1
|
Langdon C, Hinojosa-Bernal J, Munuera J, Gomez-Chiari M, Haag O, Veneri A, Valldeperes A, Valls A, Adell N, Santamaria V, Cruz-Martinez O, Morales-La Madrid A. 3D printing as surgical planning and training in pediatric endoscopic skull base surgery - Systematic review and practical example. Int J Pediatr Otorhinolaryngol 2023; 168:111543. [PMID: 37062166 DOI: 10.1016/j.ijporl.2023.111543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND Pediatric endoscopic skull base surgery is challenging due to the intricate anatomy of the skull base and the presence of tumors with varied pathologies. The use of three-dimensional (3D) printing technologies in skull base surgeries has been found to be highly beneficial. A systematic review of the literature was performed to investigate the published studies that reported the effectiveness of 3D printing in pediatric endoscopic skull base surgery. METHODS Pub Med, Embase, Science Direct, The Cochrane Library, and Scopus were searched from January 01, 2000, until June 30, 2022. Original articles of any design reporting on the effectiveness of 3D printing in pediatric endoscopic skull base surgery were included. Information related to study population, conditions, models used, and key findings of study were extracted. Quality of included studies was evaluated using the Joanna Briggs Institute's (JBI) Critical Appraisal Checklist for Studies. To exemplify the use of 3D technology in this scenario, we report a complex clival chordoma case. RESULTS Six research articles were retrieved and included for qualitative analysis. Four of the six studies were conducted in the United States, followed by two in China. According to these studies, 3D reconstruction and printed models were more beneficial than CT/MRI images when discussing surgery with patients. In clinical training, these models were more helpful than 2D images in understanding the pathology when used in conjunction with image-guiding systems. It has been found that patient-specific 3D modeling, simulations, and rehearsal are the most efficient preoperative planning techniques, particularly in the pediatric population, for the treatment of complicated skull base surgeries. All the studies had a moderate risk of bias. CONCLUSION 3D printing technologies assist in printing complex skull base tumors and the structures around them in three dimensions at the point of care and at the time needed, enabling the choice of the appropriate surgical strategy, thus minimizing surgery-related complications.
Collapse
Affiliation(s)
- Cristóbal Langdon
- Department of Pediatric Otorhinolaryngology, Hospital Sant Joan de Deu, Barcelona, Spain.
| | - José Hinojosa-Bernal
- Department of Pediatric Neurosurgery, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Josep Munuera
- Imatge Diagnòstica i Terapéutica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Department of Pediatric Radiology, Hospital Sant Joan de Déu, Barcelona, Spain; 3D4H unit, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Marta Gomez-Chiari
- Imatge Diagnòstica i Terapéutica, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Oliver Haag
- Department of Pediatric Otorhinolaryngology, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Antonio Veneri
- Department of Pediatric Otorhinolaryngology, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Ariadna Valldeperes
- Department of Pediatric Otorhinolaryngology, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Arnau Valls
- 3D4H unit, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Nuria Adell
- 3D4H unit, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Vicente Santamaria
- Department of Pediatric Oncology, Hospital Sant Joan de Deu, Barcelona, Spain
| | | | | |
Collapse
|
2
|
Rojas-Lechuga MJ, Remacha J, González-Sánchez N, Grau JJ, Castillo P, Haag O, Vilaseca I. Juvenile recurrent respiratory papillomatosis treated with combined erlotinib and celecoxib: Initial report. Int J Pediatr Otorhinolaryngol 2020; 137:110194. [PMID: 32658799 DOI: 10.1016/j.ijporl.2020.110194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/07/2020] [Accepted: 06/10/2020] [Indexed: 11/18/2022]
Abstract
Recurrent respiratory papillomatosis (RRP) is a chronic disease caused by human papillomavirus (HPV). RRP is a clinical challenge because of the high recurrence rate, poor surgery response, extension to tracheobronchial tree and because of the risk of malignancy in some cases. There is no consensus on which adjuvant therapy is better for those patients with highly recurrent course. Because papilloma cells overexpress the epidermal growth factor receptor (EGFR), together with an increased expression of COX-2 and prostaglandin E2, the combination of erlotinib and celecoxib seems plausible, and could be proposed for patients with poor response to previous lines of treatment.
