[Cylindroma of the nasal cavity originating from the left nasal concha].
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Carcinoma, Adenoid Cystic↗
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[Two cases of pleomorphic adenoma of the nasal cavity].
Pleomorphic adenoma in the otorhinolaryngological field is frequently found in the major salivary glands, but is rare in minor salivary glands. Two cases of pleomorphic adenoma of the nasal cavity are reported. Case 1. A 26-year-old female who complained of nasal obstruction had a tumor arising from the right side of the nasal septum. The tumor, 1.5 x 1.5 x 1.2cm in size, was surgically removed utilizing an intranasal approach. Histologically, it was diagnosed as a pleomorphic adenoma of the nasal septum. There has been no recurrence. Case 2. A 51-year-old male had a tumor in the left lateral nasal wall. The tumor, 0.6 x 0.6 x 0.6 cm in size, was surgically removed by the intranasal approach. Histologically, it was diagnosed as a pleomorphic adenoma of the lateral nasal wall. There has been no recurrence. Including the present cases, 59 cases of pleomorphic adenoma arising from the nasal cavity have been reported in Japan. Of these, 51 arose from the nasal septum. Only 8 adenomas had arisen from the lateral nasal wall. Attention has been called especially to differences in the reported incidences of malignant tumors and recurrent tumors. In the present survey, the incidences were unusually low. Four cases (6.8%) have been reported as malignant tumors, and 3 (5.1%) as recurrent tumors.
Adenoma, Pleomorphic↗
Malignant tumors of the nasal cavity and paranasal sinuses.
PURPOSE: To evaluate the role of radiation therapy in patients with nasal cavity and paranasal sinus tumors. MATERIALS AND METHODS: Between October 1964 and July 1998, 78 patients with malignant tumors of the nasal cavity (48 patients), ethmoid sinus (24 patients), sphenoid sinus (5 patients), or frontal sinus (1 patient) were treated with curative intent by radiation therapy alone or in the adjuvant setting. There were 25 squamous cell carcinomas, 14 undifferentiated carcinomas, 31 minor salivary gland tumors (adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma), 8 esthesioneuroblastomas, and 1 transitional cell carcinoma. Forty-seven patients were treated with irradiation alone, 25 with surgery and postoperative irradiation, 2 with preoperative irradiation and surgery, and 4 with chemotherapy in combination with irradiation with or without surgery. RESULTS: The 5-year actuarial local control rate for stage I (limited to the site of origin; 22 patients) was 86%; for stage II (extension to adjacent sites (eg, adjacent sinuses, orbit, pterygomaxillary fossa, nasopharynx; 21 patients) was 65%; and for stage III (destruction of skull base or pterygoid plates, or intracranial extension; 35 patients) was 34%. The 5-year actuarial local control rate for patients receiving postoperative irradiation was 79% and for patients receiving irradiation alone was 49% (p =.05). The 5-, 10-, 15-, and 20-year ultimate local control rates for all 78 patients were 60%, 56%, 48%, and 48%, respectively. The 5-, 10-, 15-, and 20-year cause-specific survival rates for all 78 patients were 56%, 45%, 39%, and 39%, respectively. The 5-, 10-, 15-, and 20-year absolute survival rates for all 78 patients were 50%, 31%, 21%, and 16%, respectively. Of the 67 (86%) patients who were initially seen with node-negative disease, 39 (58%) received no elective neck treatment, and 28 (42%) received elective neck irradiation. Of the 39 patients who received no elective neck treatment, 33 (85%) did not experience recurrence in the neck compared with 25 (89%) of 28 patients who received elective neck irradiation. Most patients who received elective neck irradiation (57%) had stage III disease. Twenty-one (27%) of 78 patients had unilateral blindness develop secondary to radiation retinopathy or optic neuropathy; the complication was anticipated in most of these patients, because the ipsilateral eye was irradiated to a high dose. Four patients (5%) unexpectedly had bilateral blindness develop because of optic neuropathy. All four of these patients received irradiation alone. CONCLUSION: Surgery and postoperative radiation therapy may result in improved local control, absolute survival, and complications when compared with radiation therapy alone. Elective neck irradiation is probably unnecessary for patients with early-stage disease.
Adolescent↗
Epithelial-myoepithelial carcinoma--report of a case arising in the nasal cavity.
