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Frenken AK, Sievert M, Panuganti B, Aubreville M, Meyer T, Scherzad A, Gehrke T, Scheich M, Hackenberg S, Goncalves M. Feasibility of Optical Biopsy During Endoscopic Sinus Surgery With Confocal Laser Endomicroscopy: A Pilot Study. Laryngoscope 2024. [PMID: 38761157 DOI: 10.1002/lary.31503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/17/2024] [Accepted: 04/29/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE Confocal laser endomicroscopy (CLE) is an optical imaging technique that allows in vivo, real-time, microscope-like assessment of superficial lesions. Although there is substantial data on CLE use in the upper GI tract, there is limited information regarding its application in the nasal cavity and paranasal sinuses. This study aims to assess the feasibility and diagnostic metrics of CLE in the nasal cavity and paranasal sinuses regarding differentiation between healthy/benign and malignant tissue. These structures show, however, a wider variety of frequent and concomitant benign and malignant pathologies, which could pose an increased challenge for optical biopsy by CLE. METHODS We performed CLE on a case series of six patients with various findings in the nose (three chronic rhinosinusitis, adenocarcinoma, meningoenzephalozele, esthesionneuroblastoma). Forty-two sequences (3792 images) from various structures in the nasal cavity and/or paranasal sinuses were acquired. Biopsies were taken at corresponding locations and analyzed in hematoxylin and eosin staining as a standard of reference. Three independent examiners blinded to the histopathology assessed the sequences. RESULTS Healthy and inflamed mucosa could be distinguished from malignant lesions with an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 84.1%, 85.4%, 83.1%, 72.5%, and 92.1%, respectively, with a substantial agreement between raters (Fleiss κ = 0.62). CONCLUSION This technique shows, despite its limitations, potential as an adjunctive imaging technique during sinus surgery; however, the creation of a scoring system based on reproducible and defined characteristics in a larger more diverse population should be the focus of further research to improve its diagnostic value and clinical utility. LEVEL OF EVIDENCE NA Laryngoscope, 2024.
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Affiliation(s)
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Bharat Panuganti
- Department of Otorhinolaryngology, The University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, U.S.A
| | | | - Till Meyer
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Gehrke
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Matthias Scheich
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
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Nasal Embryonal Rhabdomyosarcoma in the Pediatric Population: Literature Review and Report of Midline Presentation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3534. [PMID: 33889472 PMCID: PMC8057758 DOI: 10.1097/gox.0000000000003534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022]
Abstract
Background: Congenital midline nasal masses are rare anomalies and are typically benign nasal dermoid sinus cysts (NDSCs). Rhabdomyosarcomas (RMSs) are even less common, and only a fraction affect sites like the external nose, nasal cavity, nasopharynx, and paranasal sinuses. We review the clinical presentation and treatment of nasal, nasopharyngeal, and paranasal RMSs and report the first documented midline presentation. Methods: We queried PubMed for articles with titles containing the terms rhabdomyosarcoma or sarcoma botryoides and nose, nasal, paranasal, sinonasal, nasopharynx, or nasopharyngeal. We then searched the references of each included article using the same parameters and continued this process iteratively until no new articles were found. Results: The paranasal sinuses were the most commonly affected site, followed by the nasopharynx, nasal cavity, and external nose. Two patients presented with involvement of the external nose, but each presented with involvement of the right ala rather than a midline mass. The rates of intracranial extension and/or skull base involvement were comparable to those of NDSCs. The alveolar subtype was most common, followed by the embryonal subtype. Conclusions: Most midline nasal masses are benign; however, we report the first documented presentation of an RMS as a midline nasal mass. Accordingly, RMS should be included in the differential diagnosis of midline nasal masses in the pediatric population. Surgery for midline nasal masses is sometimes delayed due to the risks of interfering with developing structures and early anesthesia. However, early surgical treatment should be considered given this new differential and its predilection for early metastasis.
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Ni K, Li X, Zhao L, Wu J, Liu X, Shi H. Diagnosis and treatment of congenital nasal dermoid and sinus cysts in 11 infants: A consort compliant study. Medicine (Baltimore) 2020; 99:e19435. [PMID: 32481248 PMCID: PMC7249947 DOI: 10.1097/md.0000000000019435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
There have been few studies on congenital nasal dermoid and sinus cysts (NDSCs) in infants.This study was performed to obtain clinical data for the diagnosis and treatment of NDSCs in infants.We performed a retrospective analysis of 11 infants admitted with NDSCs between 2014 and 2019. Patient demographics, lesion site, preoperative radiological findings, surgical technique, intraoperative findings, and postoperative sequelae were analyzed.In total, 11 infants (average age, 19 months; lowest age, 10 months) were included in this study. All patients presented with a nasal root mass, 2 patients also had nasal tip fistula, and only 1 case had a history of preoperative infection. Preoperative enhanced computed tomography (CT) examination showed nasal surface lesion (type I) in 3, nasal intraosseous (type II) in 5, intracranial epidural (type III) in 2, and intracranial dural (type IV) in 1 patient. The main surgical methods included direct resection with a vertical midline incision (9 patients), vertical incision + transnasal endoscopic resection + skull base repair (1 patient), and transverse incision of the lower margin of the left eyebrow (1 patient). All wounds healed well without serious complications.Using the 4-type classification method in combination with the preoperative CT findings to analyze the extent of NDSC in infants is helpful for formulating the surgical plan. Using vertical incision approach alone or combined with nasal endoscopy for minimally invasive surgery can meet the needs of complete resection and reconstruction.Our results provide clinical data that can help establish standardized criteria for the diagnosis and treatment of NDSCs in infants.
