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Respiratory Epithelial Adenomatoid Hamartoma: An Uncommon Differential of Nasopharyngeal Tumor. 呼吸道上皮腺瘤样脂肪瘤:一种不常见的鼻咽肿瘤鉴别诊断。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-11-30 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9942293
Taiwo Olufemi Solaja, Kenechukwu Chinemelum Uche-Okonkwo, Moses Ayodele Akinola, John Ifeanyi Nwadiokwu

Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon tumor-like lesion that has been reported within the nose, paranasal sinuses, and less frequently in the nasopharynx. While it is believed to be benign, its clinical presentation, radiological characteristics, and microscopic features may closely mimic more aggressive tumors of the upper respiratory tract, potentially leading to needless life-altering treatment. Prior to now, there had been no reported cases of this lesion in West Africa. We present a 35-year-old male with persistent bilateral nasal obstruction, difficulty with swallowing, and bilateral reduction in hearing, whose CT findings were highly suggestive of a nasopharyngeal tumor, but upon biopsy and histology showed features most consistent with REAH. Surgery completely alleviated his symptoms with no clinical evidence of recurrence after a 1-year follow-up period.

呼吸道上皮腺瘤样火腿肠瘤(REAH)是一种不常见的肿瘤样病变,在鼻腔、鼻旁窦和鼻咽部均有报道。虽然它被认为是良性的,但其临床表现、放射学特征和显微特征可能与上呼吸道中更具侵袭性的肿瘤非常相似,有可能导致不必要的改变生命的治疗。在此之前,西非还没有关于这种病变的病例报道。我们介绍了一名 35 岁的男性患者,他患有持续性双侧鼻腔阻塞、吞咽困难和双侧听力下降,CT 检查结果高度提示鼻咽肿瘤,但活检和组织学检查显示其特征与 REAH 最为一致。手术完全缓解了他的症状,随访一年后也没有发现复发的临床证据。
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引用次数: 0
Abducens Nerve Neuropraxia due to Acute Bacterial Rhinosinusitis: Case Report and Literature Review. 急性细菌性鼻窦炎致外展神经失用1例并文献复习。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-11-27 eCollection Date: 2023-01-01 DOI: 10.1155/2023/5175871
Abdulrahman Alghulikah, Sarah Alseneidi, Hedayah Alsaady, Ahmed Alhussien, Surayie Al-Dousary, Saud Alromaih, Abdulrahman AlHumaizi

Background: Acute bacterial rhinosinusitis (ABRS) is a common infection of the paranasal sinuses that can lead to complications such as orbital and intracranial extension. The abducens nerve course is adjacent to the sphenoid sinus. Diplopia is rarely the initial presentation of sphenoid sinus pathology. In this article, we present the case of a middle-aged male who presented with diplopia and abducens nerve palsy secondary to ABRS, and we conducted a literature review in search of similar cases. Case Presentation. A 52-year-old male presented with diplopia secondary to ABRS. Imaging revealed the complete opacification of the bilateral sphenoid and frontal sinuses, with the extension of the inflammatory process to the optic nerve and cavernous sinus. The patient underwent a surgical intervention, which revealed a pyocele collection in the opticocarotid recess inside the sphenoid sinuses. After the surgery, the patient received antibiotics and reported a complete recovery.

Conclusions: Acute bacterial rhinosinusitis can present with atypical symptoms and lead to serious complications, such as abducens nerve palsy. Early diagnosis, appropriate management, and timely referral to a multidisciplinary team are crucial to preventing residual nerve damage and ensuring favorable outcomes.