Collapse
Affiliation(s)
| | - Joan Remacha
- Otorhinolaryngology Department Hospital Clinic, Barcelona, Spain
| | | | - Juan José Grau
- Medical Oncology Department, Hospital Clinic, Barcelona, Spain; IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Paola Castillo
- Pathology Department, Hospital Clinic, Barcelona, Spain; IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Oliver Haag
- Otorhinolaryngology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Isabel Vilaseca
- Otorhinolaryngology Department Hospital Clinic, Barcelona, Spain; IDIBAPS, University of Barcelona, Barcelona, Spain
| |
Collapse
|
3
|
Mariño-Sanchez F, Valls-Mateus M, Haag O, Alobid I, Bousquet J, Mullol J. Smell loss is associated with severe and uncontrolled disease in children and adolescents with persistent allergic rhinitis. J Allergy Clin Immunol Pract 2018; 6:1752-1755.e3. [PMID: 29426750 DOI: 10.1016/j.jaip.2017.12.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 12/16/2017] [Accepted: 12/19/2017] [Indexed: 02/08/2023]
Affiliation(s)
- Franklin Mariño-Sanchez
- Rhinology Unit, Otorhinolaryngology Department, University Hospital Ramón y Cajal, Madrid, Spain; Pediatric Otorhinolaryngology Department, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain; Clinical and Experimental Respiratory Immunoallergy (IRCE), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain.
| | - Meritxell Valls-Mateus
- Clinical and Experimental Respiratory Immunoallergy (IRCE), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain; Rhinology Unit and Smell Clínic, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Oliver Haag
- Pediatric Otorhinolaryngology Department, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Isam Alobid
- Clinical and Experimental Respiratory Immunoallergy (IRCE), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain; Rhinology Unit and Smell Clínic, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Jean Bousquet
- INSERM U 1168, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, Montigny le Bretonneux, France
| | - Joaquim Mullol
- Clinical and Experimental Respiratory Immunoallergy (IRCE), August Pi i Sunyer Biomedical Research Institute (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain; Rhinology Unit and Smell Clínic, Hospital Clínic, Barcelona, Catalonia, Spain
| |
Collapse
|
4
|
Valls-Mateus M, Marino-Sanchez F, Ruiz-Echevarría K, Cardenas-Escalante P, Jiménez-Feijoo R, Blasco-Lozano J, Giner-Muñoz MT, Haag O, Alobid I, Plaza Martin AM, Mullol J. Nasal obstructive disorders impair health-related quality of life in adolescents with persistent allergic rhinitis: A real-life study. Pediatr Allergy Immunol 2017; 28:438-445. [PMID: 28423474 DOI: 10.1111/pai.12724] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND We previously reported a higher prevalence of nasal obstructive disorders (NOD) in pediatric patients with persistent allergic rhinitis (PER) not responding to medical treatment. The aim of this study was to determine the impact of NOD on quality of life (QoL) in this population. METHODS Real-life prospective study including 142 patients (41 children, 6-11 years old and 101 adolescents, 12-17 years old) with moderate and severe PER. After 2 months of medical treatment (intranasal steroids and antihistamines), patients were asked whether their symptoms had improved (yes/no) and classified accordingly in R, responders and NR, non-responders. Nasal symptoms (visual analog scale, VAS), NOD (nasal endoscopy), and QoL (PRQLQ, AdolQRLQ) were also assessed. RESULTS Sixty-nine adolescents and 24 children were included in the NR group. NR presented worse QoL overall scores in adolescents (3.16±1.1 vs 1.63±0.99; P=.00001) and children (2.19±0.82 vs 1.51±0.77, P=.02). Medical treatment failure was associated with worse outcomes in QoL (adolescents OR: 1.6, P<.0001; children OR: 1.04, P=.036). Female adolescents presented worse QoL scores than males (3.19 vs 2.36, P=.001). The presence of obstructive septal deviation (OR: 1.02, P=.005), obstructive turbinate hyperplasia (OR: 1.03, P=.0006), and coexistence of both (OR=2.06, P=.001) was associated with worse QoL in adolescents. A strong and highly significant correlation was found between nasal symptoms VAS and QoL. CONCLUSION The presence of NOD, particularly in adolescents, is associated with poor QoL outcomes. Assessment of NOD in pediatric PER should be considered an essential approach to determine the response to treatment and its impact on patient's QoL.