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Affiliation(s)
- Kun Ni
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University
| | - Xiaoyan Li
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University
| | - Limin Zhao
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University
| | - Jiali Wu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University
| | - Xiaojun Liu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University
| | - Haibo Shi
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China
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4
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Morice A, Galliani E, Amiel J, Rachwalski M, Neiva C, Thauvin-Robinet C, Vazquez MP, Picard A, Kadlub N. Diagnostic criteria in Pai syndrome: results of a case series and a literature review. Int J Oral Maxillofac Surg 2019; 48:283-290. [DOI: 10.1016/j.ijom.2018.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/01/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
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Abstract
Nasal dermoids, encephaloceles, and gliomas are rare congenital lesions that result from improper embryologic development. The differentiation between them and a firm understanding of their pathology is necessary to avoid unnecessary complications. In view of their potential intracranial connection, prompt diagnosis and treatment are paramount. The authors review the embryology, diagnoses, radiologic work-up, surgical management, and complications of these midline craniofacial masses in children.
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Affiliation(s)
- Renae D Van Wyhe
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
| | - Edward S Chamata
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
| | - Larry H Hollier
- Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
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6
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Bigorre M. [Congenital cysts and fistulae in children]. ANN CHIR PLAST ESTH 2016; 61:371-388. [PMID: 27545655 DOI: 10.1016/j.anplas.2016.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
Abstract
Cysts and fistulae of the face and neck in children are formed before birth and correspond to the persistence of embryonic remnants that occur due to coalescence defects of embryonic buds or due to epidermal inclusion. They represent the most common pathological malformation of the face and neck. They may be separated according to their location into laterocervical cysts and fistulas or median cysts and fistulas. Their discovery may occur prematurely at birth or later during growth or in adulthood. Their treatment always requires surgical excision, which must be complete in order to prevent recurrences.
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Affiliation(s)
- M Bigorre
- Service de chirurgie orthopédique et plastique pédiatrique, CHRU Lapeyronie, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
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Excision and Fat Grafting of Nasal Tip Dermoid Cysts Through an Open Rhinoplasty Approach. J Craniofac Surg 2016; 27:e18-20. [PMID: 26681174 DOI: 10.1097/scs.0000000000002291] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Nasal tip dermoid cysts that are present in pediatric patients can be complicated by mass effect causing compression and distortion of underlying cartilaginous structures. The purpose of this report is to describe a single surgeon's technique and results of nasal tip dermoid cyst excision in pediatric patients through an open rhinoplasty approach followed by tip reconstruction and immediate fat grafting. A series of 3 pediatric patients presented with 1 to 1.5 cm nasal tip dermoid cysts that were causing distortion of the lower lateral cartilages. All 3 underwent excision of the cyst through an open rhinoplasty approach. The nasal tip was reconstructed with interdomal sutures and immediate fat grafting. Fat grafts were harvested from the abdominal wall and implanted in the nasal tip. The grafts filled the resulting dead space and were secured with the fibrin glue. The soft tissue was redraped, and the skin was closed. The final postoperative result, 2 years after surgical intervention, included a well-proportioned and appropriately shaped nasal tip without obvious incisional scars in all patients. The skin overlying the previously excised dermoid cyst was supple and healthy. Excision of nasal tip dermoid cysts in pediatric patients can be approached through an open rhinoplasty approach, tip reconstruction, and immediate fat grafting. This approach can provide assistance in correcting contour deformities and may help preserve an at-risk soft-tissue envelope.
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Stoddard DG, Pallanch JF, Hamilton GS. The effect of vibrissae on subjective and objective measures of nasal obstruction. Am J Rhinol Allergy 2016; 29:373-7. [PMID: 26358350 DOI: 10.2500/ajra.2015.29.4209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Nasal congestion and/or obstruction represents a prevalent and extensively studied problem. No published research exists that describes the impact of nasal hair (vibrissae) on nasal obstruction. OBJECTIVE To assess the impact of nasal vibrissae on subjective and objective measurements of nasal obstruction. METHODS In this prospective study, 30 healthy participants without nasal symptoms were assessed for baseline vibrissae density and were treated with a topical decongestant. The subjects were then asked to subjectively assess nasal breathing by using four questions from the Nasal Obstruction Symptom Evaluation instrument before undergoing rhinomanometry. Nasal vibrissae were then trimmed, and the participants repeated the subjective and objective assessments. Pre- and postintervention outcomes, including symptom scores, nasal airflow, and resistance, were compared by using statistical analysis. RESULTS Statistically significant improvement was noted in subjects' nasal airway specific symptom scores and in objective measurements of their nasal airway. Patients with moderate or many vibrissae at baseline were noted to have greater likelihood of improvement in subjective and objective obstruction assessments than patients rated with few. CONCLUSION In these 30 subjects, statistically significant improvement occurred in both subjective and objective assessments of nasal obstruction, particularly in patients with greater density of vibrissae. These findings support further study of the potential benefit of the reduction of vibrissae density in some patients with nasal obstruction.
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Affiliation(s)
- David G Stoddard
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
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Gandhi A, Sundar IV, Sharma A, Mittal RS, Gandhi S. Nasofrontal dermoid with sinus tract upto the tip of the nose: A case report with review of the literature. Asian J Neurosurg 2016; 11:178. [PMID: 27057239 PMCID: PMC4802954 DOI: 10.4103/1793-5482.145344] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Nasofrontal dermoid with sinus tract extending to the nasal tip is rare in adults. It is unique in its embryological origin, presentation, and management. Pathogenesis involves the incomplete obliteration of the developing neuroectoderm. A sinus opening with intermittent oily discharge is characteristic. Associated intracranial extension may lead to meningitis and brain abscess. We present a case of a 21-year-old adult having a nasofrontal sinus tract with intracranial extension who presented with recurrent episodes of meningitis and discuss the physical findings with relevance to embryology, elaborating on the importance and means of addressing the intracranial as well as extracranial components for complete treatment.