背景:急性细菌性鼻窦炎(ABRS)是一种常见的鼻窦感染,可导致眼眶和颅内扩张等并发症。外展神经在蝶窦附近。复视很少是蝶窦病变的最初表现。在这篇文章中,我们提出了一个中年男性的病例,他表现为复视和展外神经麻痹继发于ABRS,我们进行了文献回顾,以寻找类似的病例。案例演示。52岁男性,以ABRS继发复视为主诉。影像学显示双侧蝶窦和额窦完全混浊,炎症延伸至视神经和海绵窦。患者接受手术治疗,发现蝶窦内的视颈动脉隐窝内有幽门囊肿。手术后,患者接受了抗生素治疗,并报告完全康复。结论:急性细菌性鼻窦炎可表现为非典型症状,并可导致严重的并发症,如外展神经麻痹。早期诊断,适当的管理,及时转诊到多学科团队是预防残余神经损伤和确保良好的结果至关重要。
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引用次数: 0
Diagnostic and Treatment-Related Challenges in Sinonasal Teratocarcinosarcoma: A Report of Three Cases 鼻窦畸胎瘤的诊断与治疗:附三例报告
Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-11-11 DOI: 10.1155/2023/4788617
W. F. Julius Scheurleer, Weibel W. Braunius, Bernard M. Tijink, Luuk M. Janssen, Frank A. Pameijer, Gerben E. Breimer, Ernst J. Smid, Remco de Bree, Lot A. Devriese, Johannes A. Rijken
Background. Sinonasal teratocarcinosarcoma is a rare, aggressive malignancy located almost exclusively in the nasal cavity, paranasal sinuses, or anterior skull base. Histopathological diagnosis can be challenging due to the heterogeneous composition. Methods. Retrospective analysis of 3 patients with sinonasal teratocarcinosarcoma diagnosed and treated at the University Medical Center Utrecht was conducted. Results. Patients presented with nasal obstruction, epistaxis, headaches, or behavioral changes. All three patients had locally advanced disease, and one had lymph node metastases. Two patients underwent surgery followed by radiotherapy, and one underwent neoadjuvant chemotherapy followed by surgery. The follow-up duration ranged from 3 to 32 months. All three patients died due to progression of their disease. Conclusion. Sinonasal teratocarcinosarcoma is characterized by rapid, aggressive local expansion. The prognosis is poor due to a high risk of metastases and locally recurrent disease. Multimodality treatment consisting of surgery, followed by (chemo)‐radiotherapy, is essential for optimizing outcomes. Neoadjuvant therapy offers a promising treatment option.
背景。摘要鼻窦畸胎瘤是一种罕见的侵袭性恶性肿瘤,几乎只发生在鼻腔、鼻窦或前颅底。组织病理学诊断可能是具有挑战性的,由于异质性的组成。方法。对3例在乌得勒支大学医学中心诊治的鼻窦畸形瘤肉瘤患者进行回顾性分析。结果。患者表现为鼻塞、鼻出血、头痛或行为改变。所有三名患者都有局部晚期疾病,其中一人有淋巴结转移。2例患者行手术后放疗,1例行新辅助化疗后手术。随访时间为3 ~ 32个月。三名患者均因疾病进展而死亡。结论。鼻窦畸胎癌肉瘤的特点是快速、侵袭性的局部扩张。由于转移和局部复发的风险高,预后较差。多模式治疗包括手术,随后(化疗)-放疗,是优化结果的必要条件。新辅助治疗提供了一个有希望的治疗选择。
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引用次数: 0
A Case of Syphilis Suspected Preoperatively as a Case of Tongue Cancer. 术前疑似梅毒舌癌1例。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-11-02 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9469814
Shigeru Kondo, Ryuhei Okada, Yosuke Ariizumi, Takashi Kurita, Hiroshi Shintaku, Takahiro Asakage

Syphilis is a sexually transmitted disease caused by Treponema pallidum (TP). We report a case of syphilis that was initially suspected as tongue cancer. An 86-year-old man consulted a neighborhood clinic with an approximately one-month history of pain in the right tongue. The result of scraping cytology of the tongue performed at the clinic was classified as class V, squamous cell carcinoma, and the patient was referred to our hospital. Physical examination revealed a mass on the right side of the tongue and a firm cervical mass. Biopsy revealed no evidence of malignancy; however, the imaging findings led to the suspicion of tongue cancer and lymph node metastasis. The results of blood examination revealed that the patient had syphilis, but since the patient showed few other symptoms, we decided to treat the infection after the planned surgery. We performed right partial glossectomy and neck dissection; however, the postoperative histopathology revealed no evidence of malignancy but nonspecific inflammatory changes with TP spirochetes. The incidence of syphilis has increased dramatically around the world, including Japan, during the last 20 years, and it no longer remains a rare disease. Therefore, syphilis should be included in the differential diagnosis of oral or cervical masses.