We present an extremely rare case of epithelial-myoepithelial carcinoma (EMC) arising in the nasal cavity. The patient was a 56-year-old Japanese male with a polypoid tumour arising from the nasal septum. Histopathological examination revealed the tumour to consist of a solid proliferation of clear-cells and, in some areas, small or elongated duct structures with a double-layered arrangement of inner cuboidal cells and outer clear-cells. Dual differentiation toward myoepithelial and ductal cells were confirmed immunohistochemically. The occurrence of EMC in the nasal cavity is possible and this entity should be generally recognized by surgical pathologists, not only those engaged in head and neck surgery.
Carcinoma↗
Diagnosis of malignant lymphomas of the nasal cavity, paranasal sinuses and nasopharynx.
The diagnosis of non-Hodgkin's malignant lymphoma of the nasal cavity, paranasal sinuses, and nasopharynx was made in 15 patients over a 7 year period (nasopharynx, 9; nasal cavity, 3; maxillary sinus, 2; frontal sinus, 1). A wide variety of head and neck symptoms, often characteristic of benign disease, was reported ranging from 2 weeks to 4 months prior to presentation. Of the 15 cases, the original diagnosis was inconclusive in 6; 4 of the 6 required rebiopsy, while the diagnosis in the other 2 was confirmed on further pathologic consultation. Tissue marker studies, which have recently become available, were performed in 7 cases and were crucial in the diagnosis of 2. B-cell lymphoma was diagnosed in the 7 patients who had tissue marker studies. Five patients had palpable cervical nodes, and none had distant adenopathy or masses. With further staging, 4 of the 15 patients were found to have disseminated disease. The paper emphasizes the need for early biopsy of suspicious lesions presenting in areas in which physical examination is limited. Recommendations are made for handling the biopsy specimen when malignant lymphoma is suspected, as well as for the evaluation of local and distant sites. The role of surgery is primarily diagnostic in patients with malignant lymphoma.
Adolescent↗
Diagnosis of tumor in the nasal cavity and paranasal sinuses with [11C]choline PET: comparative study with 2-[18F]fluoro-2-deoxy-D-glucose (FDG) PET.
[11C]choline (11C-choline) positron emission tomography (PET) was performed to evaluate its clinical utility in the diagnosis of tumors in the nasal cavity and paranasal sinuses. We studied 22 patients with suspicion of malignant tumors in the nasal cavity and paranasal sinuses. Tumor uptake of 11C-choline was measured with standardized uptake value (SUV) and correlated with the pathological diagnosis. 2-[18F]fluoro-2-deoxy-D-glucose (FDG) PET was performed in all patients for comparison. Both 11C-choline and FDG PET depicted squamous cell carcinoma showing an increased activity significantly higher than that of normal tissue, and these SUVs were significantly higher than those of benign lesions. FDG uptake in malignant tumors as a whole was variable. Although 11C-choline uptake in squamous cell carcinoma was lower than FDG uptake, 11C-choline uptake in malignant tumors was relatively uniform and statistical significance was found. PET with 11C-choline may be useful to diagnosis tumors in the nasal cavity and paranasal sinuses.
Adult↗
A rare case of solitary fibrous tumor of the nasal cavity.
Solitary fibrous tumor (SFT) arises in the pleura and less commonly in extrapleural sites. SFT can be found in various head and neck sites. SFTs of the nasal cavity and paranasal sinuses are extremely rare with only ten previously reported cases in the world literature. This case report presents an additional case of SFT of the nasal cavity underlining the benign pattern and the bleeding tendency of nasal SFT, that surgeons managing these tumors should be aware of. Diagnostic procedure, clinical and histopathological findings as well as immunoreactivity of this tumor are discussed, with a review of the current literature.
Antigens, CD34↗
[Congenital atresia of the anterior nares and hypoplasia of the nasal cavity].
We described a case of congenital atresia of the anterior nares with a minute opening on the right side and underdevelopment of the nasal cavities. The hard palate was flat and the soft palate was normally mobile. Right anophthalmia and microphthalmia of the left eye with iris coloboma were also noted. In order to provide a nasal airway and to enable the newborn to suck and breathe simultaneously the patient was operated on at four days of age. By means of transpalatal approach a nasal cavity was drilled out of solid bone and connected with the small anterior duct. Trough the new created air duct a nasopharyngeal tube was introduced. In spite of that the external nasal orifice was enlarged later, there was an inclination the orifice to collapse due to lack of nostril cartilages, therefore a nasopharyngeal tube still is used. The physical and intellectual development of the now 11-month old infant is normal. Final reconstruction of the external nose will take place later.