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Affiliation(s)
- Ashok Gandhi
- Department of Neurosurgery, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - I Vijay Sundar
- Department of Neurosurgery, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - Achal Sharma
- Department of Neurosurgery, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - R S Mittal
- Department of Neurosurgery, SMS Medical College and Hospital, Jaipur, Rajasthan, India
| | - Sapna Gandhi
- Department of Pathology, SMS Medical College and Hospital, Jaipur, Rajasthan, India
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Kuboi T, Okazaki K, Kusaka T, Shimada A. Congenital dacryocystoceles controlled by nCPAP via nasal mask in a neonate. Pediatr Int 2015; 57:475-7. [PMID: 26016738 DOI: 10.1111/ped.12516] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 08/01/2014] [Accepted: 09/09/2014] [Indexed: 11/29/2022]
Abstract
Congenital dacryocystocele is a relatively rare type of nasolacrimal duct obstruction that may induce respiratory distress during the early neonatal period. We encountered a case of bilateral congenital dacryocystoceles with intranasal cysts in a premature infant delivered at 34 weeks of gestation. The patient developed symptoms of respiratory failure immediately after birth, but no ophthalmologic symptoms. Treatment with nasal continuous positive airway pressure via a nasal mask, instead of a nasal prong, effectively relieved the symptoms. Early diagnosis and appropriate treatment are critical for infants with nasal obstruction.
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Affiliation(s)
- Toru Kuboi
- Department of Neonatology, Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Kaoru Okazaki
- Department of Neonatology, Shikoku Medical Center for Children and Adults, Kagawa, Japan
| | - Takashi Kusaka
- Department of Pediatrics, Kagawa University, Kagawa, Japan
| | - Aki Shimada
- Department of Otolaryngology, University of Tokushima School of Medicine, Tokushima, Japan
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11
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Abstract
BACKGROUND Nasal gliomas are congenital neurogenic tumours that are mostly diagnosed in the perinatal period. They occur in 1 in 20 000-40 000 live births. Cases reported in adulthood are rare and the management in adults is controversial. CASE REPORT A 55-year-old female had an incidental diagnosis of nasal glioma after routine endoscopic sinus surgery and polypectomy. Post-operatively, there was symptomatic improvement, but it was complicated by a cerebrospinal fluid leak. CONCLUSION Most adults who present with nasal gliomas have non-specific nasal symptoms, and diagnosis is made from an incidental finding of heterotopic glial tissue. The management of nasal gliomas in adults is contentious. In contrast, management in the paediatric population is better established and the treatment is surgical excision. The relevant literature is reviewed.
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12
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Hartley BEJ, Eze N, Trozzi M, Toma S, Hewitt R, Jephson C, Cochrane L, Wyatt M, Albert D. Nasal dermoids in children: a proposal for a new classification based on 103 cases at Great Ormond Street Hospital. Int J Pediatr Otorhinolaryngol 2015; 79:18-22. [PMID: 25481331 DOI: 10.1016/j.ijporl.2014.10.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 10/15/2014] [Accepted: 10/19/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Nasal dermoids are rare developmental anomalies seen in children. This study reports the largest case series of 103 patients seen in a quaternary specialist unit over a 10-year period. We report the surgical and radiological findings and propose a new classification system, which clearly describes the extent of the lesions, thus allowing better surgical planning. METHODS A retrospective review of case notes was conducted. Data collection included demographics, initial presentation, site of lesion, pre-operative CT and MRI imaging, surgical procedure, intraoperative findings (including depth of lesion), complications and recurrence. Surgical findings were correlated with radiological findings. RESULTS A total of 103 patients were included in the study. The mean age at presentation was 29 months. 89% of children presented with a naso-glabellar or columellar lesion and 11% had a medial canthal lesion. All the patients underwent preoperative imaging and were treated with surgical excision. 58 children had superficial lesions, 45 had subcutaneous tracts extending to varying depths. Of these, 38 had intraosseous extension into the frontonasal bones, eight extended intracranially but remained extradural and two had intradural extension. There was good correlation between radiological and surgical findings. The superficial lesions were locally excised. The lesions with intraosseous tracts were removed via open rhinoplasty and the frontonasal bones drilled for access. Intracranial extension was approached either via a bicoronal flap and frontal craniotomy or the less invasive anterior small window craniotomy. CONCLUSIONS This report describes the largest published cases series of nasal dermoids. The cases demonstrate the presenting features and the variable extent of the lesions. The new proposed classification; superficial, intraosseous, intracranial extradural and intracranial intradural, allows precise surgical planning. In the presence of intracranial extension, the low morbidity technique of using a brow incision and small window anterior craniotomy avoids the more invasive and commonly used bicoronal flap and frontal craniotomy.
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Affiliation(s)
| | - N Eze
- Great Ormond Street Hospital, United Kingdom.
| | - M Trozzi
- Great Ormond Street Hospital, United Kingdom
| | - S Toma
- Great Ormond Street Hospital, United Kingdom
| | - R Hewitt
- Great Ormond Street Hospital, United Kingdom
| | - C Jephson
- Great Ormond Street Hospital, United Kingdom
| | - L Cochrane
- Great Ormond Street Hospital, United Kingdom
| | - M Wyatt
- Great Ormond Street Hospital, United Kingdom
| | - D Albert
- Great Ormond Street Hospital, United Kingdom
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13
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Hagiwara A, Nagai N, Ogawa Y, Suzuki M. A case of nasal glial heterotopia in an adult. Case Rep Otolaryngol 2014; 2014:354672. [PMID: 24711948 PMCID: PMC3965926 DOI: 10.1155/2014/354672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 01/16/2014] [Indexed: 11/17/2022] Open
Abstract
We report a rare case of nasal glial heterotopia in an adult. After the surgery, frontal lobe cerebral hemorrhage developed. A 58-year-old man had unilateral nasal obstruction that progressed for one year. He had been treated for hypertension, chronic heart failure, and cerebral infarction with aspirin and warfarin. A computed tomography scan showed that the tumor occupied the right nasal cavity and the sinuses with small defect in the cribriform plate. The tumor was removed totally with endoscopy. After the operation, the patient developed convulsions and frontal lobe cerebral hemorrhage. The hemorrhage site was located near a defect in the cribriform plate. Nasal glial heterotopia is a rare developmental abnormality, particularly rare in adult. Only few cases were reported. We could not find any report of adult nasal glial heterotopias that developed cerebral hemorrhage as a complication of the surgery.