梅毒是由梅毒螺旋体(Treponema pallidum, TP)引起的性传播疾病。我们报告一例梅毒,最初被怀疑为舌癌。一名86岁男子因右舌疼痛约一个月就诊于附近诊所。临床行舌刮细胞学检查结果为V级鳞状细胞癌,转至我院就诊。体格检查发现舌右侧有肿块,颈部有坚硬肿块。活检未发现恶性肿瘤;然而,影像学结果导致怀疑舌癌和淋巴结转移。血液检查结果显示患者患有梅毒,但由于患者几乎没有其他症状,我们决定在计划手术后治疗感染。行右侧部分舌骨切除术及颈部清扫术;然而,术后组织病理学显示TP螺旋体没有恶性肿瘤的证据,但非特异性炎症改变。在过去的20年里,梅毒的发病率在世界各地急剧上升,包括日本,它不再是一种罕见的疾病。因此,梅毒应列入口腔或宫颈肿块的鉴别诊断。
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引用次数: 0
Null-Cell Ectopic Pituitary Adenoma of the Nasal Cavity. 鼻腔空细胞异位垂体腺瘤。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-10-12 eCollection Date: 2023-01-01 DOI: 10.1155/2023/5561092
Nicholas Figaro, Jibran Juman, Ashton Ramsundar, Fidel Rampersad, Melanie Johncilla, Solaiman Juman

An ectopic pituitary adenoma (EPA) is an uncommon type of pituitary adenoma, accounting for only 2% of all pituitary adenomas. EPAs are benign tumors that can occur anywhere along the migratory embryonic path of the pituitary gland and have no relationship to intrasellar elements. They are usually hormonally active and have a minor female predominance. The clinical features of EPAs are highly dependent on its hormonal activity, anatomical location, and its local mass effect. Appropriate radiological imaging is essential for the evaluation of EPAs. Imaging investigations show a normal pituitary gland and sellar turcica, provide details on the size of the tumor, its margins, and extent, and help with surgical planning. The criteria for diagnosing an ectopic pituitary adenoma depend on detailed histopathological examination. EPA management should be individualized. We present a case of a 71-year-old male who presented with a 9-month history of left nasal obstruction, purulent nasal discharge, and intermittent anterior epistaxis. The patient was being managed by his general practitioner for chronic rhinosinusitis but failure of his symptoms to resolve prompted a visit to the otorhinolaryngologist. The patient was diagnosed with a null-cell ectopic pituitary adenoma through histological analysis of a biopsy specimen that showed adenohypophyseal cells without cell-type-specific differentiation. The patient subsequently underwent an endoscopic endonasal excision and had an uneventful hospital stay.

异位垂体腺瘤(EPA)是一种不常见的垂体腺瘤,仅占所有垂体腺瘤的2%。EPAs是一种良性肿瘤,可以发生在垂体胚胎迁移路径上的任何地方,与鞍内元件无关。它们通常具有激素活性,并以女性为主。EPAs的临床特征高度依赖于其激素活性、解剖位置和局部质量效应。适当的放射学成像对于评估EPA至关重要。影像学检查显示垂体和鞍区正常,提供了肿瘤大小、边缘和范围的详细信息,并有助于制定手术计划。诊断异位垂体腺瘤的标准取决于详细的组织病理学检查。环保局的管理应该是个性化的。我们报告一例71岁男性患者,他有9个月的左鼻阻塞、脓性鼻腔分泌物和间歇性前鼻出血病史。这名患者由他的全科医生治疗慢性鼻窦炎,但由于症状未能缓解,他去看了耳鼻喉科医生。通过对活检标本的组织学分析,该患者被诊断为无细胞异位垂体腺瘤,活检标本显示腺垂体细胞没有细胞类型特异性分化。患者随后接受了鼻内镜下鼻内切除术,并顺利住院。
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引用次数: 0
Reconstruction of the Tongue after Hemiglossectomy Using Serratus Anterior Muscle Free Flap. 应用前肌游离Serratus皮瓣重建半舌切除术后的舌。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-10-09 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6637271
Petr Šín, Alica Hokynková, Pavel Rotschein, Radek Pejčoch, Lucie Nártová

Background: Serratus anterior muscle free flap is widely used in numerous indicated reconstructions. Only a few studies have dealt with the use of this flap in tongue reconstruction.

Materials and methods: We present a case series of 7 patients with carcinoma of the tongue who underwent hemiglossectomy followed by immediate reconstruction with serratus anterior muscle free flap between January 2017 and December 2019 at the University Hospital Brno. The aim of this study was to evaluate safety and efficiency of the reconstruction as well as the donor site morbidity.

