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Huang AP, Zhang HZ, Cui L, Geng JQ, Wen X, Wang J, Song YL. [Analysis on clinical characteristics, diagnosis and treatment of 13 cases of infant hairy polyp]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:850-854. [PMID: 32911888 DOI: 10.3760/cma.j.cn115330-20200212-00079] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore and analyze the clinical characteristics, diagnosis and treatment of infant hairy polyp. Methods: A retrospective analysis was made on 13 cases of hairy polyp confirmed by pathology, who were admitted to the Children's Hospital of Hebei Province from January 2010 to September 2019, including 4 males and 9 females, with a male-female ratio of 1∶2.25. The age ranged from 3 hours to 1 year, and the median age was 1 month. Twelve of the 13 children were found to have difficulty breathing or feeding. All the children received coblation resection under general anesthesia. The root pedicle of the mass was found in the lateral nasopharyngeal wall in 8 cases, in the junction of palatine and palatopharyngeal arch of tonsil and the tongue and esophageal entrance in 1 case, respectively. Nasal septum was found in 2 cases, including 1 case located between two incisors. The wound at the root pedicle was ablated and the bleeding was stopped completely. Results: Postoperative follow-up lasted from 3 months to 2 years, and there was no recurrence in 12 cases. Fibrolaryngoscope showed a mass of the right eustachian tube and pharyngeal mouth in 1 case 2 years after the surgery, which was considered recurrence of hairy polyps and lost after that. Conclusion: Hairy polyps in infants is a rare clinical disease, and its main symptom is upper respiratory tract obstruction. Early diagnosis and radical surgery are the key to the treatment of the disease.
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Affiliation(s)
- A P Huang
- Department of Otolaryngology, Children's Hospital of Hebei Province, Shijiazhuang 050030, China
| | - H Z Zhang
- Department of Otolaryngology, the Second Hospital of Hebei Medical University, Shijiazhuang 050005, China
| | - L Cui
- Department of Otolaryngology, Children's Hospital of Hebei Province, Shijiazhuang 050030, China
| | - J Q Geng
- Department of Otolaryngology, Children's Hospital of Hebei Province, Shijiazhuang 050030, China
| | - X Wen
- Department of Otolaryngology, Children's Hospital of Hebei Province, Shijiazhuang 050030, China
| | - J Wang
- Department of Otolaryngology, Children's Hospital of Hebei Province, Shijiazhuang 050030, China
| | - Y L Song
- Department of Otolaryngology, Children's Hospital of Hebei Province, Shijiazhuang 050030, China
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Abstract
BACKGROUND Hairy polyps are the most common congenital deformity of the oral-nasopharynx/oral cavity in infants, which may lead to severe complications in the newborns. However, few studies have been published with respect to their radiological features, and most are case reports. OBJECTIVE This study aimed to analyze radiological features of the oral‑nasopharyngeal hairy polyps and to identify the radiological features with the highest diagnostic value. MATERIALS AND METHODS From 2014 to 2019, pediatric cases pathologically diagnosed as hairy polyps and having received radiological examination at the Children's Hospital Affiliated to Zhejiang University were retrospectively analyzed. Radiological evaluations were conducted on tumor size, location, morphology, density or signal features as well as the enhancement pattern. RESULTS A total of six infants were recruited. Clinical features observed in these cases included choking on milk with cyanosis, intermittent dyspnea, oropharyngeal mass, and snoring. Lesions were derived from the left tubal torus in three out of six cases, from the left lateral aspect of soft palate in one, from the left lateral pharyngeal wall in one, and from the right tubal torus in one. They were shown as pedicled polyp-like well-circumscribed mass with fat density or signal as well as a stalk on CT or MRI. In the contrast-enhanced scan, the fat components were not enhanced, while the stalk was mildly enhanced. CONCLUSION Hairy polyps had typical radiological features. Hairy polyps should be considered for pedicled polyp-like well-circumscribed mass in the oral-nasopharynx of infants with fat density or signal as well as a stalk.
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Affiliation(s)
- Meijun Sheng
- Department of Surgical Intensive Care Unit, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, Zhejiang, People's Republic of China
| | - Yanhong Mi
- Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, Zhejiang, People's Republic of China
| | - Fusheng Gao
- Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, Zhejiang, People's Republic of China
| | - Jiawei Liang
- Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, Zhejiang, People's Republic of China
| | - Haichun Zhou
- Department of Radiology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, Zhejiang, People's Republic of China.