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Affiliation(s)
- Akira Hagiwara
- Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
- Department of Otolaryngology, Kohsei Chuo General Hospital, 1-11-7 Mita, Meguro-ku, Tokyo 153-0062, Japan
| | - Noriko Nagai
- Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Yasuo Ogawa
- Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Mamoru Suzuki
- Department of Otolaryngology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
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Abdelmaaboud M, Nimeri N. Pai syndrome: first reported case in Qatar and review of literature of previously published cases. BMJ Case Rep 2012; 2012:bcr-02-2012-5940. [PMID: 22914230 DOI: 10.1136/bcr-02-2012-5940] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A full-term male baby born with severe complete median cleft lip and palate and multiple facial cutaneous polyps on the right nostril, left and right ears and angle of the mouth. Eye fundus examination revealed hypopigmented fundi, pigmented rings around both discs and hypopigmented maculae. Neurological, Cardiovascular and abdominal examination was unremarkable, with normal echocardiography and abdominal ultrasound. CT and MRI of the brain revealed hypogenesis of the corpus callosum and midline paracallosal lipomas and calcifications. Chromosomal study showed normal male 46, XY karyotype. This is the first reported case in Qatar and the second case in a patient of Arabian descent.
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Abdelmaaboud M, El Yafawi R, Zakri F. Pai Syndrome: First reported case in Qatar and review of literature. Qatar Med J 2012. [DOI: 10.5339/qmj.2012.1.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Pai Syndrome was first described in 1987 as a constellation of three developmental anomalies: i) complete median cleft palate, ii) cutaneous polyps and iii) midline lipomas of the central nervous system.(1) Since then, eighteen cases have been reported by Pai et al,(1) Preece et al,(2) Morgan and Evans,(3) Rudnikschoneborn and Zerres,(4) Mishima et al,(5) Al Mazrou et al,(6) Coban et al,(7), Szeto et al,(8) Guion-Almeida et al,(9) and Castori et al,(10) Vaccarella et al,(11) Chousta et al,(12) and Ochoa et al(13) To our knowledge, this is the first case of Pai Syndrome to be reported in Qatar and the second case in a patient of Arabian descent. The aim of this paper is to describe the clinical presentation of a variant of Pai Syndrome including a novel ocular finding.
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Affiliation(s)
| | - R. El Yafawi
- **Medical Education Department, Hamad Medical Corporation, Doha, Qatar
| | - F. Zakri
- **Medical Education Department, Hamad Medical Corporation, Doha, Qatar
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Hayashi T, Haba R, Kushida Y, Kadota K, Katsuki N, Bando K, Miyai Y, Shibuya S, Matsunaga T. Cytopathologic characteristics and differential diagnostic considerations of neuroglial heterotopia of the retropharyngeal space. Diagn Cytopathol 2011; 39:857-61. [PMID: 21994200 DOI: 10.1002/dc.21575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 09/22/2010] [Indexed: 11/06/2022]
Abstract
Neuroglial heterotopias (NGH) are rare congenital head and neck lesions composed of differentiated neuroectodermal tissue and representing developmental heterotopias rather than true neoplasms. The case of a male neonate with respiratory distress and early feeding problems depicting a retropharyngeal space mass which in the intraoperative squash smears revealed glial cells with multiple cytoplasmic processes is reported here. Small clusters of cuboidal epithelial cells with rosette-like ependymal structures and cuboidal cells arranged in sheets or branching folds suggestive of choroid plexus cells were also identified. Through this cytological approach a cytologic diagnosis of a NGH or low-grade astrocytoma was suggested. Further evaluation and immunohistochemical studies were conducted on formalin-fixed, paraffin-embedded material. Glial cells, ependymal structures and choroid plexus were identified on H&E sections. Immunohistochemically, the glial cells showed diffuse and strong cytoplasmic staining for glial fibrillary acidic protein (GFAP) and S-100 protein and focal immunoreactivity for synaptophysin and neurofilament. The proliferative index with MIB-1 was around 4%. The diagnosis of NGH of the retropharyngeal space was confirmed based on the clinical, cytopathologic, histopathology, immunohistochemical results, and the location of the tumor. We demonstrated here for the first time the cytopathological features of NGH of the retropharyngeal space with emphasis on differential diagnostic considerations.
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Affiliation(s)
- Toshitetsu Hayashi
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
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Ajose-Popoola O, Lin HW, Silvera VM, Teot LA, Madsen JR, Meara JG, Rahbar R. Nasal glioma: prenatal diagnosis and multidisciplinary surgical approach. SKULL BASE REPORTS 2011; 1:83-8. [PMID: 23984207 PMCID: PMC3743595 DOI: 10.1055/s-0031-1284210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Accepted: 04/22/2011] [Indexed: 11/01/2022]
Abstract
Nasal gliomas are congenital, nonmalignant rests of neuroglial tissue that typically present as a craniofacial mass. The differential diagnosis of such masses includes lesions that often require the involvement of various surgical subspecialties, including otolaryngology, neurosurgery, plastic surgery, and ophthalmology. Early surgical excision of these masses is advised to minimize nasal and craniofacial distortion. Accordingly, early diagnosis and management planning are paramount, and advances in prenatal imaging are creating a new role for obstetricians and radiologists in the initiation of diagnostic and therapeutic interventions. We describe the case history of a young patient found to have a craniofacial mass on routine prenatal ultrasound and subsequently managed with a multidisciplinary team approach.
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Francis HW, Nager GT, Holliday MJ, Long DM. Association of heterotopic neuroglial tissue with an arachnoid cyst in the internal auditory canal. Skull Base Surg 2011; 5:37-49. [PMID: 17171156 PMCID: PMC1661786 DOI: 10.1055/s-2008-1058949] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
An arachnoid cyst arising within the internal auditory canal, or within the cerebellopontine angle and subsequently extending into the internal meatus and enlarging it, is a rare occurrence. Nevertheless, the neurootologist and the neurosurgeon have an interest in its existence because its clinical manifestations are identical with the ones produced by a schwannoma, involving overwhelmingly the cochleovestibular nerve in that region. An equally rare observation in that location is the presence of ectopic neuroglial tissue. The two can occur independently or in combination. Examples of such lesions are presented, and their possible pathogenesis is discussed.