Results: There was not a single case of flap failure observed and the donor site healed completely in all cases. The functional outcome (tongue mobility, phonation, and deglutition) depended on the severity of the primary oncological disease and health status of the patient.

Conclusion: The serratus anterior muscle free flap represents an alternative option for reconstruction of the tongue.

背景:无前肌瓣广泛应用于多种指征性重建。只有少数研究涉及这种皮瓣在舌头重建中的应用。材料和方法:我们介绍了一个由7名舌癌患者组成的病例系列,他们于2017年1月至2019年12月在布尔诺大学医院接受了半舌切除术,然后立即用前锯肌游离皮瓣重建。本研究的目的是评估重建的安全性和有效性以及供区的发病率。结果:所有病例均未发现一例皮瓣失败,供区完全愈合。功能结果(舌头活动、发声和吞咽)取决于原发肿瘤疾病的严重程度和患者的健康状况。结论:前锯肌游离皮瓣是一种可供选择的舌再造术。
{"title":"Reconstruction of the Tongue after Hemiglossectomy Using Serratus Anterior Muscle Free Flap.","authors":"Petr Šín,&nbsp;Alica Hokynková,&nbsp;Pavel Rotschein,&nbsp;Radek Pejčoch,&nbsp;Lucie Nártová","doi":"10.1155/2023/6637271","DOIUrl":"10.1155/2023/6637271","url":null,"abstract":"<p><strong>Background: </strong>Serratus anterior muscle free flap is widely used in numerous indicated reconstructions. Only a few studies have dealt with the use of this flap in tongue reconstruction.</p><p><strong>Materials and methods: </strong>We present a case series of 7 patients with carcinoma of the tongue who underwent hemiglossectomy followed by immediate reconstruction with serratus anterior muscle free flap between January 2017 and December 2019 at the University Hospital Brno. The aim of this study was to evaluate safety and efficiency of the reconstruction as well as the donor site morbidity.</p><p><strong>Results: </strong>There was not a single case of flap failure observed and the donor site healed completely in all cases. The functional outcome (tongue mobility, phonation, and deglutition) depended on the severity of the primary oncological disease and health status of the patient.</p><p><strong>Conclusion: </strong>The serratus anterior muscle free flap represents an alternative option for reconstruction of the tongue.</p>","PeriodicalId":45872,"journal":{"name":"Case Reports in Otolaryngology","volume":"2023 ","pages":"6637271"},"PeriodicalIF":0.6,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic Endonasal Repair and Reconstruction of Traumatic Anterior Skull Base Defects. 外伤性前颅底缺损的鼻内窥镜修复与重建。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-10-06 eCollection Date: 2023-01-01 DOI: 10.1155/2023/6996215
Isabelle J M Williams, Annakan V Navaratnam, Mark Wilson, Mark S Ferguson

Eighty percent of cerebrospinal fluid leaks (CSF) occur following trauma and complicate 12 to 13% percent of all basilar skull fractures (Prosser, Vender, and Solares, 2011). An endoscopic endonasal approach (EEA) is often the preferred method of repair with greater than 90% success rates (Prosser, Vender, and Solares, 2011). We report a case of a 37-year-old man who presented to our regional level 1 trauma centre with multiple facial injuries. Initial cross-sectional imaging revealed multiple, continuous anterior skull base fractures with associated pneumocephalus. Though initially managed conservatively, the patient represented five days later with unilateral left-sided rhinorrhoea. An endoscopic endonasal repair with a multilayer fat, tensor fascia lata, free mucosal graft, and vascularised local flap reconstruction was undertaken. This case highlights the importance of maintaining a high level of suspicion for delayed CSF leak in traumatic base of skull injury. The EEA enables meticulous dissection and thorough inspection of the skull base, facilitating multilayered repair and reconstruction of defects.