Eye Abnormalities↗
Epidemiological analysis of structural alterations of the nasal cavity associated with obstructive sleep apnea syndrome (OSA).
AIM: The objective of this paper is to demonstrate that structural alterations of the nasal cavity, e.g. septal deviation and conchal hypertrophy have high incidence in patients with sleep apnea and hypopnea syndrome and must be addressed with associated specific procedures of the syndrome. TYPE OF STUDY: Clinical retrospective. CASUISTIC AND METHOD: A retrospective study of 200 patients was performed, with 196 male and 4 female, attended at the otorhinolaryngology ambulatory of Hospital Prof. Edmundo Vasconcelos and Unidade Paulista de Otorrinolaringologia, all of them subjected to polysomnography, otorhinolaryngological physical exam, endoscopy exam, and surgical treatment with nasal and pharyngeal procedures. RESULTS: All of them were subjected to pharyngeal procedure: uvulopalatopharyngoplasty or uvulopalatoplasty and nose procedure: 176 septoplasty with partial turbinectomy (88%) and 24 isolated turbinectomy, with satisfactory results. CONCLUSION: We can see that structural alterations of the nasal cavity have high incidence in patients with OSA.
Adult↗
Radiology of an atypical fibro-osseous lesion confined to the nasal cavity.
Fibro-osseous lesions of the sinonasal region are relatively frequent, but those strictly confined to the nasal cavity are rare. We report an atypical fibro-osseous lesion in the nasal cavity and describe its radiological features. The differential diagnosis is discussed.
Adult↗
[Is nasal cavity melanoma radioresistant? A case of long term control of neck nodal metastasis by radiotherapy].
Nasal cavity melanoma is a rare neoplasm bearing grave prognosis because of rapid development of local failure and/or distant metastases, which are usually fatal. A case of 56 year old woman, who was referred to Maria Skłodowska Memorial Cancer Institute in Gliwice, Poland, for observation after radical maxillectomy because of nasal cavity melanoma is described. After six months of follow-up she developed large isolated lymphatic metastasis in heterolateral subdigastric node. As a result of administering a course of radical radiotherapy (59 Gy in 24 fractions/30 days) complete remission of this lesion was attained. During next 11 years of follow-up neither locoregional recurrence nor distant metastases were observed. The article describes current suggestions, based on Medline literature search, regarding treatment of isolated nodal melanoma recurrence, with particular emphasis on the possible role of radiotherapy in this clinical setting.
Female↗
Histological study of Trichosomoides nasalis (Nematoda: Trichinelloidea) in the nasal cavities of the murid Arvicanthis niloticus, with associated pathology.
Histological study of the nasal cavities and upper maxillae of Arvicanthis niloticus naturally infected with Trichosomoides nasalis shows that the female worms reside in the epithelial monolayer of the nasal mucosa of the posterior and median cavities. Eggs laid by T. nasalis were infiltrated between the female body wall and the epithelial lining. Small groups of eggs, mixed with mucus and polymorphonuclear cells, were found in the nasal lumen, freed by rupture of the stretched epithelium. Two females and a few eggs were also found in the connective tissues. One male was found in a female uterus and two were apparently in the lumen of the nasal cavity but the surrounding tissues were disrupted. No male was identified in the lamina propria of the mucosa. However, significant inflammatory lesions occurred in the lamina propria, similar to those induced by the males of Anatrichosoma spp. which live in this part of the mucosa. In rodents, the lesions resulted in rhinosinusitis characterised by a lymphocytic infiltration leading to nasal obstruction.
Animals↗
Mast cell tumor in the nasal cavity of a dog.
An 11-year-old male Shetland sheepdog displayed epistaxis and nasal discharge from the left nasal foramen. Cytological examination of a smear sample obtained by rhinotomy revealed neoplastic mast cells in the nasal cavity, a definitive diagnostic sign of mast cell tumor. The case was treated by surgery combined with radiotherapy and chemotherapy. Eighteen days after the last treatment, marked enlargement of the mandibular lymph nodes and facial edema developed, and the dog was euthanized at the owner's request. At necropsy, metastatic proliferation of mast cells was confirmed in the lymph nodes and liver, but no neoplastic mast cells were observed in the nasal cavity.