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19
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Vaccarella F, Pini Prato A, Fasciolo A, Pisano M, Carlini C, Seymandi PL. Phenotypic variability of Pai syndrome: report of two patients and review of the literature. Int J Oral Maxillofac Surg 2008; 37:1059-64. [PMID: 18657395 DOI: 10.1016/j.ijom.2008.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 02/02/2008] [Accepted: 06/02/2008] [Indexed: 10/21/2022]
Abstract
Pai syndrome is a rare form of frontonasal dysplasia, first described in 1987. It is a triad consisting of midline cleft of the upper lip, facial skin polyps and central nervous system lipomas. Only 14 cases have been reported in the literature. The authors describe the clinical features, diagnostic workup and treatment of two patients. A review of all cases reported in literature is presented to show the phenotypic variability of this rare syndrome.
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Affiliation(s)
- F Vaccarella
- Department of Pediatric Surgery, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Ospedale Infantile, Spalto Marengo, Alessandria, Italy
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20
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Tornero Patricio S, Santano Gallinato M, Granero Asencio M, López Sanz A, Durán de Vargas LE. [Dacryocystocele with nasal mucocele causing neonatal respiratory distress]. An Pediatr (Barc) 2008; 68:410-1. [PMID: 18394395 DOI: 10.1157/13117722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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21
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Abstract
Midline congenital abnormalities of the skin may be related to subjacent visceral developmental defects. We report on three unrelated children presenting a small midline pit on the bridge of the nose from which a small tuft of hair was emerging. This presentation is the hallmark of a nasal dermoid sinus cyst. In one of the patients the sinus tract was connected to the anterior cerebral fossa and required neurosurgical management. Although midline cutaneous abnormalities may look trivial, dermatologists should keep a high index of suspicion for possible association with more severe underlying defect. The diagnosis of nasal dermoid sinus cyst requires appropriate imaging studies to determine the extension of the sinus tract thus allowing proper management.
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Affiliation(s)
- Stefano Cambiaghi
- Istituto di Scienze Dermatologiche, Università di Milano, Milan, Italy.
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22
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Castori M, Rinaldi R, Bianchi A, Caponetti A, Assumma M, Grammatico P. Pai syndrome: First patient with agenesis of the corpus callosum and literature review. ACTA ACUST UNITED AC 2007; 79:673-9. [PMID: 17803202 DOI: 10.1002/bdra.20392] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Pai syndrome (PS) is a rare regional developmental defect of the face, mainly characterized by the variable association of midline cleft of the upper lip (MCL), duplicated maxillary median frenulum, and midline facial cutaneous and midanterior alveolar process polyps. Its entire clinical spectrum is still poorly delineated and the etiology remains unknown. CASE We describe a 1-month-old boy presenting with MCL, left nostril hamartomatous mass, midline pedunculated polyp originating from the columella base, midline alveolar cleft, duplication of the upper median frenulum, unilateral persistent papillary membrane, lipoma of the corpus callosum, and additional minor facial dysmorphism. This patient also presents with agenesis of the corpus callosum, which has never been reported in PS. Literature review was carried out comparing clinical data of the 20 previously published patients with those observed in the present case. CONCLUSIONS The minimum diagnostic criteria for PS has been fixed in one or more hamartomatous nasal polyps plus MCL (with or without cleft alveolus) and/or midanterior alveolar process congenital polyp. Additional common ancillary findings include duplicated median maxillary frenulum, hypertelorism, nasal cleft, midfrontal skin tags, and ocular and CNS structural abnormalities. However, mental retardation is only an occasional feature and seems to be related to coexisting conditions (such as chromosome imbalance). Literature review shows that PS is etiologically heterogeneous, as it may result from chromosome abnormalities and environmental/stochastic events, as well as de novo mutations.
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Affiliation(s)
- Marco Castori
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, Rome, Italy.
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23
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Sreetharan V, Kangesu L, Sommerlad BC. Atypical congenital dermoids of the face: a 25-year experience. J Plast Reconstr Aesthet Surg 2007; 60:1025-9. [PMID: 17662465 DOI: 10.1016/j.bjps.2006.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2006] [Revised: 09/27/2006] [Accepted: 12/18/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To review the presentation and management of nasal and other facial dermoid cysts and sinuses (excluding external angular dermoids). We report on 28 patients with less common facial dermoids. They presented as a cyst, sinus or both and may be separated into four groups. Group 1 (18 cases) were in the midline on the nose and many (12) had extensions to the septum but only two to the skull base. Group 2 (two cases) were paramedian nasal lesions and one extended through the nasal bones. Group 3 were lesions around the medial orbital wall, and two of these had tracts extending into the orbit. Group 4 were a miscellaneous group of lesions on the cheek and lips. We observed that preoperative imaging, although useful and done mainly for medico-legal reasons, may not detect deep extensions and therefore surgeons should be prepared for a more involved procedure when removing atypical facial dermoids.
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Affiliation(s)
- V Sreetharan
- St Andrew's Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK.
