of EG2-positive
cells according to decreased Interleukin 5 levels in the nasal mucosa
unter LTA-treatment assumed antiinflammatory effects on ASS-associated
polyposis. CONCLUSIONS: We could demonstrate antiinflammatory effects of
Leukotriene-Receptor-Antagonists primarily during postoperative
treatment of patients with ASS-associated nasal polyps.
24
UI - 11602931
AU - Prescher A; Brors D
TI -
[Metastases to the paranasal sinuses: case report and review of the
literature]
SO - Laryngorhinootologie 2001 Oct;80(10):583-94
AD - Institut fur Anatomie I, Universitatsklinikum der RWTH Aachen, Aachen.
The case of an 87-year old man with widespread prostatic cancer is
reported. During the autopsy macroscopically visible metastases were
found within the frontal sinuses. These tumor masses destroyed the
posterior osseous wall of the frontal sinus and formed polypoid bulging
masses. In contrast to the macroscopically unaffected mucous membrane of
the sphenoid sinus the maceration specimen of the skull base
demonstrated a spongious-mossy, osteoplastic metastasis, lining the
sphenoid sinus like a tapestry. This affection started from an
exhaustive osteoplastic metastasis within the clivus. No metastases
could be found in both antrums or the ethmoids. Retrospectively no
symptoms from the paranasal sinuses could be eruated, only occasional
pain of the frontal bone. The review of the world literature with 123
reports revealed 169 cases. Renal cell carcinomas most frequently
metastasize into the paranasal sinuses (67 cases), followed by
bronchogenic carcinomas (15 cases). Thyroid cancers and cancers of the
mammary gland are responsible for 13 respectively 14 cases. The prostate
also adds 12 cases. The paranasal sinuses are affected in diminishing
frequency: maxillary sinus (55 cases), sphenoid sinus (37 cases),
ethmoidal cells (23 cases) and frontal sinus (15 cases). In 38 cases
exhaustive metastases affecting two or more paranasal sinuses are
reported. The statement of literature, that metastases affecting the
paranasal sinuses are much more frequent than reported, cannot be
supported by our study, because the intensive autoptic investigation of
50 skulls of patients suffering from widespread cancers revealed no
further cases of metastatic processes of the paranasal sinuses.
25
UI - 11676114
AU - Bora H; Bandyopadhyay SN; Sinha R; Bhunia R; Mukherjee S; Das KK;
TI -
Mukherjee PB
Large capillary haemangioma arising from the nasal columella--a case
report.
SO - J Indian Med Assoc 2001 May;99(5):269-70
AD - Department of ENT, RG Kar Medical College and Hospital. Calcutta.
A 39-year-old male presented with a mass arising from the nasal
columella for last 8 months. The mass was lobulated, dark red in colour,
firm in consistency and approximately 3 cm in diameter. It was attached
to the columella of the nose by a narrow stalk. The mass was excised
completely under general anaesthesia and histopathological examination
suggested it to be a case of capillary haemangioma.
26
UI - 11692954
AU - Torrico Roman P; Mogollon Cano-Cortes T; Lopez-Rios Velasco J; Fernandez
TI -
de Mera JJ; Blasco Huelva A
[Bladder transitional cell carcinoma with metastasis to the maxillary
sinus as first symptom]
SO - Acta Otorrinolaringol Esp 2001 Oct;52(7):622-4
AD - Servicio de O.R.L., Hospital Don Benito-Villanueva, Avda. Vegas Altas
s/n, 06400 Don Benito, Badajoz.
Maxillary sinus metastasis are very uncommon tumors (fifty have been
reported). The most frequent ones are renal adenocarcinoma, breast and
lung tumors. Up to now there is only a reported case of bladder
carcinoma in maxillary sinus. We report a 67 years old male with a right
maxillary tumor two months ago. FNA demonstrated a transitional cell
bladder tumor. The treatment was chemotherapy. The patient died two
months later. We reported some considerations about metastatic tumors of
paranasal sinus.
27
UI - 11684723
AU - Schwerer MJ; Sailer A; Kraft K; Baczako K; Maier H
TI -
Patterns of p21(waf1/cip1) expression in non-papillomatous nasal mucosa,
endophytic sinonasal papillomas, and associated carcinomas.
SO - J Clin Pathol 2001 Nov;54(11):871-6
AD - Department of Pathology, Military Hospital Ulm, D-89081 Ulm/Donau,
Germany.
AIMS: To clarify p21(waf1/cip1) expression in sinonasal lesions.
METHODS: Archived surgical specimens from 38 patients were investigated
by means of immunohistochemistry. p21(waf1/cip1) staining was evaluated
in the different layers of the epithelium. In addition, human
papillomavirus (HPV) infection and p53 protein overexpression were
assessed and correlated with p21(waf1/cip1) expression. RESULTS:
p21(waf1/cip1) staining was negative in non-papillomatous nasal mucosa.
HPV infection and p53 protein overexpression were not seen. Sixteen of
20 inverted papillomas showed p21(waf1/cip1) expression. HPV infection
was found in 16 cases and p53 protein overexpression was present in 13
specimens. Expression of p21(waf1/cip1) was restricted to surface cells
in five cases, but involved basal/parabasal cells in 11 specimens.