Collapse
Affiliation(s)
- Meritxell Valls-Mateus
- Unitat de Rinologia Pediàtrica, Otorhinolaringology Department, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain.,Unitat de Rinologia i Clínica de l'Olfacte, Otorhinolaringology Department, Hospital Clínic, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain.,Immunoal∙lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Franklin Marino-Sanchez
- Unitat de Rinologia Pediàtrica, Otorhinolaringology Department, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain.,Immunoal∙lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Unidad de Rinología, Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Karen Ruiz-Echevarría
- Sección de Inmunoalergología, Servicio de Pediatría. Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Paulina Cardenas-Escalante
- Unitat de Rinologia Pediàtrica, Otorhinolaringology Department, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Rosa Jiménez-Feijoo
- Sección de Inmunoalergología, Servicio de Pediatría. Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Jaime Blasco-Lozano
- Sección de Inmunoalergología, Servicio de Pediatría. Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - María Teresa Giner-Muñoz
- Sección de Inmunoalergología, Servicio de Pediatría. Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Oliver Haag
- Unitat de Rinologia Pediàtrica, Otorhinolaringology Department, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Isam Alobid
- Unitat de Rinologia i Clínica de l'Olfacte, Otorhinolaringology Department, Hospital Clínic, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain.,Immunoal∙lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Ana María Plaza Martin
- Sección de Inmunoalergología, Servicio de Pediatría. Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Joaquim Mullol
- Unitat de Rinologia i Clínica de l'Olfacte, Otorhinolaringology Department, Hospital Clínic, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain.,Immunoal∙lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| |
Collapse
|
5
|
Mariño-Sánchez F, Valls-Mateus M, Cardenas-Escalante P, Haag O, Ruiz-Echevarría K, Jiménez-Feijoo R, Lozano-Blasco J, Giner-Muñoz MT, Plaza-Martin AM, Mullol J. Influence of nasal septum deformity on nasal obstruction, disease severity, and medical treatment response among children and adolescents with persistent allergic rhinitis. Int J Pediatr Otorhinolaryngol 2017; 95:145-154. [PMID: 28576524 DOI: 10.1016/j.ijporl.2017.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/24/2017] [Accepted: 02/03/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the impact of different types of nasal septum deformity (NSD) on nasal obstruction, rhinitis severity and response to medical treatment among pediatric persistent allergic rhinitis (PER) patients. METHODS In a prospective, real-life study, 150 children and adolescents (mean age 13 ± 2.8 years, females 32.6%) diagnosed with PER according to ARIA guidelines were assessed by nasal endoscopy for NSD according to Mladina's classification, their response to medical treatment (intranasal steroids and antihistamines or antileucotriens), the presence of comorbidities, rhinitis severity (modified-ARIA criterion) and nasal obstruction visual analog scale score (VAS). RESULTS Most patients (87%) had 1 of the 7 types of septal deformities. There was a high prevalence of bilateral (types 4 and 6; 46%) and anterior unilateral (types 1 and 2; 25%) NSD in patients not responding to medical treatment. Type 4 (OR = 6.4; p = 0.005) or type 6 (OR = 4.4; p = 0.03) NSD increased the risk of lack of improvement with medical treatment. Coexistence of anterior unilateral or bilateral NSD with severe turbinate enlargement increased >20-fold the risk of lack of improvement. Patients with bilateral NSD presented greater rhinitis severity. Non-responder adolescents displayed higher prevalence of bilateral NSD than children (53% vs. 23%; p = 0.02). Nasal obstruction VAS was higher for patients with anterior than posterior NSD, and greater for patients with bilateral NSD than any other type of septal morphology. CONCLUSION Nasal endoscopy shows that bilateral and unilateral anterior nasal septum deformities are strongly associated with a poor response to medical treatment, greater rhinitis severity and higher nasal obstruction VAS. Consequently, nasal endoscopy is necessary in the PER patients to understand the disease severity as well as to plan a specific surgical treatment in order to improve nasal obstruction, disease severity, and patient's quality of life.
Collapse
Affiliation(s)
- Franklin Mariño-Sánchez
- Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain; Unidad de Rinología, Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Immunoal lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain.
| | - Meritxell Valls-Mateus
- Immunoal lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain; Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain
| | | | - Oliver Haag
- Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Karen Ruiz-Echevarría
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Rosa Jiménez-Feijoo
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jaime Lozano-Blasco
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - María T Giner-Muñoz
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ana M Plaza-Martin
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Joaquim Mullol
- Immunoal lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain; Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain.