80%的脑脊液漏(CSF)发生在创伤后,并使12%至13%的基底颅骨骨折复杂化(Prosser、Vender和Solares,2011)。内窥镜鼻内入路(EEA)通常是首选的修复方法,成功率超过90%(Prosser、Vender和Solares,2011)。我们报告了一例37岁的男子,他因面部多处受伤来到我们的地区一级创伤中心。最初的横断面影像学检查显示多处连续性前颅底骨折并伴有肺头畸形。尽管最初是保守治疗,但患者在五天后出现单侧左侧鼻出血。采用多层脂肪、阔筋膜张肌、游离粘膜移植和血管化局部皮瓣重建进行鼻内窥镜修复。该病例强调了在创伤性颅底损伤中保持高度怀疑迟发性脑脊液渗漏的重要性。EEA能够对颅底进行细致的解剖和彻底的检查,有助于缺陷的多层修复和重建。
{"title":"Endoscopic Endonasal Repair and Reconstruction of Traumatic Anterior Skull Base Defects.","authors":"Isabelle J M Williams,&nbsp;Annakan V Navaratnam,&nbsp;Mark Wilson,&nbsp;Mark S Ferguson","doi":"10.1155/2023/6996215","DOIUrl":"10.1155/2023/6996215","url":null,"abstract":"<p><p>Eighty percent of cerebrospinal fluid leaks (CSF) occur following trauma and complicate 12 to 13% percent of all basilar skull fractures (Prosser, Vender, and Solares, 2011). An endoscopic endonasal approach (EEA) is often the preferred method of repair with greater than 90% success rates (Prosser, Vender, and Solares, 2011). We report a case of a 37-year-old man who presented to our regional level 1 trauma centre with multiple facial injuries. Initial cross-sectional imaging revealed multiple, continuous anterior skull base fractures with associated pneumocephalus. Though initially managed conservatively, the patient represented five days later with unilateral left-sided rhinorrhoea. An endoscopic endonasal repair with a multilayer fat, tensor fascia lata, free mucosal graft, and vascularised local flap reconstruction was undertaken. This case highlights the importance of maintaining a high level of suspicion for delayed CSF leak in traumatic base of skull injury. The EEA enables meticulous dissection and thorough inspection of the skull base, facilitating multilayered repair and reconstruction of defects.</p>","PeriodicalId":45872,"journal":{"name":"Case Reports in Otolaryngology","volume":"2023 ","pages":"6996215"},"PeriodicalIF":0.6,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10575747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41239752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Seromucinous Hamartoma of the Lateral Nasal Wall with Infiltration of the Orbit: A Rare Case Report and Review of the Literature. 鼻侧壁浆液黏液错构瘤伴眼眶浸润一例罕见病例报告及文献复习。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/1923015
Lentiona Basiari, Maria Michali, Ioannis Komnos, Georgios Tsirves, Victoria Tsoumani, Ioannis Kastanioudakis

Seromucinous hamartoma is a rare benign glandular proliferation arising from the respiratory epithelium of the sinonasal tract and nasopharynx. It was described for the first time in 1974 by Baillie and Batsakis. Since then, few cases have been reported in the literature with most of them occurring in the posterior nasal septum. We report the case of a 52-year-old woman that presented to our department with left periorbital edema, pain, and dacryorrhea due to seromucinous hamartoma arising from the left inferior turbinate and extending through the lateral nasal wall into the maxilla, the nasolacrimal duct, and the orbit. Endoscopic medial maxillectomy and endoscopic transnasal orbital tumor resection were performed. The patient remains symptom-free for 16 months, till her most recent follow-up. Seromucinous hamartoma of the nasal cavity is an exceedingly rare diagnosis, especially in the lateral nasal wall. It should be included in the differential diagnosis of nasal tumors. According to the literature review, this is the first case report of seromucinous hamartoma with orbit infiltration. Endonasal endoscopic resection is the treatment of choice.

浆液黏液性错构瘤是一种罕见的良性腺体增生,起源于鼻窦和鼻咽部的呼吸道上皮。1974年,Baillie和Batsakis首次描述了它。此后,文献报道的病例很少,大多数发生在后鼻中隔。我们报告一位52岁的女性,因左下鼻甲浆液黏液错构瘤引起的左侧眶周水肿、疼痛和泪漏而就诊于我科,该错构瘤起源于左侧下鼻甲,并通过鼻外侧壁延伸至上颌骨、鼻泪管和眼眶。行内窥镜下上颌骨内侧切除术及经鼻眼眶肿瘤切除术。患者在最近一次随访前16个月无症状。鼻腔浆液黏液错构瘤是一种非常罕见的诊断,特别是在鼻侧壁。应列入鼻肿瘤的鉴别诊断。根据文献回顾,这是第一例浆液黏液错构瘤伴眼眶浸润的报道。鼻内窥镜切除是治疗的首选。
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引用次数: 0
Transnasal Endoscopic Treatment of Tension Pneumocephalus Caused by Posttraumatic or Iatrogenic Ethmoidal Damage. 经鼻内镜治疗创伤后或医源性筛损伤所致张力性脑气。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/2679788
Goran Latif Omer, Riccardo Maurizi, Beatrice Francavilla, Kareem Rekawt Hama Rashid, Gianluca Velletrani, Hasan Mustafa Salah, Giulia Marzocchella, Mohammed Ibrahim Mohialdeen Gubari, Stefano Di Girolamo

