Cases reported "Nasal Obstruction"

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1/153. craniopharyngioma invading the nasal and paranasal spaces, and presenting as nasal obstruction.

    A case of craniopharyngioma invading the nasal and paranasal sinuses and presenting as nasal obstruction is reported. Imaging showed a destructive mass of the skull base with involvement of the nose and paranasal sinuses. In the excised mass mitoses were frequent and the proliferation index was high. Invasion of the nasopharynx and presentation as a nasopharyngeal mass is uncommon for a craniopharyngioma.
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2/153. Primary amyloidosis presenting as a nasopharyngeal mass.

    Amyloid is defined as a pathologic proteinaceous substance which, when deposited between the cells of tissues and organs, leads to various clinical conditions. immunohistochemistry has allowed for better classification and understanding of the pathophysiology of amyloidosis. In the upper aerodigestive tract, amyloidosis is a rare condition occurring most frequently in the larynx. We present the case of a 42-year-old woman with complete nasal obstruction due to primary nasopharyngeal amyloidosis. This represents the first reported case of primary nasopharyngeal amyloidosis containing both the lambda and kappa immunoglobulin light chains. The clinical and radiologic findings, as well as the management of primary amyloidosis of the upper aerodigestive tract, will be discussed. A review of the literature pertaining to nasal and nasopharyngeal amyloidosis will be presented.
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3/153. CT of intranasal pleomorphic adenoma.

    Intranasal pleomorphic adenoma is rare. We report the CT features this tumor in a 41-year-old woman who presented to us with right nasal obstruction and a 2-day history of epistaxis.
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4/153. Suboccipital meningocele presenting as a huge retropharyngeal mass in a patient with neurofibromatosis Type 1. Case report.

    The authors report an extremely rare case of neurofibromatosis Type 1 (NF1) with a suboccipital meningocele presenting as a huge retropharyngeal mass. A 73-year-old woman with typical cutaneous manifestations of NF1 presented with nasal obstruction and dysphagia due to a retropharyngeal mass. magnetic resonance imaging revealed a huge mass lesion extending from the right occipital bone defect to the retropharynx through the right paravertebral region. Computerized tomography scanning after intrathecal administration of contrast material confirmed that the mass was a meningocele protruding through a right occipital bone defect. The authors attempted to ligate this meningocele, most of which was excised via a suboccipital approach, but a second transcervical operation was required. Finally, the meningocele resolved and the patient was discharged without symptoms.
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5/153. Gingival lesions and nasal obstruction in an immunosuppressed patient post-liver transplantation.

    Although rare, metastatic hepatocellular carcinoma (HCC) presenting only to the mandible, gingiva, and nasal cavity in patients subsequently found to have primary HCC has been reported. In the age of transplantation, certain HCC patients may receive treatment with an orthotopic liver transplant. Due to the proclivity of HCC for early micrometastases, immunosuppressive therapy can induce significant metastatic lesions. Nasal mass obstruction, gingival lesions, or facial growths in this population must be considered metastatic until proven otherwise.
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6/153. A rare case of upper airway obstruction in an infant caused by basal encephalocele complicating facial midline deformity.

    A four-month-old male infant with basal encephalocele of the transsphenoidal type presented with upper airway obstruction and facial midline deformity, including cleft lip, cleft palate, hypertelorism and exophthalmos. Basal encephalocele is a rare disease, and usually not detectable from the outside. In this case, initially the cause of an upper airway obstruction was considered to be posterior rhinostenosis, and posterior rhinoplasty with inferior nasal conchectomy was scheduled. However, in preoperative examination, computed tomography (CT) and magnetic resonance imaging (MRI) revealed a bony defect in the sphenoidal bone and a cystic mass in communication with cerebrospinal fluid, herniating into the nasal cavity through the bony defect. The mass was diagnosed as a transsphenoidal encephalocele, the scheduled operation cancelled, and tracheostomy performed for airway management. The possibility of basal encephalocele should be considered in the case of upper airway obstruction with facial midline deformity.
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7/153. Sinonasal lymphomas. Case report.

    In the field of Otorhinolaryngology sinonasal lymphomas are relatively uncommon and represent less than 1% of all head and neck malignancies. Nowadays, they are regarded as consisting of two distinct subgroups, characterised by phenotype, location, prognosis and treatment. Lymphomas of the B-Cell phenotype are the most frequent type found in the paranasal sinuses. They are less aggressive and carry a relatively better prognosis. T/NK-Cell lymphomas are mostly found in the nasal cavity. They are more aggressive and carry a relatively worse prognosis. We present a case of a 65-year-old patient, who complained with unilateral right-sided nasal obstruction associated with a sensation of right aural fullness. CT scan demonstrated opacity of the posterior ethmoid and sphenoid sinuses on the right side, with evidence of erosion of the anterior wall of the sphenoid. Nasal endoscopy revealed a smooth purple mass, arising from the right superior meatus, which bled on contact, and which was subsequently shown to be, on histological assessment, a malignant high grade lymphoma, non-hodgkin's B-cell phenotype. Following a discussion of the case we will present a review of these tumours, which have a poor overall prognosis, focusing on epidemiology, sites of origin, symptoms, investigation and management.
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8/153. Management of respiratory failure with ventilation via intranasal stents in cystic fibrosis.

    The case history is presented of a patient with acute respiratory failure complicated by nasal obstruction resulting in intolerance of nasal ventilation. Urgent insertion of nasal stents permitted restoration of ventilation with resolution of breathlessness and stabilisation of arterial blood gases.
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9/153. Dermoid (hairy polyp) of the nasopharynx.

    Dermoids or hairy polyps, the most primitive forms of teratoma are rare lesions affecting the nasopharynx. They arise during early embryogenesis, being derived from only two germinal layers, ectoderm and mesoderm and are invariably benign. They usually present at or soon after birth with signs of upper aerodigestive tract obstruction. A case of hairy polyp of nasopharynx in a neonate is reported for its rarity. The etiology of teratomas, their classification in head and neck region, clinical features, and management in neonates are discussed.
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10/153. Congenital nasal pyriform aperture stenosis in newborn: report on three cases.

    Congenital nasal pyriform aperture stenosis (CNPAS) is recognized as a cause of nasal airway obstruction in the newborn. The nasal pyriform aperture is narrowed by a bony overgrowth of the nasal process of the maxilla. The CNPAS may occur as an isolated congenital defect or in combination with other abnormalities. Three cases of CNPAS are reported with special attention to the clinical presentation and to the management recommendation prior to surgery. Surgical repair was performed for all these three highly symptomatic patients using a sublabial approach for drilling the nasal process in order to obtain a wider nasal vestibular patency. All of them were equipped with bilateral nasal stenting.
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