Animals↗
Enzymatic equipment of the nasal mucosa in the developing human nasal cavity.
The activities of some enzymes were described in the developing human nasal cavity in relatively early stages. In cryostat sections of the 8-14-week-old fetuses processed by standard Lojda methods, activities of the following enzymes were found in the respiratory and olfactory regions: ALP, ACP, ATP, TPP, alpha-GPDH, G6PDH, SDH and ANE. The positive reaction for DPP IV failed to be proved in this localization, it was not detected even in the capillary bed of the nasal cavity.
Fetus↗
Leiomyoma of the nasal cavity.
A case of rare leiomyoma of the nasal cavity is reported. The pathological and clinical characteristics of this tumour are discussed.
Humans↗
Clinical study of malignant lymphoma of head and neck in the nasal cavity and Waldyer's ring.
Clinical outcome of fifty-one cases of non-Hodgkin's lymphoma limited to the head and neck were studied for differences with involvement of one of two sites: Waldyer's ring, and the nasal cavity and paranasal sinuses taken together. The median survival for patients with involvement of Waldyer's ring was 58.6 months, and for the other group, 10.3 months. The patients with involvement of the nasal cavity and paranasal sinuses responded poorly to treatment and the lymphoma rapidly progressed. In these patients, the lymphomas were not of the diffuse small cell type, which has a relatively good prognosis: but T cell type. The poor outcome with involvement of the nasal cavity and paranasal sinuses may be due to histological and immunological factors, and to inadequate therapy. Early combination chemotherapy might give better results for this group.
Head and Neck Neoplasms↗
The augmentation of intrinsic laryngeal muscle activity by air-jet stimulation of the nasal cavity in decerebrate cats.
The purpose of this study was to examine the functional roles of nasal afferents in modulating the activity of the intrinsic laryngeal muscles. The electromyographic activities of the intrinsic laryngeal muscles and major respiratory muscles were recorded in cats during nasal air-jet stimulation. The activities of brainstem respiratory neurons were also recorded to determine which neurons transmit nasal afferent signals to the intrinsic laryngeal motoneurons. These axonal projections were identified by antidromic activation evoked by stimulation to the spinal cord at C4 level and the laryngeal nerve. The length of the respiratory cycle was prolonged and the diaphragmatic activity was decreased during air-jet stimulation of the nasal cavity. In contrast, the activities of both the intrinsic laryngeal adductor and abductor muscles were increased. Examination of the laryngeal reflexes revealed increase in the activities of intrinsic laryngeal motoneurons during both respiratory phases. Most of the respiratory neurons recorded decreased their peak firing rate during air-jet stimulation, reflecting decreased diaphragmatic activity; however, the peak firing rate of the bulbospinal expiratory neurons in the portion of the ventral respiratory group caudal to the obex did not decrease during stimulation. These findings demonstrate the nasal air-jet stimulation decreases the activities of major inspiratory muscles in order to avoid inspiration of foreign bodies into the nasal cavity and augments the activities of intrinsic laryngeal muscles, enabling prompt elicitation of the laryngeal airway reflex. Our findings also suggest that the nasal afferents suppress the major inspiratory activities by way of brainstem inspiratory neurons, but that the activities of intrinsic laryngeal muscles are controlled through undetermined pathway(s) other than the pathway through respiratory neurons.
Animals↗
An experimental and clinical study of osseointegrated implants penetrating the nasal cavity and maxillary sinus.
Implants were inserted in the upper jaw of three dogs in such a way that they penetrated the bone wall of the nasal cavity. The dogs were killed one year later, and the hard and soft tissues around the penetrating implants were analyzed. Radiographic and histologic examinations did not show any signs of adverse tissue reaction. The implants were all integrated in bone without fibrous tissue formation in the interface. A total of 139 implants, which pierced the bone of the sinus or nasal cavity, were inserted in the upper jaws of 101 patients. Forty-four sinus- and 47 nasal-penetrating implants were observed for five to ten years. The success rates were 70% and 72%, respectively. For 25 sinus- and 23 nasal-penetrating implants that were observed for two to five years, the success rates were 88% and 96%, respectively. The implant losses in nearly all clinical cases occurred during the first two years of function.
Animals↗