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24
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Hedlund G. Congenital frontonasal masses: developmental anatomy, malformations, and MR imaging. Pediatr Radiol 2006; 36:647-62; quiz 726-7. [PMID: 16532348 DOI: 10.1007/s00247-005-0100-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2005] [Revised: 12/06/2005] [Accepted: 12/12/2005] [Indexed: 10/24/2022]
Abstract
The newborn, infant, or young child who presents with a midline frontonasal mass often poses a diagnostic challenge to the clinician. The most pressing issue is whether the mass extends intracranially. The development of the frontonasal region or anterior neuropore is complex. Aberrant embryogenesis leads to three main types of anomalies: nasal dermal sinus, anterior cephalocele, and nasal glioma. Understanding the developmental anatomy of the anterior neuropore and postnatal maturation will serve the radiologist well when it comes to imaging frontonasal masses. Pitfalls particularly common to CT imaging interpretation include the evolving ossification of the frontal, nasal and ethmoid bones in the first year of life, morphology and size of the foramen cecum, and the natural intumescence of the anterior nasal septum. Determination of the presence of a connection between the frontonasal mass and the anterior cranial fossae is crucial in the imaging assessment and clinical management. In the case of the nasal dermal sinus, failure to appreciate the intracranial components of the malformation can lead to fatal meningitis. MR imaging is the modality of choice for assessing the pediatric frontonasal region. Its advantages include multiplanar imaging, distinguishing the interface among cartilage, bone, brain and fluid, diffusion imaging to detect epidermoid tumors, and the capacity to evaluate the brain for associated cerebral anomalies.
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Affiliation(s)
- Gary Hedlund
- Department of Medical Imaging, Primary Children's Medical Center, Salt Lake City, UT 84113, USA.
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25
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Mathew PJ, Gombar KK. Neonatal nasal polypectomy -- consequence of nasal packing. Acta Anaesthesiol Scand 2006; 50:522-3. [PMID: 16548875 DOI: 10.1111/j.1399-6576.2005.00892.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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26
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Hanikeri M, Waterhouse N, Kirkpatrick N, Peterson D, Macleod I. The management of midline transcranial nasal dermoid sinus cysts. ACTA ACUST UNITED AC 2005; 58:1043-50. [PMID: 16084501 DOI: 10.1016/j.bjps.2005.05.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2004] [Accepted: 05/24/2005] [Indexed: 10/25/2022]
Abstract
The most common congenital midline nasal masses are nasal dermoid sinus cysts (NDSC) [Hughes GB, Sharpino G, Hunt W, Tucker HM. Management of the congenital midline nasal mass--a review. Head Neck Surg 1980;2:222-33.]. Their clinical importance hinges on their potential to communicate with the central nervous system. Preoperative diagnosis of an intracranial extension allows for referral to a craniofacial team with the appropriate skills and experience for a transcranial approach. All patients with a NDSC require imaging with high resolution multiplanar MRI scans and complimentary fine cut CT scan to reveal the anatomical extent of the tract and its relationship to the anterior cranial fossa. A single-stage craniofacial approach to resection of midline NDSC extending to the anterior cranial base is effective with minimal morbidity [Yavuzer R, Bier U, Jackson IT. Be careful: it might be a nasal dermoid cyst. Plast Reconstr Surg 1999;103:2082-3; Denoyelle F, Ducroz V, Roger G, Garabedian EN. Nasal dermoid sinus cysts in children. Laryngoscope 1997;107:795-800; Rohrich RJ, Lowe JB, Schwartz MR. The role of open rhinoplasty in the management of nasal dermoid cysts. Plast Reconstr Surg 1999;104:2163-70; Rahbar R, Shah P, Mulliken JB, et al. The presentation and management of nasal dermoid-a 30-year experience. Arch Otolaryngol Head Neck Surg 2003;129:464-71; Posnick JC, Bortoluzzi P, Armstrong DC, Drake JM. Intracranial nasal dermoid sinus cysts: computed tomographic scan findings and surgical results. Plast Reconstr Surg 1994;93:745-54 [discussion 755-56]; Bartlett SP, Lin KY, Grossman R, Kratowitz J. The surgical management of orbitofacial dermoids in the pediatric patient. Plast Reconstr Surg 1993;91:1208-15.]. The cyst and tract are accessed through a combination of a nasal and transcranial approach. This allows visualisation and dissection of the tract with only a small incision on the nasal dorsum to include the cutaneous punctum when present. Transnasal endoscopic techniques have been advocated where the dermoid is located within the nasal cavity and there is little or no cutaneous involvement [Weiss DD, Robson CD, Mulliken JB. Transnasal endoscopic excision of midline nasal dermoid from the anterior cranial base. Plast Reconstr Surg 1998;101:2119-23.]. We present a review of five cases referred to our unit between 1999 and 2004 with a diagnosis of a midline nasal dermoid sinus cyst and radiological evidence of intracranial communication. All cases had a communication with the anterior cranial fossa diagnosed preoperatively and were treated surgically with a craniofacial approach. An intracranial extension was identified at operation in each case and this was confirmed on histopathology. The only significant complication resulted from an early postoperative infection, requiring re-operation. There were no recurrences and acceptable aesthetic outcomes have been observed in all cases.
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Affiliation(s)
- M Hanikeri
- Department of Craniofacial Surgery, Chelsea and Westminster Hospital, Chelsea, London SW10 9NH, UK.
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27
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Aguilar Mandret F, Oliva Izquierdo MT, Vallés Fontanet J. [Nasal glioma]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2005; 55:346-50. [PMID: 15554592 DOI: 10.1016/s0001-6519(04)78535-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Congenital midline nasal masses are rare and therefore easily misdiagnosed, but due to their possible complications, they require prompt diagnosis and management. In this article we review the three most common: dermoid cyst, glioma and encephalocele. Their tendency to have a similar presentation requires very good skills in taking the history and performing the physical exam as well as an adequate radiologic diagnosis including CT, MRI or both. It is very important that we always consider them to avoid taking a biopsy.
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28
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Chau HN, Hopkins C, McGilligan A. A rare case of nasal glioma in the sphenoid sinus of an adult presenting with meningoencephalitis. Eur Arch Otorhinolaryngol 2005; 262:592-4. [PMID: 15729549 DOI: 10.1007/s00405-004-0808-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2003] [Accepted: 03/30/2004] [Indexed: 11/25/2022]
Abstract
Nasal gliomas are rare embryologic development defects that commonly present shortly after birth. Very few cases have ever been reported in adults. Of those presenting in adult life, most were casual findings in patients with no symptoms. Rare localizations have been described in the nasopharynx, soft palate, orbital cave and scalp. We present an unusual case of a 56-year-old man who initially presented with meningoencephalitis and was found to have nasal glioma in the sphenoid sinus. Having discussed their embryology and histology, we conclude that MRI scanning is the preferred method of investigation. However, radiological evaluation preoperatively should not lead to any sense of security if no bony defect (and thus, the possibility of intracranial extension) is demonstrated. Extirpation via a functional surgical approach is the treatment of choice to prevent deformities in the facial bones. This can range from direct incision over the gliomata to removal transnasally by endoscopy or using a lateral rhinotomy approach depending on the location, size and involvement of the glioma.