| |
Collapse
|
6
|
Mariño-Sánchez FS, Valls-Mateus M, Ruiz-Echevarría K, Alobid I, Cardenas-Escalante P, Jiménez-Feijoo R, Lozano-Blasco J, Giner-Muñoz MT, Rodríguez-Jorge J, Haag O, Plaza-Martin AM, Mullol J. Nasal obstructive disorders induce medical treatment failure in paediatric persistent allergic rhinitis (The NODPAR Study). Pediatr Allergy Immunol 2017; 28:176-184. [PMID: 27801958 DOI: 10.1111/pai.12679] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) is the most common chronic disease among children. To characterize the disease, a modified classification of severity (m-ARIA) has recently been validated in AR children. When medical treatment fails, surgery for nasal obstructive disorders (NOD) may be a therapeutic option. Our objective was to assess the prevalence of NOD and their influence in medical treatment response among children with persistent AR (PER). METHODS In a prospective, real-life study, 130 paediatric PER patients (13.1 ± 2.8 years, females 31.5%, severe rhinitis 49%) referred from Allergy to ENT department were assessed for their response (R, responders; NR, non-responders) to medical treatment (intranasal steroids and antihistamines or antileukotrienes) by direct questioning and nasal symptom visual analogue scale, the presence of NOD (septal deformity, turbinate enlargement and adenoidal hyperplasia), comorbidities, nasal symptoms, rhinitis severity (modified ARIA criterion) and asthma control (International Consensus On Pediatric Asthma criterion). RESULTS After 2 months of treatment, the NR group presented a higher prevalence of obstructive septal deformity and severe inferior turbinate enlargement when compared with the R group. Higher septal deformity and turbinate enlargement scores were strongly associated with treatment refractoriness. The prevalence of severe PER was also higher for the NR group. Higher asthma control scores were associated with the probability of treatment-induced improvement. CONCLUSIONS In paediatric PER patients, medical therapy refractoriness was associated with NOD, mainly septal deformity and turbinate enlargement. In those patients, ENT examination will facilitate an early NOD diagnosis in order to indicate potential corrective surgery.
Collapse
Affiliation(s)
- Franklin S Mariño-Sánchez
- Unidad de Rinología Pediátrica, Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain.,Unidad de Rinología, Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain.,Immunoal∙lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. Research Group of Excellence 2014-SGR-748, (Generalitat de Catalunya)
| | - Meritxell Valls-Mateus
- Unidad de Rinología Pediátrica, Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain.,Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Karen Ruiz-Echevarría
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Isam Alobid
- Immunoal∙lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. Research Group of Excellence 2014-SGR-748, (Generalitat de Catalunya).,Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain
| | - Paulina Cardenas-Escalante
- Unidad de Rinología Pediátrica, Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Rosa Jiménez-Feijoo
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Jaime Lozano-Blasco
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - María T Giner-Muñoz
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | | | - Oliver Haag
- Unidad de Rinología Pediátrica, Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ana M Plaza-Martin
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain
| | - Joaquim Mullol
- Immunoal∙lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. Research Group of Excellence 2014-SGR-748, (Generalitat de Catalunya).,Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain
| |
Collapse
|
7
|
Mariño-Sánchez F, Lopez-Chacon M, Jou C, Haag O. Pediatric intranasal lobular capillary hemangioma: Report of two new cases and review of the literature. Respir Med Case Rep 2016; 18:31-4. [PMID: 27144115 PMCID: PMC4840420 DOI: 10.1016/j.rmcr.2016.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 03/21/2016] [Accepted: 03/23/2016] [Indexed: 11/08/2022] Open
Abstract
Background Lobular capillary hemangioma (LCH) is an acquired benign vascular tumor of unknown origin. It usually affects skin and mucous membranes of the oropharynx. It rarely involves the nasal cavity which most commonly manifests as epistaxis. To our knowledge, only fifteen pediatric intranasal LCH cases have been reported in the literature. None of these occurred in the inferior turbinate. We report two new pediatric cases of LCH, one of them on the inferior turbinate and the other one on the anterior nasal septum. Our principal aim was to highlight the importance of considering this lesion as a differential diagnosis for pediatric unilateral nasal obstruction and epistaxis. Methods Retrospective case series and review of current literature regarding the possible causes, diagnosis, and treatment of nasal LCH. Description of cases Two adolescents presented with symptoms of unilateral nasal obstruction and epistaxis. Plain and contrast enhanced computed tomography revealed a well-defined intensely enhancing lesion in both cases. Patients underwent transnasal endoscopic excision and bipolar electrocautery at the base of the tumor for hemostasis. Histopathological examination confirmed the diagnosis of LCH. Discussion Current epidemiological and pathophysiological data suggests that the development of LCH may be associated to previous nasal trauma or endocrine disorders. LCH should be considered in the differential diagnosis of all pediatric endonasal masses associated with unilateral epistaxis and nasal obstruction. Endoscopic total excision with bipolar electrocautery for hemostasis is an appropriate treatment.