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Lepera D, Volpi L, De Bernardi F, Shawkat SA, Cimetti L, Bignami M, Castelnuovo P. Endoscopic transnasal resection of Eustachian-tube dermoid in a new-born infant. Auris Nasus Larynx 2015; 42:235-40. [PMID: 25582821 DOI: 10.1016/j.anl.2014.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/14/2014] [Accepted: 10/22/2014] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Dermoids of the Eustachian tube are rare benign developmental tumours that typically occur in female children. General consensus of classification and nomenclature has still not been reached. The treatment of choice consists of a radical surgical excision. Several approaches have been described and few cases are reported in literature. A gross total resection is now safely achievable through an endoscopic mini-invasive approach. MATERIALS AND METHODS We have reported a case of dermoid pedicled in the left Eustachian tube and resected with a pure endoscopic transnasal approach. A review of the literature was performed. CASE STUDY The aim of this paper is to present the first case of pure endoscopic transnasal resection in a 4-day-old infant as emergency treatment of Eustachian tube dermoid presenting an acute respiratory failure at birth. CONCLUSION The endoscopic transnasal resection is a safe and feasible technique in selected dermoids of the Eustachian tube, when the middle ear is not involved. This approach could be used also in new-born children, decreasing the morbidity of the classic surgical treatment and avoiding the risk of craniofacial alterations.
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Affiliation(s)
- Davide Lepera
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Luca Volpi
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
| | - Francesca De Bernardi
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - S Alaa Shawkat
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Laura Cimetti
- Department of Surgical and Morphological Sciences, Anatomic Pathology Unit, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Maurizio Bignami
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology and Head and Neck Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy
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Abstract
Hairy polyps of the nasopharynx display characteristic radiological imaging findings, including the presence of fat in the polypoid mass. Furthermore, diagnostic imaging is useful for delineating the site of origin of these lesions, which can facilitate surgical planning. For instance hairy polyps that arise from the right Eustachian tube can be amputated via a trans-nasal approach with endoscopy, but may necessitate a two stage approach in order to avoid injury to critical structures, such as the internal carotid artery. On histology, hairy polyps comprise an outer keratinizing squamous epithelium with adnexal tissue, including hair follicles, and central fibroadipose and cartilaginous tissue. These features are exemplified in this sine qua non radiology-pathology correlation article.
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Affiliation(s)
- Judy Wu
- Department of Radiology, Pritzker School of Medicine, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA
| | - Jefree Schulte
- Department of Pathology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Carina Yang
- Department of Radiology, Pritzker School of Medicine, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA
| | - Fuad Baroody
- Departments of Surgery, Section of Otolaryngology-Head and Neck Surgery, and Pediatrics, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Daniel Thomas Ginat
- Department of Radiology, Pritzker School of Medicine, University of Chicago, 5841 S Maryland Avenue, Chicago, IL, 60637, USA.
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Abstract
We report a newborn with soft palatal mass. We excised the mass. On the gross pathological examination, it was polypoid lesion covered with skin. Histologically, it consisted of a core of lobules of mature adipose tissue admixed with fascicles of striated skeletal muscle and covered by keratinized squamous epithelium containing many hair follicles associated with sebaceous and eccrine glands. These findings confirmed mature teratoma.
Teratoma is a true neoplasm that consists of tissues from all 3 embryonic germ layers: ectoderm, mesoderm, and endoderm. Nasopharyngeal teratoma is very rare. We present one case of nasopharyngeal teratoma attached to the soft palatal wall in a newborn.
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Nalavenkata S, Meller C, Forer M, Patel NP. Dermoid cysts of the eustachian tube: clarification [corrected] of histopathology. Int J Pediatr Otorhinolaryngol 2013; 77:1624. [PMID: 23886496 DOI: 10.1016/j.ijporl.2013.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 06/22/2013] [Indexed: 10/26/2022]
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Abstract
Hairy polyps are common congenital benign lesions of oroand
nasopharynx containing elements of both ectodermal
and mesodermal origin. However, their occurrence in palate
is quite rare. Here we present a case of hairy polyp associated
with palatal cleft in an eight months old female infant. We
discuss the clinicopathological features, etiology, proposed
theories related to its formation and its significance.
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Affiliation(s)
- Gokul S
- Postgraduate, Department of Oral and Maxillofacial Pathology, SDM College of Dental Sciences and Hospital, Sattur, Dharwad Karnataka, India, e-mail:
| | - Veda Hegde
- Assistant Professor, Department of Oral and Maxillofacial Pathology, SDM College of Dental Sciences and Hospital, Sattur Dharwad, Karnataka, India, e-mail:
| | - Kaveri Hallikeri
- Associate Professor, Department of Oral and Maxillofacial Pathology, SDM College of Dental Sciences and Hospital, Sattur Dharwad, Karnataka, India, e-mail:
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