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29
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Abstract
Encephaloceles consist of heterotopic brain tissue that remains connected to the central nervous system. As such, these lesions can occur anywhere along the midline of the head, neck, and back. The clinical findings associated with an encephalocele are often cutaneous, prompting consultation with a dermatologist. Although abnormalities of the skin overlying the spinal cord are readily recognized by our specialty as markers for dysraphism, head and neck lesions may present a diagnostic challenge. We describe a case of an anterior encephalocele to increase awareness of this disorder and to emphasize the clinical findings that will assist with diagnosis. Our case is of particular interest because of the parasagittal location of the facial nodules and minimal actual midline involvement.
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Affiliation(s)
- Mary Grace Petrick
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania 17822, USA.
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30
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Affiliation(s)
- Santiago Restrepo
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
| | - Felipe Martínez
- Department of Otorhinolaryngology, Universidad Javeriana, Bogota, Colombia
| | - Alfredo Herrera
- Department of Otorhinolaryngology, Universidad Javeriana, Bogota, Colombia
| | - Enrique Palacios
- Department of Radiology, Louisiana State University Health Sciences Center, New Orleans
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31
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Huisman TAGM, Schneider JFL, Kellenberger CJ, Martin-Fiori E, Willi UV, Holzmann D. Developmental nasal midline masses in children: neuroradiological evaluation. Eur Radiol 2004; 14:243-9. [PMID: 12904880 DOI: 10.1007/s00330-003-2008-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2002] [Revised: 05/27/2003] [Accepted: 06/20/2003] [Indexed: 12/14/2022]
Abstract
Developmental nasal midline masses in children are rare lesions. Neuroimaging is essential to characterise these lesions, to determine the exact location of the lesion and most importantly to exclude a possible intracranial extension or connection. Our objective was to evaluate CT and MRI in the diagnosis of developmental nasal midline masses. Eleven patients (mean age 4.5 years) with nasal midline masses were examined by CT and MRI. Neuroimaging was evaluated for (a) lesion location/size, (b) indirect (bifid or deformed crista galli, widened foramen caecum, defect of the cribriform plate) and direct (identification of intracranially located lesion components or signal alterations) imaging signs of intracranial extension, (c) secondary complications and (d) associated malformations. Surgical and histological findings served as gold standard. Nasal dermoid sinus cysts were diagnosed in 9 patients. One patient was diagnosed with an meningocele and another patient with a nasal glioma. Indirect CT and MRI signs correlated with the surgical results in 10 of 11 patients. Direct CT findings correlated with surgery in all patients, whereas the direct MRI signs correlated in 9 of 11 patients. In 2 patients MRI showed an intracranial signal alteration not seen on CT. Neuroimaging corrected the clinical diagnosis in 1 patient. One child presented with a meningitis. In none of the patients was an associated malformation diagnosed. Intracranial extension is equally well detected by CT and MRI using indirect imaging signs. Evaluating the direct imaging signs, MRI suspected intracranial components in 2 patients without a correlate on CT. This could represent an isolated intracranial component that got undetected on CT and surgery. In 9 patients CT and MRI matched the surgical findings. The MRI did not show any false-negative results. These results in combination with the multiplanar MRI capabilities, the different image contrasts that can be generated by MRI and the lack of radiation favour the use of MRI as primary imaging tool in these young patients in which the region of imaging is usually centred on the radiosensitive eye lenses.
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Affiliation(s)
- Thierry A G M Huisman
- Department of Radiology and Magnetic Resonance, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
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32
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Karagama YG, Howarth K, Steel PRM, Spencer MG. Lobular capillary haemangioma of the nasal vestibule: a rare entity. Int J Pediatr Otorhinolaryngol 2002; 66:71-5. [PMID: 12363425 DOI: 10.1016/s0165-5876(02)00207-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The authors report a case of an 8-year-old boy with lobular capillary haemangioma (LCH) of the nasal vestibule presenting with nasal blockage, nasal discharge and epistaxis. LCH of the nasal vestibule is rarely reported in the English literature, and the authors feel that it should be considered in the differential diagnosis of lesion of the nasal vestibule. Unnecessary investigations could be avoided if its diagnosis is considered, especially in children.
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Affiliation(s)
- Y G Karagama
- Department of Otolaryngology, Countess of Chester Hospital, Chester, UK.
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33
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34
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35
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Al-Mazrou KA, Al-Rekabi A, Alorainy IA, Al-Kharfi T, Al-Serhani AM. Pai syndrome: a report of a case and review of the literature. Int J Pediatr Otorhinolaryngol 2001; 61:149-53. [PMID: 11589982 DOI: 10.1016/s0165-5876(01)00555-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pai syndrome is a rare congenital disorder first described in 1987. The main clinical features of the syndrome include median cleft of the upper lip, intra-cranial lipoma, and cutaneous polyps. Only four cases have been described previously. This is the fifth who is a twin of Arabian descent to be reported. Full description of the clinico-pathological features and a review of the relevant medical literature is presented. To the best of our knowledge, this is the first case of Pai syndrome in a twin in the English literature.
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Affiliation(s)
- K A Al-Mazrou
- Department of Otolaryngology, King Abdul Aziz University Hospital, PO Box 245, 11411, Riyadh, Saudi Arabia.