Collapse
Affiliation(s)
- Franklin Mariño-Sánchez
- Pediatric Rhinology Unit, Otorhinolaryngology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Mauricio Lopez-Chacon
- Pediatric Rhinology Unit, Otorhinolaryngology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Cristina Jou
- Anatomic Pathology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Oliver Haag
- Pediatric Rhinology Unit, Otorhinolaryngology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| |
Collapse
|
8
|
Sans Capdevila Ó, Wienberg P, Haag O, Cols M. Comorbilidades de los trastornos respiratorios del sueño en los niños. Acta Otorrinolaringológica Española 2010; 61 Suppl 1:26-32. [DOI: 10.1016/s0001-6519(10)71242-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
9
|
Abstract
Rhinoliths are foreign bodies of the nose, which may be found during the course of a routine examination or whe the show, if undetected for a long time, symptoms of nasal obstruction, similar to the ones of sinusitis. They require a high level of suspicion to be diagnosed and surgical removal is the treatment of choice. We present the case of a woman diagnosed of rhinolithiasis and we carry out a literature review.
Collapse
|
10
|
Doménech Juan I, Cisa Lluis E, Nogués Orpí J, Aragón Casas J, Haag O, Dicenta Sousa M. [Retropharyngeal phlegmon in the adult. Presentation of a case]. An Otorrinolaringol Ibero Am 2003; 30:213-220. [PMID: 12784572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Nowadays retropharyngeal phlegmon and abscesses are uncommon. Advances in medical care have changed the morbidity and mortality of this processes. The advance of computed tomography (CT) has made possible a more exact diagnosis of these infections. If CT suggests a cellulitis medical treatment is used, but abscesses need surgical drainnage.
Collapse
|
11
|
Müller M, Haag O, Burgdorff T, Georgopoulos A, Weninger W, Jansen B, Stanek G, Pehamberger H, Agneter E, Eichler HG. Characterization of peripheral-compartment kinetics of antibiotics by in vivo microdialysis in humans. Antimicrob Agents Chemother 1996; 40:2703-9. [PMID: 9124826 PMCID: PMC163607 DOI: 10.1128/aac.40.12.2703] [Citation(s) in RCA: 92] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The calculation of pharmacokinetic/pharmacodynamic surrogates from concentrations in serum has been shown to yield important information for the evaluation of antibiotic regimens. Calculations based on concentrations in serum, however, may not necessarily be appropriate for peripheral-compartment infections. The aim of the present study was to apply the microdialysis technique for the study of the peripheral-compartment pharmacokinetics of select antibiotics in humans. Microdialysis probes were inserted into the skeletal muscle and adipose tissue of healthy volunteers and into inflamed and noninflamed dermis of patients with cellulitis. Thereafter, volunteers received either cefodizime (2,000 mg as an intravenous bolus; n = 6), cefpirome (2,000 mg as an intravenous bolus; n = 6), fleroxacin (400 mg orally n = 6), or dirithromycin (250 mg orally; n = 4); the patients received phenoxymethylpenicillin (4.5 x 10(6) U orally; n = 3). Complete concentration-versus-time profiles for serum and tissues could be obtained for all compounds. Major pharmacokinetic parameters (elimination half-life, peak concentration in serum, time to peak concentration, area under the concentration-time curve [AUC], and AUC/MIC ratio) were calculated for tissues. For cefodizime and cefpirome, the AUCtissue/AUCserum ratios were 0.12 to 0.35 and 1.20 to 1.79, respectively. The AUCtissue/AUCserum ratios were 0.34 to 0.38 for fleroxacin and 0.42 to 0.49 for dirithromycin. There was no visible difference in the time course of phenoxymethylpenicillin in inflamed and noninflamed dermis. We demonstrated, by means of microdialysis, that the concept of pharmacokinetic/pharmacodynamic surrogate markers for evaluation of antibiotic regimens originally developed for serum pharmacokinetics can be extended to peripheral-tissue pharmacokinetics. This novel information may be useful for the rational development of dosage schedules and may improve predictions regarding therapeutic outcome.
Collapse
Affiliation(s)
- M Müller
- Department of Clinical Pharmacology, University of Vienna, Austria
| | | | | | | | | | | | | | | | | | | |
Collapse
|