Background: Tension pneumocephalus is a neurosurgical emergency caused by progressive accumulation of air in the intracranial spaces mediated by a valve mechanism. Tension pneumocephalus usually presents with headaches, reduced consciousness, and even death. One of the most common causes is an ethmoidal defect resulted by nasal surgery or facial traumas.

Methods: A literature review about tension pneumocephalus resulting from ethmoidal damages was performed. Surgery strategies included decompression by frontal burr holes and multilayer repair of the ethmoidal defect. In this paper, an endoscopic technique that exploits the ethmoidal defect to decompress the intracranial spaces and to resolve tension pneumocephalus with fewer complications and shorter hospitalization in comparison to frontal craniotomy is proposed.

Conclusion: The proposed endonasal endoscopic technique could be effectively used as a first-line treatment for symptomatic tension pneumocephalus caused by posttraumatic or iatrogenic ethmoidal defect.

背景:张力性气颅是一种神经外科急症,由气门机制介导的颅内间隙空气进行性积聚引起。紧张性气颅通常表现为头痛、意识下降,甚至死亡。最常见的原因之一是鼻部手术或面部外伤引起的筛缺损。方法:回顾文献,对乙窦损伤所致张力性气颅进行分析。手术策略包括额叶钻孔减压和筛骨缺损的多层修复。在本文中,我们提出了一种内镜技术,利用筛骨缺损来减压颅内间隙和解决张力性脑气,与额骨开颅术相比,并发症更少,住院时间更短。结论:鼻内内镜技术可作为创伤后或医源性筛窦缺损所致症状性紧张性脑气的一线治疗方法。
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引用次数: 0
A Case of Laryngeal Cryptococcosis that Responded to Itraconazole. 伊曲康唑治疗喉隐球菌病1例。
IF 0.6 Q4 OTORHINOLARYNGOLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/8847838
Sorane Maezumi, Ray Motohashi, Yusuke Shoji, Kiyoaki Tsukahara

Laryngeal cryptococcosis is a rare condition. While there is no reliable evidence regarding the treatment of laryngeal cryptococcosis, oral fluconazole was successful in most previous cases. We experienced a case where we could not continue fluconazole because of adverse drug effects. An 88-year-old female was referred to our department with a 5-month history of sore throat and cough. She had used oral steroids and a corticosteroid inhaler for poorly controlled asthma. Flexible laryngoscopy showed leukoplakia of the vocal cords and subglottic mucosa, and biopsy revealed cryptococcal infection. We started the treatment with fluconazole but changed to itraconazole because of adverse events. Since laryngoscopy performed 6 months later was unremarkable and drug interactions had occurred, we stopped the itraconazole use at 6 months. Our experience suggests that itraconazole is also useful for treating laryngeal cryptococcosis.

喉隐球菌病是一种罕见的疾病。虽然没有可靠的证据关于治疗喉隐球菌病,口服氟康唑是成功的,在大多数以前的病例。我们经历了一个病例,我们不能继续氟康唑,因为药物的不良反应。一名88岁女性以5个月的喉咙痛和咳嗽病史转介至我科。她曾使用口服类固醇和皮质类固醇吸入器治疗控制不佳的哮喘。软性喉镜检查显示声带及声门下黏膜白斑,活检显示隐球菌感染。我们开始用氟康唑治疗,但由于不良事件改用伊曲康唑。由于6个月后喉镜检查无明显变化,且发生药物相互作用,我们在6个月时停止使用伊曲康唑。我们的经验表明伊曲康唑对治疗喉部隐球菌病也有效。
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引用次数: 0
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Case Reports in Otolaryngology
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