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36
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Bilkay U, Gundogan H, Ozek C, Tokat C, Gurler T, Songur E, Cagdas A. Nasal dermoid sinus cysts and the role of open rhinoplasty. Ann Plast Surg 2001; 47:8-14. [PMID: 11756796 DOI: 10.1097/00000637-200107000-00002] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
All suspected congenital abnormalities of the nose require further evaluation. The nasal dermoid sinus cyst (NDSC) is one of the many midline nasal masses that often pose diagnostic and treatment dilemmas for the plastic and reconstructive surgeon. NDSCs are distinct from other facial dermoids in their potential for involving deeper contiguous structures, and intracranial extension. Accurate diagnosis and effective treatment are essential to avoid craniofacial skeletal deformation, cyst rupture, and infection that could cause cutaneous, ocular, or intracranial complications. A comprehensive discussion of the embryogenesis, pathogenesis, diagnosis, and surgical management of the NDSC is presented to delineate the role of open rhinoplasty in optimizing the management of this congenital nasal deformity.
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Affiliation(s)
- U Bilkay
- Department of Plastic and Reconstructive Surgery, Ege University, Izmir, Turkey
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37
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Ozek C, Gundogan H, Bilkay U, Cankayali R, Guner U, Tokat C, Songur E, Akin Y, Cagdas A. A case of total nasal agenesis accompanied by Tessier no. 30 cleft. Ann Plast Surg 2001; 46:663-4. [PMID: 11405380 DOI: 10.1097/00000637-200106000-00027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Kim DW, Low W, Billman G, Wickersham J, Kearns D. Chondroid hamartoma presenting as a neonatal nasal mass. Int J Pediatr Otorhinolaryngol 1999; 47:253-9. [PMID: 10321780 DOI: 10.1016/s0165-5876(98)00121-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We present a case of a 3-month-old female with a right nasal mass. Upon evaluation with computed tomography, magnetic resonance imaging and angiography, a large right intranasal mass extending through the cribiform plate, displacing the dura, was noted. The patient underwent a combined midfacial degloving and bifrontal craniotomy for complete resection of the tumor mass. Pathologic evaluation demonstrated a mesenchymal tumor with spindle and stellate cells from which islands of immature cartilage emerged. The spectrum of histologic features closely resembled a mesenchymal chondroid hamartoma typically located in the chest wall. It is the first reported case of a chondroid hamartoma of the head and neck in the literature to date. We examine the characteristics and treatment of this unusual tumor.
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Affiliation(s)
- D W Kim
- Division of Otolaryngology, UCSD Medical Center, San Diego, CA 92103-8895, USA
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39
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Niederhagen B, Reich RH, Zentner J. Temporal dermoid with intracranial extension: report of a case. J Oral Maxillofac Surg 1998; 56:1352-4. [PMID: 9820226 DOI: 10.1016/s0278-2391(98)90622-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- B Niederhagen
- Department of Maxillofacial Surgery, University of Bonn, Germany
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40
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Pasquini E, Farneti G, Giausa G, Biavati M. A rare case of nasal glioma in adult age. Otolaryngol Head Neck Surg 1998; 118:905-6. [PMID: 9627265 DOI: 10.1016/s0194-5998(98)70297-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- E Pasquini
- Department of Otolaryngology, University of Bologna, Italy
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41
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Affiliation(s)
- R Howard
- Division of Pediatric Dermatology, Children's Hospital Oakland, CA 94609, USA
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42
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Abstract
Thirty-six children with nasal dermoid sinus cysts were treated in the Department Pediatric Otolaryngology, Armand Trousseau's Children's Hospital (Paris, France) between 1974 and 1994. Ten of the patients presented with a midline cyst only, eight had nasal pits only, and 18 had combined cases. In six of the 36 patients, presurgical imagery indicated signs of intracranial extension of the tract, reaching the foramen caecum without intracranial mass. Three surgical techniques were used: an external rhinoplasty approach with medial crura section in 23 cases, a direct median approach in seven cases, and a paracanthal approach in six cases. Only two cases had meningeal adherences. Two superficial recurrences occurred within the 7-year follow-up period. Widening of the scar occurred in four children after verticomedian approach or nasal pit excision. The external rhinoplasty procedure with medial crura section results in a wide surgical approach, low recurrence rate, and good aesthetic results.
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Affiliation(s)
- F Denoyelle
- Department of Pediatric Otolaryngology and Head and Neck Surgery, Armand Trousseau's Children's Hospital, Paris, France
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43
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Nocini PF, Barbaglio A, Dolci M, Salgarelli A. Dermoid cyst of the nose: a case report and review of the literature. J Oral Maxillofac Surg 1996; 54:357-62. [PMID: 8600248 DOI: 10.1016/s0278-2391(96)90761-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- P F Nocini
- University Department of Oral and Maxillofacial Surgery, Verona, Italy
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44
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Abstract
Hairy polyp of the nasopharynx is an unusual but well-recognized entity, generally presenting as a single mass at birth or in the first year of life. We describe the clinico-pathological features of a previously unreported bilateral hairy polyp in an adult and briefly discuss the pathogenesis of this condition.
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Affiliation(s)
- V Franco
- Istituto di Anatomia, Università degli Studi di Palermo, Italy
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45
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Kapadia SB, Janecka IP, Fernandes S, Curtin H, Pollack I. Lateral basal Encephalocele of the Infratemporal Fossa. Otolaryngol Head Neck Surg 1996; 114:116-9. [PMID: 8570231 DOI: 10.1016/s0194-59989670296-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- S B Kapadia
- Department of Pathology, Presbyterian University Hospital, PA 15213-2582, USA
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 14-1995. A 12-year-old boy with progressive nasal obstruction. N Engl J Med 1995; 332:1285-91. [PMID: 7708074 DOI: 10.1056/nejm199505113321908] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Paoli C, François M, Triglia JM, Frydman E, Polonovski JM, Narcy P. Nasal obstruction in the neonate secondary to nasolacrimal duct cysts. Laryngoscope 1995; 105:86-9. [PMID: 7837921 DOI: 10.1288/00005537-199501000-00019] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- C Paoli
- Department of Pediatric Otolaryngology, Robert Debré Hospital, Paris, France
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