Immunoreactivity for p21(waf1/cip1) in basal/parabasal cells colocalised
with p53 protein overexpression. Enhanced expression rates for
p21(waf1/cip1) were seen in transitional and squamous epithelium
compared with columnar epithelium. p21(waf1/cip1) expression involved
only surface cells in cylindrical cell papillomas. HPV infection and p53
protein overexpression were detected in all specimens. One of five
squamous cell carcinomas showed p21(waf1/cip1) expression. HPV infection
was seen in two cases, and all carcinomas showed p53 protein
overexpression. CONCLUSIONS: Expression of p21(waf1/cip1) is associated
with terminal differentiation in surface cells in inverted papillomas
and cylindrical cell papillomas, but not in non-papillomatous nasal
mucosa. Overexpression of p53 protein colocalises with p21(waf1/cip1)
expression in basal/parabasal cells in inverted papillomas but not in
cylindrical cell papillomas. Expression of p21(waf1/cip1) in squamous
cell carcinomas involves a subset of tumours with p53 protein
overexpression.
28
UI - 11688043
AU - Ducic Y
TI -
Hard palate reconstruction with a pedicled osteomyocutaneous mandible
flap: case report.
SO - J Oral Maxillofac Surg 2001 Nov;59(11):1355-8
AD - Department of Otolaryngology at the University of Texas SouthWestern
Medical Center in Dallas, TX, USA. yducic@aol.com
29
UI - 11696428
AU - Lin CW; Lee WH; Chang CL; Yang JY; Hsu SM
TI -
Restricted killer cell immunoglobulin-like receptor repertoire without
T-cell receptor gamma rearrangement supports a true natural killer-cell
lineage in a subset of sinonasal lymphomas.
SO - Am J Pathol 2001 Nov;159(5):1671-9
AD - Department of Pathology, National Taiwan University Hospital, National
Taiwan University College of Medicine, Taipei, Taiwan.
The cellular lineage of sinonasal T/NK (natural killer) cell lymphoma
remains controversial. Lineage assignment is difficult because T cells
and NK cells have a similar morphology and surface markers.
Consequently, the assignment must depend heavily on the status of T-cell
receptor (TCR) rearrangement. A monoclonal TCR rearrangement supports a
T lineage; however, a corresponding monoclonality test for NK cells has
not yet been established. Each NK cell bears a distinct set of killer
cell immunoglobulin (Ig)-like receptors (KIRs) that are randomly
distributed over three groups. In principle, restriction of the KIR
repertoire signifies a monoclonal or possibly oligoclonal NK-cell
proliferation, just as Ig light-chain restriction usually indicates a
monoclonal B-cell neoplasm. Using a novel group-specific reverse
transcriptase-polymerase chain reaction, we found a restricted KIR
repertoire in most sinonasal lymphomas (9 of 10), but only rarely in
T-cell lymphomas (2 of 10) or reactive conditions involving T/NK cells
(1 of 10). KIR+ sinonasal lymphomas usually lacked a monoclonal
TCR-gamma rearrangement pattern, expressed another NK cell receptor,
NKG2a, and were usually CD56-positve, cyclin-dependent kinase-6
(CDK6)-positive, CD44-negative, a phenotype already reported to indicate
a true NK cell lineage. We conclude that, although sinonasal lymphomas
have heterogeneous genotypes and phenotypes, a restricted KIR repertoire
without TCR-gamma rearrangement provides preliminary support for the
monoclonality hypothesis and can be used for defining a true NK-cell
lineage in a subset of sinonasal lymphomas.
30
UI - 11710649
AU - Jaehne M; Jakel KT; Ussmuller J; Feller AC
TI -
Nasal NK/T-cell-lymphoma metastazising into the masseteric muscle
mimicking a parotid mass.
SO - Virchows Arch 2001 Oct;439(4):597-8
31
UI - 11707809
AU - Liang R
TI -
Diagnosis and management of primary nasal lymphoma of T-cell or NK-cell
origin.
SO - Clin Lymphoma 2000 Jun;1(1):33-7; discussion 38
AD - Division of Haematology and Oncology, Department of Medicine, University
of Hong Kong, Queen Mary Hospital Pokfulam, Hong Kong.
rliang@hkucc.hku.hk
The primary nasal natural killer cell (NK/T cell) lymphoma is
histologically characterized by angiocentricity with invasion of blood
vessels and blockage of blood vessels by lymphoma cells, resulting in
marked ischemic necrosis of the normal and neoplastic tissues. The
cytological appearances of the neoplastic cells are highly variable and
accompanied by a mixture of inflammatory cells. On immunophenotyping,
the diagnostic features are surface CD3(-), cytoplasmic CD3 epsilon(+),
and CD56(+). For the majority of the cases, T-cell receptor gene
rearrangement is absent, confirming an NK-cell origin of the tumor
cells. Clonal proliferation of Epstein-Barr virus (EBV) is usually
present in the tumor cells and is a useful diagnostic marker. Patients
commonly present with nasal symptoms: mass, obstruction, or bleeding.
The tumor is locally invasive and may infiltrate surrounding tissues and
organs, such as the orbits, nasopharynx, oropharynx, and palate. The
cranial nerves are sometimes affected. The tumor may also disseminate to
skin, gastrointestinal tract, and the testis at the time of progression.
Occasionally, other organ sites such as the skin are involved, sparing
the nose, and it is then called the non-nasal type. A high index of
suspicion is required for the diagnosis of this disease. Because of the
small size of the specimen and the necrotic nature of the tumor, biopsy
of the nasal tissue may not be easy to interpret. Repeated biopsies are
often required. The special stain for EBV in the tumor cells may also be
helpful in making the correct diagnosis. Response of
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